HomeMy WebLinkAboutTransfiguration Church •
ELIZABETH A. NEVILLEd • Town Hall, 53095 Main Road
TOWN CLERK ; ona P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER `� 0 � �, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICERV ��� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ���
OFFICE OF THE TOWN CLERK
SOUTHOLD imnitizitemaRrneaeosAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2659 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : TRANSFIGURATION OF CHRIST CHUR
Address 1 : PO BOX 1162
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
ADDITION TO EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT
WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES.
EXCAVATION INSPECTION REQUIRED.
Name Of Owner TRANSIFGURATION CHURCH
Mailing Address 1 PO BOX 1162
City St Zip MATTITUCK NY 11952
Property Address 1 BREAKWATER ROAD
City St Zip MATTITUCK NY 11952
Tax Map No. section 106.00 block 9 lot 6.001
Cross Street STANLEY ROAD
Building Permit Number Cross Reference:
Issue Date: 9/25/01 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE Town Hall, 53095 Main Road
TOWN CLERK ; ef4 hz; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS • �« " j iF.y l Southold, New York 11971
MARRIAGE OFFICER :� ® ' � 1, Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER 4 ss�� ®•i� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER `z�' �•gI
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: September 13, 2001 76/9
Transmitted herewith is a copy of application No. ' for a Cesspool/Septic Tank Construction
Permit submitted by:
Doug Cooper for Transfiguration of Christ Church
Please review the application and location map and advise if the project has received Suffolk County
Health Department approval and if this office may issue the permit.
Please complete the form below and return it to me.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
Comments:
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OFFICE OF THE TOWN CLERK 1 � „II'•••�����
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TOWN OF SOUTHOLD 0 C�� �vFFOQGy Application Noot7Y.
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FS 17ABETH A.NEVILLE,TOWN CLERK
P.O.BOX 1179 Construction
SOUTHOLD,NEW YORK 11971 p rn Alteration
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Telephone1.0,��0 ies $10.00 - Residential
(631) 765-1800 1 > 00 $25.00 -Non--Residential
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TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
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Fee .$
DATE5 / / 3 O�
APPLICANT NAME: S..v,._saa_kc2 e.A
APPLICANT ADDRESS: �fy��y /4 ivet
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' a77 - i- !. �/-lG,. /lf$Z
SEPTIC CESSPOOL x �/
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: 5�m...st
OWNER MAILING ADDRESS: Pp 6167 /(C7
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: 292 S'/93-
TAX MAP NO. : Section /04 Block 7 Lot 4_1
CROSS STREET: __5'11- 17(_
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BUILDING PERMIT NUMBER KOSS REFERENCE:
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S' ature of App-1 an
RECEIVED BY: AL-7/-- --4---1(..t_
Town Clerk's Office
DATE: y, r
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