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HomeMy WebLinkAboutFirst Baptist Church (2) ,I�aol ftSAFF0114 ELIZABETH A.NEVILLE ��1, OGy� Town Hall, 53095 Main Road TOWN CLERK o P.O. Box 1179 REGISTRAR OF VITAL STATISTICS Prti Southold,New York 11971 MARRIAGE OFFICER ,L 1% Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER `ma "�Ql �,,•I Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER ,�� southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 3096 R Residential x Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : FIRST BAPTIST CHURCH OF CUTCH Address 1: PO BOX 534 City St Zip CUTCHOGUE NY 11935 Descripton of Proposed Construction or Alteration SANITARY SYSTEM FOR ONE FAMILY DWELLING. APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES. REF #C10-02-0005 Name Of Owner FIRST BAPTIST CHURCH OF CUTCH Mailing Address 1 PO BOX 534 City St Zip CUTCHOGUE NY 11935 I - Property Address 1 15945 COUNTY ROAD 48 City St Zip CUTCHOGUE NY 11935 Tax Map No. section 101.00 block 1 lot 14.005 Cross Street ALVAH'S LANE Building Permit Number Cross Reference: Issue Date: 10/20/03 Elizabeth A. Neville Southold Town Clerk (TOWN 5E4) 1,111r". --- ' a) ?6. ELIZABETH A.NEVILLE 4 0t ‘� Town Hall, 53095 Main Road TOWN CLERK p , P.O.Box 1179 REGISTRAR OF VITAL STATISTICS Southold, New York 11971 MARRIAGE OFFICER G /� Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER \A, �0- 0 Telephone(631) 765-1800 FREEDOM OF INFORMATION OFFICER =_'� �i" southoldtown.northfork.net OFFICE OF THE TOWN CLERK -- -- ___ TOWN OF SOUTHOLD f; P n - : _-._-- --" �`„--- i- . SEP 2 3 2nn 3 TO: Southold Town Building Department c 1 c FROM: Linda J. Cooper, Southold Town Clerk's Office _ _- __ , DATED: September 23, 2003 Transmitted herewith is a copy of application No. 3230NR for a Cesspool/Septic Tank ALTERATION Permit submitted by: First Baptist Church of Cutchogue 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: Maintain required setbacks from adjacent wells,buildings,property lines and water J Bodies. EXCAVATION INSPECTION REQUIRED. c cy..... Lam.• _ - i /"..�.'�►�: _i/ ll'�%�'�"�a�6. / � 7ire14‘ 4/ Signature .416,b....e.a.t. 3 ' 3 Dated � r ELIZABETH A. NEVILLE /0, G°;� Town Hall, 53095 Main Road TOWN CLERK • P.O. Box 1179 REGISTRAR OF VITAL STATISTICS Southold, New York 11971 MARRIAGE OFFICER "V 0 Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER ? ®�d� Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER -_ 1',1s.� southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT APPLICATION CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK Residential @ $10 or Non-Residential @ $25 ✓ Application No.3230 46(64 6aph eiuu(d4 of u_e_ ogPermit No. Applicant Name ASV►. ,/lie IeQ5S Applicant Mailing Address P.O. R:p)c 5 34- G.tth09uL XL/ t(6/35. Septic Tank or Cesspool ,,,,rr Brief Description of Proposed Construction or Alteration Alfa) atardi Location of Proposed Construction/Alteration: /� Owner of Property: 1 r3-f tgQ 1- Li/weal or C. 0e/44 j lam- L :. 41. Owner Mailing Address: P. D. epic 5 311- ekcte i o9ut. NA( 11q35" Owner Property Address: 15°t 5 c...0.44 I oaa Lg C 'c�'n�9► >'w tRas- (10 31) 765- 1437 urr EP Name and phone number of contact person t UP 30 £t ? ' y�o►n¢- ' Tax Map No: Section I 0( Block ( Lot 14.5. Cross Street A[14.}15 All1— Q.ND( ""'"'-( " l q-g NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL -Q. -tJ R/`�l f13 • Signature of Applicant Date Received by: \ I, j;;;/:7,1/ 16,1/ COUNT. 06 S 't, o. ., ccvlt.rPuts, il . . I 1 I • \ 0* -,)/4 . / . I 1. 6,ok`) . \ li) I 1 .k. 1 . „ • • KE_`( r.v1 o,ie (" 500'. H! . 1 , • ...._. „ , : , • , : ),Et..1.-.- 1:3E.7 A.I,L_ wL I. ft ‘21-... _ .E.,, L..t5ELOLJ Zt.,U WY INK:e \--ez5 ,-: i V- ... c...ktOG 11,69' LorJG 1 ' 1,___• SC,R.E.E.O.,:-_ _NAG ilc cl.K.1 , ,5.`i c,)i IVA-E--t E.--I.3,t. .4i' LLD_is) .? . i 1 I,L,E.L11-.) . . / [ i . . . ..• . ... _ . . _, . . . . . 1.5 5A.60"0 ' 1 . t 1 •' t ,..._ . ,gt.P.ID/ oqC.Ui5A7,5, ... . "74 I .1,...C.q ' 1...50, .G. 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"'1 liI cy ' .'. .} ` .. -�__ ^__...__ _ ° '"mss"•' ti„r_ �� titn --~-4.- ' —",,,k,•,,-t.;',, :.•r 4 ,T;�°� :-1. APPROVED ',': x.; ' il SOAR® =�;:., , ®F SOUTHOL® Ir I _ I; _,..�._ _ -{,• . .. :;..Q. .. ` _, , , AUG,; .w _ �” qtr,' t. � ,�t� t. 1 , f' / Imo. 1 Y.. ;.; fir. 4., Lel i ; -, . ___„\\N 1 w ; \ _rty # 1 A -L (S) MUST BE INSPECTED I ,� I( w" -� .._ -; _ :� "Fy'' ,...„-,-----4*FFOLK COUNTY DEPT. OF HEALTH SE `. a ' , __ -� . CALL • ;,� =92-2097 48 HOURS IN ADVA , iiv1 t /'w 'y/pppy����Kµyy SCHEDULE INSPECTION(S). �, - 1 ,:;..o-,,,-_�. ,.t, -,„n,,til' ' '+„(. j(�F- ,-•G�! 4 .a`' -"`*"---.-..._„�,_. Y, _ :..j +� - �,-•, { y�t, �`•' ttd"" -'V.G,x+T.i:..1: e; - S "+f. • ,P'sl. V E.GE-'1 7,;"(10 t�� .'-:047,,;----„..,„.„` '"-,...,'i, ,. .� p + - ' ' -,` ,'4 •'' • •UFFOLK` OUNTY DEPARTMENT OF HEALTH' �` • ' ""� , � _ - `F 4,..*,,,... 1- ' " :APPROVED FOR CONSTRUCTION ONL i tgrk;k '^'an.^„V ..„,...,..,....,,,—...•.....„..., _ i .,..;Y ..' -'r,; • ' .S:•REF.NO.G -m6g -0000 FLOW .. t �'4�T - - r :' . -.-' X41- - ' " ,PE' • ' "v A ,,,; slr - ` . is .approval is granted for the construction-of I " . ,, •t� t µ I :' • . , „ {P = N.'_- .isposal and:water supply facilities pursuant to Arti .. I;.t'. t- ---,-,,,,,-,p.,,. vj- ;°v'; s . ,7-of the, Suffolk'County Sanitary-Code-and is not a rz' F ="' •15, ... ,, .c, �' � _= ;_ nor'implied"approval:to discharge from or;Occup -0 - t �' 1 �' ;;_.-4-;-. ` {f{ .1%.::::',-;-4', r • ' - stnicture(s) =shown' THIS'AP ROYAL IRES •-"""^"•^•+--- ' . _ 7' xll.•��M:�+,wL:'"', , ' ,1/4.,..•-• i -.1O1•' j±t-S' t.4.:,'V.'�:,Y' '%,';„�+' ,,. �k: ', ',r ;YEARS FAOIVIT,FE DATE JCOW; ') A`