HomeMy WebLinkAboutRaynor OFFICE OF THE TOWN CLERKOc��FFU[/�`,D'
Town of Southold
Judith T. Terry, Town Clerk L
Town Hall, 53095 Main Road ::
P. O. Box 1179
Southold, New York 11971 O ',�,
Telephone O! , iv"
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 105 Residential x
Non-Residential
Fee $ 10.00
Septic Cesspool x
PERMIT ISSUED TO:
NAME: Elliott A. Raynor
ADDRESS: c/o E. Lamb. 121 Benson Avenue
Sayville. New York 11782
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
Residential one family. one story house.
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER OF PROPERTY: Elliott A. RAynor
c/o E. Lamb
OWNER MAILING ADDRESS: 121 Benson Avenue
Sayville, New York 11782
OWNER PROPERTY ADDRESS: N/E corner - Grange RoFtd
Southold, New York
TAX MAP NO. : Section 75 Block 4 Lot 12
CROSS STREET: Bayview Avenue
BUILDING PERMIT NUMBER CROSS REFERENCE: Unknown
Judith T. Terry
Southold Town Clerk
DATE: February 1'0, 1987
(TOWN SEAL)
. l r-r7 Town Hall, 53095 Main Road
®df. _ 1
-- ::. w- � P.O. Box 1 179
"1/4.19/ NO 0 Southold, New York 11971
JUDITH T TERRY
�i-rn// �/ TELEPHONE
TowN CLI.RK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
February 10, 1987
Elliott A. Raynor
121 Benson Avenue
Sayville, New York 11782
Re: N/E Corner - Grange Road
Southold, New York
Dear Mr. Raynor:
Enclosed herewith is the Construction, Alteration or Modification
Permit for a Septic Tank or Cesspool System for which you applied.
Please be advised that each owner of real property operating an
on-site sewage disposal system, such as a septic 'tank or cesspool must,
prior to such operation, possess in the name of the owner an Operation
Permit for the system. The Operation Permit is issued by the Town
Clerk's Office.
The fee for an Operation Permit is ten dollars ($10. 00) for
residential use and twenty-five dollars ($25. 00) for non-residential.
Please have the owner complete the enclosed Application for an Operation
Permit and return it to this office along with the proper fee.
•
For your general information I have enclosed an Informational
Bulletin regarding the Scavenger Waste Laws adopted by the Southold
Town Board. Should you have any questions pertaining to either permits
or the Scavenger Waste Laws, please do not hesitate to contact this
office. We will be glad to assist you in any way possible.
Very truly Yours,
•
Judith T. Terry
Southold Town Clerk
Enclosures (3)
JTT/Ijc
OFFICE OF THE TOWN CLERK
Town of Southold
Application No. /D7,
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road Construction
P. O. Box 1179
Southold, New York 11971 Alteration
Telephone Residential
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. /OL
Fee
DATE
APPLICANT NAME: E LL ! OTT A . i\"/ p R
APPLICANT ADDRESS: s 640 E , i,.,A(Y\ b
S/ Yv LLE_N )< 1178 2-
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
t?e s c!e j,► T I it.,__ f F f B 1 L. ,�.,I
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: E L L i Q i i A. RA y 0
OWNER MAILING ADDRESS: 0 1 a L, LA P112) I . I 6Erlsot'1 Ave-
�WYVIL1,erl•LY,
OWNER PROPERTY ADDRESS: NI E CoRfee GR KNEE WnnA
'-- 4w
TELEPHONE NUMBER OF CONTACT PERSON: 511- 584-0
TAX MAP NO. : Section orig. oQ Block ®4}, oo Lot 12 •
CROSS STREET: .73(2)-Y (I / A (J E.;
�«
BUILDING PERMIT NUMBER CROSS REFERENCE:
,i,..t.
Signature ,f 1pplicant
RECEIVED
C mown Cl / k's Off .e
DATE: FR 1 01987
Town Clerk Southold
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EXPIRES DA/ YEARS FROM DATF r OF APPROVAL
SURVEY FOR '
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICER ELLIOTT RAY N O R
PART OF LOT 9 ,"SOUTH HARBOR HOMES"
FO' APPROVAL OF CONSTRUCTION ONLY -AT SOUTHOLD DATE' SEPT. 2, 1986 J .i
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(� TOWN OF SOUTHOLD SCALE, 1 " = 40'
DATE a / -s - ' ; „C.(1 r.S } off- SUFFOLK COUNTY, NEW YORK NO. 86 -979
F // � *UNAUTHORIZED ALTERATION OR ADDITION TO THIS ` 9F
4�PROVED
la."'
- SURVEY ISA VIOLATION OF SECTION 7209 OF THE iti f ,
NEW YORK STATE EDUCATION LAW -Sar.. r
<a r 7 S 1 H COPIES O THIS SURVEY NOT SEARING THE LAND p
l a SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL *PSI W �- .1p
/' (l NOT BE CONSIDERED TO BE A VALID TRUE COPY 0 0
1 / HGUARANTEES INDICATED HEREON SHALL RUN ONLY 1O -'''
THE PERSON FOR WHOd THE SURVEY IS PREPARED 1 $ -
HEALTFI OEPARTRIENT-DATA FOR APPROWII TO CONSTRUCT 'r :."-- 0
AND ON HIS BEHALF TO THE TITLE COMPANY,GOVERN-
H NEAREST WATER mAIN_MI. H SOURCE OF WATER' PRIWITE L PUaLIC.1L MENTAL AGENCY AND LENDING INSTITUTION LISTED i~ .4 I
1 SttFF-CO. TAX NAP DIST 1000-SECTION 075 BLOCK-.0-LOT 012 HEREON,AND TO THE ASSIGNEES OF THE LENDING `_ ...
*THERE ARE NO DWELLINGS WITHIN 100 FEET OF THIS PROPERTY INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE
OTHER THAN THOSE SHOWN HEREON. TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT �� I'p'0 / i
ERS
R THE DATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FOR THIS RESIDENCE
*DISTANCES SHOWN HEREON FROM PROPERTY UNES C'c�d 5
WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. TO EXISTING STRUCTURES ARE FOR A SPECIFIC 1�►"'
APALICLTH PURPOSE AND ARE NOT TO BE USED TO ESTABLISH ^+P'D - Rl
I
a =a1 o - A yN v 4' PROPERTY LINES OR FOR THE ERECTION OF FENCES -
—
ADDRESS_
Lar�PIae r.Lc11+fl ISI RF_ ('%1/P
' YOUNG a YOUNG R0 SAD NEW YORDER K
SH7ViLlr� i�. tt'?�7 ���L1sf-l-S
NOTE : •= MONUMENT A= STAKE ... ,,,,,,,,,,,,,y.A. -4 . . ' -
SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF •,-.14 '=•- ALDEN W:YOUNG,PROFESSIONAL ENGINEER _
SUFFOL K CO. ON JULY 14,1964 AS FILE NO.4096 '4.-.14-:- AND LAND SURVEYOR N.Y.S.UCENSE NO 12845