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North Ray Corp
/,�••ilii��� - ,,��,O��OFFOlit 00'- `� JUDITH T.TERRY ���� A Town Hall, 53095 Main Road TOWN CLERK ; _ P.O. Box 1179 w PPP t Southold,New York 11971 REGISTRAR OF VITAL STATISTICS s'`. ®y ����� Fax(516) 765-1823 RECORDS MANAGEMENT OFFICER MARRIAGE OFFICER ®1 �`® �� Telephone (516) 765-1800 • FREEDOM OF INFORMATION OFFICER l� • OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 1405 R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X PERMIT ISSUED TO: Name : NORTH RAY CORP Address 1 : BOX 4 City St Zip MATTITUCK NY 11952 Descripton of Proposed Construction or Alteration SANITARY SYSTEM FOR NEW SINGLE FAMILY DWELLING. APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES. SCHD REF. #R10-94-109 Name Of Owner NORTH RAY CORP. Mailing Address 1 BOX 4 City St Zip MATTITUCK NY 11952 Property Address 1 MCCANN LANE City St Zip GREENPORT NY 11944 Tax Map No. section 33.00 block 4 lot 8.000 Cross Street SOUND DRIVE Building Permit Number Cross Reference: Issue Date: 10/27/95 Judith T. Terry Southold Town Clerk (TOWN SEAL) of V.o 1,0\;,1,,,WIFIRireo; Ott JUDITH T.TERRY o Town Hall,53095 Main Road TOWN CLERK c g P.O.Box 1179 REGISTRAR OF VITAL STATISTICS � Q Southold,New York 11971 MARRIAGE OFFICER �A4%,„ � Fax(516)765-1823 RECORDS MANAGEMENT OFFICER --:&4 Vo/I Telephone(516)765-1800 FREEDOM OF INFORMATION OFFICER „,,,,i,of OFFICE OF THEi!' � TOWN OF OUTHOLD CLERK /%g CSSoci oa. � TO: Southold Town Building Department /i / �”<< / FROM: Linda J J. Cooper, Southold Town Clerk's Office `g� r ' DATED: October 17, 1995 ' a Transmitted herewith is a copy of application No. 1457 for a Cesspool/ Septic Tank Construction Permit submitted by: North Ray Corp. • 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. Thank you. Linda J. Cooper * * * * * * * * * * * * I have reviewed the application and location map of the project cited above and make the following recommendations: APPROVE e� DISAPPROVE Comments: fa'//l /U— 9c1— Signatur= /0/95;/75— Dated OFFICE OF THE TOWN CLERK ,,,,""""'••, '� Town of Southold �• 1.����DLK�', Application No. /47/3---7Judith T. Terry, Town Clerk e' % G Town Hall, 5305 Main Road � ``} '; ,. . Construction P. O. Box 1179 z v .T_;. 'T' • - Alteration Southold, New York 11971 • tt, • �.• Telephone =y��� 11)��'/ $10.00 - Residential (516) 765-1801 _ "l , ' $25.00 - Non-Residential TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. Fee $ DATE APPLICANT NAME: taa;ll-t-4-' I / /2k APPLICANT ADDRESS: G `N SEPTIC CESSPOOL(/ DESCRIPTION OF PROPOSED CONSTRUCTION OR R ALTERATION Cfri.kraft AQ-efx-c6. oy1A^4-A LOCATION MAP: ' Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONST-RUCTION OR ALTERATION: OWNER OF PROPERTY: la/94,a) OWNER MAILING ADDRESS: • OWNER PROPERTY ADDRESS: (��< T TELEPHONE NUMBER OF CONTACT PERSON: TAX MAP NO. : Section ✓ Block 7/ Lot S CROSS STREET: �o Lk' BUILDING PERMIT NUMBER CROSS REFERENCE: Signature of Applicant • RECEIVED BY: Town CItIcJ � 'fiFe DATE: OCT 1 7 1995 Southold Town Clerk ' '! -`,!-•e l'' ''''''q' ''".'\:'. ;1.• ,::::1,-;:fi!,,L''':'',..:„'eSS,t"..-,•;,1.-1:,,,,,T;, J. 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