HomeMy WebLinkAboutNorth Ray Corp (2) t 1 0 [�ii
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JUDITH T.TERRY tt Town Hall,53095 Main Road
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TOWN CLERK ; �r s g P.O.Box 1179
x5 Southold,New York 11971
REGISTRAR OF VITAL STATISTICS �`� �1
MARRIAGE OFFICER �� Fax(516)765-1823
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RECORDS MANAGEMENT OFFICER ®) �ti'/,,ei Telephone(516)765-1800
FREEDOM OF INFORMATION OFFICER ,,o"
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1351 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : NORTH RAY CORP.
Address 1 : BOX 655
City St Zip SHIRLEY NY 11967
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. #R10-95-0034
Name Of Owner NORTH RAY CORP.
Mailing Address 1 BOX 655
City St Zip SHIRLEY NY 11967
Property Address 1 SUTTON PLACE
City St Zip GREENPORT NY 11944
Tax Map No. section 33.00 block 5 lot 3.000
Cross Street MCCANN LANE
Building Permit Number Cross Reference:
Issue Date: 7/12/95 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY : Town Hall, 53095 Main Road
TOWN CLERK .
co ,� P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ate® •'‘ Fax Fax (516) 765-1823
MARRIAGE OFFICER _ -`" �•I.1� Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER scan, .
FREEDOM OF INFORMATION OFFICER .�,��,Iiii"ill
OFFICE OF THE TOWN CLERK ' ' _It.; —a
I JUN 2 8 1995 II
TO: Southold Town Building Department j 1•
FROM: Linda J. Cooper, Southold Town Clerk's Office 4+__ ,11Ql f64 Oa.S0U1110E D_
DATED: June 27, 1995
Transmitted herewith is a copy of application No. 1402 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 ./...---
DISAPPROVE DISAPPROVE
Comments: Feee/-,_frizy., sc/e) 4 „90 9s----0 O3/'
401 / -4-.
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JUL 1 1 1995 :::
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OFFICE OF THE TOWN CLERK ,.,'""""'
Town of Southold .11., �FFUI�
Judith T. Terry, Town Clerk ��' �� �`14',1% Application No. /y0
nor,: „. . R:; ,
Town Hall, 53095 Main Road Z •� • Construction
P. 0. Box 1179 - rn
� :
Southold, New York 11971 : t•51 �: Alteration
Telephone ,>f' $ , $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: /0611ZA, at t 6t ?
APPLICANT ADDRESS: aV)e. 6—S71 ✓l �lv 7
SEPTIC 1 CESSPOOL
t'= DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
/40-4^--ek-52--
LOCATION MAP: . Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY:
OWNER MAILING ADDRESS:
OWNER PROPERTY ADDRESS: � Or eget,C..-Z___L
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section _33Block 5 Lot _ -- 3
CROSS STREET: % /[,, - y,
BUILDING PERMIT NUMBER CROSS REFERENCE:
i
O Signature of Applicant
1 RECEIVED BY: (}../V-4A_____-
if
Town C erk's Office
DATE: / Z C
SUF Lk CO HEAI TN DEPT, APPROVAL!°°e,
Tfi,czavEn .:..-,,i
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-,:.•=,, FEB 24 1995 _ _ - _-- ----------- - - --- FEB c4 1995
S.C.DEPT.OF < -
S C. DFPT f)f
HEALTH..SERVICES 3 --- i ., - < P.. - • t _ _ _
A T-v EN THEAUNSERVICES
, 6- -----`-----------------. - - -j •a- THE WATER SUPPLY AND SEWAGE DISPOSAL
-- --- — - SYSTEMS " =CR TIS RESIDENCE WILL
o WATER MAIN,- - .- - -- _- Ick,Cha P/".".tL
CONFORM TC rE STANDARDS OF, THE
- 23+^vT:tJN 1t AC^ ;..T `� TOWN, OF: '..=...0 UTL{'�: �.., SUFFOLK CC DEBT OF HEALTH SE DICES.
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. - . - , APPLICANT
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- r I :-SUFFOLK COUNTY DEPT OF' r!_ALTn t
227 :r' _ , ..'-- - - _ \. SER VICES' - FOR APPROVAL FORT
= , Q :'' p ' �:` J�\_ , CONSTRUCTION ONLY - ,
m� 's ��- y v - - ` DATE- - 3-7/ "��
ti H.S. REF:NO S O
_ CESSPOOL- / t
.i - 3 -. _ - - -i, - _ , - - !! -. _ - - - _APPROVE^u
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SUFFOLK CO TAX NI,-.4 SIGNATION.
_ DIST - SECT; BLOCK -PCL
�G • iC00 - _3 , 5
-� OWNERS ADDRESS -
al ^ _� :KEEN?"•�"- NY.IS"Aa
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L ' DEED L.UTA P -
— — -- �1 SS.Z7 ` z21 65.53 a•
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--__-_-� ? �— TEST HOLE STAMP
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- `' s SINGLE FAMILY DWELLHG ONLY f
m EXP{RES THREE YEARS FR0�1 DATE OF APPROVA! .0
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SEAL
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I LOT NOS.�EFci<'C�MAr CF tiA.'Ef!t�n'7SES,FiLE
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IN 714E BUFF:CO CLERICS CFF.10E AS •-•Ari !N.Q..4:•i -
2 ELEVATIONS ZEFEZ� MEA' EA !EL 'vCG':. :�vAR;.N 2-E: I:. S cGENAMP'CN tih-'L Bhl�:t. % v,� ,
- __ AS SLI C J t.:� r c: . .. ,; ,.5- ;ifJj ''',1- G\' ` ,
ROCERICK VAN TUYL.P C., f�= s�-�
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-�- LICENSED LAND SURVEYORS °LS zs`..,-
! GREENPORT NEW YORK i i !