HomeMy WebLinkAboutNorth Ray Corp (5) /" -2
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JUDITH T.TERRY ;' Town Hall,53095 Main Road
TOWN CLERK tP.O.Box 1179
A '1� Southold,New York 11971
REGISTRAR OF VITAL STATISTICS ® 1
MARRIAGE OFFICER -� �s2, �` Fax(516)765-1823
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RECORDS MANAGEMENT OFFICER ®d ' � ,�1 Telephone(516)765-1800
FREEDOM OF INFORMATION OFFICER ,,i
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1357 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. #R10-95-0074.
Name Of Owner NORTH RAY CORP.
Mailing Address 1 BOX 4
City St Zip MATTITUCK NY 11952
Property Address 1 ALDRICH LANE
City St Zip MATTITUCK NY 11952
Tax Map No. section 120.00 block 3 lot 8.007
Cross Street SOUND AVENUE
Building Permit Number Cross Reference:
Issue Date: 7/26/95 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
l
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1.
JUDITH T. TERRY %• -.4. Town Hall, 53095 Main Road ' "
TOWN CLERK ,
v ac P.O. Box 1179
tt' yC ,� Southold, New York 11971
REGISTRAR OF VITAL STATISTICS I V®` .1 Fax (516) 765-1823
MARRIAGE OFFICER 7 % 1e
RECORDS MANAGEMENT OFFICER =_ 44 + $'66 Telephone (516) 765-1801
FREEDOM OF INFORMATION OFFICER .:'",...ii//<i °'
OFFICE OF THE TOWN CLERK 77-7--)
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TOWN OF SOUTHOLD '+ ,�,� � -- __`— _-_-L--L
Lu fah al.. ' J?,
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office TOWN OF �CQLI? i
DATED: July 12, 1995
Transmitted herewith is a copy of -application No. 1409 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 ,
Comments: se/76 ey' 7® 99- ®O 7 c
,
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rzfe sfr/24-0
JUL 2 4 1995 Signature
-rain Oak &alai f •7A®
Datetl
OFFICE OF THE TOWN CLERK ,.
Town of Southold ��'�� �FF��x
Judith T. Terry, Town Clerk ,•' �� OG
' ' i; Application No. �7`d�
Town Hall, 53095 Main Road Z '` 12.; Construction
P. 0. Box 1179 o s: ,�,
Southold, New York 11971 • if) . Alteration
Telephone 0Qi $10.00 - Residential /Gi_ --
(516) 765-1801 '��l ��'�I
$25.00 - Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
, Fee .$ / G�
DATE /
' Z
APPLICANT NAME: Nal-4(6- 42A-
APPLICANT ADDRESS: Air ,
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: . Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION O LTERA�,•N:
OWNER OF PROPERTY: /2c9 74 /�
OWNER MAILING ADDRESS: / 6 ::''' / % ✓ ,4 /
OWNER PROPERTY ADDRESS: aedi,
D-144aXace,01--'
TELEPHONE NUMBER OF CONTACT PERSON: 3w:-. 3
TAX MAP NO. : Section �2 0 Block 3 Lot
CROSS STREET: 3avt-L__
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applicant
RECEIVED BY: /4— t.
l
Town�iClek's Office
DATE: �, / / --/ •
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- - ` ' ' THREE YEARS,FROLI DATE OF-APPROVAL:
S.C.DEPT OF i �4 -
a, HEALTH SERVICESj. O - .STATEMENT OF INTENT
11in:yy (YAC.)-. :_ . ._
THE WATER SUPPLY_AND SEWAGE DISP,OSA
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