HomeMy WebLinkAboutNorth Ray Corp (6) ,II"A" ®e-
JUDITH T.TERRY o Town Hall, 53095 Main Road
TOWN CLERK t g P.O.Box 1179
REGISTRAR OF VITAL STATISTICS ® O 1 Southold,New York 11971
MARRIAGE OFFICER 4� �`r 0 Fax(516)765-1823
RECORDS MANAGEMENT OFFICER ®� I/06 Telephone(516)765-1800
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1259 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
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. #R10-94-0108
Name Of Owner NORTH RAY CORP
Mailing Address 1 BOX 655
City St Zip SHIRLEY NY 11967
Property Address 1 HARVEST LANE
City St Zip MATTITUCK NY 11952
Tax Map No. section 120.00 block 3 lot 8.009
Cross Street FARMVEU ROAD
Building Permit Number Cross Reference:
Issue Date: 12/12/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY : Town Hall, 53095 Main Road
TOWN CLERK ® ac •
P.O. Box 1179
CP . Southold, New York 11971
REGISTRAR OF VITAL STATISTICS = �® �. .," Fax (516) 765-1823
MARRIAGE OFFICER *' Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER �,i
FREEDOM OF INFORMATION OFFICER '�� ��r40
OFFICE OF THE TOWN CLERK � _
TOWN OF SOUTHOLD M I 0 U N 1
DEC e 7 •f'
TO: Southold Town Building Department "ziA r'
FROM: Linda J. Cooper, Southold Town Clerk's Office BLDG.DEPT.
TOWN OF SOUTHOLD
DATED: December 6, 1994
Transmitted herewith is a copy of application No. 1305 for a Cesspool/
Septic Tank Construction Permit submitted by:
Raymond Hartman / 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
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I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE
DISAPPROVE n c� �+
Comments: I ,/./ c� /[ /a 1/ �o U
RECeivED
e; Signature
O'er— V
DEC 9 1994 /e9/�
town Clerk Southold Dated
G,aa,•- -l' -! ''• -
OFFICE OF THE TOWN CLERK ,f---, <, •
• 4 Town of Southold Q�`'rr� �' �'
Judith C; - '- `O�
T. Terry, Town Clerk �,•'- .
Town Hall, 53095 Main Road j r� "''� �, Application No. /3 03
-
Judith
P. O. Box 1179 c ��?i'. _
U' I' i' 4„ ; Construction
Southold, New York 11971
0�' '�'
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Q�- `' Alteration
Telephone °l � y�1{tS
(516) 765- 1301 Residential L�
ir1t
Non-Residential
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TOWN OF SOUTHOLD
r.
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
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APPLICATION -
for •
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CONSTRUCTION or ALTERATION PERMIT •
SEPTIC TANK or CESSPOOL •
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Permit No,
Fee .$
7. 24/ j43 .
DATE
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APPLICANT NAME: /Vett
APPLICANT ADDRESS: Aga �.S"T..1f •
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SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED D CONSTRUCTION OR ALTERATION
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LOCATION MAP: - Must be attached hereto before
permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR AL RATION:
zil. '
OWNER OF PROPERTY: 6.6
• • • OWNER MAILING ADDRESS: A� J / �
/ /
OWNER PROPERTY ADDRESS:
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TELEPHONE NUMBER OF CONTACT PERSON: 3 '
TAX MAP NO. : Section /( 2, Block
Lot
CROSS STREET:LJ` ;
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BUILDING PERMIT NUMBER CROSS REF
iNCE:
/ /
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• 1 Signature of Applicant •
RECEIVED BY: ,L.A....) •
wn Clerk's Office
DATE: h- Ce ( �7 Y
} 1-' SUFFOLK CO.HEALTH DEPT.APPPOW AL
�� , ` H S NO Y +
vacAN.Z I SINGLE FAMILY DWE1.LNG ONLY
MAP O F PR C P E t c T EXPIRES THREE YEARS FROM)ATE OF APPROVAL
�1.T019 30 E 60.0
— -- ---- --- — - c SURVEYED POP
i , A
O Y ����\ r�t L I STATEMENT OF INTENT
\ O Q ‘,.0.12 I —'ti _ THE WATER SUPPLY AND SEWAGE DISPOSAL
O N A�_ I SYSTEMS FOR THIS RESIDENCE WILL
I CONFORM TO THE STANDARDS OF THE
0.1 I MAT T ITUCIC • SUFFOLK CO DEPT OF HEALTH SERVICES
} I PROP WELL ? !7 ,1 C TOWN OF SOU TH Ol D I t\!.Y. i ISI APPLICANT
t /7� ifYl �1l --d_ -0:-,04,- ,t00(\ �0 I I SUFFOLK COUNTY DEPT OF HEALTH
1� 1 h�J lr si�y L�
//r /\ j SER VICES — FOR APPROVAL FOR
CApi ! \ ( CONSTRUCTION ONLY
/ —11 g ; I DATE j t 2�
>{11�IrvA' E AREA. s ' \ H S. REF NO I D— ���►
rR VAC. , / � _
\ ; �J/ V i APPROVEDMOP .�'�. _
--� i ----i 5, �/
SUFFOLK CO TAX DESIGNATION•
, � r— 55,t-----= PLEASE NOTE i I DIST
SECT : OCK PCL.89
I I I + , P20P. HO 1- - - --
�. ' �----55 -�
3 ' Minimum distance between well
V - OWNERS ADDRESS..- ;_ _ and cesspool is to be 150 feet.
m Lb t544 WM.FLOYD PICWAY
j I I O / 1 f 0 i SH12LEY NY. 11967
- ' J i.- ,.1 I I r / --
ID In - w O i I
Z �Y�;'o , .-..11
/ , i EL 399-3255
L- 155,0 — — — — - I i I Ln /`� DEED L NVA P
TEST HOLE STAMP
S.70 19 30'`/ 150.0
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HARVEST LAN ES AREA.40,000 SQ PT.5i0'
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1.LOT N05.REFER-TO�MAP OF FARMVEU� FILED IN THE SG• S�� w ppg,
St_iFF.CO.CI_£2KS OFFICE AS MAP N0.8808 ----- �F � eiti� ccv�ir�
i 2.CONTOUR t ELEVATION (REFER TO MEAN SEA LEVEL,NGVD As SURVEYED _OCT_t7,994 ^^'�� -AI' °lit'.
RODERICK VAN TU . P lti. ,*
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LICENSED LAND SURVEYORS �,�?
GREENPORT NEW YORK }:n