HomeMy WebLinkAboutNorth Ray Corp (11) 1‘111' lf air
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JUDITH T. TERRY _ Town Hall, 53095 Main Road
TOWN CLERK ® ' Eg t, P.O. Box 1179
�' Southold, New York 11971
REGISTRAR OF VITAL STATISTICS �, 4, 1'
�-� `:� r Fax (516) 765-1823
MARRIAGE OFFICER i�`
RECORDS MANAGEMENT OFFICER V-446 )\‘�IVTelephone (516) 765 1801
FREEDOM OF INFORMATION OFFICER
'W.fi;i141`�'
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1250 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : NORTH RAY CORP.
Address 1 : P. O. 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.
Name Of Owner NORTH RAY CORP.
Mailing Address 1 P. O. BOX 655
City St Zip SHIRLEY NY 11967
Property Address 1 FARMVUE ROAD
City St Zip MATTITUCK NY 11952
Tax Map No. section 121 .00 block 7 lot 6.000
Cross Street HARVEST LANE
Building Permit Number Cross Reference:
Issue Date: 11/28/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK ® Fri • P.O. Box 1179
d' W Southold, New York 11971
REGISTRAR OF VITAL STATISTICS %=_V® �� Fax (516) 765-1823
MARRIAGE OFFICERo,�'/ too 1� Telephone (516) 765 1801
RECORDS MANAGEMENT OFFICER 7®1 4 FREEDOM OF INFORMATION OFFICER =''%.•,,i/i/s/
OFFICE OF THE TOWN CLERK � 7.,.,
TOWN OF SOUTHOLD 0 N N N O U I E
NOV 2 2 6 94 ` ' $
TO: Southold Town Building Department i1 °
FROM: Linda J. Cooper, Southold Town Clerk's Office a - _"
p BLDG.®EPS:
L....---TOWN OF SOUTHOLD a R
DATED: November 22, 1994
Transmitted herewith is a copy of application No. 1296 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: L.- /� f
1
.410./
'�� ` _
gnat re /
// 7i
Dated
OFFICE OF THE TOWN CLERK c,I, �,
Town of Southold Q j`„ `(: -
Judith T. Terry, Town Cleric C' ; ���Y
v
Town Hall, 53095 Main Road ~'. te Application No.ra90
ter:. • i -tet
P. O. Box 1179 " Ft`1� r
Southold, N
u' Iv;••' jy Construction v
env York 11971 �� 2-O., ' �
Alteration
Telephone `O *- �bOC4
l
(516) 765- 1301 Residential
•
Non-Residential
TOWN OF SOUTHOLD —`
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
•
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
/ I 42/5)
DATE
APPLICANT NAME: `1 / f
7•
isionw / /0, „.....
APPLICANT ADDRESS: x' s s t
*.
SEPTICESSPOOL :-/-
DESCRIPTION OF PROPOSED CONSTR T
, ettAi
4 --- ,A J• y )ON OR ALTERATION
LOCATION MAP: Must be attached hereto before
permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALT RATION:
OWNER OF PROPERTY: •
OWNER MAILING ADDRESS:
OWNER PROPERTY ADDRESS: l ,/ reL
•
•
• TELEPHONE NUMBER OF CONTACT PERSON: 3 .
TAX MAP NO. : Section i79-1,
Beck • Lot 67 -
•
CROSS STREET: IrAb•i l ! '-1 a`
BUILDING PERMIT NUMBER CROSS REFERENCE:
/11/11°. 9K jeL/1„44:------- ,
4.- ,nature of Applicant
RECEIVED BY: / j
Town Cleric's i e
DATE: // — a �--9'C
�4'
Y _
.1 _
, Jl
- r t. -
] •tU!Fy�1at - - - - -
? ca ��I S E•YEARS_FROM DATE.0
]c, 1--- so, ----- 0-g
.VAC.
6 - ` • . STATEMENT OF IN-TEN- a
m,' e THE WATER SUPPLY AND SEWAGE a
f_ 'K70.19 30 E. __v y _� _334. SYSTEMS FOR _ THIS , RESIDE
�- f J CONFORM T- THE/ ANDARD
/ I I SUFFOLK %/` •. 'T r}F
di , t
Cs �_ 41 t `t I . (s) /L.4i�/ :_ F
Q — i0 50/o EXPI.� \��, �u APPLI ANT
!mop �`�- ' ods — SUFFOLK COUNTY DEPT. OE
Q ;mop
So, N / SERVICES - FOR A P P R O
7� 1-�-�— -f PSP' L `Q riil
> CONSTRUCTION ONLY OCT A 1
W EO , . Q • j DATE o f fO 1
qC > '''<c--0)
' 1ill j -PROP.WELL Irk ,� i I H.S. 'EF 0.. i O� _ ti- A
O I_ PROP-DRIVE '- l d APP 'y '' ' � �
I-
LL -�•� 1 VA 41 (( �- SCALE-50= 1'
'� ((� • ( I✓1Q Io-srn AREA'4bS F i ; SUFFOLK CO TAX MAP DESI
I ici
`ei`Iwa`z`- � a 1---- ----- i DIST SECT BLOCK
I Iwo at -r
S 70 !9 30 `'J (d .` `d 334 64 I OWNERS ADDRESS
—c-_,,u(32_ _ I 1344 WM FLQYD PKvv
-
LL .p,1,t JL 1 SHl2LEY N.Y, 11967
PLEASE NOTE ,------, TEL399-3255
Minimum distance between well ` 3/
and cesspool is to be 150 feet. DEED: L. N/A P.
TEST HOLE STA
.r e ,lz't ;r-
L -Gamy ki St V:c
NOTES: "-:•L,T:.^a ct the t.
- L LOT N05.QEFER.TO MAP OF FARMVEU FILED IN cc0:3o20-E1t4avoy
THESL1Ft? CO.CLERK'S OFFICE AS MAP NOi88tr•,e ILIA etuvcyota in.,
08, embossed goal slot
tV
LAT,50 lobe amild WIDOW
Z.LOT l5 GEElZALLY FLAABOV FA LEVEL- co..r„dossit6ca idd
orJytothe tnd�v
MAP of PROPERTY �� - � oIs propere4
SURVEYED FOR •
. OW'.
V. `�w Ws company,govorto
Irrdal36t�,10es0k:t.
i012T!1 ?A CORP .gEQ �9 ',:11:4-....:.I.
AT -- -- ti,,., , _ ' - .
s� OtV.\ V\65 p, SEF
MATT1TUCK N�P\�N' 'Qf
01
TOWN OF SUUTNOLD , N.Y. > . ' ^e$o4`
- AS MAPPED= - -.~' - SEP.T 12 1994 O'
•- - _ RODERiC VAN'TUYL.P.C. r Ik
" LICENSED LAND SURVEYORS:, ` . — .�o_L
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