HomeMy WebLinkAbout2022 PERMITS TO OPERATE A FOOD ESTABLISHMENT AND
PERMIT FEE PAYMENTS ARE NOT TRANSFERABLE
Notify the Bureau of Public Health Protection of any change of
ownership,type of business activity,business name,or billing
address by calling 631-852-5999 Permits become void upon
change of ownership New owners must apply and pay for a new
permit prior to beginning operation Operating without a valid
permit may subject you to legal action,including a hearing,fines
and possible suspension of the operating permit
RECEIVED
E NEVILLE,TOWN CLERK DEC 7 2021
SOUTHOLD HUMAN RES CTR
PO BOX 1179
SOUTHOLD,NY 11971 Southold Town Clerk
DETACH PERMIT HERE AND-DISPLAY PROMINENTLY TO THE-PUBLIC
Suffolk County Department of Health Services
360 Yaphank Avenue Suite 2A
STECOUNTYVE LONE GREGSCOM COMMISPIGOTTSIONER
Yaphank,NY 11980
SUFFOLK COUNTY EXECUTIVE COMMISSIONER
631-852-5999
SUFFOLKCOUNTY www.suffolkcountyny.gov/health
DEPARTMENT OF HEALTH SERVICES
PERMIT Facility ID FA0001557
Account ID AR0009086
TO OPERATE A FOOD ESTABLISHMENT Issued 11/26/2021
SOUTHOLD HUMAN RES CTR
750 PACIFIC ST
MATTITUCK, NY 11952
OWNER NAME.TOWN OF SOUTHOLD
Restaurant Seats=0 Permit ID Number- PT0001350 Mechanical Dishwasher Required
Exterior Seats=0 Hot&Cold Delivery
Catering Seats=0 Valid From 11/26/2021 To 12/31/2022
Bar Seats=0
Total Seats=85
This permit will expire upon the date specified or upon a change of ownership
This permit is NOT transferrable and is granted subject to compliance with the provisions of Artrcle 13 of the Suffolk County Sanitary Code and all applicable state,local,and
municipal laws,ordinances,codes,rules,and regulations
THIS PERMIT MUST BE PROMINENTLY DISPLAYED TO THE PUBLIC
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County of Suffolk neopost'N FIRST-CLASS MAIL
Department of Health Services 11/3012021 PRSRT
360 Yaphank Avenue, Ste. 2A a € �$000.494
Yaphank, NY 11980-9645
ZIP 11788
S4 041h,11"2251-57
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FOOD ESTABLISHMENT PERMIT
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AFFIRMATIVE ACTION EMPLOYER