HomeMy WebLinkAbout2010 SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
PERMIT
....... ~;".~;; .... [;/~/~? ...... ~"~'H4U'%%D° '~ TO OPERATE A FOOD ESTABLISHMENT
~ THIS PERMIT WILL EXPIRE UPON THE DATE SPECIFIED OR UPON A CHANGE OF THE OPERATOR
u
su~o~ COUN~ THIS PERMIT IS NOT TRANSFERABLE AND IS GRANTED SUBJECT TO COMPLIANCE WITH THE
PROVISIONS OF ARTICLE 13 OF THE SUFFOLK COUNTY SANITARY CODE AND ALL APPLICABLE STATE,
LOCAL AND MUNICIPAL LAWS, ORDINANCES. CODES RULES AND REGULATIONS.
IF THE FACILITY IS SERVED BY AN ON SITE WELL THE DISINFECTION REQUIREMENTS OF THE
STATE SANITARY CODE ARE WAIVED PENDING CONTINUED SATISFACTORY COMPLIANCE
WITH THE PROVISIONS OF PART 5
ESTABLISHMENT NAME:
ESTABLISHMENT ADDRESS:
SOUTHOLD HUMAN RES. CTR.
750 PACIFIC STREET
NATTITUCK
OPERATOR'S NAME:
ISSUE DATE:
EXPIRATION DATE:
SCOTT A. RUSSELL,
11/23/09
12131/10
RESTRICTION~
MECHANICAL DISHWASHER REQUIRED
APPROVED FOR HOT AND COLD DELIVERY
SUPERVISOR
I.D. ~ 91238
APPROVALS
PERMIT ISSUING OFFICIAL
TOUN OF SOUTHOLD
E. NEVILLE, TO~N CLERK
PO BOX 1179
SOUTHOLD
NY 11971
IF NOT DEL
SUFFOLF
360 YAPH~ AVbNUb, ~¢TE. 2A
YAPHANK, NEW YORK 11980-9744
FOOD CONTROL
FIRST CLASS MAIL
FOOD ESTABLISHMENT PERMIT ENCLOSED
STEVE LEVY
SUFFOLK COUNTY EXECUTIVE CObIMISSIONER
SUFFOLK COUNTY
DEPARTMENT OF HEALTH SERVICES
TOUN OF $OUTHOLD
E. NEVILLE, TOWN CLERK
PO BOX i179
$OUTHOLD
NY 11971