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JUDITH T. TERRY : • GL ; Town Hall, 53095 Main Road
TOWN CLERK t p rZ P.O. Box 1 179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER 0 17"0
- .$ Fax (516) 765-1823
1 1D� �� Fax
(516) 765-1801
Alt OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 801 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : D B M CO.
Address 1 : P. O. BOX 2130
City St Zip GREENPORT NY 11944
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLING WITH CESSPOOL SYSTEM.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES ON 10/19/91 .
Name Of Owner D B M CO.
Mailing Address 1 P. O. BOX 2130
City St Zip GREENPORT NY 11944
Property Address 1 ORIOLE DRIVE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 55.00 block 6 lot 15.010
Cross Street LISA DRIVE
Building Permit Number Cross Reference:
Issue Date: 2/03/92 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY 8 �, y. Town Hall, 53095 Main Road
TOWN CLER " P.O. Box 1179
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REGISTRAR OF VITAL STATISTICS ih �: Southold, New York 11971
MARRIAGE OFFICER ya �. •�� Fax (516) 765-1823
_ ,rOl , Telephone (516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
To: Southold Town Code Enforcement Officer
From: Linda Cooper, Southold Town Clerk's Office
Dated: January 28, 1992
Transmitted herewith is a copy of application No. 824 for a Cesspool/
Septic Tank Construction Permit submitted by:
D B M Co.
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 •
�C
DISAPPROVE
Comments: p,,, c fr & 1,‘.\r -st4-k°1
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Signature
JAN 31 199?
Dated
TOVn ast 0001111
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OFFICE OF THE TOWN CLERK c��FFO(,?
Town of Southold �� .•��• CQG
Judith T. Terry, Town Clerk Application No.
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Town Hall, 53095 Main Road c 17-
P. O. Box 1179 cn '! b. Construction XX
Alteration
Southold, New York 11971 1 _
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Telephone �l .a0 Residential XX
(516) 765-1801
Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. `Th& S�
Fee $ /p
DATE Januany 20, 1992
APPLICANT NAME: D B M Cn .
APPLICANT ADDRESS: 443 Main S.tcee-t, P. U. Box 2130
Cneeopntc -, N. Y. 11944
SEPTIC CESSPOOL xx
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: D B M Co .
OWNER MAILING ADDRESS: P. U. Box 2130
Gneenpon-t, N. Y. 11944
OWNER PROPERTY ADDRESS: Otio1 e D'-ive, ' Southo.2d
TELEPHONE NUMBER OF CONTACT PERSON: 477-2223
TAX MAP NO. : Section 55 Block 6 Lot 15. 10
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CROSS STREET: L.%&. Dn-.ve
BUILDING PERMIT NUMBER CROSS REFERENCE:..
1111
Signature of Applicant
RECEIVED BY: / /
// Town Clerk s Office
DATE: �/O g—/��
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Subdivision-°Mapof Yennecott Park"
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Suffolk County File No.5187
Lot 53 Lot 52 —�—
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SURVEY FOR 4/,4,:-)-
D.B.M. COMPANY
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES LOT NO.7,"HIGHPOINT MEADOWS,SECTION TWO"
AT SOUTHOLD DATE: OCT.15,1990
FOR APPROVAL OF CONSTRUCTION ONIT TOWN OF SOUTHOLD SCALE I""50'
C�, _ _ _ 7 SUFFOLK COUNTY, NEW YORK No. 90.0799
OCT91990 HS REF. NO.J a 1/�/�e�/ ruwurNORuto ION ON ADDITION 10 rMl!
1 / SURVEY I A VIOLATION OF SECTION 7205 OF THE 1'SE Df /VEw
/ ',\�\ /, N[W YORK STATE EDUCATION LAN
C� •COPIES OF THIS SURVEY NOT SEANN! THE LAND S
APPROVED �V�.l\ fZ--__J -- 'PLOT ETel ONSiMILDaSEAL Di•DM50ilreui COPY *P'PD W, h �t
3U. /) V✓'\ RGUARANT((S INOICATCD HEREON y1Al'L NUN GILT A 0 a�
HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT THE PERSON FOR WHOM THE SUNV[T IS Nf 4'
ANO a NIS !WHALE TO THE TITLE COMPANY,GOVERN-
•NEAREST WRIR 5AIM_MI I •SOUNC!OF WWI PROWL_PUBLIC_ RENTAL AGENCY AND LENDING INSTITUTION LISTED L$k I
II GUFF CO TAN SUP&ST 102.SIC TION...31,_/LOCK_A_LOT D(RII.I HEREON,AND TO THE ASSIGNEES OF IN!LENDING \`�J^
•1111* AA[NO ONILLMMS WITHIN 100 FEET OF TINS FR INSTITUTION GUARANt[tS ARE NOT 01.41. DLI •
OTNIN THAN TMO$L SHOWN MINION TO ADDITIONAL INSTITUTIONS OR SUDS(GY[NT
N Till WATER SUPPLY AND SENSOR DISPOSAL STIT[1 POR THIS MIDI= OWN[Rf
WILL CONFOIN TO TOE STAMO NOS OF TME SUFFOLK COUNTY DIP *DIST (! SHOWN M(REOM FROM PN01[RTY LINES • ' -54
0/WEAL TM MINIM TO amino* STNIC ND[S M(FOR A SPECI►IC 04.. ('
APPLIuwT. �a TNRPOII A AND ARE NOT TO DE USED TO ISH 'LEND SUFE
W PROEEEEE LINES ON FON THE[RECTION OF FENCES
AD011IU 4y3 hAa,„v 5-1-... .,fv-r w,4.
4/77-zaz3 YOUNG a YOUNG AVENUE,
ORK
NOTE,
SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF AL DEN W.YOUNG,PROFESSIONAL ENGINEER
SUFFOLK COUNTY ON MAR.19,1990 AS FILE NO.8911. AND LAND SURVEYOR N Y.S.UCENSE NO.12845
HOWARD W.YOUNG, LAND SURVEYOR
ISM LOGATNI V UnLab*umc TANKUTII CIENOMPOLSICRE NIDWN 1110111011 N.Y S.LICENSE NO.45893
• Am PROW FICES ONEMIITIOMS AND ON BATA ONTAINPP CRON
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SNOIS S SONS INC..
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