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JUDITH T. TERRY : L ; Town Hall, 53095 Main Road
TOWN CLERK Z p ►Z P.O. Box 1 179
REGISTRAR OF VITAL STATISTICS ` to $ Southold, New York 11971
MARRIAGE OFFICER yQ �, Fax (516) 765-1823
_',yo ��� � Telephone (516) 765-1801
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 869 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : DBM 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 1/7/92.
Name Of Owner DBM CO.
Mailing Address 1 P. O. BOX 2130
City St Zip GREENPORT NY 11944
Property Address 1 ORIOLE DRIVE
(LOT 24)
City St Zip SOUTHOLD NY 11971
Tax Map No. section 55.00 block 6 lot 15.027
Cross Street LISA DRIVE
Building Permit Number Cross Reference:
Issue Date: 7/20/92 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY = z i Town Hall, 53095 Main Road
TOWN CLERK 11:=3
rT P.O. Box 1179
REGISTRAR OF VITAL STATISTICS _ Southold, New York 11971
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MARRIAGE OFFICER 0` O�l����� Fax (516) 765-1823
Fax
(516) 765-1801
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OFFICE OF THE TOWN CLERK -='
TOWN OF SOUTHOLD
. . ' 91992
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: JULY 9, 1992
Transmitted herewith is a copy of application No. 893 for a Cesspool/
Septic Tank Construction Permit submitted by:
DBM 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 p(
DISAPPROVE 1�'' "
Comments: cL, S ,�.. 'hash.
CIE-004,4,0e
Signature
/1/ 9,k_
Dated
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OFFICE OF THE TOWN CLERK S�F.F
Town of Southold ``� Application No.U3
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road o tX,. � '— Construction v
P. O. Box 1179 v' t" 4 t`
Southold, New York 11971 ? •*= ‘r Alteration
Telephone 516:1r �� Residential
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT •
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee
$ to
DATE Ju,2c}_ 8, 1992
APPLICANT NAME: D B M Co.
APPLICANT ADDRESS: P. 0. Box 2130, 443 Main StAzet, Gneenpant, n.V. 11944
SEPTIC CESSPOOLXX
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
new home
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. 0. Box 2130, Gn.eenponc, N.Y. 11944
OWNER PROPERTY ADDRESS: 0nio.ee Dn�ve, Sowtha.2d
TELEPHONE NUMBER OF CONTACT PERSON: 477-2223
TAX MAP NO. : Section 55 . Block 6 Lot 15.27
CROSS STREET: ijAa
BUILDING PERMIT NUMBER CROSS REFERENCE:..
1A<JCLAe3. ' 41•=44Pit
Signature o Applicant
RECEIVED BY:
/ Town Jerk's Office
DATE:
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Lot 31 --EX 1RES TWO -YEARS
DATE OF APPROVAL
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SURVEY FOR
D.B.M. COMPANY
AUFFOLK COUNTY DEPARTMENT OF HEALTH SFRYICE5 LOT NO.24,"HIGHPOINT MEADOWS,SECTION TWO..
AT SOUTHOLD DATE NOV. 27,1991
FOR APPROVAL OF CONSTRUCTION ONLY 'TOWN OF SOUTHOLD SCALE I".40•
)ATE JAN 0 71992 maiREFr q NO.� .-J \/p SUFFOLK COUNTY, NEW YORK NO 91 1031
R UMNu1HORIZEO ALTERATION OR ADDITION TO THIS
/ J SURVEY 4 A VIOLATION OF SECTION 7209 OF THE
,P°QOVED -W �/•�.. A./"\, 9A-W YORK STATE EDUCATION LA• . _
/ _ \ M COPIES OF THIS SURVEY MOT SEARING THE LAND
.3 i( _s-)—7 n./G` ) SURVETOR'S INKED SEAL OP EMBOSSED SEAL SHALL t E
! A �o~ MOT S[CONSIDERED TO BE A VALID TRUE COPY �1P Y M'
■GUARANTEES INOICATEO HEREON SHALL RUN OILY TO
HEALTH DEPARTMENT-DATA FOR APPROMAL TO CONSTRUCT TME PERSON FOR WHOM THE SURVEY IS PREPARED /P0 W. 4t
AND OI NIS BEHALF TO THE TITLE COMPANY,GOVERN-
■ WATER MAIN Mi _ N SOURCE Of WATER/PRII&TE_PUBLIC MENTAL AGENCY AND LENDING INSTITUTION LISTED 2� OG
N SIRF CO. TAX MAP DST 1000 SECTION_L11L_BLOCK_$_,LOT 1327 MEMON,AND TO THE ASSIGNEES OF THE LENDING 4 'y
N THERE ARE NO DWELUMS WITHIN 100 FEET OF TIBS PROPERTY INSTITUTION GUARANTEES ARE NOT TRANSFERABLE I ``V�t t p
OTHER THAN THOSE SHOWN HEREON
TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT Ilp -
N THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FOR THIS ROI DCNCE OWNERS \[\
WILLCONFORM TO THE STANDA11Df OF INC SUFFOLK COUNTY DEPARTMENT *DISTANCES SHOWN HEREON FROM PROPERTY LINES 9%��•
Of HEALTH SERVICES. TO EKISTINA STRUCTURES ARE FOR A SPECIFIC 1 •
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APPLICANT•�n / PURPOSE AND ARE NOT TO BE USED TO ES TARO SM !� ti°. 45$(j3
�SjM a. PROPERTY LINES OR FOR THE ERECTION D< FENCES -05.
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y71LzL,- YOUNG & YOUNG 400OSNDERAVENUE
RIVERHEAD,NEW YORK
NOTE,
SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF ALDEN 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
Fe *ME LOCATOI OF WELL(W),SLPTIC TANKISTIS CESSPOOLS(CP)WIOWN HEREON N.Y.S.LICENSE NO 45893
. ARE PROM FIELD ONR[R ATION5/POOR DATA OSTNNED FROM OTHERS
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BRANDIS & SONS INC.