HomeMy WebLinkAboutDBM Co (13) t r iii
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JUDITH T.TERRY � Town Hall, 53095 Main Road
TOWN CLERK r ; P.O.Box 1179
REGISTRAR OF VITAL STATISTICS O .F� Southold,New York 11971
MARRIAGE OFFICER A ��� Fax(516)765-1823
RECORDS MANAGEMENT OFFICER �.( `t►a � Telephone(516)765 1800
FREEDOM OF INFORMATION OFFICER �•�„ ,,i"
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1302 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : DBM CO.
Address 1 : P. O. BOX 2130
City St Zip GREENPORT NY 11944
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. SCHD REF. #R10-95-0028
Name Of Owner DBM 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 15.032
Cross Street TUTHILL ROAD EXT.
Building Permit Number Cross Reference:
Issue Date: 3/23/95 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK z o T P.O. Box 1179
REGISTRAR OF VITAL STATISTICS y �� Southold, New York 11971
0 �� Fax (516) 765-1823
MARRIAGE OFFICER '=' ��O .$ Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER --__"1/4 .�
FREEDOM OF INFORMATION OFFICER ��.��,�oi°°°°��
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
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TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: March 17, 1995
Transmitted herewith is a copy of application No. 1349 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.
(4,e ),c-`tom'..
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 CJ _ a 40
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orrICE: OF TILE TOWN CLERK '��\1C[ !li,r+- -_
lawn of Southold
A',/01(;:.'( � � Application No. /,51/ ?
Judith T. Terry, Town Cleric yf
Towtn. Hail, 53005 Main Road Y Construction
P. O. f3ox 1 179 cn tI
�• _ Alteration
Southold,
New York 11971 - ,1•iy � � ti�
Telephone r ri �itt Residential
(516) 765- 11101 Non-Residential
t OWN OF SOl1THOLD
SOUTIHOt_1) WAS'1 EWA I FR DISPOSAL DISTRICT
API'I.ICA Floll
for
CONST RUC I ION or Al F EU AT ION PERMIT
SEPTIC TANK or CESSPOOL.
•Permit No. `
Fee $
DATE__ .3-Ib - 9S
APPLICANT NAME: V B It Co.
APPLICANT ADDRESS: 443 Main St-heat, 1'. O. Sox 2130
Gne-enpo'dt, N,Y. 11944
•
SEPTIC X CESSPOOL
DESCRIPTION OF PROPOSED CONS-t RUl:1-ION OR ALTERATION
new dtuetLt.Itg
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION Or PROPOSED CONSTRUCTION OR ALTERATION:
OWNER Or PROPERTY : Ii 8 ('o•
OWNER MAILING ADDRESS: 443 Main Stheet, P. 0. Box 2130
Gheenl►oh t, N.Y. 11944
OWNER PROPERTY ADDRESS : .o Rt o
Southold, N.V,
TELEPIIONE: NUMBER OF CONTACT PERSON: 411-2223
TAX MAP NO. : Section 55 Block f' Lot /5,.3.2-
• CROSS STREET: 7- u TH ILL R4- EXT
BUILDING PERMIT NUMBER (:ROSS REVERENCE :.
/"/
tAl /41
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Skjnatu -e of Applicant
RECEIVED BY: /LCA--"?
town Cleric's Office
DATE: 17��1
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