HomeMy WebLinkAboutDBM Co (15) 141
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JUDITH T. TERRY p —4
Town Hall, 53095 Main Road
P.O. Box 1179
TOWN CLERK c Southold, New York 11971
REGISTRAR OF VITAL STATISTICS V. or Fax (516) 765 1823
MARRIAGE OFFICER = �/� �0 � Fax
(516) 765-1801
RECORDS MANAGEMENT OFFICER / 4 ►1
FREEDOM OF INFORMATION OFFICER '�"..iiid/�����
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1238 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : DBM CO.
Address 1 : P. 0. 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.
Name Of Owner DBM CO.
Mailing Address 1 P. 0. 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 15.036
Cross Street LISA DRIVE
Building Permit Number Cross Reference:
Issue Date: 11/15/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
•
���,1�o��FFOIKCOG
JUDITH T. TERRY : .G ; Town Hall, 53095 Main Road
P.O. Box 1179
TOWN CLERK %
Southold. New York 11971
REGISTRAR OF VITAL STATISTICS t 00 .. ��I Fax (516) 765 1823
MARRIAGE OFFICER =_ .�' �� �� Telephone (516) 765-1 801
RECORDS MANAGEMENT OFFICER =_Ca I0
FREEDOM OF INFORMATION OFFICER �iiii11#,1'���
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: October 28, 1994
Transmitted herewith is a copy of application No. 1284 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.
e
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE
DISAPPROVE )
Comments: (71,:!‘„,,,-- -_,,, ,,e4-v2 ;J G/;) •k- 47
4
Signature /- , 1,
///
Dated
I •
or CE or THE 1 OWN CLERK
► t,�ti�i '!l ;' ,, •
lcnvrt of Southold �'c� , ,,;rr••-.�'((?,:;\
Judith T. y l' 1
Jucl ; ' ') Application No✓fie
I overt lull, 53095 M;iirr Road E `•��a `� .
P. O. Hnx 1 1 19 • c►' i' `,` �h+�� r;1 c. construction
Southold, New York 11911 .r^ 't;�31J� w ► Altera
• c;ct ion
Telephone
C��! �'� `�itt(t1 Residential
(516) 765 1901 �i Nuti-Etesitletitlai
I ()tVi1 t)1" S011111101_D
SON 11101 I) WAS I EWA I ER I)ISI'OSA1.. DISTRICT
APPI It:A I loll
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hi!.
CONST t1 IC I U)i1 nt A1. I'I:RA1 ION PERMIT
!ATI It: r-Aiir or CESSPOOL OOL
Permit No. - I
Pee $
DATE 10 -'2 _4,f.
a APPLICANT NAME: U li 1I ('v.
APPLICANT ADDRESS: 443 Maio Sihrrt, P. 0. Box 2130 •
( hrrrrr'r,'(t, 11. V. 1i944 -- _
SEPTIC X CESSPOOL
DESCRIPTION or PRor'OSI:I) CONS I It N(: 1 ION OR ALTERATION
nem cltuef t i.ng ---
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LOCATION MAP: Must lie attached Iter elo before permit may lie issued.
LocA l-Io 1 or PROPOSED CONST WW1 ION OR AL-f EI1AT ION:
OWNER or PROPERTY : U (3 1.1 Co.
O%VNER MAILING ADDRESS: 4.13 no lit St'feet, I'. 0. Box 2130
G'rclip'',t, 1J.V. 11944
OWNER I'RO1'CRTY AI)UIt1:SS O E batU e- L o T 33 FttGr+p A)T
Soit.tttc►f u, N.V.
TriEpiloNli NUMBER (Il t 011.1 At: i Plitt S )11417-2223
TAX MAi' NO. : Section 56.-- I31Oc (c 1ot IS. 36
CROSS Si MEET: LISA -Dan/6
I3UILI)ING PERMIT C N111013EU 01205 II If UIIR 1: :.�
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SURVEY FOR
SUFFOLK COUNTY DEPARTMENT OF HEALTH ERVICE, D.B.M. COMPANY
LOT NO.33, HIGHPOINT MEADOWS, SECTION TWO
AT SOUTHOLD GAT E Nov 27, 1991
FOR APPROVAL OF CONSTRUCT!, ONLY
TOWN OF SOUTHOLD SCA;E I":40'
l�
DATE 07 111 •EF. • •.` ,. <<„ ..;I SUFFOLK COUNTY, NEW YORK NO 91 1033
I 1 •,MM UTHONIZED ALTERATION OR ADDITION TO THIS
I lim \`,..._
SURVEY 0 A VIOLATION OF SECTION 7209 OF THE.
APPROVED\tom.. ' ' // L \ NEW YORK STATE EDUCATION LAW -
•COPIES OF THIS SURVEY NOT BEARING THE LAND f/ y - -------,14'
•` `O
SUR VE YOI►S INKED SEAL OR EMBOSSED SEAL SHALL J 41., "P
D
r NOT SE CONSIDERED TO BE A VALID TRUE COPY JJJ vA
HE PERSON FOR WHOMM
HEALTH DEPARTMENT-DATA FOR APPROAL TO CONSTRUE T TARAN r[ES INDluHEREON SHALL RUN ONLY 10
TME THE SURVEY IS PREPARED 13TY ' ...Sr'?',.
AND ON HIS BEHALF TO THE TITLE COMPANY,GOVERN-
*NEAREST WATER HAIR MI * *SOURCE OF WATER- PRIMATE_PUMLIC_ MENTAL AGENCY AND LENDING INSTITUTION LISTED r` i.
•*VP CO. TAXSSAP DOT TOOOSECTION 55 'LOCK 6 LOT-16_3_6 HEREON,AND TO THE ASSIGNEES OF THE LENDING f[ •
*THERE ARE NO DWELLIMSS WITHIN 100 FEET OF THIS PROPERTY INSTITUTION GUARANTEES ARE NOT T S`
OTHER THAM THOSE SHOWN HEREON TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT
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*THE WATER SUPPLY AM SEWASE DISPOSAL SYSTEM FOR THIS RESIDENCE OWNERS ti
WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT A DISTANCES SHOWN HEREON FROM PROPERTY LINES (f:, Q 45'•'x`
OF H[AL TN SERVICES
TO EXISTING 3TRUC TURES ARE FOR A SPECIFIC
APPLICANT, PURPOSE AND ARE NOT TO BE USED TO ESTABLISH .y
���\ 4"� PROPERTY LINES OR FOR THE ERECTION OF FENCES
LARD SU
ADOREu I C 3L� c)/30 43/I,t(un'„ —
U9-'R u_,, ,v6' 'V. • TEL V77-2-Z-2-3 (m 1 YOUNG a YOUNG 400 OSTRANDERAt
NOTE •:MONUMENT RI VERFEAD,NEW Y�ORIrl