HomeMy WebLinkAboutDBM Co (21) ,,o��FFOLKc(v
Town Hall, 53095 Main Road
JUDITH T. TERRY
TOWN CLERK
P.O. Box 1179
�; Southold, New York 11971
REGISTRAR OF VITAL STATISTICS = VO �� Fax (516) 765-1823
MARRIAGE OFFICER �0 ,I' Fax
(516) 765-1801
RECORDS MANAGEMENT OFFICER 'T�1 it
FREEDOM OF INFORMATION OFFICER '�� ,,ii,,,/
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1224 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. #R10-94-0088
Name Of Owner DBM CO.
Mailing Address 1 P. O. BOX 2130
City St Zip GREENPORT NY 11944
Property Address 1 MOCKINGBIRD LANE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 55.00 block 6 lot 15.058
Cross Street TUTH I LL ROAD EXT.
Building Permit Number Cross Reference:
Issue Date: 10/13/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY : L Town Hall, 53095 Main Road
TOWN CLERK : c T I P.O. Box 1179
N � Southold, New York 11971
REGISTRAR OF VITAL STATISTICS = '' �. 1 - (516) 765-1823
MARRIAGE OFFICER '_.)iLj� , ) ,� ne (516) 765-1801
RECORDS MANAGEMENT OFFICER _ ,l ,e
FREEDOM OF INFORMATION OFFICER =..,,,,1011°.
OFFICE OF THE TOWN CLERK .'jam
TOWN OF SOUTHOLD " '
TO: Southold Town Building Department f«
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: Ocotber 4, 1994
Transmitted herewith is a copy of application No. 1268 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
DISAPPROVE
Comments: 5 'D P /I 40 0 0 5
�� ,
Signature
t:/k/);5Z'
Dated
O1'I'ICE or: THE TOWN CLERK ►►►�rrtrrir��,r.11
i
own of Southold �' .Ds� CJI ��)'
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/0240(YApplication No. ,
Terry, town ( erk 1;aFrowrt Hall. 53095 Alain Road
,��' i
P. O. 13ox I I /9 '1vt ` �� r; • Constt ucliort
Southold, New York 119/1 1 � :
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�� Alteration
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Telephony 'r '���(((t Residential
(516) 765 !mil
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t OcrU OI' ;u11 I Iic)LI)
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AI'I'II(:,\ Holl
for
coNSI PIM: I loll ,n,► Al. II:RA-1-Rill PERMIT
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. APPLICANT NAME: It B II ('n.
APPLICANT ADDRESS: 44.3 Main ';(tirrl, P. 0.+St,rx 2130
G'ree►rl►o'r(, N. V. 1 194;j
SEPT 1c X CESSPOOL
- --- ..---- ------- - -_ ----
DESCRIPTION or PROPOSED CONS ! PM; IION OR Al.FERAl ION
new (beating -- _
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LOCATION MAP: Must be attached het c'to before permit may be issued.
LOCATION or PRovosCE) Coll s litU: t ic.)o OR ALTERATION:
OWNER Or PROPERTY : 11 Ii 1.i ('o.
OWNER MA11_ING ADDRESS: •f13 ll,(i►r ,Slheet, I'. 0. Box 2130
G'reniu►'r 1, H.V. 11944
OWNER PROPERTY AI)mRI:SS :
Solttlrt►[c1, N.V.
TELEPHONE ll(J1jI3ER Or c Ott t A(• I PRISON: 411-2223
TAX MAI' NO. : Section ------`-___�_
Bloc k f' ----1-.ot
CROSS STREET: `-_ --
I3tJILt)INc; PERMIT. Ntlh1tlt It (:Itc1St
iclry etre of Applicant
RECEIVED 13Y : oYf
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S.C. DEPT.OF 1 -
HEALTH SERVICES
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SINGLE FAMILY DWELLNG ONLY .
19P1RES THREE YEARS FROM DATE OF APPROVE 7'
SURVEY FOR
D.B.M. COMPANY I
NuFFOLK COUNTY DEPARTMENT OF HEALTH 1111F9CT LOT NO.52,"HIGHPOINT MEADOWS,SECTION THREE.. , ;
AT SOU THOLDDATE: NOV. 29,1991
FOR APPROVAL OF CONSTRUCTION ONLY TOWN OF SOUTHOLD SCALE: 1"z 50'
0D�ii SUFFOLK COUNTY, NEW YORK NO. 9I lois �
"l
DATE , 2- "qi NO l� k
M WMUTHORIZEO ALTERATION OR ADDITION TO THIS
SURVEY O A v1OLATION OP SECTION 7209 OF THE
/, / ` /�_ NEM YORK STATE EDUCATION LAW
APPROVED *COPIES Or THIS SURVEY NOT REARING THE LAND
SURVEYOR'S INKS0 SEAL OR EMBOSSED SEAL SHALLit OF NS*
NOT GE CONSIDERED TO GEA VALID TRUE COPY /
,0' D w }O
RGU AAANTEIS INDICATED HEREON SHALL RUN ONLY TO •
HEALTH DEPARTMENT-DATA FOR APP • TO CONSTRUCT THE PERSON FOR WHOM THE SURVEY IS PREPARED f!�'' }
A ANO 011 HIS BEHALF TO THE TITLE COPPERY,GOVERN- • OG `
G IMAREST MOD SUIN_P1.• M SOURCE O WATER 'Man_gUMLIC_ MENTAL AGENCY AND LENDING INSTITUTION LISTED 4
R IMF CO.TAX PAP OPT 11332-u T10N BEACR.-�LOT.1.6.111 HEREON,AND TO THE ASSIGNEES OF THE LENDING
*MPS AMMO SWELLMMS WITHIN 100 [R Or.TRS PROPERTY INSTITUTION GUARANTEES ARE NOT IRAN 'S .5 ',
°THEA THAN THOS( SHOWN Noncom TO ADDITIONAL INSTITUTIONS OR SUGfEOUENT < * ¢y'
*THE WATER SUPPLY AIM swine asPosAL resume ran THIS*01011,401 OWNERS
WILL CONPORN TO TILE$TAMOSRp/0/TN[�SUNIOLR COUNTY IMPARTMENT N DISTANCES SHOWN HEREON FROM PRO►CRTY UNEP • '
Of MALTA SOIVICLS. TOEIfIfTINS STRUCTURES ARC►011 A 7►ECIFIC
APPS.ICANT. D CO. PURPOSE AND ARE NOT TO SE USE0 TO ESTABLISH L' r .;;, is
443 M va PROPERTY LINES OR FOR THE ERECTION OF FENCES -
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