HomeMy WebLinkAboutDBM Co (28) JUDITH T. TERRY Hall, 53095 Main Road
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Town
TOWN CLERK ;: ' P.O. Box 1179 w1`I, Southold, New York 11971
MARRIAGE OFFICER X
REGISTRAR OF VITAL STATISTICS �, �'
11. Fax (516) 765-1823
®�L/� s2, �! Fax
(516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 1815-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New X Existing
Name Of Owner DBM CO.
Mailing Address 1 P. O. BOX 2130
Mailing Address 2
City St Zip GREENPORT NY 11944-0000
Property Address 1 690 ORIOLE DRIVE
Property Address 2 HIGHPOINT MEADOWS LOT NO. 1
City St Zip SOUTHOLD NY 11971-0000
Owner Telephone No. 516-477-2223
Tax Map No. section 55.00 block 6 lot 15.003
Cross Street LISA DRIVE
Date Of Last Pump Out 0/00/00
Issue Date: 12/04/91 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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OFFICE' OF THE TOWN CLERK �COFN.,r�'-
Town of Southold �O �0 = Application No. /F��
Judith T. Terry, Town Clerk .
Town Hall, 53095 Main Road ; �' -� $10.00 - Residential
P. O. Box 1179 � moi. 4.0W 4 $25.00 - Non-Residential
Southold, New York 11971 O ® s2.a.. -/
Telephone 49014'-'''--0-.0
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ •
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DATE 4913 1
OWNER NAME: I) S M Ca.
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OWNER MAILING ADDRESS: 443 Main SPLeet, P. 0. Box 2130
Gtceenpo t, N.Y. 11944
OWNER PROPERTY ADDRESS : 1% Ciu:afe Dian, h'iptipa,cn,t.Meadat s,',tot #1
Sowthafd, N.Y. 11971
OWNER TELEPHONE NUMBER: (516) 477-2223
TAX MAP NO. : Section 55.0.0 Block 6 Lot 15.003
CROSS STREET: Lusa: Vitive
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New X Existing
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT:
LOCATION MAP: Must be attached hereto before permit may be issued.
(Locate building and system; give north arrow and feet
of distance, approximately, to building and closest road.)
1— PAet,( 1- t-t-P
Signature -of Applicant
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RECEIVED BY: - l.)X-r/!-,-"�--
own Clerk's Office
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DATE: /2-73 /
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SURVEY FOR
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES D.B.M. COMPANY NOV 20,1991
NOV S NGLE FAMILY DWELLING ONL SO /� ATLOT SOOUTNOLIDHPOINT MEADOWS,SECTION ONE" MAR 8,1991
DATE DEC 7,,1990
DATE Z 7 1991HS REF NO JJL�
The sewage d'sccsal and water supply facilities for this TOWN OF SOUTHOLD SCALE I'=50'
location have been inspected by this Department and/or SUFFOLK COUNTY, NEW YORK NO 90-0977
other alre f0U t0 ?^^�}��tsra {p
NSO TH0111z cD AL TLR•ri0S ON ADDITION m THIS CERTIFIED TO
. NJ�I... �(:.
J SURVEY 95 A vIOL•TIOM OF SECTION 2209 OF THE BRIDGEHAMPTON NATIONAL BANK
Chief of Bureau of Wastewater Mana ement NE•YORSTATE EDUC•n ON LA• TIMOR T .TEE
g ,O COPIES OF THIS SURVEY MOT BEARING TMC LANG
SURVEYORS IE D SEAL OR EMBOSSED SEAL SHALL D B M 4 . Y Sp
MOT BE CONSIDERED TO BE•vAL10 TRUE COPY S j0
■GUARANTEES INDICATED HEREON SHALL RUN OILY ND rflD W $
HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT THE PERSON FOR WHOM THE SURVEY i5 PREPARED YO t
AND OI HIS BEHALF TO THE TITLE COMPANY GOVERN- SA _� G
N WATER BAIM_MI II SOURCE OF WATER INNATE_PUBLIC_ MENTAL AGENCY MID LENDING INSTITUTION LISTED Y Z
B SVP CO TAX MAP DIST 1000-SEC TION _BLOCK_G__.LOT Al_ HEREON,AND TO THE ASSIGNEES OF THE LENDING = Vii. (a
OTHER( ARE ID DWELLINGS WITHIN 100 FEET OF TMS PROPERTY INSTITUTION GUARANTEES ARE NOT TRANSFERABLE 77 .d
iS
OTHER THAN THOSE SHOWN HEREON TO ADOITIONAL INSTITUTIONS OR SUBSEQUENT .1t`
N THE WATER SUPT AND SEWAGEMISDISPOSAL SYSTEM FOR IS RESIDENCE OWNERS `^•
RSEWAGE
WILL CONFORM TO TIM STANDARDS OF THE SUFPOLR COUNTY
*DISTANCES SHOWN HEREON FROM PROPERTY LINES
TO[FISTING STRUCTURES ARE FOR A SPECIFIC �JJ
�LHEAL TM�DNIC[S n PURPOSE AND ARE NOT TO BE USED TO ESTABLISH /C,p OE' /
,-11 1 6/1Y J/�/,5 - PROPERTY LINES OR FOR THE ERECTION OF FENCES 4fFG[AND S;IEiE{O?
ACORL SS
11�.7 4/'!(/�i„/l- T50x /30
U--Ae-&-nJ,e,f A/79///9 1 TEL i171 z7.-.2 3 YOUNG a YOUNG 400
HEAD EW AVEYOE
NOTES•■=MONUMENT 6,.STAKE
SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF ALDEN W YOUNG,PROFESSIONAL ENGINEER
SUFFOLK COUNTY ON MAR 19,1990 AS FILE NO 8910. AND LAND SURVEYOR N YS UCENSE NO 12845
HOWARD W YOUNG, LAND SURVEYOR
E •TME LOCATOR a WELL(WI,BEITIC TANGISTIB CESSPOOLS(0)SHOWN MAIM N Y S LICENSE NO 45893
• ARE FROM FIELD OS•[RNTIONS AMO OR DATA OBTAIM[D FROM OTHERS
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BRMDIS A SONS INC