HomeMy WebLinkAboutDBM Co (30) q.
® fi t TA,
JUDITH T. TERRYAzt ��� t•; Town Hall, 53095 Main Road
TOWN CLERK *114, `�` P.O. Box 1179
� ,' r�� Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ` � '`<„ '� �� ti � �� Fax 516 765-1823
MARRIAGE OFFICER 1. - ' ( )
-®4�) �����! Fax
(516) 765-1801
EZ OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 1814-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 1 630 ORIOLE DRIVE
Property Address 2
City St Zip SOUTHOLD NY 11971-0000
Owner Telephone No. 516-477-2223
Tax Map No. section 55.00 block 6 lot 15.008
Cross Street LISA DRIVE
Date Of Last Pump Out 0/00/00
Issue Date: 11/29/91 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
}
OFFICE OF THE TOWN CLERK •c,VFFU(,(-,'-
) " Town of Southold ,% ,_• , CQG',. Application No. /gl5_
Judith T. Terry, Town Clerk % 4. 3 i IN5F .gr, y
Town Hall, 53095 Main Road hw ...t. $10.00 - Residential
P. O. Box 1179 u' ...� i ��' $25.00 - Non-Residential
Southold, New York 11971 O 1,-(z fir{"" „, ' -$
Telephone ( 0
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
DATE / (-8 -91
OWNER NAME: D L H Cid .
OWNER MAILING ADDRESS: LI (43 11,-),J S % P. D • 80 x z 13 0
C� ,ems cA)166 -- N Y i i 9 '1f
OWNER PROPERTY ADDRESS: 630 6/e / 0 t Lf /•('
_SO o 7-7-id c /) ici Y 1 1 9 71
OWNER TELEPHONE NUMBER: c..15-/ (o - q -1 7- Z -2,•- ).-'
TAX MAP NO. : Section ,5%.5.- Block (, Lot /`-5--) 8
CROSS STREET: , I. 15,4 1Jg 0 ti 1:,---
TYPE
:TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New 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.)
' -\2-e./PirAAJ411111 -4
r
•
Signature of Applicant
0QRECEIVED BY: �`�
k-C-,— --.
( ,..e...-e-4?---3----
Town Clerk's Office
DATE: ,gCj / ?/
..,
..:-.••
..-_-...-. ..
, lelf.
_<
oFfr ,
. _
- , -
",,
.. ,
, .
, <
. ,
. • '
_ < ,
, , • <
. '
1 - ,
, .
. '
, I
I -
-F --
I
now or formerly
Mary Wheeler - 1 ,
. , •
in ,S,
r-
,.k
_----___
. c• . .
, .
, <
0,,
_
0 0 ,
(• .
\-A,
now or formerly
Robert Goldsmith oig
...,, r
- .
sl,
_ru
co
ro
0
' _ EV ,
Z
. ,
C. .. - ----l3-i IL.
---------- .
, .
. .
.- ...i., ,
-%, '0'9.
/4-'t
I
. ,,, ,.".• 4,, . ,
.
I ,
4,4 ,Ss* ,N,,,, /
- ' ,I t"7,75; ' / .
- 4 4
..'• • r. '
. '
I <o A' . . N./
A.i\
Ic./ :' ' i , ‘4f' /
tA 0 /
• 0
.2, ,:::$ / 4
' 4 •/
1• 4 5 3/ ..<<"
'-' *
, --7 ....
, .
. / .--.
/ 4, -
....„
, 0
Subdivision - "Highpoint Meadows .....„
, C4- . .
.: :•. Section One
.0
.
-- .:, ,):::- Suffolk County File No 8910 ,S3- dig ,
.
.
. . ........
.- .
f ,
-, LISA DRIVE • ,
• - .
, ,,,,,.., •
S. / •
) ,..- .,..
.z..'>, • _
. .
. ,
•
•
SURVEY FOR
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES D.B.M. COMPANY
-
. .._ SINGLE FAMILY DWELLING ONLY LOT NO 5,"HIGHPOINT MEADOWS,SECTION TWO OCT 28,1991
Dont/ 0 6 1991H S REF.NO. 57-1 --70 AT SOUTHOLD SEPT 18, 1991
DATE JULY 22,1991
The sewage disposal and water supply facilities for this TOWN OF SOUTHOLD SCALE 1 .50. ----'
location have been inspected by this Department and/or SUFFOLK COUNTY, NEW YORK NO 91-0644
other a/enci s and found to be satisfactory. , ,
CeZ"d Management •uplAuTi.0111ZED ALTERATION OR ADDITION TO THIS
SURVEY IS A VIOLATION Of SECTION 7209 OF THE
. I
. OF NE .
Chief of Bureau of Wastewater HEW TUNE STATE EDUCATION LAW ,,..0 IV
H COPIES OF THIS SURVEY NOT BEARING TN(LAND S. .
SURvEYOPIS INKED SEAL OP EMBOSSED SEAL SHALL 9,0 W.
l-C'e
• . NOT BE CONSIDERED TO BE A VALID TRUE COPY
AGu-----ILES INDICATED HEREON SHALL RUN OT/LY TO 0 6
1HEALTH DEPARTMENT-DATA FOR TO C
APPROVAL ONSTRUC T THE PERSON FOR WHOM THE SURVEY IS PREPARED -1
, AND CO/HIS BEHALF TO THE TITLE COMPANY,GOO"...
N/4------NEVI MAIN MI • N SOURCE OF WATER PRIM__PUBLIC_ MENTAL AGENCY AND LENDING INSTITUTION LISTED, .. 1
MILNE CO TAX MAP 01010912-SECTION..9,5_BLOCK_9--LOT 15.8 HEREON,AND TO THE ASSIGNEES OF THE LENDING , kW ,
-,
I/TIMM ARE MO DWELLINGS WITHIN 100 FEET OF TINS PROPERTY INSTITUTION GUARANTEES ARE NOT TRANSFERABLE
OTHER THAN THOSE SHOWN HEREON TO ADO1TIONAL INSTITUTIONS OR SUBSEQUENT
OWNERS S
S THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FOR THIS ROI MCI ,
U) ,. 5. 1-
.,DISTANCES SHOWN HEREON FROM PROPERTY LINES2.
WILL CONFORM TO THE STANDANDS OF TME SUffOLX COUNTY
TO EXISTING STRUCTURES ARE FOR •SPECIFIC
Of HEALTH SERVICES PURPOSE AND ARE NOT TO BE USED TO ESTABLISH
..11.4'
APPLICANT. ,_
PROPERTY LINES OR FOR THE ERECTION OF FENCES 1/IND SO- •,, .
ARCHERS ' - '
\ ' .
llt. YOUNG a YOUNG 400 OSTRANDER AVENUE
RIVERHEAD.'NEW YORK
' NOTES"•.MONUMENT AX 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 8911 , 1
' , AND LAND SURVEYOR p Y.S UCENSE NO 2845
HOWARD W YOUNG, LAND SURVEYOR
•THE LOCATION OF 111ELLIWLSEPTIC TANKISTISCESSPOOLSICF)SNOWS HEREON NY S LICENSE NO 45895
ARE FROM FIELD OINERWITIONS MID OR DATA OBTAINED FROM ES
. ,
' ' BRAND1S•SONS INC. ' . -