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JUDITH T.TERRY ��_� y1`� Town Hall, 53095 Main Road
TOWN CLERK y Z P.O. Box 1179
v. Pry I Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ����1, Fax (516) 765-1823
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER $ �� Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER .-•w. �••���''
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1787 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : SCHEMBRI HOMES INC.
Address 1 : P. O. BOX 163
City St Zip WADING RIVER NY 11792
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. REF #R10-97-0137
Name Of Owner CARDANO, DONALD
Mailing Address 1
City St Zip 0000
Property Address 1 THE GREENWAY
PEBBLE BEACH FARMS
City St Zip EAST MARION NY 11939
Tax Map No. section 30.00 block 2 lot 36.000
Cross Street THE STRAND
Building Permit Number Cross Reference:
Issue Date: 12/31/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T.TERRY �$ y< Town Hall, 53095 Main Road
TOWN CLERK ; CO3 = P.O. Box 1179
�1 Southold, New York 11971
REGISTRAR OF VITAL STATISTICS Fax Oy l*". Fax(516) 765-1823
MARRIAGE OFFICER =;�f� 0���i'fre Telephone(516) 765-1800
RECORDS MANAGEMENT OFFICER 1 l i
FREEDOM OF INFORMATION OFFICER '�
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: December 23, 1997
Transmitted herewith is a copy of application No. 1861 for a Cesspool/
Septic Tank Construction Permit submitted by:
Schembri Homes, Inc. for Donald Cardano
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. Coo er414
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE /
DISAPPROVE
Comments:
pgnatu e
I2-11-3 V41
Dated
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OFFICE OF THE TOWN CLERK ,_°'
n.
Town of Southold ffairA,." ..
Judith T. Terry, Town Clerk Application No. / 4
Town Hall, 53095 Main Road Construction G---''^
P. O. Box 1179
Southold, New York 11971 ,;' Alteration
Telephone ', ilk � '' ,+'F $10.00 -Residential
(516) 765-18011/#4 r
- � $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT 1;
i
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee '$
DATE /e2 / 3 97
APPLICANT NAME: --J ('-'111"c(5
c -
' APPLICANT ADDRESS: a - ‘11( ( 60,3
X0.45 kp,, )/ ( 79 L
SEPTIC CESSPOOL L—
DESCRIPTION OF PROPOS D CONSTRUCTION OR ALTERATION
en
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTI N OR ALTERATIO c r
64-.
OWNER OF PROPERTY: � r-C��ty'�(. 6I&L1 "'' ve�
OWNER MAILING ADDRESS:
—TIXOWNER PROPERTY ADDRESS: c2t ,
TELEPHONE NUMBER OF CONTACT PERSON: f#"i– 5�/6.'
TAX MAP NO. : Section 30 Block (-- ' Lot
CROSS STREET:_ 1J__S:
BUILDING PERMIT NUMBER CROSS REFEREN E:
// , // /
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Signature of Applicant
RECEIVED BY: c —
Town CJerkgs Office
DATE: j _./tr. /9-7.
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