HomeMy WebLinkAboutSchembri Homes Inc ,,i UFO-j
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ELIZABETH A.NEVILLE ��hZ` Gym Town Hall, 53095 Main Road
TOWN CLERK ; P.O.,- Box 1179
y Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ;0 al, 1
MARRIAGE OFFICER y Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER ` �� jai1�, Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICERgest,
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1891 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 #R10-97-0167
Name Of Owner SCHEMBRI HOMES INC.
Mailing Address 1 P. O. BOX 163
City St Zip WADING RIVER NY 11792
Property Address 1 PLUM ISLAND LANE
City St Zip ORIENT NY 11957
Tax Map No. section 15.00 block 5 lot 5.000
Cross Street
Building Permit Number Cross Reference:
Issue Date: 7/10/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
r OFF 0 ot (
ELIZABETH A.NEVILLE $h� y� Town Hall, 53095 Main Road
TOWN CLERK p -4 P.O. Box 1179
REGISTRAR OF VITAL STATISTICS v-• rpi Southold, New York 11971
MARRIAGE OFFICER
,�� Fax (516) 765-1823
y
RECORDS MANAGEMENT OFFICER � �� Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER
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OFFICE OF THE TOWN CLERK
4 TOWN OF SOUTHOLD
BLDG. DEPT. c
sQ"ISinuthold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: June 23, 1998
Transmitted herewith is a copy of application No. 1965 for a Cesspool/
Septic Tank Construction Permit submitted by:
Schembri Homes Inc.
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 r commendations:
APPROVE
DISAPPROVE
Comments:
rnatu e
11/kS
Dated
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OFFICE OF THE TOWN CLERK �' FQU ,,-
Town of Southold C' No./&.1.--:7
Judith T. Terry, Town Clerk ���\ �� Application
Town Hall, 53095 Main Road �i G $10.00 - Residential
P. O. Box 1179 to ; $25.00 - Non-Residential
Southold,' New York 11971 Ory *'$
Telephone "'0j L `J�� ���
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION 4
efeityasawesaisfor roodio
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
DATE Ci A C*
OWNER NAME: 6 `'4 ,
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OWNER MAILING ADDRESS: le C--). /1-1 (/. 3
Lc) / //(4775.1-.
OWNER PROPERTY ADDRESS: ;// ( i / , .,,
(2 - / -
OWNER TELEPHONE NUMBER: I)- ' — s-----77
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TAX MAP NO. : Section l/c Block V S Lot () -`
CROSS STREET: nJ,. eit---e, _ ________
-----
TYPE OF SYSTEM: Septic Tank �//�/ v New Existing
Cesspool (.//-New sting
Residential / Non-Residential
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.)
/
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Signature of Applicant
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RECEIVED B Y: . w/ 4-----_—
/ 7. -3 /7o.
own Clerk's Office
DATE:
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