HomeMy WebLinkAboutSchembri Homes Inc (6) F FOLt
JUDITH T.TERRY if y� Town Hall, 53095 Main Road
TOWN CLERK ; y P.O. Box 1179
REGISTRAR OF VITAL STATISTICS %%°e1 41 Southold,New York 11971
MARRIAGE OFFICER : y1. ..
�� Fax (516) 765-1823
41,RECORDS MANAGEMENT OFFICER ���.( ��0,1�� Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1777 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 #R10-97-0046
Name Of Owner SCHEMBRI HOMES
Mailing Address 1 P. O. BOX 163
City St Zip WADING RIVER NY 11792
Property Address 1 WILLOW DRIVE
(HOMESTEAD ACRES LOT 10)
City St Zip GREENPORT NY 11944
Tax Map No. section 33.00 block 6 lot 3.000
Cross Street HOEMSTEAD WAY
Building Permit Number Cross Reference:
Issue Date: 12/08/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T„Tg ,_.; 41997 ���` -.t1 • Town Hall, 53095 Main Road
TOWN OLE ` _ P.O. Box 1179
�� Southold, New York 11971
REGISTRAR OF VIDAL S a T -DEPT. k ��, Fax (516) 765-1823
MARRIAGE"* 7A: •F SOUTHOLD �'y� �� �1
RECORDS MANAGEMENT OFFICER '-r/k,
* *a " Telephone (516) 765-1800
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 4, 1997
Transmitted herewith is a copy of application No. 1851 for a Cesspool/
Septic Tank Construction Permit submitted by:
Schembri Homes
•
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 reccoommendations:
APPROVE ti/
DISAPPROVE
Comments:
RECEIVED
— c.)"(A."."--e....-7.-----
DEC `.: 1997gnature
Southold Town C :A Dated
t
OFFICE OF THE TOWN .CLERK ,►,'"' "
Town of Southold , �Ff
Judith T. Terry, Town Clerk �' 4� CSG Application
Town Hall, 53095 Main Road Construction
P. O. Box 1179
Southold, New York 11971 "FA Alteration
Telephone O,jy :0 ' $10.00 - Residential
(516) 765-1801 - l41
► , ' $25.00 -Non-Residential__
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
_tet_..__��.�.._--•�,.__
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE �VV„
APPLICANT NAME: SCinemb n Vi-omes
APPLICANT ADDRESS: P,O ► B 1b,
W�dIr4 ►yep' ��___ � Z
SEPTIC CESSPOOL LV
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION / /_�
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY:_
OWNER MAILING ADDRESS: 19104E✓" a3
VVns� r0 ( r V er N I r19.7%
OWNER PROPERTY ADDRESS: me9}�,�1 --�Ckree ko#- IC)
1� ! 116 O v z__ r een prDrt
TELEPHONE NUMBER OF CONTACT PERSON: ICOR 5-c Q%
TAX MAP NO. : Section____3 _Block b Lot 3
CROSS STREET: o meSiesaci
BUILDING PERMIT NUMBER CROSS REFEREN
f
' is nature of Applicant
RECEIVED BY :
Town Clerk's Office
DATE:
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LANE
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OVED ' -
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I'OR .411 OF.,L.B CAK. 18,1 0
pow TEE YEARS FROM DATE OF APPROVAL W 3
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4.1 '�dF 4. t i it ,� t f i re Afa�rt It!ma N
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THE WATER SUPPLY&SEWAGE .%t' ` r /' S"S i 72'7' 2
DISPOSAL FOR THIS RES.<�: NCE :) /i-z.,/ .0 jS"1e-7=,
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WILL CO "ROM TO THE STAND- 1, >c
ARDS OF THE SUFFOLK COUNTY
DEPT.OF HEALTH SERVICES.
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NO2'17'10"E 125.00'
SUFFOLK COUN1Y DEPT.OF •
HEALTH SERVICES FOR
APPROVAL .= CO N ST ONLY N/F MORRISON
DATE
• HS.REF. NO.
APPROVED BY T - 4o•
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A.) e.01,..4:-.' �ovN�( uwti -,li
uaaoMrlxed elleratloo or oddtlon to Mit document M o violation of Section 7209 Afs' .. "of the New York Stole Educdiet Low. SURVEY OF: 0
Cer,ificMtam indicated hereon Mal too only to the person for whom II to prepared ��
oed nn hie kneel to Ike IOM Company,Governmental/pency and Lending i�I
irrtomense,,Ir,!rem,and m the emirate*,a the lung Institutions or subse-
quent MAP OF HOMESTO6 ACRES
satito
ornn■
Copies of the document not bearing the professional's inked seat or embossed
,sol shell not be considerd a yard true .�
`.P'. ( eE+Jpbhe- 'r"o Ncerm- ,'
The offsets for dimen,rm sham hereon Irom structures to the properly Noes ors
for a eperaie pew.,and use aro Iherelme me not intended to guide IM teeetion of I t 1r
fences,retaining sola,pooh.polio,.planting woos,addlion to landings or any other ' 1.;oi. -
O'� -s ,>-v'Fi�oNC Govt c TY Lew meg.
can,nn,rtion. ek • _, s,�..
The ert,lenca of right or says cod/or easements of recero,it ony,not.horn as „AV' •SU- 1 DATE: Z I lei lei 1 SCALE: 1' = 40'
nal guaranteed.
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CERTIFIED ONLY TO: �G4}EMPxi 4�: e — . L.. _, _y;;_„ DESTIN Ge GRAF
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� —`" LAND SURVEYOR
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DESTIN G. GRAF N.Y.S. UC No. 500. ‘ ,„„VII; A. 73 rloolwuln"°'0
Roan PONT.NEW NNW( 11778
TAX I.D. No. 1000-33-6-3 , P1ONE(31$)$21-3442