HomeMy WebLinkAboutSchembri Homes Inc (9) ELIZABETH A.NEVILLE �� Gy Town Hall, 53095 Main Road
TOWN CLERK �� p 1 P.O.�- Box 1179
y = Southold, New York 11971
REGISTRAR OF VITAL STATISTICS %%‘44 '
MARRIAGE OFFICER �` r Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER 4*Ol %� 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. 1812 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 #R10-97-0049
Name Of Owner SCHEMBRI HOMES INC.
Mailing Address 1 P. O. BOX 163
City St Zip WADING RIVER NY 11792
Property Address 1 WILLOW DRIVE
City St Zip GREENPORT NY 11944
Tax Map No. section 33.00 block 6 lot 6.000
Cross Street INLET POND ROAD
Building Permit Number Cross Reference:
Issue Date: 2/23/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
''1,0 Aran,y / A-/
•
ELIZABETH A.NEVILLE �• `Z Gym% Town Hall, 53095 Main Road
TOWN CLERK' 4 c < P.O. Box 1179
C4 Z t Southold, New York 11971
REGISTRAR OF VITAL STATISTICS %A.. �'�i Fax (516) 765-1823
MARRIAGE OFFICER :- y �1
RECORDS MANAGEMENT OFFICER : �Ol ��� �� 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: February 11 , 1998
Transmitted herewith is a copy of application No. 1886 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 recommendations:
APPROVE Y
DISAPPROVE
Comments:
ignatu e
--) 13 /qs
Dated
OFFICE OF THE TOWN CLERK •
Town of Southold 0.1"C foure. = Application No./P(�
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road Construction c/
P. O. Box 1179
Southold, New York 11971 Alteration
Telephone =., �,i �,� $10.00 -Residential `�
(516) 765-1801 *��,, $25.00 - Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT 1
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE , 1/0/91/
APPLICANT NAME: _.5C1L4A./CA: (.\--(v-kA SI"-‘ .
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APPLICANT ADDRESS: `(• -0- ni 7
\ 4:L...
vu_,_ i (-29'.2.,
SEPTIC CESSPOOL
DESCRIPTION OF PRO44 # .
CO STRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATIO -. /
OWNER OF PROPERTY: j cif).,,,,/ C k
OWNER MAILING ADDRESS: �0- / 34c/ //7rj-L s '
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: . 202.- f--- 592
TAX MAP NO. : Section 5) Block Ce Lot (4%'
CROSS STREET: C ,
BUILDING PERMIT NUMBER CROSS REFERENCE:
�t/ii4/ , j
Signature of Applicant
RECEIVED BY :
Town tferk's Office
DATE:
: UFFOLK ♦s DEPARINIEN to OP HEALTH SERVICES
I.
1'"f i , Part AP.MOV L OF OO? T*VCTIOM/OR A
SINCLIT FAMILY
ONLY
. l -j, 1Jt: 4. .IVIb.
5". 404-
i
p 'i oil` st"�, if CC C
SOUND DRIVE
FOR MAXIMUM OF, BSOROOMS
= a.t.x?k S?S THREE YEARS FROM DATE OF APPROVAL
THE WATER SUPPLY&SEII G�
DISPOSAL FOR THIS RESIDE•;CE
WILL CONFROM TO THE C`TAND-
ARDS OF THE SUFFOLK COUNTY
v, DEPT.OF HEALTH SERVICES.
`''o
o,
Noy SUFFOLK CQUN1Y DEPT. OF
HEALTH SERVICES FOR
to
c'cl,. APPROVAL OF CONST.ONLY
`� ' DATE
*`3 H.S.REF.NO.
4144:14.4*
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` APPROVED BY
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Unauthorized alteration or oddition to this document is a...Polon of Section 7209 SURVEY OF:
al M» .'fort stat.Education torr LOT 13
ce,.pno^s indicated hereon Shan ran only to the person for whom it is peeved
and on his behold to the Tale Corneae.Oooemmentat Agency and tending
institution fisted hereon,and to the assignees of the lending instilulions or sub..-
MAP OF HOMESTEAD ACRES WOWS.
Copies of this document not beefing the proressinwls Hied seal
or embossed
seal shag not he consiaerd o yoed foie copy.
live offsets(or dimeasptl)shown hereon Iron structures to the property tines ore /J/J// r 7"3"•1
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far a speak max and use oriel therefore ore not intended to guide IM erection of C.71�.IG{!j (f ` ' 1 V W fJ L//'7�l-w,
knees,retaining naafi,gook,patios, planting arras, oMilion to buildings or any other
cnniheXtion —
g1r Meer. i :- v.; r M
n riMd nl mays nM�n ens•menle nl i roM, it any, not shn«n are / ! U� LK N, • s Ew o
no qu moles 1 {.
,,. ' �, ' S EY DATE; SCALE; 1" - 60'
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CERTIFIED ONLY TO •
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/71-14 OI \---• _..r - . --f4:"'""`"..:'' r ESTIN Ge GRAF
LAND SURVEYOR
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BY
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DESTIN G. GRAF N.Y.S. LIC No. 50067 I
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TAX LD. No. 1000-33-6-6 . 1U €t.t- r ‘' coy.r NONTO c 1177°
(NONE 0314)II21-3442
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