HomeMy WebLinkAboutSchembri Homes Inc (10) ,...
JUDITH T.TERRY
4 Town Hall, 53095 Main Road
TOWN CLERK y P.O. Box 1179
�' Southold, New York 11971
REGISTRAR OF VITAL STATISTICS Oy ����', Fax(516) 765-1823
MARRIAGE OFFICER ?J O
RECORDS MANAGEMENT OFFICER ---•O.1 '' ,,s 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. 1762 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.
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 40.00 block 2 lot 6.006
Cross Street INLET POND ROAD
Building Permit Number Cross Reference:
Issue Date: 10/29/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T.TERRY 4 = y< Town Hall, 53095 Main Road
TOWN CLERK y i P.O. Box 1179
v. �$ Southold, New York 11971
REGISTRAR OF VITAL STATISTICS `may ��,�# Fax (516) 76 -1823
MARRIAGE OFFICER ��l �a� �� n (� `I'ele�flori� ( 765-1800
RECORDS MANAGEMENT OFFICER •'Il ,'",."i D u L , u
FREEDOM OF INFORMATION OFFICER U
ROCT i 9 !�-.��
OFFICE OF THE TOWN CL RIK 1
TOWN OF SOUTHOLD BLDG.DEPT.
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: October 28, 1997
Transmitted herewith is a copy of application No. 1836 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 reco endations:
APPROVE
DISAPPROVE
Comments:
----9--
1, 2_6? q 7
Signature
Dated
OFFICE OF THE TOWN CLERK """'" -
Town of Southold �o''� e01./(`:
Town Clerk Application No. / 53 6
Judith T. Terry, ;�
Town Hall, 53095 Main Road ; Construction 1,,'.P. O. Box 1179 � =' m -.
,
Southold, New York 11971 tJ W; Alteration
Telephone =O,jy0A4-'�� $10.00 -Residential
(516) 765-1801 _ 1 ,, ' $25.00 Non Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE p /AL/ /7
�
APPLICANT NAME: (No 4
APPLICANT ADDRESS: VP' ‘-`°'-)7,7,��-
C_A}Cedt---5, 41- 7(/,' 7 .-1"--
SEPTIC CESSPOOLLC
DESCRIPTION OFP OPosED CONSTRUCTION OR ALTERATION
4
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION O•. LTE' ON: 614 jx4),,_}4 1
,�,�
OWNER OF PROPERTY: �----:- -�-==-
OWNER MAILING ADDRESS: / 1 `
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OWNER PROPERTY ADDRESS: a
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TELEPHONE NUMBER OF CONTACT PERSON: ),019.---57Z
TAX MAP NO. : Section ' " °Block 2- Lot (0
I(CROSS STREET: l l v 1/ .^/1n4 74N0
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applicant
RECEIVED BY: ,
To n Cler s Office
DATE: !Q/ fi
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mow POR APPROVAL or CQI�!'nturmOr1 T r tV 4Ca-
I r FAMILY IntSZBOICS OMJY
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DA'I'S Z l_ .NO. /L. > . .. = 3 a
FOR MAXIMUM OF seen BEDROOMS �o Nt-
EXPIRES THREE YEARS FROM DATE OF APPROVAL r!N Z
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DATE .,, ! 4""'
H.S.REF.110.___ i
APPROVED BY s Si
hura,,K. Coders' 7rt
....utrk...aer.t:ew w d�wion to WI downed is o deletion of section 7204 SURVEY OF:
of the tem Yore stat,Education tae. LOT 4
Certification nickeled Noreen•t.4 run onto to the person fer seem it is prepared
and on Nd,Mop to the Poo Cortgany,Gooeranot*at Agency.td tending
institution Odra boom.ad b tlN.eeign..."�.lording bt lwelen.w mks_
ueo1 owners. MAP OF HOMESTEAD ACRES
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vul,/.u...e k cu"nkre u wadi true wog
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to.a atm is Nene and use and Ponders aro foot intended to Aide the weeder of
fence,.relenting not,.pook paha.,planting aro,.eddMko to t Jdto.of any other !t„ 600,111°i 6'Ai 1<
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not,a.rit...f ( DATE: 21191147 SCALE: 1" 40'
CERTIFIED ONLY TO: % . m.--:5-rv. '. - , •
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LAND SURVEYOR
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DESTIN G. GRAF N.Y.S. LIC No. 50061 9�� / -':''r/ n Ra00{ItNR Raw V
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TAX I.D. No. 1000-40-2-6.6 ''S;�'r >%`}: PHONE CM)x1-34+: