HomeMy WebLinkAboutSchembri Homes Inc (12) •jF
ELIZABETH A.NEVILLE 1 % OGyl$ Town Hall, 53095 Main Road
TOWN CLERK , p _ P.O. Box 1179
y Z Southold,New York 11971
REGISTRAR OF VITAL STATISTICS iv,'�� Fax(516) 765-1823
MARRIAGE OFFICER Iji
RECORDS MANAGEMENT OFFICER ��$91 jr. ���eel
Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER ar tie
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1876 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 #R10-97-0051
Name Of Owner SCHEMBRI HOMES INC.
Mailing Address 1 P. O. BOX 163
City St Zip WADING RIVER NY 11792
Property Address 1 INLET POND ROAD
City St Zip GREENPORT NY 11944
Tax Map No. section 33.00 block 6 lot 8.000
Cross Street WILLOW DRIVE
Building Permit Number Cross Reference:
Issue Date: 6/03/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILt.F 1 /� ��
y Town Hall, 53095 Main Road
TOWN CLERK 1
P.O. Box 1179
y 2 Southold, New York 11971
REGISTRAR OF VITAL STATISTICS v'
MARRIAGE OFFICER y11� Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER : 'fo 0�� Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER 41( *-010'
4110
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: June 1, 1998
Transmitted herewith is a copy of application No. 1950 for a Cesspool/
Septic Tank Construction Permit submitted by:
Schembri Home 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
DISAPPROVE
•
Comments:
ignatu /
Dated
e •
OFFICE OF THE TOWN •CLERK ,,,'"""
Town of ,Southold ,�' C�FFOt��+ /r
at:'
re
Judith T. Terry, Town Clerk Application No.
Town Hall, 53095 Main Road Construction_ ✓
P. O. Box 1179 Alteration
Southold, New York 11971
Telephone � ,,r �� $10.00 - Residential
(516) 65-1801 ,� ��ir
$25.00 -Non-Residential____
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE 1 0tr
APPLICANT ,NAME: \\ 4
APPLICANT ADDRESS: V, n- 6 I t0 3 _
f,;,„
1 ( 792
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CQNSTRUCTI N R ALTERATION
RAW /
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: 5 aNit,k
OWNER MAILING ADDRESS: 0 /76' ( Co (A.)`` '
OWNER PROPERTY ADDRESS: _5;4,4
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section '22 .5 Block Co' Lot g
CROSS STREET: (Ai/024,J p/�.� Y `�
BUILDING PERMIT NUMBER CROSS REFERENCE:
ignature of Applicant
RECEIVED BY: ilk,
(wn C erk's Office
DATE: S �
pay o
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ARDS OF 'HE Sti 4=O . ;:ts)i INT)
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era or n I.-nog .:the Tilt Cimpaliy.Co,nwy, , f hq.n y and:l.atWip. '"A"; -$-`" .:"r ;
utut,ia t ne•-�n,and to the d'I* x _..
5 5(IOne or aubse MAP OF HOMESTEAD A • '
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to oft a n enl not bearing the prot.aaionOrS inked sed or embossed °.',..,..,1.'
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o wh�� r -ono use sed tnerdore ore not intended b gage the erectan of toy LW T C
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CERTIFIED ONLY 'I V: t ,�
Au ► ...4r)w ->/-',.L, —v,-:- DESTIN G. GRAF
rIII?! ' 4.„.-
LAND SURVEYOR
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DESTIN G. GRAF N.Y.S. LIC No. 50067 r _ = = fit
1000-33-6-8 '��:<� "r ` Y ,.YORK 11778
By TAX I.D. No. i,SI s �s;o;see-s;2