HomeMy WebLinkAboutSchembri Homes Inc (13) 00,OAF
OFFOc'
ELIZABETH A.NEVILLE %1 %r. �y�; Town Hall, 53095 Main Road
TOWN CLERK ; p s- P.O. Box 1179
• ti Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS t
�, Fax (516) 765-1823
MARRIAGE OFFICER :. y
RECORDS MANAGEMENT OFFICER ;� 4.o0
1 Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER „1
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1867 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 #R10-97-0052
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 9.000
Cross Street INLET ROAD
Building Permit Number Cross Reference:
eg- f4*-
Issue Date: 5/19/98 Elizabeth A. Ne ille
Southold Town Clerk
(TOWN SEAL)
Cf
�!`"gUF:0, c0 7
ELIZABETH A. NEVILLE •"-
* *4 Gym 4 Town Hall, 53095 Main Road
TOWN CLERK ; p :� P.O. Box 1179
ti Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ry'r',�
MARRIAGE OFFICER •` Fax (516) 765-1823
Ws.RECORDS MANAGEMENT OFFICER s. 0 ,•I Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER �1
4V ie.
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD 8
TO: Southold Town Building Department . t
FROM: Linda J. Cooper, Southold Town Clerk's Office �.._._
DATED: May 18, 1998
Transmitted herewith is a copy of application No. 1941 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
DISAPPROVE
Comments:
Itur:
Dated
IIII III,,,
OFFICE OF THE TOWN CLERK ,� CAV0 Ktt
TOWNOFSOUI'N.OLD ��' �14QG Application No LG
ELIZABETH A.NEVILLE,TOWN CLERK �,
P.O.BOX 1179
► � � Construction
SOUTHOLD,NEW,YORK 11971 T ;
4112 Alteration
Telephone ,��0 �Q��i� $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 57/ 7f
APPLICANT NAME: ( I) 4-- CS)11-1 01-1
APPLICANT ADDRESS: e(r)- /co 3
i -a R/1?/ /796x--
SEPTIC CESSPOOL
DESCRIPTION PROPOSED ONSTRUCTION OR ALTERATION
-5-74f 1;7-'1LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTI N OR ALTERATION:
OWNER OF PROPERTY: CO�Q , OK (1. .
OWNER MAILING ADDRESS: t7-4'G , 3
OWNER PROPERTY ADDRE S: 01 /e(
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section 33 Block CO Lot q
CROSS STREET: 7 „po-oe
BUILDING PERMIT NUMBER CROSS REFERE E:
//
ignature of Applicant
RECEIVED BY: CLi/Ulf---
•w Clerk's Office
DATE: J �
a
THE WATER SUPPLY&SEWAGE SUFFOLK COUN1Y DEP.i. (Jr:
DISPOSAL FOR THIS RESIDENCE HEALTH Sia"V'£',s'`'COR
• APPROVAL O',v CON ST ONL'{ 0
WILL CON FROM TO THE STAND-
DATE -._�--------- O
ARDS OF THE SUFFOLK COUNTY H.S.REF.140. _ ______ - • O.
DEPT.OF HEALTH SERVICES. APPROVED BY _. __ 3
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• 150.00' Q
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BEDROOM
,�, �j n FROM DATE OF O
APPROVAL EXCAVATION INSPECTION �QUIQED
„1---=c_ 67-cs ! -7--A.7?,--- /S / c 1 /- ,
Unouthor,.eft....or edition to Ws docwrwnt is a violation of Section 7200 SURVEY OF:
of the New York State Education tae LOT 1 6 II"Certirieotinns indicoled hereon shad run ordy to the penes for.teen it is prpored
ono on Ivim henna to the title Company.Government l,garrc7 and Lending .1-.1,.11kJ7��11-
n,.rhu...n korai h.r.nn.nNi In the writ.,,...at IM leadln,inatihdbne or suit.-
MAP OF I I V M:( fG ( ,.
F .
Coon, of Iter doournenl not bearing the p.of.nio,ays inked veal or embossed t' 1.
5,11 chill not he<onsderd a solid true copy. �-"� ` �"
lb.nn..l,(or aimmsinns)Shown hereon from sfnrctwn to the property Nan are V5i T I Qwht Q-\*. . .091
for o specd.r. pupose and use and therefor*are nit intended to guide the erection of
ren,:.; retainira rats.Moi,. Don's.ldnntima areas."01"to bola"a any atter 0'� 7- +'�. N 6w10
Yc-�1.'f ? gi,*.J1'i", 1 -,,� e{s1`—
I..., .,f „,,,,,,i .ay,...v.•, wc.mew,of mord,it.w.nal,lento rye ,t...0•,---- '.,,,-.,,,,,,SEY DATE: Z 111 161 1 CA O `'" '
CERTIFIED ONLY TO: r• x:. •
/ ,‘1,4e1,4451,1 `-. - -_NW--j-_, DESTIN G. AF
bad . I% ,
I LAND SURVEYOR
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DESTIN G. GRAF N.Y.S. LIC No. a'67 C'SSsc �;(,. / v 7Nom p�„" 0O1ANf,�y, fins
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TAX I.D. No. 1000-33-6-9 "°'Me)121-3442
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