HomeMy WebLinkAboutSchembri Homes Inc (14) /0,��ofFO(
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ELIZABETH A.NEVILLE ;„yam Gym Z, Town Hall, 53095 Main Road
TOWN CLERK c
•� P.O. Box 1179
ti Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS % Fax (516) 765-1823
MARRIAGE OFFICER �‘41 %N.��� Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER Wiz'/Q! 1p 1.* 10I
FREEDOM OF INFORMATION OFFICER •
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1790 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 #R10-97-0041
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 6.007
Cross Street INLET POND ROAD
Building Permit Number Cross Reference:
Issue Date: 1/12/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
• SUF(r / 7YO
• �
ELIZABETH A.NEVILLE �`1y� Town Hall, 53095 Main Road
TOWN CLERK c -� P.O. Box 1179
y Z Southold, New York 11971
•
REGISTRAR OF VITAL STATISTICS • rrr
\0 I Fax (516) 765-1823
MARRIAGE OFFICERL�# 0� Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER
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: January 7, 1998
Transmitted herewith is a copy of application No. 1864 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 rreecommendations:
APPROVE ✓
DISAPPROVE
Comments:
RECEWED
JAN '
199$ nature
Southold Tows � � S/4
CDated
OFFICE OF THE -TOWN CLERK ,ii'
Town of Southold
Judith T. Terry, Town Clerk Application No.ZSS6'K
Town Hall, 53095 Main Road Construction t
P. O. Box 1179
Southold, New York 11971 s f �';' Alteration
Telephone � ��' $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 i)5jr
APPLICANT NAME: er-,Liu ,
APPLICANT ADDRESS: P• 0 , ( 3
1 l I-p---
SEPTIC CESSPOOL
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: _5 CAO---1,1% � -•-d
OWNER MAILING ADDRESS: J. 0, 4-17V (6 3. ,
�A-�I • i' )/ / / 11)-
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: 6,1°,1-6-1 —
TAX MAP NO. : Section A7/0 Block , . Lot 6 ,
CROSS STREET: j)t1„,
BUILDING PERMIT NUMBER CROSS REFERENCE:
I
Signature of Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
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'THE WATER SUPPLY&SEWAGE K
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DISPOSAL FOR THIS r.. F.-7:7:77710E
WILL CO,:T:,,0:,',TO TiL
ARDS OF THE SUFFOLK COUNTY
DEPT.OF HEALTH SERVICES. -t.,' 1 -9---- -1: IV 0
atiffyilifiteisitTY D#INAMIENT OF HEALTH SVCS
PERMIT FOR APPROVAL OF CONSTRUCIION FOR A
SUFFC/ r. COLN'?''.,'DE77. OF
HEALTH ..•-q-=-i ',/;C.L:"1;FOR
it ?ARMY avalwava3 ONLY
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APPRON,; . :.:: -.... -.1,,• ::::,.',..'..::--:LY DATE 4 ilio..,' '"!..N04 /0...49) - 00 9 •
DATE _____..___________—
APPROVED r ,...,40/ z_,-2
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APPROVED BY C.- ./ t. 4 g f ji I. l _Iv :.1:i Rooms
E.XPIRES THREE YEARS FROM DATE OF APPROVAL
iNiam..YINNIONIMMINNIMM.1011M.1.......... .m.....•••••••••••••••••••••••••••••'
.5...‹.<-1:kAe... 60( ,11'1' d tierZitA
0.11100.4M etrgeie.Cf odddier to this&noises...I 4 a 0010100 of Seetihn -mg SURVEY OF:
of the New ears State Education tars LOT 5
ce.,,,....i,...,„.hereon shah nos only to the person In, whom it is prepared
end on Pis bettatt to the title Company.Goventriseniai Agency and Lending
inefitutioe listed hereon.and to the=dames of the lending institutions or eubse-
. MAP OF HOMESTEAD ACRES
event owners.
Copies Of this document not Dr.:swig the professional's inked seal or embossed
seta Aug mil be...We'd OF. ;
nstid iner copy.. ig. 4,,I faer 1-r-bw,,t OF 41Aritzt,,I.
donenstons)shown hereon from structures to the properly In,We
I),a specific PoPoSe and use and lhenifore on not intended to guide the erection 01
lenCes.retaining walls. pools. potins. plontind weds addition to bu4Ongs or any other 6,0aTIT, 14 .v./...„. • k
construction. '''...Of NE-''.:f -,.
It*enstance
Of right of rays and/or itotements of record if ony. not shown ote .i., ‘, RVEY DATE: 2-1 ief)i-7 .,gic.1,'W.,i, E: 1" = 40'
net guaranteed.
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CERTIFIED ONLY TO: / ,
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DESTIN G. GRAF N.Y.S. LIC No. 50067 ' ,NIVIliab -,/'::.) (
TAX I.D. No. . 1000-40-2-6.7 "SON' V •, '. .•\‘
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