HomeMy WebLinkAboutSchembri Homes Inc (21) '0,0"re
ol�OFFO�t
ELIZABETH A.NEVILLE � OG Town Hall, 53095 Main Road
.04
TOWN CLERK p 4 P.O. Box 1179
2 Southold, New York 11971
REGISTRAR OF VITAL STATISTICS 0 iv"t Fax (516) 765-1823
MARRIAGE OFFICER %.4 �� '��� Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER
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. 1860 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 #R10-98-0068
Name Of Owner SCHEMBRI HOMES, INC.
Mailing Address 1 P.O. BOX 163
City St Zip WADING RIVER NY 11792
Property Address 1 KERWIN BLVD.
City St Zip GREENPORT NY 11944
Tax Map No. section 53.00 block 4 lot 44.032
Cross Street AUGUST LANE
Building Permit Number Cross Reference:
Issue Date: 5/11/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE �, .-..- �Gy . Town Hall, 53095 Main Road
TOWN CLERK o= _. % P.O. Box 1179
% y Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS % 0 �',t
MARRIAGE OFFICER •` 4. Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER � �� �0 �I�, Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER �1 ����
•44
OFFICE OF THE TOWN CLERKR
TOWN OF SOUTHOLD L5 O W
' 11998 J
j
TO: Southold Town Building Department BLDG. DEPT.
FROM: Linda J. Cooper, Southold Town Clerk's Office T.WN •FS•UTHOLD
DATED: May 8, 1998
Transmitted herewith is a copy of application No. 1934 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.
4a .------
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 e
IIt / cl8'
Dated
OFFICE OF THE TOWN CLERK ,'''' --
Town of Southold "OKCOG=_ Application No. / ��
Judith T. Terry, Town Clerk
Town Hall,
53095 Main Road �,1 Construction
P. O. Box 1179 Alteration
Southold, New York 11971 ;P W$
Telephone `VAI„,0 IV"'
(516)
$10.00 - Residential
(516) 765-1801 = 1 ,, $25.00 -Non-Residential
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TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ DATE S/0/
APPLICANT NAME: S .\0-)\it4 (9)/1-'( .
APPLICANT ADDRESS: PO-- 4-0'( / Ca
..`r ` Y 'E` yv-r.1 ('7'j J---
SEPTIC CESSPOOL (---------
DESCRIPTION OF PROPOS D CON TRUCT ION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRU�TIONOR ALTERATION: - c0
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,
OWNER OF PROPERTY:
OWNER MAILING ADDRESS: f?` 0 fg/7( (-Co j
OWNER PROPERTY ADDRESS: --t-A-Cfl•--cs-t- iq-1--A-d,
TELEPHONE NUMBER OF CONTACT PERSON: y )-- - ---5---? - /
TAX MAP NO. : Section 5-',..5 Block d Lot VY
3-2
CROSS STREET: alfv-4.1- ii4,--t
BUILDING PERMIT NUMBER CROSS REFERENCE:
ije-tfrij
ignature of Applicant
Ilk
RECEIVED BY :.
,.....lepe own Clerk's Office
i
DATE:
0-v970
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EXCAVAT',ON iii0 .'Er::. C«:"J P-�t=UiRED._
FOR SANITARY SYSTEM -3
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3 BY HEALTH.t)EPI'RT14ENT
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. . - VA[- \JA` e�ajerM�s
THE WATER SUPPLY&SEWAGE •
DISPOSN. FOR THIS RESIDENCE
WILL.;^,0;.•:FR.O2:S TO THE STAND-
•
--1.r0.1 )ti AcSVt.i ..c;:i cIA-ritiv\- AP,D;: CF T ` u FOLK COUNTY
vJ : Pu 6I i l-WA-Tew-
� Dr-.'T. OF HEALTH SERVICES.
Unauthorized alteration or addition to this document is a violation of Section 7209 SURVEY OF: (,9.1"- 0
of the New York State Education Law.
Certifications indicated tth ed tle Companly, only to the Agency
whom it isprepared ,, ,1/►� ;� /�_ ,644 17 ' /V.—0,4 I
and on his behalf to the Title C n ,Governmental A n and Lending ��/�,[1+ CJS /'f I/1 I'A (�1
Institution listed hereon,and to the assignees of the lending institutions or subse-
quent owners. A V no u� , --I-3(4Q Or 411-1-6..4:1�.
Copies of this document not bearing the professional's inked seal or embossed ,_,1' '1 VYKJ ( �/"��1 rTL{ii
seal she e (o considered valid trhe copy. (4, 4. rr dw 'sole
The offsets(or dimensions)shown hereon from structures to the property lines are h
for a specific purpose and use and therefore are not intended to guide the erection of
fences.retaining walls,pools,patios,planting areas,addition to buildings or any other
construction. �.7"�,"�
The existence of right of ways and/or easements of record,if any,not shown are Or•
not guaranteed. g y •di''`i' ``Sq`�;.Y DATE: 41p SCALE: I tt410 i
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CERTIFIED ONLY TO: ,
—v-"I DESTIN G. GRAF
Nil
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LIG■ 'w)/r mow---_., !reqLAND SURVEYOR
IIIIIM v.-4.,,..,; :.'-it:' ':,› '
By O $CENS• 00' •,r A
�' 4,•.... I / i • ®\ 73 WOODLAWN ROAD
DESTIN G.GRAF N.Y.S.LIC No.50067 0'/ ROCKY POINT,NEW YORK 11778 O
TAX I.D. No. t PHONE(516)821-3442
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