HomeMy WebLinkAboutSchembri Homes Inc (24) ores
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ELIZABETH A.NEVILLEGym; Town Hal], 53095 Main Road
TOWN CLERK I p -' P.O. Box 1179
y % Southold, New York 11971
REGISTRAR OF VITAL STATISTICS 7'� Fax (516) 765-1823
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER ��0 • Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER W 00
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1851 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 #R10-97-0181
Name Of Owner SCHEMBRI HOMES INC.
Mailing Address 1 P. O. BOX 163
City St Zip WADING RIVER NY 11792
Property Address 1 ORIOLE DRIVE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 55.00 block 6 lot 15.029
Cross Street LISA DRIVE
Building Permit Number Cross Reference:
Issue Date: 4/29/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
ELIZABETH A.NEVILLE 11•= (* Town Hall, 53095 Main Road
TOWN CLERK % p P.O. Box 1179
ce 2 Southold, New York 11971
REGISTRAR OF VITAL STATISTICS I us.- Fax (516) 765-1823
MARRIAGE OFFICER �` y
RECORDS MANAGEMENT OFFICER -01 *010.
FREEDOM
Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICERili ,,I����
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: April 24, 1998
Transmitted herewith is a copy of application No. 1925 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 mendations:
APPROVE
DISAPPROVE
Comments:
'gnature
Dated
Ni
(.FFICE OF THE TOWN CLERK .,,
, Town of Southoldl'i �f 1L
� KCS Application No. icv�S
Judith T. Terry, Town Clerk6'1%-J Gy_
Town Hall, 53095 Main Road Construction f—
P. Or Box 1179
Southold, New York 11971 ` Vs ca r'n' Alteration �r
Telephone ---..:442O' _4-.; $10.00 - Residential
(516) 765-1801 4 $25.00 -Non-Residential
.,�'
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ G
DATE / Tf
APPLICANT NAME: „_(..,; (1/4/%
t41z4
APPLICANT ADDRESS: )!0 £p( / 6,3
w /0! 1 i 7N---
SEPTIC CESSPOOL (-. t
DESCRIPTION OF PROPO D CONSTRUCTION OR ALTERATION164"44 40 d
` 414-x7
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRU T�ION� OR ALTERA ION:
OWNER OF PROPERTY: l.J �2�c, --0
OWNER MAILING ADDRESS: 5 G
OWNER PROPERTY ADDRESS: O/ ).-6-- O/1AA'-
TELEPHONE
NUMBER OF CONTACT PERSON: qct _ T94' r
TAX MAP NO. : Section 3) Block b ( Lot f c . O 01-9'
CROSS STREET: AA__ j2/tt.1^-k..
BUILDING PERMIT NUMBER CROSS REFER NCE:
r /
Signature of Applicant
RECEIVED BY : •, (/(_i'.
Tow Clerk's Office
DATE:
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c`I THE WATER SUPPLY&SEWAGE
DISPOSAL FOR THIS RESIDENCE
I
i/
-* (,0 WILL CON FROM TO THE STAND-
N. / ARDS OF THE SUFFOLK COUNTY
, V DEPT.OF HEALTH SERVICES.
SUFFOLK COUNTY DEPARTMENT OF HEALTH SBRVKBs
"MIT P'Oit APPICWAir OF CCIMIntrier N FOR A
q 0.a Nificaii. FA ,Y maw=ONLY
02v/ DATE DEC s, . _ _o e
h I 30.0o
APPROVED Air �.�.. 1 .
FOR MAXIMUM . .4. BOO?
EXPIRES THREE YEARS FROM DATE OP APPROVAL
(,—o-1-3I
at-vATio4 ► Aiiulme-cl ciProm
Unauthorized alteration or addition to this document is a violation of Section 7209 SURVEY OF: r 1,,-e-r
01 the New York State Education Law.
Certifications hs to tth ed hereon shallanrun onlyrto the person for whom it Is prepared /j 42 o f1164miNn- ,�A— .oj / . ' 2-
and on his behalf to the Title Company,(iovemmental Agency end lending 1f' (�/� {?'�i�
ution listed hereon,and to the assignees of the lending institutions or subse-
quent k2ou T'Iw / TaK� OV. 12 �
owners.
Copies of this document not bearing the professionals inked seal or embossed
seal shall not ts be codimsidered ensions)
on ) hvalid true copy. f_k_ , _ / II I / L
The offsets(or dimensions)shown hereon from structures to the property lines are �Ft 'jal� C_ (�.�/1 'v TQK k--
tor 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. ` OF I';r.,./,Vf
The existence of right of ways and/or easements of record,if any,not show T✓ �! r�
not guaranteed. •t, '�
' . Y DATE: I I 1 SCALE: 1 =40
CERTIFIED ONLY TO: P - TIDES IN G I
G Lo .. I LAIRD sOiceritdit1997
�w .roZL, rte: d. �t cis
�,• F5 `, / 'Oifi; A wastew iLer kiwi*,
By -4 - / ` -
73 Nn �SCSDMITROA'D
DESTIN G.GRAF N.Y.S.LIC No.50067
40Z-147%•,r b ROCKY POINT,NEW YORK 11778
TAX I.D.No. I occ,- c • - o(o - i‹, o 2A •PHONE(516)821-3442