HomeMy WebLinkAboutSchembri Homes Inc (33) ow 441/
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JUDITH T.TERRY ���� y�c Town Hall, 53095 Main Road
TOWN CLERK 4 y z P.O. Box 1179
Pr, I Southold,New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER ‘ * ,, ���, Fax(516) 765-1823
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RECORDS MANAGEMENT OFFICER �'� J �► '/ Telephone(516) 765-1800
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. 1756 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 #R10-97-0148
Name Of Owner SCHEMBRI HOMES, INC.
Mailing Address 1 P. O. BOX 163
City St Zip WADING RIVER NY 11792
Property Address 1 HARVEST LANE
City St Zip MATTITUCK NY 11952
Tax Map No. section 120.00 block 3 lot 8.015
Cross Street FARMVEU ROAD
Building Permit Number Cross Reference:
Issue Date: 10/24/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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OFFOLA,
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JUDITH T.TERRY4�' `� Town Hall, 53095 Main Road
TOWN CLERK ; P.O. Box 1179
u' Southold,New York 11971
REGISTRAR OF VITAL STATISTICS •
MARRIAGE OFFICER
# 1 Fax(516) 765-1823
� � � ,/
RECORDS MANAGEMENT OFFICER i � `�► �� Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER .‘v~, ,•g°'�
TipOFFICE OF THE TOWN CLERK / r G� tl �j
TOWN OF SOUTHOLD b V fE
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TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office Y
DATED: October 23, 1997
Transmitted herewith is a copy of application No. 1830 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:
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Dated
OFFICE OF THE TOWN CLERK �,,,,,,,,,,,, _ r
Town of Southold '' � Ellik '- /Cf 36
' . Application No.
Judith T. Terry, Town Clerk
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1.
Town Hall, 53095 Main Road ; < - Construction
P. O. Box 1179 c rn ; Alteration
Southold, New York 11971 -� �;
Telephone =yv,,'y� ����,i1 $10.00 - Residential L-
(516) 765-1801 = l ,, $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 $ l
DATE ( 7/4)7
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APPLICANT NAME: ._,. '�"> ,/� /
APPLICANT ADDRESS: f?0 rIG
46,
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LA) ecit-3 '' I V / / 79d—
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTIONALTERATION
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR LTER TION: �I J," '`
OWNER OF PROPERTY: $ C t
OWNER MAILING ADDRESS: 5 '4"t. a Yl."-k....
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OWNER PROPERTY ADDRESS: ` 0 • 47( f/ 6,-3 7717-r-( T�_c_( --
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TELEPHONE NUMBER OF CONTACT PERSON: 991 'ITC
TAX MAP NO. : Section / #2-0 Block CI .. Lot E• f J
CROSS STREET : 4"=41•2I M V � ��,
BUILDING PERMIT NUMBER CROSS REFERENG :
/4/4/,
Signature of Applicant
RECEIVED BY :
own C erk's Office
DATE: / 02- ��
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THE WATER SUPPLY&SEWAGE SEP 3 0 '
IGC '
DiSFO ,::.L. FON THIS RESIDENCE
WILL CON FROM TO THE STAND-
ARDS OF THE SUFFOLK COUNTY
DEPT.OF HEALTH SERVICES.
Unauthorized alteration or addition to this document is a violation of Section 7209 SURVEY OF: lo -r ' j
of to Naw York slate Education Law.
Ce?tilicadons indicated hereon shah run only to the person for whom it is prepared
and on his behalf to the Tide Company,Governmental Agency and Lending MAPQ �-. . /.sf.
Institutio(t listed hereon.and to the assignees of the lending institutions or subse- �Y�
wont owne(s.
Copies of this document not bearing the professional's inked seal or embossed /Vs. flT1 A/ I/ I w,1
seat shall not be Considered a valid true Copy. 1 t/V1�� FV of �`�.�'��+�++
The offsets for dimensions)shown hereon from structures to the property lines are O / N Yo
for a specific purpose and use and therefore are not intended to guide the erection Of l J l�'tFi��/'oma
fences,retaining wass,pools,patios,planting areas,addition to buildings or any other .....----
construction.
....--- -construction. .Of NEN.' L, /r,
The existence of right of ways and/or easements of record,if any,not shown are I.
not guaranteed. -_*41:- S ATE: 1 (2-g�7 SCALE: I = J o
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DEVIN ri..trlti►r`\
CERTIFIED ONLY TO: ' I """ DESTIN G. GRAF
NtA.v.The I wt1 •. 1 "a "� ;1
in LAND SURVEYOR
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By7(•) L 4,, ,�,
� ` ",Z .. /1. 73 WOODLAWN ROAD
DESTIN G.GRAF N.Y.S.LIC No.50067 ' ,5.\- ROCKY POINT,NEW YORK 11778
TAX I.D.No. PHONE(516)821-3442
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