HomeMy WebLinkAboutSchembri Homes Inc (34) pro iii
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JUDITH T.TERRY Town Hall, 53095 Main Road
TOWN CLERK y Z i P.O. Box 1179
1:0��/1 Southold, New York 11971
REGISTRAR OF VITAL STATISTICS �� , Fax (516) 7654823
MARRIAGE OFFICER �f O ��
RECORDS MINFORMATION •1* �,. Tlephone (516) 765-1800
FREEDOM OFOFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1771 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 #R10-97-0156
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 8.016
Cross Street FARM VUE ROAD
Building Permit Number Cross Reference:
Issue Date: 11/24/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
--- 177/
,O�0S�fFO�,�G0
JUDITH T.TERRY ���� y1 Town Hall, 53095 Main Road
; y = P.O. Box 1179
TOWN CLERK
n7 $ Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ;
MARRIAGE OFFICER yif'1 1�
� �� , Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER ���i Telephone (516) 765-1800
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: November 14, 1997
Transmitted herewith is a copy of application No. 1845 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:
gnature
111r ? A
Dated
4,41
OFFICE OF THE TOWN •CLERK ,�,'"""
Town of Southold � �
Judith T. Terry, Town Clerk ,11'4G) 4 Application No. _T_
Town Hall, 53095 Main Road Construction ✓
P. O. Box 1179P M,
Southold, New York 11971 yr Alteration
Telephone %,6.1641t # •0
$10.00 - Residential
rr
(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 __..._.__ 1 a/
APPLICANT NAME: ,,.A.41
APPLICANT ADDRESS:����0=
/ /77.1--
SEPTIC
/7/a1---
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTCTIO OR A _TERM TION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALT RATIO
OWNER OF PROPERTY : '
OWNER MAILING ADDRESS: .Q-11 "/`X_.._. a/ /V
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: 9,2_9 -
TAX MAP NO. : Section_`)--G __Block_ b 3_�Lot ' • /‘::"
Y _
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applicant
RECEIVED BY:` 4111,
Town Jerk's Office
DATE: // //ilt f/f� ��-
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SUFFOLK COUNTY DEP i.R 1 ' `T• ... '1:trail 022
MAST FOR APPROVAL a?cc Yi a.z 1 i' ::•;'i r�. ' A
THE WATER SUPPLY&SEWAGE FAMIL ' r71:L;TL-.`.i'i:::.G,;>Y4'!' - °- -"'
�% D Received
(ved
DISPOSAL FOR THIS REST ��- Cl off-"r; (;:;•;rlf
WILL CON FROM TO THE STAND:-rrivu� vAill.r . OCT 2 2 1997
ARDS OF THE SUFFOLK OOUNTY
FOR MAXIMUM OF BEDROOMS I Dept. Of Health Services
DEPT.OF HEALTH SERVICES. • . .:.... .—........:.:.;.-1-1!.42..: :._.
e Of Wastew:5.• r'1,,-rr7 '
EXPIRES THREE YEARS FROM LATE or,' P r,.�)VA
Unauthorized alteration or addition b AD daumern re a vroatbn of tt.ctlon 7209 ' SURVEY OF �j�— L}
of the New York State Education Law. "
Certifications his
beh indicated"'Hi,
ed de Con ensue run only to thnt person fya Lehom It is A4 A 9 o P A A f/,—k-
and on his behaM to tits Title Company,OowmvnenW and /T Itr, TAT/
Institution listed hereon,and to the assignees of the kNitU or subs.-
quern owners. „ /- 1
Copies of this document not bearing the professional's inked seal a embossed / T( ' TOWN OP lel Iirtirt .1
teal shall not be considered a valid true copy. / NN"�'it,TTT77I7 J77 J
The offse4 la dimension.)a d Mason from of I n rade b iM properly knee nro )U / 61 4, , . / i I—
for a apediic purpose and use and tl»refon an not ktlertded b gukie Ue encbon d (�CNin(' / ,
Nonce',retaining walls,pools,patios,planting areae,addition to buildings a any other I
Thew of right of ways andlor easements of record,if any,not shown ere ,S OF N 1
not ��. :DATE: )0 I 1 197 SCALE: Iii : b
0.4.1*-"‘
DESTltf 0.GRAF l..
CERTIFIED ONLY TO: -18%'''"' DESTIN G. GRAF
5111 ,
F;!{ LAND SURVEYOR
Aug;All\ VA • . _
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4 �A ,o „:,
. 73//0' 73 WOODLAWN ROAD `_
AN G.GRAF N.Y.S.LIC No.50067ROCKY POINT,NEW YORK 11778
.No. 1000- t Z o— 03 -. 63,t(, 8 NA ` PHONE(516)821-3442 L.