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ELIZABETH A. NEVILLE ' c., C Town Hall, 53095 Main Road
TOWN CLERK ; p P.O. Box 1179
y = Southold, New York 11971
REGISTRAR OF VITAL STATISTICS v► t
MARRIAGE OFFICER
yC Fax (516) 765-6145
RECORDS MANAGEMENT OFFICER `t*/) Telephone (516) 765-1800
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. 2161 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : SCHEMBRI HOMES INC
Address 1 : 2042 NORTH COUNTRY ROAD
City St Zip WADING RIVER NY 11791
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 #R10-99-0187
Name Of Owner SCHEMBRI HOMES INC
Mailing Address 1 2042 NORTH COUNTRY ROAD
City St Zip WADING RIVER NY 11791
Property Address 1 THE CRESENT
City St Zip EAST MARION NY 11939
Tax Map No. section 30.00 block 2 lot 28.000
Cross Street THE GREENWAY
Building Permit Number Cross Reference:
Issue Date: 10/05/99 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE $�'1' Gym: Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
REGISTRAR OF VITAL STATISTICS y /',� Southold, New York 11971
MARRIAGE OFFICER Fax(516) 765-6145
RECORDS MANAGEMENT OFFICER > 'If,, 0.1 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: September 21 , 1999
Transmitted herewith is a copy of application No. 2247 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:
S. nature
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Dated
AOF1FICE OF THE TOWN CLERK ,,,'"'"
. Town of Southold ���'1,C.���FOI./(C' -
Judith T. Terry, Town Clerk l�' � �: Application No. c �-`�7
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Town Hall, 53095 Main Road •� Construction
P. O. Box 1179 c=1
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Southold, New York 11971 . til ���`
Alteration
Telephone .;04. ,���*'4 $10.00 - Residential
( 51 6) 765-1801 '�Ol 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 $
DATE 7C
11
APPLICANT NAME: ii"-- ,....57/ idi
APPLICANT ADDRESS: ).--e,b... C11,1 ,40Avt
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SEPTIC CESSPOOL L../..------- 6tt-
DESCRIPTION OF PROPOSED ONST UCTI N O ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTI N OR ALT Z TION :
OWNER OF PROPERTY : 56A-a _
OWNER MAILING ADDRESS: 94....._ (/C..A7"'C
OWNER PROPERTY ADDRESS. . .
-
TELEPHONE NUMBER OF CONTACT PERSON : —, < 6 /
TAX MAP NO. : Section 3 0 Block 601-- Lot 4:4
CROSS STREET : T4,_
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BUILDING PERMIT NUMBER CROSS REFERENCE :
/7/„4/Z/
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/ ,, Signature of Applicant
RECEIVED BY : (/U/U.
own Clerk's Office
DATE : ?/-1--( ? 7
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EXPIRES THREE YEARS FROM FATE CF APPROVAL
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NOTE
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11 TEST •. ON FILE MAP SNOW CLAY 104.t
.SOUTH OF SUBJECT LOT. N 2143920w
4 - ' '4 •. MUST SE SACKFIU.ED 6427'
1.1" .AND GRAVEL IN -.,
ACODORDAMIDEMATH SUFFOLK COUNTY
PEAL7N DEPT.STANDARDS
GOLF couRse 4,.
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ELEVATIONS IN ASSUMED DATUM FILE MAP No.6266 6/11/75 .,
_
Untreated allsoplion or addition lo Inis document is s violation d Snot=7200
dem Nov Yon aft Num=Wit
ns SURVEY OF: LOT 27 •
CselloolloMOW*,Moon slid tun only tole moon truism it as puma
Ind an PAs POW to Ine Ms Cowoony.Oossiosontal Sitonsy and WAIN
Installons woo wow end NON owoosio Mlle LIMN Irotalgion 0,
wwwwwwww MAP OF PEBBLE SfifiZifF/OMB
Of NEM/y
'‘ Cools.MP*dosoinot not OWN Op probrAiscors lima owl Of eialuesed EAST MARION,TOVSSOFU1INOLD
•cv• q, wi tan natio comidompt•soNtstasnoolt _ _.
67 DEST1N G.GRAF The Moist or dinoolons I Moe tiopoon Ow moms*am pow Imo in
ors ammo mom or mot 114111111/AMII Wil rost knopondlospittotho wool°,g. SUFFOLK COUNTY,NSWYORK •
,,. fen....owiong wit pools pain plonting atm WOW*billpsor any other
1. oonaltuolkos
Tits siolontsat dont dross AMON ossintsnIA At okooddl Any.not show are SURVEY DATE: se0/99 Wig:,1"041, :-•,C,
x I not guswisimd.
CERTIFIED ONLY TO: •
No,444P1' masseur
SCHEMBRI HOMES DEWING.GRAF
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By DESTIN G.GRAF N.Y.S.Up NO.50067
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