HomeMy WebLinkAboutSchembri Homes Inc (44) iNOFFOL/( ,„
��e 6OG��� Town Hall, 53095 Main Road
ELIZABETH A. NEVILLE
TOWN CLERK P.O. Box 1179
y Southold, New York 11971
REGISTRAR OF VITAL STATISTICS 'J Fax (516) 765-1823
MARRIAGE OFFICER y O� Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER '..7 4'
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. 2203 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : SCHEMBRI HOMES INC
Address 1 : PO BOX 728
City St Zip AQUEBOGUE NY 11931
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 #R10-9-0162
Name Of Owner SCHEMBRI HOMES INC
Mailing Address 1 PO BOX 728
City St Zip AQUEBOGUE NY 11931
Property Address 1 485 THE CROSS WAY
City St Zip EAST MARION NY 11939
Tax Map No. section 30.00 block 2 lot 18.000
Cross Street THE CRESENT
Building Permit Number Cross Reference:
Issue Date: 12/21/99 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE =`1` y� Town Hall,53095 Main Road
TOWN CLERK % p - % P.O. Box 1179
REGISTRAR OF VITAL STATISTICS �y t� Southold,New York 11971
MARRIAGE OFFICER V O 0 Fax(516) 765-6145
RECORDS MANAGEMENT OFFICER `.. 4, a��l��� Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER ." J ,..
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: December 6, 1999
Transmitted herewith is a copy of application No. 2291 for a Cesspool/
Septic Tank Construction Permit submitted by:
Schembri Homes •
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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/Signatur
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Dated
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OFTIGE OF THE TOWN CLERK ,,•""" "'"..,
Town of Southold �•�'..��MUrt,
JCidith T . Terry, Town Clerk t,'�O OGy� Application No.p���
Town Hall, 53095 Main Road ) .4 Construction _ k
P. O. Box 1179 ; c rn
Southold, New York 11971 . tt� ye •• Alteration_
Telephone �y�,f� �O�,P'� $10. 00 - Residential
( 516) 765-1801 0l '
. �� • � ,� $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 ee C•e yykAl_. (D 19 q
APPLICANT NAME: 3e�lc 1D(h
APPLICANT ADDRESS: Po 1, of 12--
- - - - - - - - - - ------------ ----- ------
SEPTIC CESSPOOL V
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
Re.O__ -_- _tom-e1-- n------- ---1----fc ._ -1 - - -
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSE[) CONSTRUCTION OR ALTERATION :
OWNER OF PROPERTY :
OWNER MAILING ADDRESS: Po 1M 7�
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---- -------------- ..._�..__- ---- ---- --
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OWNER PROPERTY ADDRESS : ati5 isi eC pa A r - , •_ - - -- - • ' (-Lip 1
TELEPHONE NUMBER OF CONTACT PERSON : '70..a PiDA J
TAX MAP NO. : Section 3OBlock o2 Lot 15
CROSS STREET :
-the__-.-Cr.r3Ce_n.t _ Pebbi if awl') -1--citm3
BUILDING PERMIT NUMBER CROSS REFERS► E :
__ AV__ /, / •
ignature of Applicant
MICIMIW
RECEIVED BY :
Tgv.% CIiy
lief ffice
DATE : Itt�
44 4
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t •.1a..&a.l.a+.d.ee oremoo.ed EAST MARION,TOWN OF SOUT TOLD
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