HomeMy WebLinkAboutSchembri Homes Inc (52) S
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ELIZABETH A.NEVILLE Town Hall, 53095 Main Road
TOWN CLERK c - P.O. Box 1179
ti Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER * p}/
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2125 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : SCHEMBRI HOMES INC
Address 1 : PO 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 #R10-99-0039
Name Of Owner SCHEMBRI HOMES INC
Mailing Address 1 PO BOX 163
City St Zip WADING RIVER NY 11792
Property Address 1 EASTWOOD DRIVE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 103.00 block 14 lot 10.000
Cross Street CROSS ROAD
Building Permit Number Cross Reference:
Issue Date: 3/22/99 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE Town Hall, 53095 Main Road
TOWN CLERK = -� 'r P.O. Box 1179
v) = Southold, New York 11971
REGISTRAR OF VITAL STATISTICS Fax (516) 765-1823
MARRIAGE OFFICER , y 0���� Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER .-4JQ1 � _��,
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: March 19, 1999
Transmitted herewith is a copy of application No. 2125 for a Cesspool/
Septic Tank Construction Permit submitted by:
Schembri Homes for Robert E. Higgins
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:
ignatu
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Dated
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OFFICE OF THE TOWN CLERK ,"'4GOI&' -
TOWNOFSOUTHOLD 'IQG Application No.- `
ELIZABETH A.NEVILLE,TOWN CLERK �, 0
P.O.BOX 1179 Construction
SOUTHOLD,NEW YORK 11971
i Alteration -�
Telephone ,f► Q ��' $10.00 - Residential
(516) 765-1801 : 0l � '� $25.00 - Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE 3//7/fq
APPLICANT NAME: 54e/ht/ /677)--1-<9 '
APPLICANT ADDRESS: "61 /4/
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SEPTIC CESSPOOL ' ,,,,
DESCRIPTION OF PROPOSED CONSTRUCTIiO ppR ALT RATI
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONST T N OR ALTE ATION:
OWNER OF PROPERTY: •
OWNER MAILING ADDRESS: w/, 6,j
.)4/r- /79�-
OWNER PROPERTY ADDRESS:
s
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section )0 3 Block / V Lot /d
CROSS STREET: v64.4- Pd
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applicant
RECEIVED BY: //AL-,
Town Cler Office
DATE: /00/ �
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