HomeMy WebLinkAboutSchembri Homes Inc (57) FFO(K���
ELIZABETH A.NEVILLE � y� l/„I„ Town Hall, 53095 Main Road
TOWN CLERK c < I P.O. Box 1179
CI, Southold, New York 11971
REGISTRAR OF VITAL STATISTICS Zr•rFax (516) 765-1823
MARRIAGE OFFICER 1
RECORDS MANAGEMENT OFFICERy O� 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. 1970 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 #R10-98-0155
Name Of Owner SCHEMBRI HOMES INC.
Mailing Address 1 (MR. ORLOSLSKI)
P. O. BOX 163
City St Zip WADING RIVER NY 11792
Property Address 1 HARBOR LANE
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 103.00 block 1 lot 20.011
Cross Street MAIN ROAD
Building Permit Number Cross Reference:
Issue Date: 11/16/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
Ios.0E0L4-
ELIZABETH A.NEVILLE �0 �Gy Town Hall, 53095 Main Road
TOWN CLERK c , P.O. Box 1179
y Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICSFax (516) 765-1823
MARRIAGE OFFICER `� ?,& '/,‘'s
FREEDOM � Telephone(516) 765-1800
RECORDS MANAGEMENT OFFICER = O
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 12, 1998
Transmitted herewith is a copy of application No. 2047 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.
c�c.c�w
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE ✓
DISAPPROVE
Comments:
ignat
Dated
i 1
OFFICE OF THE TOWN CLERK 11' ��DiK
TOWN OF SOUTHOLD ;`s% �QG Application No02-04 7
ELIZABETH A.NEVU.I.F,TOWN CLERK #P.O.BOX 1179 Z Construction
SOUTHOLD,NEW YORK 11971 Alteration
,
Telephone ��'y �Qr�' $10.00 - Residential �\
(516) 765-1801 ----_ - ','�� 25.00 -Non-Residential
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TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$ i01/
DATE
APPLICANT NAME: f -NA-o)1
APPLICANT ADDRESS: r(2 - / (e---
C/3
(- '
a41-6
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CON RUCTION OR ALT RATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRU TION OR ALTS TIO ,c:/az j'xii...4.1"4
OWNER OF PROPERTY: 6
OWNER MAILING ADDRESS: '‹-a / S
(..0 /r//i-
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OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: 9 2.4 ' L 6/
TAX MAP NO. : Section (‘ Block 0 ( Lot ea 0 - C (
CROSS STREET: 0 oj,c
BUILDING PERMIT NUMBER CROSS REFERE • E:
S •
_1(eigi/
Signature of Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
,� 16--tit. DISPOSAL FOR THIS RESIDENCE
WILL CONFROM TO THE STAND-
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TAND-
t () ARDS OF THE SUFFOLK COUNTY
611.8 `�O_ Th K 6o1- ►q,3 DEPT.OF HEALTH SERVICES.
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1 00� CONSTRUCTION FOR A
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O / INGL FAMILY RRIDENCE ONLY
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N DATE
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S�SO e �� Received
38 CZ - SIiffnik(-minty
99.9 OCT 141998
Dept.Of Health Services
�1, • hl • 1(/ p A�>'t/M f 4. s cI(vo L !.Office Of Wastewater Mgmt.
Unauthorized,alteration or addition to this document is a violation of Section 7209
of the New York State Education Law. SURVEY OF: *
Cerdricatkms indicated hereon shall run only to the person for whom it is prepared '� 'r
and on his behalfh to the and Company, neesmmente Agency and Les rtg 'AAP,AP D t/.,,r�/ Om,. /_
Institution listed hereon,and to the assignees of the lending institutions or subse- r � jCFC.h rv�fif
que
seal es of
G�7}{L(, C ��O 0 d ni-D c�.
Copies of this document not bearing the professional's inked seal or embossed M . �/ �/�
seal shall not ts considered on) valrhe copy.f t '�1.( �`1`^"�1�1
The offsets(or os dimensions)shown hereon arers of de the guide
the are `� ria L VYV t h 1 r,
for a specific purpose and use and therefore not intended to guide the erection of f -��i{i1�. )
fences,retaining walls,pools,patios,planting areas,addition to buildings or any other
construction.
The existence of right of ways and/or easements of record,if any,not shown are
not guaranteed. .(S 0- N , Y DATE: 11130 I Gi p SCALE: " s <o '
@ GAP
CERTIFIED ONLY T0: Mi
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Ask -.:1L,,-,, \Is\ LAND SURVEYOR
By ` _ 'ia -n '%" 'r ,\� 73 WOODLAWN ROAD
DESTIN G.GRAF N.Y.S.LIC No.50067 %QO '. �• ROCKY POINT,NEW YORK 11778
TAX I.D.No. (000_103--oi-20.II S .�itprL�'P PHONE(516)821.3442