HomeMy WebLinkAboutSchembri Homes Inc (59) N µ'ms
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ELIZABETH A.NEVILLE �y Town Hall, 53095 Main Road
TOWN CLERK � c -� P.O. Box 1179
Z N Z 4 Southold, New York 11971
REGISTRAR OF VITAL STATISTICS Z
MARRIAGE OFFICER Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER Vl
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1947 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 #R10-98-0136
Name Of Owner SCHEMBRI HOMES INC.
Mailing Address 1 P. O. BOX 163
City St Zip WADING RIVER NY 11792
Property Address 1 WATER TERRACE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 88.00 block 6 lot 13.012
Cross Street MAIN BAYVIEW ROAD
Building Permit Number Cross Reference:
Issue Date: 10/19/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE tt/.7� OGy1,. Town Hall, 53095 Main Road
TOWN CLERK p _ % P.O. Box 1179
y Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICStyt O ��� Fax(516) 765-1823
MARRIAGE OFFICER ‘4. Ate �a����,/ Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER 1.--000
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: October 7, 1998
Transmitted herewith is a copy of application No. 2024 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 natur
e
Dated l0/ 3 /il
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OFFICE OF THE TowN CLERK �C FO(.fr-
TOWN OFSOUCHOLD , D Application No. c2pD Cy�
ELIZABETH A NEVILLE,TOWN CLERK
P.O. BOX 1179 $10.00 - Residential
SOUTHOLD,NEW YORK 11971
$25.00 - Non Residential_
Telephone( Nt
•
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
C4JedgiggiricAd
PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
DATE IC)/ L /C/g
OWNER NAME: '
OWNER MAILING ADDRESS: 7g, V 2 t L (e3
wY
OWNER PROPERTY ADDRESS : c, w f37�t — 7'E1 /' Lt-
1ef <$ oc€
OWNER TELEPHONE NUMBER : 55110 qaq 5QLo
TAX MAP NO. : Section a Block OC-0Lot ( 3
CROSS STREET : AP-1;N V:6L>
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool \/ N ✓ Existing
Residential Non-Residential
LOCATION MAP: Must be attached hereto before permit may be issued.
(Locate building and system; give north arrow and feet
of distance, approximately, to b ilding and closest road. )
Si.lnature of Applicant
RECEIVED BY :
own Clerk's Office
DATE : /0/71 �'S
S
111 TER SUPPLY&SEWAGE
DISPOSAL FOR THIS RESIDENCE
WILL CONFROM TO THE STAND-
ARDS OF THE SUFFOLK COUNTY OP 4pA6e- ...."*.----ii .,
DEPT.OF HEAL . SERVICES.
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Unauthorized alteration or addition to this document is a violation'of Section 7209 SURVEY OF: lie,-r- 10
of the New York State Education Law.
Certifications indicated hereon shall run only to the person for whom it is prepared
and on his behalf to the Title Company,Governmental Agency and Lending MAT Q r�4rt
Institution listed hereon,and to the assignees of the lending institutions or subse-
quent owners. —T uI I 'o�� 4p 11-1-0LEZL
Copies of this document not bearing the professional's inked seal or embossed , 1 •ter v./
seal shall not be considered a valid true copy. �II l fill / / 9 4 O I n.1
The offsets(or dimensions)shown hereon from structures to the property lines are J 1� Vli� lvr�r at-K.
for a specific purpose and use and therefore are not intended to guide the erection of
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. 0.O - URVEY DATE: 111 014 SCALE: 1 '% 4b/
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CERTIFIED ONLY TO: y DESTIN r- _0..., �, DESTIN G. GRAF'
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' —1-i: ' k i'' LAND SURVEYOR
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By \,.._10..._ a ' '8 • � 73 WOODLAWN ROAD (�
DESTIN G.GRAF N.Y.S.LIC No.50067 `+/r ;OCXY POINT,NEW YORK 11778 �I
TAX I.D.No. 1000-8s-0(0, (3, 1- ' . sIo A%-y' PHONE(516)821.3442