HomeMy WebLinkAboutSchembri Homes Inc (62) • '#F
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ELIZABETH A.NEVILLE `1` Gy Town Hall, 53095 Main Road
TOWN CLERK p < P.O. Box 1179
2 Southold, New York 11971
REGISTRAR OF VITAL STATISTICS �'%� Fax (516) 765-1823
MARRIAGE OFFICER y ����� Telephone(516) 765-1800
RECORDS MANAGEMENT OFFICER *01 ..
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. 1929 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
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 # R10-98-0111
T-.- Name Of Owner SCHEMBRI HOMES INCS
Mailing Address 1 PO BOX 163
City St Zip WADING RIVER NY 11792
Property Address 1 WESTWOOD LANE
City St Zip CREENPORT NY 11944
Tax Map No. section 33.00 block 2 lot 13.000
Cross Street HOMESTEAD WAY
Building Permit Number Cross Reference:
Issue Date: 9/24/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
14811111.*.. • 0111 OFF011( '' / -.c›IY
ELIZABETH A.NEVILLE 1'�ff -t f 8 Town all, 53095 Main Road
TOWN CLERK ; p -� 14 P.O. Box 1179
i y Z Southold,New York 11971
REGISTRAR OF VITAL STATISTICS �'�� Fax (516) 765-1823
MARRIAGE OFFICER : -* 0�/ Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER "'/Ql �a
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 17, 1998
Transmitted herewith is a copy of application No. 2009 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 t/
DISAPPROVE
Comments:
SQ
ignatur
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Dated
111111W-‘,.. ,
OFFICE OF THE TOWN CLERK •,i,' CQG St 11Lk q
TOWN OF SOUTHOLD ;%`,.% Application No. ��/
ELIZABETH A.NEVIT.LF,TOWN CLERK
P.O.BOX 1179 Construction l./
SOUTHOLD,NEW YORK 11971 P T
In Alteration e/
Telephone O,�„y ir. $10.00 - Residential
(516) 765-1801 _ (l 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 $ � G'
DATE 11/
`
APPLICANT NAME:
APPLICANT ADDRESS: a- g-`, / V;
Wale3 gAn.k AH.
SEPTIC CESSPOOLC---
DESCRIPTION OF PRO OSED NSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTIO OR LTER TION:
OWNER OF PROPERTY:
OWNER MAILING ADDRESS: 1 '_o- 163
loth Ra ,
,,,,
OWNER PROPERTY ADDRESS: ,,e_Z.k.A1,64
....4.4).„4_,
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section K3 Block 0,). Lot t 3
CROSS STREET: NVINAla.Ula W
O6kei_
BUILDING PERMIT NUMBER CROSS REFEREN
41,-
A". 7
Signa ure of Applicant
RECEIVED BY:Z
Town 's,(5/Voe
DATE:
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Unauthorized alteration or addition to this document is a violation bf Section 7209 SURVEY OF: �,'r pj7
of the New York State Education Law. ,
nisCertifications indicated oth hereon panll run only to the person for whom it is prepared /� I ��. - _ l ' 2—
and on his behalf to the Title Company,Governmental Agency and Lending Vw(1v �i'7/FL/.,f h/
Institution listed hereon,and to the assignees of the lending ndetg institutions or subse-
quent ,/ /►�
owners.
ors. (' c. .gyp i ( �"1
Copies of this document not bearing the professional's inked seal or embossed � To��
sealshallfnot ts be considered n ) valid truehcopy. hu �K. �,,,,,,,,r, N-Cw Y
The offsets(or dimensions)shown hereon from structures to the properly lines are �,�I/
for a specific purpose and use and therefore are not intended to guide the erection of FJ
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. • A�� :.y' DATE: 5)q& SCALE: f,_ '
CERTIFIED ONLY TO: y
DESTIN G. -:.:4;...
DESTIN G. GRAF
1 "., If G t LAND SURVEYOR
• I _A4,,k•• j t
.. By 4; ` C- s ri .r' A 73 WOODLAWN ROAD
DESTIN G.GRAF N.Y.S.LIC No.50067 :9O I �p ROCKY POINT,NEW YORK 11778ci
TAX LD.No. l�D'D - 3 3- 02. - 1$ s��o�t��‘p PHONE(518)821-3442