HomeMy WebLinkAboutSchembri (2) tiffatir
:
GAG
ELIZABETH A. NEVILLE �� . 4654
M F.. : Town Hall, 53095 Main Road
eh t
TOWN CLERK t ' 8 P.O. Box 1179
REGISTRAR OF VITAL STATISTICS , 4 �� Southold, New York 11971
MARRIAGE OFFICER . �s J ��1� Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER <1° *tots' Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER `z r2, to* t
OFFICE OF THE TOWN CLERK
SOUTHOLD PLASTIITEXAMEIRTEECEMIDSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2610 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : PETER SCHEMBRI
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 #R10-00-0180
Name Of Owner PETER SCHEMBRI
Mailing Address 1 PO BOX 728
City St Zip AQUEBOGUE NY 11931
Property Address 1 THE CROSS WAY
City St Zip EAST MARION NY 11939
Tax Map No. section 30.00 block 2 lot 46.000
Cross Street THE LONG WAY
Building Permit Number Cross Reference:
Issue Date: 6/27/01 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
076
0.
ELIZABETH A. NEVILLE ���� ��� Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
TO
Southold, New York 11971
REGISTRAR,OF VITAL STATISTICS ; ® � Fax (631) 765-6145
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER ��®� ,ss��, ���®�1��/ Fax
(631) 765-1800
FREEDOM OF INFORMATION OFFICER _ LZ-r �0�
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: June 20, 2001ciz^b
Transmitted herewith is a copy of application No. 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 tlr permit.
Please complete the form below and return it to me.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE V
DISAPPROVE
Comments:
ignature
/3--0 Lo
Dated
.„
) .:16,--,,, a�civ�''S�' OLK--`---
TOWN
-
d OFFICE' NIHSTOWNCLERIC S
TOWNOFSOUFAOLD ;�� C�Gy Application No,
ELIZABETHA NEVILfE,TOWN CLERK �i 4 Construction 4--
SOUTHOLD,
BOX 1179 1= . t
S011fNOLD,NEW YORK 11971 1 p rn Alteration
FA
Telephone .%). �.a0,''� $10.00 -Residential L-
(631) 765-1800 =0.1 )y ,.'' $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ /n /-�
DATE W' 2V ' OI
APPLICANT NAME: PefeR_ vCh-erb v i
APPLICANT ADDRESS: 'PO 2 f- ---r2...
SEPTIC_CESSPOOL
DESCRIPTION OF PROPOSEDj/jjjCONS UCTION OR ALTERATION
4.7
LOCATION MAP: Must be attached hereto before permit may be Issued.
LOCATION OF PROPOSED CONSTRUCTION ORfJALTERRATI N: ,
OWNER OF PROPERTY: P ��T (2 na r-efMbei
OWNER MAILING ADDRESS: P.() t P,DX. 7Zg
OWNER PROPERTY ADDRESS: L / /t'
TELEPHONE NUMBER OF CONTACT (.-03(PERSON` ) 7/a.(3 q�/
TAX MAP NO.: Section 3D Block 0Z Lot Orb
pn
CROSS STREET: W
BUILDING PERMIT NUMBER CRO REFERENCE:
/, //
Signature of Applicant
RECEIVED BY. i'd- 6 '
` Town C rk'ss Office
��}j
DATE: CO ! �J�O/
JOB No 00-45 TAX I D. No. 1000-30-02-17
LOT 40
VACANT
LOT 39
LOT 38 OCC RES PW
OCC RES PW -
- ` 60'
- - - 98.7 HE CRSS WAY [
T R=20.00'
98.9 1---,29.16'
---
____-
EDGE — — ��E 77.73'
_ — -- N 83027'45
98.2
Vi. 00 TIE349.08'
100.0 9�
V m
�Q r
�m • 60' LOT 15
o VACANT Z
a) 0
4 \ sEPA\O ,
LOT 1774.
UNDER CONST PW ' \ ➢G
15
616
Ose° 9.
PROP 00A0 S\ 0- P
•
N
. N�
2 ) A
FF1,98
1- GM'
GM . 0o
at
0 N
O 4. -
1
N .
NOTE —a
1] TEST HOLES ON FILE MAP SHOW CLAY ' A
AND SAND EAST OF SUBJECT LOT N
2] LEACHING POOLS MUST BE BACKFILLED
WITH CLEAN SAND AND GRAVEL IN
ACCORDANCE WITH SUFFOLK COUNTY
HEALTH DEPT.STANDARDS.
..mlr
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICE
PERMIT FOR APPROVAL OF CONSTRUCTION FOR A
"SINGLE FAMILY RESIDENCE ONLY
DATE �S'I®---E0 HS REF.NO. gt°-6)r)-0L 1 `-=•r-
r_� rr0
APPROVED � 111 CD C . —11
FOR MAXIMUM OF 4L ' q B •MS )` �T m
EXPIRES THREE YEARS FROM DATE OP APPROVAL r. —
98.4 830271421 77.73' ; b
��V .
ELEV IN ASSUMED DATUM Wim"
FILE MAP N6266 6/11/75
Unauthorized alteration or addition to this document is a violation of Section 7205
of the New York State Education Law SURVEY OF:
Certifications indicated hereon shall run only to the person for whom it is preparedLOT 16
and on his behalf to the Title Company,Governmental Agency and Lending
Institution listed hereon,and to the assignees of the lending institutions or MAP OF PEBBLE BEACH FARMS
subsequent owners