HomeMy WebLinkAboutSchembri (3) ',OFF®Ur =
ELIZABETH A.NEVILLE Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
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REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER �� '4 �_ -, .i ®� ��, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER � ®� • ��i Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER �
OFFICE OF THE TOWN CLERK
SOUTHOLD IVAISIRECNAMEIRTEIESPROSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2607 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 #R10-01-0102
Name Of Owner SCHEMBRI, PETER
Mailing Address 1 PO BOX 728
City St Zip AQUEBOGUE NY 11931
Property Address 1 BEEBE DRIVE
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 30.00 block 2 lot 17.000
Cross Street DEERFOOT PATH
Building Permit Number Cross Reference:
Issue Date: 6/27/01 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE i0 ,' *' �d% Town Hall, 53095 Main Road
TOWN CLERK % P.O. Box 1179
REGISTRAR OF VITAL STATISTICS % s"4-,,,,,, �� Southold, New York 11971
%MARRIAGE OFFICER ®� � Fax
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, ' 1� Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER =__4 ,,ss��,, $ '.i Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ------...0'.
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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, 2001
Transmitted herewith is a copy of application No. 2696 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.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
Comments:
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ature
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Dated
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~.. OFFICE OF THE TOWN CLERIC '�.
'c0FOLA-e, l
TOWN OF SOUOLD �,�Q� CpGy
IHApplication No
ELIZABETH A PO OLLX I TOWN CLE9 Construction •
SOUTHOLD,NEW YORK 11971 rn: Alteration
Telephone i �.a0�'e�' $10.00 -Residential
(631) 765-18j�
00 •
-O 1 ,.'�' $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ / `2_O ,O
DATE( � f�-Cn h�J
APPLICANT NAME: Pt—Fe R / C 7 e 1� v,`}
APPLICANT ADDRESS. plJ �C ! �g 4� i 166
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SEPTIC CESSPOOLL//10 Y`1T1J111.vW�.(p
DESCRIPTION OF PROPOSED
RUCTI NOR TERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATI N:
OWNER OF PROPERTY: P TI+e Ye, \S7,L - �pV
OWNER MAILING ADDRESS: P k3O I7Z (�
uoUr, h ( IG31
OWNER PROPERTY ADDRESS• K
R � X31) �D-�_ctl
TELEPHONE NUMBER OF COINTACT PERSON
TAX MAP NO.: Sects 3 C) Block 02- Lot 7
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applicant
RECEIVED BY.
AZ-
/Town 7's Office
DATE. /��
'._� , ,�. _� 3 `ei t .:_ Pet rI Q QI-0/02 '
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ELEVATIONS ARE REFERENCED TO NGVD. (DWEL WATER
PUBLIC
(TES 1F NE
m .familiar with the STANDARDS FOR APPROVAL .ki j
D CONSTRUCTION OF SUBSURFACE SEWAGE • o� 'F T
SROSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES j ' ,,
' }; will abide by -the conditions set forth therein and LOT NUMBERS REFER TO 'MAP OF MOOSE COVES FILED 1 -, II �C
-the permit to construct. AUG. 30, 1960 AS FILE NO 3230. \
• ,Y �' NO. 491.�o �
re lo[ation of wells and cesspools shown hereon are wE�L / // N S' C j& .. ., 9 -�` `
•om field observations and or data obtained from others. ANY ALT ATION OR ADDITION TO THIS SURVEY ISA VIOLATION ',ECONIC 1 ' VE'YORS', • ----. i i N S .7.' � •1
nr c'ri-rrnei -3flo nr r�r AIL-1./ Yr+pte cTATr FrnJr,4TTfN LAW. (6 31) 765 - 5020 FAX: -.--._ `--(>z 1797
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