HomeMy WebLinkAboutSchembri (2) • ® :
ELIZABETH A.NEVILLE ����`�° M' p. ; Town Hall, 53095 Main Road
TOWN CLERK % ® P.O. Box 1179
REGISTRAR OF VITAL STATISTICS ; n r Southold, New York 11971
7 � Fax (631) 765-6145
MARRIAGE OFFICER �o .,* , ;, .•
RECORDS MANAGEMENT OFFICER � �®i .00.0 Telephone (631) 765-1800
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FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2742 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : SCHEMBRI HOMES INC
Address 1 : 2042 NORTH COUNTRY ROAD
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 #R10-01-0264
Name Of Owner SCHEMBRI HOMES INC
Mailing Address 1 2042 NORTH COUNTRY ROAD
City St Zip WADING RIVER NY 11792
Property Address 1 ROCKY POINT ROAD
City St Zip EAST MARION NY 11939
Tax Map No. section 21 .00 block 6 lot 2.000
Cross Street MAIN ROAD
Building Permit Number Cross Reference: 0
Issue Date: 2/20/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE Town Hall, 53095 Main Road
TOWN CLERK ® ' P.O.Box 1179
REGISTRAR OF VITAL STATISTICS �' Southold, New York 11971
® Fax(631) 765-6145
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER `--4:*®( � / Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ���� southoldtown.northfork.net
.. .iii
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD I • ' 3 ®
TO: Southold Town Building Department TO °4-TOWN 't tiu
How
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: January 30, 2002
Transmitted herewith is a copy of application No. 2836 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:
Signature
�y of v
Dated
/
OFFICE OF TEE TOWN CLERK COl/( //"
TOWN OF SOUTHOLD ,`'�� COp ; Application No.� �3'F"
ELIZABETH A NEVILE.TOWN CLERK ��
i PO.BOX 1179 `• Construction
• SOUTHOLD,NEW YORX 11971 1
--en. Alteration
Telephone ��oj .a0�7..
' $10.00 -Residential
,,(631) 765-1800 --•�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 $ /�1O
� �yD��ATE
APPLICANT NAME: l 2, s •a hi
APPLICANT ADDRESS: r a� YA • _A>,,
Teiri i ell . I fa,r 11 . ' 1 7 9..,--
SEPTIC CESSPOOL
DESCRI/TIONRO�± C•ONSTRUCTIOQIc��F��T�ON •
11
CC�^��11 I
LOCATION MAP: Must be attached hereto before permit may be Issued.
LOCATION OF PROPOSED CONST UCTION OR ALTERATION: . � e
OWNER OF PROPERTY; //��� /� �J r•
OWN MAILING ADDRESS:c G—T� / V . J
i
.k ' rel; • -•
�/ OWNER P OPERTY ADDRESS• ' `��_il7r i>• � .4„,1
IQ_
�n A TELEPHONE NUMBER OF CONTACT PERSEN: `cc 9- 96 T
1 V TAX MAP NO.: Section �1 Block 0 y� Lot �/®
1 EE (�/� ,, e(a
CROSS STR T: JSN "w�.+
BUILDING PERMIT NUMBER GROSS REFERENC
. 4 .2
t� Signature of Applicant
RECEIVED BY. °"'`�
DATE: � 7rk.:.?
c
JOB No. 01-62 TAX I.D.No. 1000-21-06-02
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LOT 6 LOT 3
' VACANT VACANT
N 13°05'50"W 164.58'
I 1
1000
99 0
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t,S- LOT 7 VACANT `-e.
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i { 93 7
•• •' 95 0 PROPOSED
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O LOT 1
4' ROCKY POINT ROADS 8°59'50"E 165.00'
ft ( 49.5' ] 949
94.0
gip: .
TAX LOT 7
OCC RES TAX LOTS 6 AND 5
. WELL FRONT YARD WELLS TYPICAL FRONT YARD TAX LOT 4
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