HomeMy WebLinkAboutSchembri (9) ELIZABETH A.NEVILLE ����� �'y� Town Hall, 53095 Main Road
TOWN CLERK r P.O. Box 1179
REGISTRAR OF VITAL STATISTICS ; - � Southold, New York 11971
MARRIAGE OFFICER Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER �-.�®� Sik ��®����,
Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER - ,r�� 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. 2783 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 RIER 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 #R10-02-0040
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 6.000
Cross Street MAIN ROAD
Building Permit Number Cross Reference:
Issue Date: 3/21/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
,
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ELIZABETH A.NEVILLE 4ill=,0 O4 ; Town Hall, 53095 Main Road
• TOWN CLERK ` H - P.O. Box 1179
REGISTRAR OF VITAL STATISTICS
v, �� Southold, New York 11971
MARRIAGE OFFICER Fax�����, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER __Wei .0.,iii Telephone (631) 765-1800
FREE-OM_OF INFORMATION OFFICER _ r � southoldtown.northfork.net
tri ''OFFICE OF THE TOWN CLERK
MAR '
u`�': 19 200 : „ ;; TOWN OF SOUTHOLD
TO: "-Southold!T_oowwnf Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: March 19, 2002
Transmitted herewith is a copy of application No. 2883 for a Cesspool/Septic Tank Construction
Permit submitted by:
Scrembri 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: C 7
fil.)241‘&6
7,fr4,ii...,,, ,,,,w,.". .,)
Signature
, V*A'3/42-..
Dated
.0
OFFICE OF THE TOWN CLERIC C�\F F 0U(
TOWN OF SOI/IHOLD ••(�"J CQGy: ' Application NclZQ ES--F-7
ELIZABETH A NEVI112,TOWN CLERX
90 BOX 1119
Construction
SOUTHOLD,NSW YORX 11911 g•
Lra 'r Alteration
$10.00 -Residential
Telephone '�7• �O1 .�0�,�'
...(63t) 765-1800 ,.�' $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ DATE
,b3/i (o
APPLICANT NAME: C, i-4636.4
APPLICANT ADDRESS: 7d61-0- ND%
/.,CiLlq,/
iD`
SEPTIC_CESSPOOLX
DESCRIPTION OF PROP SED CONSTR�1nCTIONORR ALTERATION
51►Jg16' fJ LAA t,
LOCATION MAP: Must betl//attached hereto before permit may be Issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: 7 C("!'�` j4 <
OWNER MAILING ADDRESS:
X1301-41
OWNER PROPERTY ADDRESS:
AfJr 12-P. e-DT6
iwqr .
TELEPHONE NUMBER OF CONTACT PERSON:^/
TAX MAP NO.: Section C2 I''II Block 1�`6 Q ,Lot ®l.!
CROSS STREET: gc11iL_Y CP)AJJ LTA,®
BUILDING PERMIT NUMBER CROis REFER NCE:
pit
of Applicant ,
RECEIVED BY:
Town Jerk's Office
DATE: C
JOB No. 02-09 TAX I.D. No 1000-21-06-06
{
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PROPOSED
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PROPOSED WELL FRONT YARD
DWELLING 150'TO PROP SEPTIC
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PROP WELL NORTH p— — — — — — - -- — -
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N 76°54'10"E 150.00' '
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UF Oiat.COUNTY €s ,PAR MEN T OF HEALTH`SERVICES L0
PERMIT FOR APPROVAL,raP COMSTRUCTl0N FOR A
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i SINGLE,. VAMP'I , c'SIDPNCE ONLY
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_ f EX IRE.`i`HR E, YEAP,,1' i"F.OM ri .312,OF APPROVAL
.—
ELEV IN ASSUMED DATUM FILE MAP No, 8759 6/07/89
Unauthorized alteration or addition to this document is a violation of Section 7209
of the New York State Education Law � SURVEY OF:
Certifications indicated hereon shall run only to the person for whom it is prepared LOT 6
and on his behatf'to the Title Cornpany,Governmental Agency and Lending
Institutions listed hereon,and to the assignees of the Lending Institution or MAP OF EAST MARION WOODS
,. subsequent owners -
Copies of this document not bearing the professional's inked seal or embossed EAST MARION, TOWN O F SO UTH O L D
OF NEW seal shall not be considered a valid true copy
Y The offsets{ or dimensions}shown hereon from structures to the property lines are
�Q'�� 04,1..
�` fora specific purpose and use and therefore are not intended to guide the erection of SUFFOLK COUNTY, NEW YORK
j fences,retaining walls,pools,-patios,planting areas,addition to buildings,or any other
DEST1N G.GRAF ; construction
a R I — The existence of right of ways and/or easements of record if any,not shown are SURVEY DATE: 02/10/02 SCALE' 1"=50'
f R not�uarardeed r
c
f CERTIFIED ONLY TO:
r„ u yJ t ,, la
•
Cr
SCHEMBRI HOMES DESTlN G. GRAF
'Oq� • O LAND SURVEYOR
L - vt- -dal ., 73 Woodlawn Road
Rocky Point,New York, 11778
` - -------- - - - -- --- 631-821-3442
` ' By DESTIN G.GRAF N.Y.S LAC NO 50067