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ELIZABETH A. NEVILLE ?� • Town Hall, 53095 Main Road
TOWN CLERK ; y • P.O. Box 1179
REGISTRAR OF VITAL STATISTICS a $ Southold, New York 11971
MARRIAGE OFFICER :� y `!�11 Fax (631) 765 6145
RECORDS MANAGEMENT OFFICER We! /411 .���1.�� Telephone (631) 765-1800
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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. 2450 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 # R10-00-0179
Name Of Owner SCHEMBRI HOMES INC
Mailing Address 1 2042 NORTH COUNTRY ROAD
City St Zip WADING RIVER NY 11792
Property Address 1 325 THE CROSS WAYS
City St Zip EAST MARION NY 11939
Tax Map No. section 30.00 block 2 lot 16.000
Cross Street THE LONG WAY
Building Permit Number Cross Reference:
Issue Date: 11/20/00 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
Nirrjr.
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ELIZABETH A. NEVILLE ��_ 7)4: Town Hall, 53095 Main Road
TOWN CLERKy Z P.O. Box 1179
REGISTRAR OF VITAL STATISTICS �� Southold, New York 11971
MARRIAGE OFFICER y ��,1� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER =_19l �aO,1' Telephone (631) 765-1800
FREEDOM( F`-IT�'OR14IATIQNM(J&'FICER ,,,,���
OCT I OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: August 31, 2000
Transmitted herewith is a copy of application No. 2538 for a Cesspool/Septic Tank Construction
Permit submitted by:
Schrembri 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
Dated
OF'FTCE OF THE TOWN CLERIC 1'' 'tt'j9 jf =
TOWN OF SOUTHOLD %��'40 G _ Application No.5
ELIZABETH A.NEVILLE,TOWN CLERK i 0
P.O.BOX 1179 Z Construction
SOUTHOLD,NEW YORK 11971
Alteration
Telephone �,j 47/' $10.00 -Residential t
(631) 765-1800 -=�'1ARI ' ,' $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE /D/50/0
APPLICANT NAME: C°,(,/-�'/ate/ e)/2,6,-- .S
A+��7:-; -c
APPLICANT ADDRESS: �L� )- /'(L) C i4J{i!>j A-�J
V/ /A)Co a_ Lit/ //79�
SEPTIC ZEssPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
�t)-'o- .o. )7GUJC 2 '
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: Setl32.) M - 0
OWNER MAILING ADDRESS: 0`. - JO . tooturiZnl
Lki cp ikq -7cd.
OWNER PROPERTY ADDRESS: 141
TELEPHONE NUMBER OF CONTACT PERSON: 7 ' -9(0 41
TAX MAP NO. : Section /DC 0 Block 3 O- OA Lot I(p
CROSS STREET: 7-11C--
kiCo (,) Al
BUILDING PERMIT NUMBER CROSS REFERENC :
Alf
/17.7 41).„1/
Ala+. •
Sign re of Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
..„. Ilk -
sV,
JOB No. 00-42 • TAX I.D. No. 1000-30;02-413. i ,:;[',,-...,;
, r[ ,
LOT � I '
LOT 40 OCC RES PW I ' .i 'i i
LOT 39 VACANT ---- •
OCC RES PW --
--
--- NAY
�`/ [ 601
97.9 THE CROSS
99.7 Ro20.Oo' 1`
L=29.16'
-- — N S3°27'45"E 77.73'
1 '1 97.1
TIE 271.35'
98.2 ‘ O -"i
\ V°CANT m
$ 0, • 60' r0
LOT 16 z
VACANT '< S�P. \C, G)
•
1471'
-<
5i o w(Y1
g\N
N
AO Z FPa9 6 r3?
IJP G 00s
so00a -)
T-).
NOTE 1._.\
1] TEST HOLES ON FILE MAP SHOW CLAY 0
AND SAND SOUTH OF SUBJECT LOT.
2] LEACHING POOLS MUST BE BACKFILLED
WITH CLEAN SAND AND GRAVEL IN
ACCORDANCE WITH SUFFOLK COUNTY
HEALTH DEPT.STANDARDS.
PEIV4:1 i '',7, ..D`'.,. ^.i' CC:47',77:..- : '-) ,
Di. ,7.$':leD. . .. t,.r .. i:,:-.7.1 `-- ...7),...p.\-11_. 97.2
App%:,yr.-..D C /p2,--L " . --.-V2.1-, ...._
FOR i,',u:;;,.,,:';', C"j" ___ 97.8 83°27'42"' 77.73'
ELEEVAR1i;[l" tvl kARS FR ' DAI E. `' FILE MAP No.6266 6/11/75
Unauthorized alteration or addition to this document is a violation of Section 7209
of the New York State Education Law. SURVEY O F
Certifications indicated hereon shall run only to the person for whom It is prepared LOT 15
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.
Copies of this document not bearing the professional's inked seal or embossed
seal shall not be considered a valid true copy. EAST MARION, TOWN OF SOUTHOLD
The offsets[or dimensions[shown hereon from structures to the property lines are
for a specific purpose and use and therefore are not intended to guide the erection of SUFFOLK COUNTY, NEW YORK
fences,retaining walls,pools,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 SURVEY DATE: 6/29/00 SCALE: 1"=401
not guaranteed.
CERTIFIED ONLY TO: 40P NEtir k
SCHEMBRI HOMES ••CQ` 04 DESTIN G.GRAF
co ut51ING.GRAF 't' LAND SURVEYOR
Aglikr ;' ' 73 Woodlawn Road
N : - er Rocky Point, N.Y. 11778
`:)N z - •#050047 516-821-3442
By DESTIN G. GRAF N.Y.S. LIC No. 5006' .0 ��
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