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ELIZABETH A.NEVILLE ���� , % Town Hall, 53095 Main Road
TOWN CLERK ; y ; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS v' i Southold, New York 11971
MARRIAGE OFFICER 4 �, Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER `�y'flp �����,, Telephone (631) 765-1800
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. 2271 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : SCHEMBRI HOMES INC
Address 1 : PO BOX 163
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 #R10-00-0023
Name Of Owner SANDI, MICHAEL
Mailing Address 1 SCHEMBRI HOMES INC
PO BOX 163
City St Zip WADING RIVER NY 11792
Property Address 1 4260 THE LONG WAY
City St Zip EAST MARION NY 11939
Tax Map No. section 30.00 block 2 lot 94.000
Cross Street MAIN ROAD
Building Permit Number Cross Reference:
Issue Date: 3/21/00 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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,�,o�OS11f FO��CO •
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ELIZABETH A. NEVILLE ; Town Hall, 53095 Main Road
TOWN CLERK - P.O. Box 1179
W Southold, New York 11971
REGISTRAR OF VITAL STATISTICS Fax (631) 765-6145
MARRIAGE OFFICER ��y' `��1�,
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RECORDS MANAGEMENT OFFICER =-_�'/O! 4; 0 Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER _ ,���
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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: March 14, 2000
Transmitted herewith is a copy of application No. 2359 for a Cesspool/
Septic Tank Construction Permit submitted by:
Schembri Homes, Inc. .
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.
Thank you.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recom ndations:
APPROVE
DISAPPROVE
Comments:
Signature
Dated
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OFFICE OF THE TOWN CLERK .,,,'",,""',%
Town of Southold �•l'� �FF0 Kc
Application No
Judith T. Terry, Town Clerk ,,��'� Gy4
Town Hall, 53095 Main Road Z Construction
P. O. Box 1179 ... = rnI
Southold, New York 11971 : t.rs �� Alteration
Telephone ‘..`O A,j�,O �-sr 4* $10.00 - Residential
(516) 765-1801 1 $25. 00 - Non-Residential
... I ,TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
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APPLIA
CATION M
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CONSTRUCTION or ALTERATION PERMIT War.
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SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE 3/(1/°Z)
APPLICANT NAME: 5Gt br/ ii-Q/y/e5—.� C._ - - — — —APPLICANT ADDRESS: i v (G--
(.1/ C4---)\/LL• 1‘?. (i.:. /i7/.)-
SEPTIC CESSPOOL
DESCRIPTION OF PROPOS CONS UCTI N OR ALTERAT ION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSE[) CONSTRUCT N R ALT ATI N :
OWNER OF PROPERTY :
OWNER MAILING ADDRESS: ., ,SWdiiet
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OWNER PROPERTY ADDRESS : " - - r i —. - .f-1,
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OP dllo eL-23C, ,_p_
TELEPHONE NUMBER OF CONTACT PERSON : ,
TAX MAP NO. : Section O Block c°2` Lot
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CROSS STREET : • ii,t a,
BUILDING PERMIT NUMBER CROSS REFERENCE .
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Signature of ApplicantRECEIVED BY : \ 8
Town,�,�IClerk's Office
DATE : y
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LOT 68I
g6.56' 49.E `���,
VACANT 2
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so' aLOT 67 49.0 PI
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SANDY
LOAM
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Q SAND AREA: 24,386 Sq.Ft. = 0.560 Ac.
!t • u I ` O GRAVEL ELEVATIONS ARE IN ASSUMED DATUM.
A ' NO SURFACE WATER EVIDENT WITHIN 300 FEET
—24 ADJACENT DWELLINGS SERVED BY PUBLIC WATER.
•
CERTIFIED TO: JOB NO. F2035 u
SURVEY OF
FIDELITY NATIONAL TITLE INSURANCE COMPANY MAP NO. 6266 AO• NW
OF NEW YORK, TITLE No. FNT9921961 FILED: 6/11/1975 E. LOT 67 _
MICHAEL SANDE •
REVISIONS: MAP OF O � ?- A:1 . T
ANN SANDE PEBBLE BEACH FARMS
ADD PROP. DWELLING 12/3/99 -------:.:::;:;;:
.. and:o .:. :.
1
EASEMENTS AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED t
1 - ".4 SITUATE AT 132 _ • ,;t:4 way
ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT , . EAST MARION Ha'.•. on Ba N.Y.
THE TIME OF THE SURVEY. _ X9,46
GUARANTEES INDICATED HEREON SHALL RUN ONLY TO THE PERSON(S) FOR �4 - EAST
OF SOUTHGLD (631) '8-5330
WHOM THE SURVEY IS PREPARED. AND ON HIS BEHALF TO THE TITLE COM— 1
PANT. GOVERNMENTAL AGENCY AND LENDING INSTITUTIONS MILLI HEREON. Z.„1,t4NO '' Marc E Charost LS.
AND TO THE ASSIGNEES OF THE LENDING 1NS11TUTTON. GUARANTEES ARE SUFFOLK COUNTY, NEW YORK
NOT TRANSFERABLE TO ADDITIONAL INS TTUITONS OR SUBSEQUENT OWNERS. a LAND Successors to
THE OFFSETS (OR DIMENSIONS) SHOWN HEREON FROM THE STRUCTURES TOPoul T. Canolizo, L.S. Robert A. Kart, L.S.
THE PROPERTY LINES ARE FOR A SPECIFIC PURPOSE AND USE AND THERE— SCALE 1 ” = 50' JUNE 1 1, 1999 Good Ground Surveyors, P.C.
FORE ARE NOT INTENDED TO GUIDE THE ERECTION OF FENCES RETAINING
WALLS. POOLS. PATIOS. PLANTING AREAS. ADDmONS TO BUILDINGS AND license no. 050149 S.C.T.M. DIST. 1000 SEC.30 BLK. 2 LOT 94
ANY OTHER CONSTRUCTION.