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ELIZABETH A.NEVILLE �l/,y�� Town Hall, 53095 Main Road
TOWN CLERK c -• P.O. Box 1179
REGISTRAR OF VITAL STATISTICS ‘,0 N Southold, New York 11971
Fax (516) 765-1823
MARRIAGE OFFICER �,�0� 0-0 Telephone(516) 765-1800
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER0.0
1
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1972 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : SCHEMBRI HOMES
Address 1 : P. O. 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 #R10-98-0117
Name Of Owner JERSEY, ALONZO (JOYCE BARRY)
Mailing Address 1 P.O. BOX 1103
City St Zip CUTCHOGUE NY 11935
Property Address 1 875 WEST COVE ROAD
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 111 .00 block 3 lot 18.000
Cross Street HAYWATERS
Building Permit Number Cross Reference:
Issue Date: 11/23/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
11111L-
ELIZABETH A.NEVILLE A$1' y��� Town Hall, 53095 Main Road
TOWN CLERK c . r P.O. Box 1179
ti Southold, New York 11971
REGISTRAR OF VITAL STATISTICS Fax (516) 765-1823
MARRIAGE OFFICER yfj SON- Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER
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: November 17, 1998
Transmitted herewith is a copy of application No. 2050 for a Cesspool/
Septic Tank Construction Permit submitted by:
Schembri Homes for Alonzo Jersey (Joyce Barry)
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 recommendations:
APPROVE Y
DISAPPROVE
Comments:
ignat e
Dated
.
OFFICE OF THE TOWN CLERK ,'''""' '''
Town Of Southold �it's'%IfILA
Judith T. Terry, Town Clerk ,' % i.W*:\ Application No. ____ -�
Town Hall, 53095 Main Road cc,/ z Construction p'- ..,P. O. Box 1179
Southold, New York 11971 ;
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NORTH CROSS ROAD
TEST HOLE DATA I
PERFORMED BY : McDONALD GEOSCIENCE
EXISTING GRADE SURVEY OF i
.•v i�ww�Nrcs DARK MOWN SAW LOAM OL DESCRIBED PROPERTY
10.5 i
SITUATE II.-', I
DROWN LOAMY Su40 SM -
CUTCHOGUE, TOWN OF SOUTHOLD
' • SUFFOLK COUNTY, N.Y.
PALE MOWN no- TO MEDIUM SAND SP
SURVEYED FOR :
n'
THOMAS M. SENENFELDBER
DEBORAH SENENFELDBER
FINISHED GRADE
""",Nrx\k� 1' MIN.
Iia.fit, r�r_t"� 2' MAX. ZONING R40 •
N
300 S.F. 1
$lDf WALL
TAX MAP NO.
£ACACHING I I
FOOL 1000-103-13-27
2' MIN. GROUNDWATER
TYPICAL CESSPOOL SYSTEM SCALE 1'=2O'
-AREA= 23,855.206 Sr
N. T. S. OR
0.548 ACRES
Guarantees indicated here on shall run
only to the person for whom the survey
is prepared, and on his behalf a the
Unauthorized alteration or addition to this
title cernpeny, Govermental Agency, s.rvey is a violation of Section 7209 of
FINISHED GRADEending institution, if listed hereon, and 'he New York State Education Low. i
0.7n r,J,y7
l; MIN. t,, the assignees of the. leading institution.
2! MAX. `ucrontees cre nct transf able to
1/4'l t _ I/8,/I,- additional institutions or subsequent owa"s+ ELEVATIONS SHOWN ARE
g ASSUMED DATUM
I 8' MIN. TO CESSPOOL
900 GAL. SEPTIC TANK
GUARANTEED TO
TYPICAL SEPTIC TANK
THOMAS M. SENENFELDBER
DEBORAH SENENFELDBER
COMMONWEALTH LAND TITLE INS. CO.
SUFFOLK CO. HEALTH DEPT. APPROVAL TOWN OF SOUTHOLD
H.S. NO.
STATEMENT OF INTENT
THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS
FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS SURVEYED: 27 JULY 1998
OF THE SUFFOLK CO. DEPT OF HEATH SERVICES
S SURVEYED BY
TOWN OF SOUTHOLD
FOR APPROVAL OF CONSTRUCTION ONLY STANLEY J. ISAKSEN, JR.
DATE : P.O. BOX 294
APPROVAL : NEW SUFFOLK, NY 11956
•
SUFFOLK CO. TAX MAP DESIGINATION 516-734-5835
DIST. SECT. BLOCK PCL.
1000 103 13 27 .
OWNER : 1,THOMAS M. SENENFELDBER aI
DEBORAH SENENFELDBER _ rt ;.•-,/
,/
Copies of this survey mop not beor•ng ,�LICEN' D AND SURV YOR
the Land Surveyors embossed seal shall NYS LIC. NO. 49273 ,
not be considered to be a valid true
=WY. 98C721
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