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ELIZABETH A.NEVILLE �� Town Hall, 53095 Main Road
TOWN CLERK ; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS P ,� Southold, New York 11971
MARRIAGE OFFICER �i :'V.
el Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER ®d V I. Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2542 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : MANZI HOMES INC
Address 1 : PO BOX 702
City St Zip ROCKY POINT NY 11778
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 #R10-99-0061
Name Of Owner MANZI HOMES INC
Mailing Address 1 PO BOX 702
City St Zip ROCKY POINT NY 11788
Property Address 1 400 RENE'S DRIVE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 54.00 block 6 lot 4.004
Cross Street SOUNDVIEW AVENUE
Building Permit Number Cross Reference:
Issue Date: 4/26/01 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
•� ®SUFFO`,r� 0/5icZ
ELIZABETH A.NEVILLE ��1 • Town Hall, 53095 Main Road
TOWN CLERK ; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS � Southold, New York 11971
MARRIAGE OFFICER � .f� ���1�, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER = �®� ��®„.i6 Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ii"
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: March 28, 2001
Transmitted herewith is a copy of application No. 2630 for a Cesspool/Septic Tank
CONSTRUCTION/ALTERATION Permit submitted by:
Manzi 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.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
Comments: Maintain required setbacks from adjacent wells,buildings,property lines and water
Bodies. EXCAVATION INSPECTION REQUIRED.
r
ature
Dated
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OFFICE OF THE TOWN CLERK '�.1i��fot L ' /
TOWN OF SOUTHOLD ��� � ,r •} QQ Application No.p2430
ELIZABETH A.NEVILLE,TOWN CLERK � . �
P.O.BOX 1179 -�a ; Construction
SOUTHOLD,NEW YORK 11971 : 13 • ��
Z; " '�' Alteration
00.
�, 10.00 - Residential
Telephone .� `=� A �� $
(516) 765-1801 d
$25.00 -Non-Residential
•
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. •
Fee .$ l O,O
DATE •3 2.7- 0
APPLICANT NAME: MQ1 1Zi Or cs I6-la✓° / RIC[-lar d_ Mar _i
APPLICANT ADDRESS: P• O ° 8 ® x 702-
c)C k v N e nv ` fi r k H17
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: 1v {06'17°1 1-1-0 ane. S �� r
OWNER MAILING ADDRESS: P .Q . i3 ox 10 2--
R o c•k_-1 P I KR �/ H 114
OWNER PROPERTY ADDRESS: LFo0 Rp Pip. 15
LA+4•-1-)nIr1 . ) i\Ie.u ) 3Qr1.`
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section 0 5 A - BlockA ®(v Lot OO L 00
\/
CROSS STREET: Sol.k_nd ,e (.0 /-1)PnitP. So„ {-f--kt))r-I
J
BUILDING PERMIT NUMBER CROSS REFERENCE:
_
Signature of Appl• ant
RECEIVED BY :
`own Clerk's Office
DATE: I�Z Cj
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CLAYEY SANDY I Y 44 '00"W 348.C 72S' OCP
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CLAY & CLAYEY SAND
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-371 WATER IN BROWN FrNE LAND NOW OR FORMERLY LAND N/F LAND NOW OR FORMERLY LAND NOW- OR FORMERLY
TO MEDIUM SAND CARROLL ENGEL MARTIN BERGAN
AREA: 57,459 S.F. = 1.319 AC. -4,3' -- - WATER SUPPLY INFORMATION UNAVAILABLE
ELEVATIONS ARE IN ASSUMED DATUM.
CERTIFIED TO: JOB NO. F3450 SURVEY OF
REVISIONS: LOT TWO
fal"8481j1)11k-
' MINOR SUBDIVISION MAP OF _ �{'__ _'� j� T ,�° Ll�
/ INDIAN WOODS • ., s .
URFAC YrArEASEMENTS AND/OR SUBS £STRUCTURES RECORDED OR UNRECORDED "611'
` .I ARE TRE NOT OF SANT SED UNNLESS PHYSICALLY EIDE T ON THE PREMISES AT - ! +k`{I -+ ,SITUATE AT 132 • o' a • fLy_�.TWO 6
, GUA2WIE�ES INDICATED HEREON SHALL RUN ONLY TO THE PERSON(S) FOR `-• • SOUTHOLD Hof... On BO , Al.i.~4
WHOM RT.-SURVEY IS PREPARED, AND ON HIS BEHALF TO THE TITLE COM-
4.14'''...:;(:,;. iii�i�...:���_ TOWN OF SOUTHOLD (631) 'P8-5330
PAhY,, VEENMENTAL AGENCY AND LENDING INSTTTU77ONS LISTED HEREON, \'x,
AND VII ASSIGNEES OF THE LENDING INSTITUTION. GUARANTEES ARE
NOT TO A00070NAL INSTITUTIONS OR SUBSEQUENT OWNERS. �, � SUFFOLK COUNTY, NEW YORK Marc E. Charost, L.S.
THE 0 EIS(OR DIMENSIONS) SHOWN HEREON FROM THE STRUCTURES TO Successors to
THE PROPERTY ONES ARE FOR A SPECIF7C PURPOSE AND USE AND THERE- - SCALE: 1"-60' DATE: FEBRUARY 21, 2001 Paul T. Canalizo, LS. Robert A Kart LS.
FORE ARE NOT INTENDED TO GUIDE THE ERECTION OF FENCES, RETAINING Good Ground Surveyors, P.C.
ANYOTHER CONRRUC770ATPLANTING AREAS, ADDmoNs TO BUILDINGS AND
license no. 050149 S.C.T.M. DIST. 1000 SEC.054 BLK.06 LOT 004.004