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ELIZABETH A. NEVILLE ®�o ; Town Hall, 53095 Main Road
,
TOWN CLERK % P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER `� ?s �til�, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER =_ 1 o.� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ��
OFFICE OF THE TOWN CLERK
SOUTHOLD I.'$C8[HDSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2630 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : PETER DENICOLA
Address 1 : 1695 CAHBLIS PATH
City St Zip SOUTHOLD NY 11971
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 #R10-001-0164
Name Of Owner SMITH, ALBERT & PATRICIA
Mailing Address 1 1695 CHABLIS PATH
City St Zip SOUTHOLD NY 11971
Property Address 1 MANOR ROAD
City St Zip EAST MARION NY 11939
Tax Map No. section 38.00 block 3 lot 1 .000
Cross Street GILLETTE DRIVE
Building Permit Number Cross Reference:
Issue Date: 8/08/01 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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���I'®OFFOL4
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ELIZABETH A.NEVILLE �; Town Hall, 53095 Main Road
TOWN CLERK ` o - P.O. Box 1179
Pry
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS �` ,
MARRIAGE OFFICER 4, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER ®1 ��®�i� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ��,,
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: July 27, 2001
Transmitted herewith is a copy of application No. 2718 for a Cesspool/Septic Tank Construction
Permit submitted by:
Peter DeNicola for Smith
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:
)S6
2ate
'1 / a10 I
Dated
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OFFICE OF THE TOWN CLERK 1'1'4EO11(C
TOWN OF SOUTHOLD OG Application Nop��� ((ff
ELIZABETH A.NEVI LE,TOWN CLERK ,� 4 Construction
`
P.O.-BOX 1179 .
SOUTHOLD,NEW YORK 11971 0 • T
csi
Alteration
Telephone �0�''1, •
$10.00 -Residential
(631) 765-1800 -=�Ol. 4/,.' $25.00 -Non-Residential
TOWN OF SOUTHOLD •
SOUTHOLD WASTEWATER DISPOSAL DISTRICT RECEIVED
APPLICATION JUL 2 7 2001
for
Southold Town Clerk
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE 7/ / /
APPLICANT NAME: ? _k _ l eiL (DIG-
APPLICANT ADDRESS: Mc elf, ! LJS &'&ft
¶Ota_k0 LLQ i N ui,
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
r(�W Ve-e__Sia)ev'Ce
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: •
. OWNER OF PROPERTY: OdAfie- auto d.4vtdteek Sri 44
OWNER MAILING ADDRESS: 16gc L' t3L,4 Pdt.
55k44 Lo
OWNER PROPERTY ADDRESS: (4-e .
TELEPHONE NUMBER OF CONTACT PERSON: `Vo'S•^c3128'
TAX MAP NO. : Section 3I Block 3 Lot
CROSS STREET: v.0 ,4- 6 a LLe i4e b-
BUILDING PERMIT NUMBER CROSS REFERENCE: .
• • (LAC/Iik _3
/ Signature of Applicant
RECEIVED u
Town Clerk's Office
DATE: •
S.C.T.M. NO. DISTRICT: 1000 SECTION: 38 BLOCK: 3 LOT(S): 1
/
WELL
Z.
DWELL N
DWELL PUBLIC WATER
DWELL
N1T#5 / PUBLIC WATER
NYT#10 NYT#V
CL 50.15 VACANT
7
MANOR (50'9 ROAR- 50.02
DI
goo, EL 50.15
VACANT NN
N 6411'10" E 79.57'
lc 0.4
bpp'1n U,z �?
,� p'b el 50.9 ® ° CL 50.81 NO W:LL 1 THIS AREA
q�/
ti
el 50.5 c I S.T. I of 51.4 C4
$ 6 oz A
m
^ 11 m
. A a 40' (52 .5) n ^ DWELL
'SPR•'OSE) WATER SERVICE(52.0)
PROPOSED O
r to 14' W/L R O
fv
t
` VACANT
in F (52.5) FFL EL (55.0) In inFA
t"4 /
3&8'
200' 1 F R (52.0) 54' x(53.0) .39.7, F
oyv
H
iLZv it0- - -
3 a LOT 57 to
z z 62
' NYT#6 y_ el 50. E
'� ASTK FD ` el 52.4 w
gk .144
Ilr' ,/ CL 50.34 S 84' 'SILO" .. 131.49' PI CL 51.34
os'S
VACANT NYT#
100'
LOT 58
c
ELEV.
DR BROWN
SANDY LOAM3.5' •
BROWN CLAYEY
LOAMY SAND �R .S�
6.5 us i`LI°A.119
SUFFOLK CC-UNIT DEPARTMENT
PALE PERMI► FOP. APPROVAL OF 0NSTRUCTtOis FOR'..A-
TO MEDIUM SINGL FAMILY RESIDENCE ONLY
TO
COARSE
SAND C7) - vl
12' DATE 7 ��iS3. rEF �� Q._:
PAL!` APPROVED �^ _.
BROWN EDROOM x
MEDIUM FOR NiI..wI:7t9tdi OF
NO
EXPIRES`i KR_EE YEARS FRS( DATE F i'�,Y�'PR0 'dam
SAND
NO WATER
17'
7-7-01 THE WATER SUPPLY, WELLS AND CESSPOOL
LOCATIONS SHOWN ARE FROM FIELD OBSERVATIONS
. AND OR DATA OBTAINED FROM OTHERS.
AREA: 12,761.1 S.F. OR 0.29 ACRES ELEVATION DATUM: ASSUMED
UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY
MAP NOT BEARING THE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN
ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE TIRE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION
LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTITUTION, GUARANTEES ARE NOT TRANSFERABLE.
THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE
NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE ERECTION OF FENCES, ADDITIONAL STRUCTURES OR AND OTHER IMPROVEMENTS. EASEMENTS
AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE TIME OF SURVEY
SURVEY OF: LOT 57 CERTIFIED TO: PETE DENICOLA;
MAP OF: MARION MANOR MH1RSMfl1O S IV 4J
FILED: MARCH 18, 1953 AS 12038
SITUATED AT: EAST MARION
E :Oi WI 61 liif 4007 .
TOWN OF: SOUTHOLD AI f OO wiamS • KENNETH M. WOYCHUK L.S.
SUFFOLK COUNTY, NEW YORK 03M33 tai Land Surveying and Design
4 .i%1ik,1i �� P.O. Box 3, Mattituck, New York 11952
FILE # 21-148 SCALE: 1"=30' DATE:JULY 10, 2001 PHONE (831) 298-1588 FAX (831) 298-1588
N. Y. S. LIC NO. 50227 maintaining the records of Robert J. Hennessy