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ELIZABETH A.NEVILLE ,� �' Town Hall, 53095 Main Road
TOWN CLERK 4R a ` P.O. Box 1179
4 ` =, v 3 Southold, New York 11971
REGISTRAR OF VITAL STATISTICS � .� 1
MARRIAGE OFFICER ® fi 11 Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER �,�el ,`ss22,, $; 116 Fax
(631) 765-1800
FREEDOM OF INFORMATION OFFICER Zs
OFFICE OF THE TOWN CLERK
SOUTHOLD INANSIREWASUERPHCEIBIDSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2619 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 #R10-01-0109
Name Of Owner MANZI HOMES INC
Mailing Address 1 PO BOX 702
City St Zip ROCKY POINT NY 11778
Property Address 1 1010 BRIGNATINE DRIVE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 79.00 block 4 lot 31 .000
Cross Street SQUARE RIGGER LANE
Building Permit Number Cross Reference:
Issue Date: 7/24/01 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE t�_ 'fid; Town Hall, 53095 Main Road
TOWN CLERK H - P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER .fi �4 �, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER . �i� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER �9�1
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: July 12, 2001
Transmitted herewith is a copy of application No. 2707 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.
Yignatur
Dated
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Or FILE OF THE TOWN CLERK ,1'���% J J fr
TOWN OF SOUTHOLD ,�� y'~" .,, ®l/= Application No. 02707
ELIZABETH A.NEVILLE,TOWN CLERK ,��� Ar; " , y�
P.O.BOX 1179 s�: ,1. !, .t., Construction OL
1. .,', `t f; ,.-,.� •
SOUTHOLD,NEW YORK 11971 = '',: x t
; ; Alteration
Telephone �,�• ...-,'•�hQ��''� $10.00 - Residential ��
(516) 765-1801 =_®1 44 •0' $25.00 -Non-Residential
. ''' ...a.,00
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TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
. for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE '7 /io/o i
APPLICANT NAME: Man-7j 140 rnec, G .
APPLICANT ADDRESS: P,O . 8, y 1®02.
fl ky Po -, 9J 'i 1 rrig
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
new Cc)r5krclC- ,c;h
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: WIQ.n7 1 1-ernes , IT c -
OWNER MAILING ADDRESS: P. O . 8. ox /09.-
RoC,iC c,,� P a i n+- t Kt y i i r'7 S
OWNER PROPERTY ADDRESS: J row '�j�
Rr� o9ctn�in� .ti.VrIv'P
Soa- h0IcL . , NV
TELEPHONE NUMBER OF CONTACT PERSON: •
TAX MAP NO. : Section 7I Block 04 ' Lot 3 6
Rer CROSS STREET: Square LA n
BUILDING PERMIT NUMBER CROSS REFERENCE:
01 / ,
ignature of Applicant
RECEIVED BY : I_ / 2._ S'-'
' •To n Clerk's Office
DATE: 7/> /
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SUFFOLK COUNTY DEPARTMENT OF HEALT I SERVICES • —12' WATER
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PERMIT FOR APPROVAL OF CONSTRUC^ION FORA .
--IN LE FAMILY&' S$7 `NCE ONLY AREA: 21,508 'S F. 0.494 AC.,
-_J 1 Q
ELEVATIONS ARE IN;ASSUMED DATUM.
DAT, �� �� ISS t 1�IO/l �O / C�/ ADJACENT DWELLINGS SERVED, BY•PUBLIC WATER.
' '� SURVEY OF
LOT 50:
FOR MAS OF hED:iOQRiS �,A� ,
MAXIMUM
MAP OF — c-
EXPIRES THREE YEARS Mom DATE OF APPROVAL `i �'`'
. HARBOR LIGHTS -ATES .-7-1�
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EASEMENTS AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED • SITUATE ATN';, N .7:j j '
ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON,THE PREMISES AT ' n -
THE TIME OF THE SURVEY , ' • ' BA YVI EW =` C'7
GUARANTEES INDICATED HEREON SHALL RUN ONLY'TO THE PERSON(S) FOR a{-r1 ,
WHOM•THE-SURVEY IS PREPARED, AND ON HIS BEHALF TO THE TITLE•COM+;.-�; - TOWN .OF SOUT.HQ�D""" c-:-Q •
PANY, 'GOVERNMENTAL AGENCY AND LENDING INSTITUTIONS.LISTED HEREON,. ,SUFFOLK,.:COUNTY
AND TO THE ASSIGNEES OF THE LENDING INSTITUTION. GUARANTEES ARE NC ' ,1�ORf ,
NOT TRANSFERABLE TO ADDITIONAL INST7TU77ONS OR SUBSEQUENT-OWNERS. „ , -'r _
THE OFFSETS (OR DIMENSIONS) SHOWN HEREON FROM THE STRUCTURES'TO -, 'SCALE•• 1 =40 DATE:: 1RlL 23, 2001 '
THE PROPERTY LINES ARE FORA SPECIFIC PURPOSE AND USE,AND THERE- _
FORE ARE NOT INTENDED TO GUIDE THE ERECTION OF FENCES, RETAINING •,S,C,T,til, DIST. 1000 SEC. 145 BLK.' 01 LOT 018 '
WALLS, POOLS, PA77OS, PLANTING AREAS, ADDITIONS TO BUILDINGS AND
ANY OTHER CONSTRUCTION.
JOB N0. F3524 Jj •- ;N0. 5147 -1L7k ; 0 • '� —f=T A
FILED:AUG. 7, 1968
..; ��,
REVISIONS: / % a�f ` , 1.32.-- , , w - • way
''`.;.; :. , ;.. �, Ha,,: On, Ba k: N.Y. • .��46
�'4 �� /'G ,-w ;.&;' ? (631) 7'8-5330
^-' '' ''1 Marc E. Charest, LS.
•: k.,�'"' Successors to
4: ., Paul T. Canalizo, LS. Robert A. Kart, L.S.
license ITC:. 050149 Good Ground Surveyors, P.C.