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ELIZABETH A.NEVILLE t��� yd; Town Hall, 53095 Main Road
TOWN CLERK % y - P.O.Box 1179
v, Southold, New York 11971
REGISTRAR OF VITAL STATISTICS Fax(631) 765-6145
,
MARRIAGE OFFICER �®ifi
RECORDS MANAGEMENT OFFICER =__'*®1 Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ,��� southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2753 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : SCHEMBRI HOMES INC
Address 1 : 2042 N COUNTRY ROAD
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 #R10-01-0265
Name Of Owner STALLER ASSOICATES
Mailing Address 1
City St Zip HAUPPAUGE NY 0000
Property Address 1 ROCKY POINT ROAD
City St Zip EAST MARION NY 11939
Tax Map No. section 21•.00 block 6 lot 7.000
Cross Street MAIN .ROAD
Building Permit Number Cross Reference:
Issue Date: 3/11/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE 0.o 4. •
Town Hall, 53095 Main Road
TOWN CLERK ® - P.O. Box 1179
REGISTRAR OF VITAL STATISTICS
0 0 Southold, New York 11971
MARRIAGE OFFICER : Fax���1+, Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER -'/®� illg ��®'ii Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ���,,•" southoldtown.northfork.net
OFFICE OF THE TOWN CLERK --- - .- .
--
TOWN OF SOUTHOLD f' - ,i 1
n1FEB
2b2002\'rlij
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office TQ).'?r's'`-= TFioLO
DATED: February 26, 2002
Transmitted herewith is a copy of application No. 2849 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.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations:
17.
APPROVE
DISAPPROVE
Comments: #7,,,,4
f-s--•-es /4,2; 9Alte,,f,,,,,,,g' ,4
Signature
00-6/./a 2--
Dated
•11.
.................,
OFFICE OF THE TOWN CURE
• . FOLA-e-%
TOWN OF SOUTHOLD Application No
ELIZABETH A NEVILLE,TOWN CLUE
P O.BOX 1179 Construction 1•••••••---
SOUTHOLD,NSW YORE 11971 •
r-n? Alteration
•1.11
$10.00 -Residential
Telephone
..(63t)
' '
..,(63t) 765-1800 • -7` $25.00 -Non-Residential
TOWN OF SOUTHOLD •
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
C2/
DATE
APPLICANT NAME: \-211-ei‘rybe1IV, )Ji77:
APPLICANT ADDRESS:c:T44 -
Va
SEPTIC / CESSPOOL 1/1
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be Issued.
LOCATION
LOCATION OF PROPOSED CONST" CT-10N •• ALTERATION: 40
OWNER OF PROPERTY: , MG,
,--4„daiii,n077MMIP_,L,„. .
OWNER MAILING ADDRESS: ,
111111=1
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OWNER PROPERTY ADDRE S: 41411MI
IA.
P
TELEPHONE NUMBER OF CONTACT PERSON: //' /
TAX MAP NO.: Section(„,2,/ DI ,C)(;-, Lot C.) —7
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERE. • :
Signature of Applicant
RECEIVED BY: AlAtie-1---74--4,_
o%..am Clerk 0 ce
DATE:
JOB No 01-59 TAX I.D No 1000-21-06-07
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LOT 6 LOT 3 1
VACANT VACANT II
99.0
95 0 1
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I I N 13°05'50"W 164.58' I
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VOT 8ACANT •
D SEPTIC I VACANT
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FF 985
q `ro. < I GAR 97 0 -n
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7
C o�` 70' D
Gd' PROPOSED co I
O DRIVEWAY SINGLE FAMILY
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�O \ — 40'
0
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Cr ,II I
J TIE 3672 62'
• PROPOSED WFI i I , PROPOSED
' ! 4 LOT 8 O 96 3 b WELL II I
950 I I
S 8°59'50"E 165.00' I
ROCKY POINT ROAD [ 49.5' ) 959
949
TAX LOT 8
OCC RES TAX LOT 7 TAX LOT 6 ,
: : ARD OCC RES W ELLS TYPICAL FRONT YARD
t
WELL FRONT YARD
....._.._,_-,._ ._.__._- . ... [WELL NOT FOUND)
SUFFOLK COUNTY '������� ® f�flaTE���` EAR , SEPTIC REAR SMALL SUMMER COTTAGE
+ PramiT FOR APPROVAL OF COe'E.3TP.UC i ION FOR A !
``S'°y—c - ' _� s',--- --r.or, ONLY
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FILE MAP No. 8759 6/07/89
ELEVATIONS IN ASSUMED DATUM
jUnauthorized alteration or addition to this document is a violation of Section 7209
of the New York State Education Law SURVEY OF: LOT 7
ICertifications indicated hereon shalt run only to the person for whom it is prepared j
I and on his behalf to the Title Company,Governmental Agency and Lending IMAP OF EAST MARION WOODS
1 Institutions listed hereon,and to the assignees of the Lending Institution or i
subsequent
®p NEW yo I pes of this document not bearing the professionals inked sal or embossed j EAST MARION, TOWN OF SOUTHOLD
seal shall not be considered a valid true copy
q I The offsets[ or dimensions I shown hereon from structures to the property lines are
y�Q' GRAF � for a specifib purpose and use and therefore are not intended to guide the erection of I SUFFOLK COUNTY, NEW YORK
DEST1N I fences,retaining walls,pools,patios,planting areas,addition to buildings,or any other I
construction
t k'.+ Tho=�encee of right of ways and/or easements of record,if any,not shown are I SURVEY DATE: 12/10/01 SCALE_ 1"=50'
g
- CERTIFIED ONLY TO: '
�"� ENS' 405006 I SCHEMBRI HOMES I DESTIN G. GRAF
'Oq,� p�' I LAND SURVEYOR 1
I - - - - - -- - - - - - - --- 1
I 73 Wood[awn Road 1
Rocky Point,New York,11778
631-821-3442
;1-- ' . [ I B DESTIN G.GRAF N.Y S.UC NO. 50067