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ELIZABETH A.NEVILLE ����® C:it Town Hall, 53095 Main Road
TOWN CLERK % O - P.O. Box 1179
REGISTRAR OF VITAL STATISTICS i Southold, New York 11971
MARRIAGE OFFICER `� 4#* �� � Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER � �Q lip �44. 0 Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER .,I ,�'� 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. 2948 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 #R10-02-0067
Name Of Owner MANZI HOMES INC
Mailing Address 1 PO BOX 702
City St Zip ROCKY POINT NY 11778
Property Address 1 1020 LAUREL COURT
City St Zip MATTITUCK NY 11952
Tax Map No. section 126.00 block 12 lot 1.000
Cross Street LAUREL TRAIL
Building Permit Number Cross Reference:
Issue Date: 12/26/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE t1= * ; Town Hall, 53095 Main Road
TOWN CLERK % o - % P.O. Box 1179
REGISTRAR OF VITAL STATISTICS i Southold, New York 11971
MARRIAGE OFFICER ``�) �'W Fax Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER "'/RI st iii Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ,,,s" southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
'
' TOWN OF SOUTHOLD
F � tjCU Zo0L ..�}i
12.-.._ ,Z--,r:','Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: November 26, 2002
Transmitted herewith is a copy of application No. 3069• for a Cesspool/Septic Tank Construction
Permit submitted by:
Manzi Homes
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: _ /
s�.�- >- - / !F
i
71‘e..''‘
Signature
/67V) 6/2_
Dated
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OFFICE OF THE TOWN CLERK •.i•" tf acre
TOWN OF SOUTHOLD • .
► �G Application No. '3(�0
L•LIZABETH A.NEVILLE,TOWN CLERK � /
P.O.BOX1174 • /C Construction !/
SOUTHOLD,NEW YORK 11971 t v ►
ct� Alteration
• ��
Telephone 010• • $10.00 - Residential
(516) 765-1801 '��?t * r•
������,,� $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE WO 192 M 6e c c9 5 4-1.1i oZOo'a,.
APPLICANT NAME: ' �Y1 (�(12' 140
�l es I n
APPLICANT ADDRESS: - C 77Qa
(2,coC�t,�-f Pc);),-,'i. &1)\ I r>) •
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: ry--\Qy1 Zi I4Ory es I r'
OWNER MAILING ADDRESS: P. a_
1RCOCi(_ PCO , 0)rrf""
OWNER PROPERTY ADDRESS: ""'I•�,
TELEPHONE NUMBER OF CONTACT PERSON: .7 LI I- /QT
TAX MAP NO. : Section )� D Block ( 3 Lot €1 I
CROSS STREET: Lc _A
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applicant
RECEIVED BY :
-' Town Clerk's Office
DATE: `(rZh
•
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•
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_ - ._ ..• - > - ,=. .: _ -•,4..z.,,_•,--;.....:1;.,- .._•_>%'(-+ •a _,i!`,c:--- - '- - _ : - -
AREA: 37,232 s F = 0.865 AC. - - PREPARED 0 "
RE FOR:
ELEVATIONS ARE'IN NC V D.-DATUM. ;- ,
NO SURFACE.WATER EVIDENT WITHIN 300 FEET - ' - N8729'Z5"E 179.03 - MANZI HOMES, INC.
ADJACENT DWELLINGS TO BE SERVED BY PUBLIC WATER. E i' -- -- '29.0
j
- - SUFFOLK COUNTyr- 29.2 -
N EASEMENTS AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED
J OPEN SPACE
ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT
R P' 2002 MAR 20 IO' I % O THE TME OF THE SURVEY.
(PARCEL A) GUARANTEES INDICATED HEREON SHALL RUN ONLY TO THE PERSON(S) FOR
WHOM THE SURVEY IS PREPARED, AND ON HIS BEHALF TO THE 771LE COM-
1EF'T QF HEA LTH SER I GAO LOT 13 PANY, GOVERNMENTAL AGENCY AND LENDING INSII7l710NS LISTED HEREON,
RL OFFICEWASTEWATER t'9GhfT VACANT AND TO THE ASSIGNEES OF THE LEWING INSTTURON• GUARANTEES ARE
NOT TRANSFERABLE TO ADDI71ONAL INSTTTUITONS OR SUBSEQUENT OWNERS
THE OFFSETS(OR DIMENSIONS)SHOWN HEREON FROM THE STRUCTURES TO
LA \\ THE PROPERLY LINES ARE FOR A SPECIFIC PURPOSE AND USE AND THERE—
FORE ARE NOT INTENDED TO GUIDE THE ERECTION OF FENCES, RETAINING
WALLS, POOLS. PATIOS PLANTING AREAS ADO/77ONS 70 BUILDINGS AND
OPEN SPACE \ $ ANY OTHER CONSTRUCnON•
(PARCEL A) ��
f� /� 'gyp JOB NO. F3736-13
N •,off '-. .4' , �_ MAP N O. • 10712
•
E--30' �o�'Oo FILED:NOV. 23, 2001 ,�s OF NEW y y
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TEST HOLEIPROVIDE➢ ttz:[ / �/C ' '<1l,,,. S 409
4500,GALLON_ ii i ,
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