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Home My WebLink AboutAxberg, Arthur 4;00' L,#, i „ i Town Hall, 53095 Main Road j P.O. Box 1179 4I y0 �Q� Southold, New York 11971 JUDITH T.TERRY ��,;1 -' TELEPHONE TOWN CLERK 4h�ww"'"' (516) 765-1801 REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 1629 R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X PERMIT ISSUED TO: Name : ANDREAS KUPECKI - CRASS PLUS Address 1 : 1755 STANLEY ROAD City St Zip MATTITUCK NY 11952 Descripton of Proposed Construction or Alteration ADDITION OF CESSPOOL TO AN EXISTING SYSTEM. APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS BUILDINGS, PROPERTY LINES, AND WATER BODIES. EXCAVATION INSPECTION REQUIRED. Name Of Owner AXBERG, ARTHUR Mailing Address 1 P. O. BOX 1695 City St Zip MATTITUCK NY 11952 Property Address 1 3705 CAMP MINEOLA ROAD City St Zip MATTITUCK NY 11952 Tax Map No. section 123.00 block 5 lot 34.000 Cross Street KRAUSE ROAD Building Permit Number Cross Reference: Issue Date: 4/01/97 Judith T. Terry Southold Town Clerk (TOWN SEAL) 1111111.1 OWArou, 4 ? . JUDITH T.TERRY �, Town Hall, 53095 Main Road TOWN CLERK N Z P.O. Box 1179 i Southold, New York 11971 REGISTRAR OF VITAL STATISTICS k‘4° 'y��1 �► �� Fax(516) 765-1823 RECORDS MANAGEMENT OFFICER MARRIAGE OFFICER � a�,�l� Telephone(516) 765-1800 FREEDOM OF INFORMATION OFFICER •••��I OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Linda Cooper, Southold Town Clerk's Office DATED: March 27, 1997 • Transmitted herewith is a copy of application No. A 1704 for an ALTERATION PERMIT for a cesspool or septic system submitted by Andreas J. Kupecki/Grass Plus on behalf of Arthur Axberg • Please review the application and location map and advise if this office may issue the permit. Please complete the form below and return it to this office. Thank you. Linda J. Cooper * * * * * * * * * * * * * I have reviewed the application and location map of the project listed above and make the followin commendation: APPROVE - DISAPPROVE - COMMENTS: Maintain required setbacks from adjacent wells, buildings, property lines and water bodies. EXCAVATION INSPECTION REQUIRED. RECEIVED APR 11997 SignatuG Southold Town Clerk .3 '2-e / 7 Date OFFICE OF THE TOWN CLERK . Town of Southold : 9 Judith T. Terry, Town Clerk Application No.�rf� Town Hall, 53095 Main Road Construction ir P. O. Box 1179 • AlterationSouthold, New York 11971 Tele hone 1` $10.00 -Residential I f P 1�•' (516) 765-1801 e $25.00 -Non-Residential TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for CONSTRUCTION r ALTERATION ERMIT SEPTIC TANK or CESSPOOL Permit No. Fee $ DATE M4eGh ca 1 / 9 7 APPLICANT NAME: if/lcyr@q 5 a• 4/7, egess RA/.f APPLICANT ADDRESS: /7.5'S S-744,7 �Ey d/ ify74/274, SEPTIC CESSPOOL DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION ./s 1"7 `42), /10-74e r `7�lv LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY: Ar h(I1. 4)I-c ki • OWNER MAILING ADDRESS: R D . Be)X 49S" OWNER PROPERTY ADDRESS: 3 705 LQwi M%r!eo4 A%/ TELEPHONE NUMBER OF CONTACT PERSON: c' ,)4 "OI' TAX MAP NO. : Section /o)-3 Block r Lot 3' V CROSS STREET: kraal/S.4 Rai , BUILDING PERMIT NUMBER CROSS REFERENCE: Signature o pp Icanb RECEIVED BY: low-74- 01("1411ece DATE: C3 , . v� 1 l ` i3 11/ ® .n /lleLai GesSpool 3 x g © A �. T f7"