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FORM NO. 3 RECEIVED
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TOWN OF SOUTHOLD NOV 16 2021
................-
BUILDING DEPARTMENT SouthoW IFow'in"--
SOUTHOLD,N.Y. Flannurig IBoard
NOTICE OF DISAPPROVAL
DATE: November 10, 2021
TO: NoFo Partners (Unit#3)
10200 Main Road
Mattituck,NY 11944
Please take notice that your application dated October 12, 2021:
For permit to: Construct iiiterior alterations qf_anexi�still I 0�fflce s,�ace i�ntosrn� Lall,,r office,
__
a se erste retail sho anal a rivate office for com' lex manner -cit.
Location of property: 75 Marlene Lane, Laurel_NY
County Tax Map No. 1000— Section 143 Block 3 Lot I
Is returned herewith and disapproved on the following grounds:
Pursuant to Article XXI Section 2 0-127 the top as d use 7a quires site Iwlan ap rove
from tlic Southold.Town Plavi.n board.
You may now apply to these agencies directly.
Authorized Signature
Note to Applicant: Any change or deviation to the above referenced application,
may require further review by the Southold Town Building Department.
CC: file, Planning Board
ED
P,EC`1\ OR INTERNAL USE ONLY
ERMINATION
SITE PL
AN USE DE.
P1z:tia)n�np Go al r
initial peterrWi ntiot
Date Sent:_= �-
0d
Project-Nar ne: a
project Address:
Suffolk County Tax Map,NO-J000=_ 3�
�✓ -=Zoning Distrct.,
Reg
Cori ver �� ---
of Br ildIng ermit App
lication and supporting documentation°as to
(Note: spy
. be submitted.)
proposed use or uses should
tlal Determination as to Whether use is permitted:
1ni.
Initial Determinationas to whether site plan is regtaire : +
Signature of Building Inspector
planning Department (P.D.)
Referral:
!=___ ..pate of Comment:,...
P,p, ,Date Received:__
Comments:
Dept-,staff Reviewer
Signature of Planning . °
Fjt�t l Deternlin t o
Date:
cc�,„at7irp �f Rriildina InGnector
1 q5qf 4 TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone(631) 765-1802 Fax(631) 765-9502 litti) a/lwww soLltholdtownal a-.
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only F
PERMIT NO Building Inspector: OC,T 15 2021
�u"�'ry 2�l><�a �r1rF 1/"II�Irr�U✓�r"�;�xY 9 r,vG, / ! 6Ya'�1�isU'tl �U� r��/,�°l!r,/ail U;I� �i"�r ��,�✓f!„' rii�w rry r ,r, l;, iq Mt
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Date:10/12/21
Oi PI ER � OF PROPERTY
a„ cif,
Name:Christopher Pia, NOFO Partners scrM #1000-143-3-1
Project Address:85 Perry St New York, NY 10014
Phone#:631-767-1069 Email:doug@interfg.com
Mailing Address:85 Perry St New York, NY 10014
COTC"1'”PE;R' O?
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Name:AMP Architecture, Jess Magee
Mailing Address: 1075 Franklinville Rd Laurel NY 11948
Phone#:516-214-0160 Email:jmagee@amparchitect.com
DENN PROFESSNCNA�,IiFORINATI � ,
Name:AMP Architecture, Anthony Portillo
Mailing Address:1075 Franklinville Rd Laurel NY 11948
Phone#:516-214-0160 TErn aportillo@amparchitect.com
CONTRACTOR INFORMATION
Name:
Mailing Address:
Phone#: Emailt
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
(]Other Change in use. $
Will the lot be re-graded? ❑Yes ._ No Will excess fill be removed from premises? l_IYes FmiNo
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