HomeMy WebLinkAbout1000-69.-5-7.1 ...�
RECEIVED
TOWN OF SOUTHOLD
MAY 2 6 2,023
BUILDING DEPARTMENT
SOUTHOLD,N.Y.
Planning Board
NOTICE OF DISAPPROVALDATE: May May 25, 2023
TO: Bill Kelly (Altintoprak)
22355 Cox Lane, Unit#4
Cutchogue,NY 11935
Please take notice that your application dated April 6, 2023:
For permit to: construct agilt�ur4l stoarage bui l n„g at:
Location of property: 1375 Ackerly_'ond LanejSoqtho l N"'
County Tax Map No. 1000— Section 69 Block 5 Lot 7_1
Is returned herewith and disapproved on the following grounds:
Pursuant to Article XXI1 ion 280 t2 tl�e o ose use re ui�°es site i�an a rpyal
from the Southold Town Plannin Board.
You may now apply to this agency 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
FOR INTERNAL USE ONLY
. .
SITE PLAN USE DETERMINATION MA'Y I i
,.
566 t"hoid,
I n......_,f
Initial Determination
Planning Board
Date: , �`3 Date Sent: �� ��.._
Project Name:
Project Address: '"Mland z–/1
Suffolk County Tax Map No.: 1000- - -�� Zoning District: /
Request: C(ti .. ., .. - (PI Q 1/
:
(Note: Copy of Building Permit Application and supporting documentation as to proposed use or uses should
be submitted.)
Initial Determination as to whether use is permitted: t
Initial Determination as to whether site plan is required. !
;Signature of Buil spector
--------------------------------------------------------------
Planning Department (P.D.) Referral:
P.D. Date Received: / / Date of Comment:—!;'I 24/
Comments:,
Signature of Planning e t. Staff Reviewer
Final Determination
Date:
Decision:
Signature of Building Inspector
FOR INTERNAL USE ONLY RECEIVED
SITE PLAN USE DETERMINATION MAY 1, :1. 2023
Initial Determination Planning
aniwimmou��Board
Planning Board
Date: l , �`3 Date Sent:
Project Name: 4 t
Project Address: 3�s '
Suffolk County Tax Map No.: 1000--�Jl- -�� Zoning District:
Request: a �C :.,_ Jo it ��Il
u P
(Note: Copy of Building Permit Application and supporting documentation as to proposed use or uses should
be submitted.)
Initial Determination as to whether use is permitted: P t
Initial Determination as to whether site plan is required:
;Signature of Buil spector
--------------------------------------------------------------
Planning Department (P.D.) Referral:
P.D. Date Received:—J—� Date of Comment:
Comments:
Signature of Planning Dept. Staff Reviewer
Final Determination
Date: _
Decision:
Signature of Building Inspector
4 �yi� t TOWN OF SOUTHOLD —BUILDING DEPARTMENT
Town . Box 1179 .. 11971 0959
Telephone
l(631) 765l Annex
x (63)P65U-9502 ,SouholdY1N uv1
_ .
lit
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only
4 f„
PERMIT NO Building Inspector.,,.-.,,._............... ......... _. _...... , �i� �
w
a G
Applications and forms must be filled out in their entirety. Incomplete
applications will not be accepted. Where the Applicant is not the owner,an
Owner's Authorization form(Page 2)shall be completed.
Date:.4 -- 3
OWNER(S) OF PROPERTY:
�w
Name: SCTM# 1000-
Project Address:
Phone#:
Mailing Address:
75W.
CONTACT PERSON:
Name:
Mailing Address: Z22 ✓ � ���
Phone#
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address: 4
Phone#:L "Will ..._... . f
CONTRACTOR INFORMATION:
Name:
Mailing Address:
�L)
Phone#:�?J�- Z _ Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
•1New Structure ❑Additio�
n ❑Alteration ❑Repair ❑ m
Deolition Estimated Cost of PrVct:
❑0ther _ .. _...__. ....
...
Will the lot be re-graded? ZYes ❑No Will excess fill be removed from premises? ❑Yes [XIO
1
_....w....._.._.__ w ..._ww... ..w._w�
PROPERTY INFORMATION
Existing use of property. Intended use of property:
.............
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
�L this property? %Yes ONO IF YES, PROVIDE A COPY.
❑ Check Box After Reading: The owner/contractor/design professional is responsible for all drainage and storm water issues as provided by
Chapter 236 of the Town Code. APPLICATION 15 HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone
Ordinance of the Town of Southold,Suffolk,County,New York and other applicable Laws,Ordinances or Regulations,for the construction of buildings,
additions,alterations or for removal or demolition as herein described.The applicant agrees to comply with all applicable laws,ordinances,building code,
housing code and regulations and to admit authorized inspectors on premises and in building(s)for necessary inspections.False statements made herein are
punishable as-class A misdemeanor pursuant to Section 210.45 of the New York State Penal Law.
Application Submitted By (print name): , uthorized Agent []Owner
Signature of Applicant: Date: 41.
STATE OF NEW YORK)
SS:
COUNTY OF )
r 1HOMN_....... being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)he is the
(Contractor, Agent, Corporate Officer,etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
application;that all statements contained in this application are true to the best of his/her knowledge and belief; and
that the work will be performed in the manner set forth in the application file therewith.
Sworn before me this .
LIE-day of 4. r► 20 t� _.... � . . .m
N a Public
"-It\'E L„GATZ-SCHWAMBORTN
"�01'ARY 1"G��1�1...0C" S�",. .1EOF,NEW 1°"O R
PROPERTY OWNER AUTHORIZATION ° `°'Qualified Stiffn NoCour �
C uS1�1:r�1 a±Lca1&t ruarre7
(Where the applicant is not the owner) 1:`a�inmis'ion 1 xP° rcgDec,24,20�
l� V � — residing at l _._ w...._..._
do hereby authorize _' w _ _ _ ,�to apply on
my behalf to the Town of outhold Building Department for approval as described herein.
wn rs igna .ir Date
—'P41414—
Print
. 1
Print Owner's Name
2