HomeMy WebLinkAbout1000-63.-4-5.5 I 1
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PRECAST RE AST
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CONCRETE DRYWELL SYSTEM
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1200 E TSE
DR IST
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ARTIFICIAL TUPE
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SITE PLAN
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TAX MAP #10001-64-04-03
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r�°MAIN h ' { TAX MAP
Sr?EMA drl NIEDICALARTS APPROXIMATELY 5900
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LOT COVERAGE
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PROPOSED LOT AR EA:
EXISTING RErRl29263 SQ FT
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PAVED
RE. °:L 141 HOUSE, P IE AND RAMPS:
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PARKING lit
FE i 2,055 T
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-- — 6,290 SQ FT
DPATN 14
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AM d "� 5.900 SQ FT
E — � TOTAL COVERAGE:
41
14,245 SQ FT
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P13 HL NIT, 13C_
FORM NO. 3
sff !.
TOWN OF SOUTHOLD
BUILDING DEPARTMENT 2atp
SOUTHOLD, N.Y.
}
ou h n.
NOTICE OF DISAPPROVAL L 2�
DATE: May 23, 2018
TO: Templeton/Pelletier
57190 Main Road
Southold, NY 11971
Please take notice that your request dated April 19, 2018
For permit install an artificial turf track accessor,,to an existing medical office building, and make site
improvements(paving and drainage) at
Location of property: 57190 Main Road. Southold. NY
County Tax Map No. 1000— Section 63 Block 4 Lot 5.5
Is returned herewith and disapproved on the following grounds:
The proDosed construction Mutres siteIan a royal from the Southold Town Pl Board.
------- _-,.r__-- _®m ______
oried Signature
Cc: File, planning,
F FOR INTERNAL_ USE UNLY a APR 24 2018
SITE PLAN USE DETERMINi4Tl N- S,,,r,0£. os:,n
_ Initial Determination
Date Sent:_11 q
��--' — �
Date:__
Project Name: _
Project Address:
Proj _ Q
Zoning District:
Suffolk county Tax Map No.:1'000=
110,
orting dorner Cation a to
_ - Permit Appli . tion and su.pP =
(N,te: copy of building
proposed case or uses should he submitted-) I
•-
- - .m
Initial Determination as to whether use is p ermitted� e
Initial-Determination as to whether site Pi is required:— { _
Signat
ilding In pe car
Planning De'partment (P.D.) Referral:
�.
-Date of orrimert -�
p.D.Date Received:
comments: ,L
Signature of Planning Dept. Staff Reviewer
Ifni Dornmfinfion
Date: / !_
Decision:
c;.-+nnhirp- of Ruiviina insnPctnr
FOR INTERNAL USE UNC Y
SITE PLAN USE DETERMINATION
initial ete `m nation
-1 — .:
Date Sent:
Date: •
Project-Name:
Project Address:
Zoning District:
t Tax Map No.:1_000-a_
Suf€olk County
Request`!.n _..
and supporting ortin documen(ation,a!5 to
- iication
N te: C0P cif building Permit App
proposed use or uses should he submitted.)
as to whether use
Initial Determination is permitted
tion as to whether site plan is required:_�;�'j,
term►na
Initial De
e
gnat tiding rope car
Planning Department (P.D.) Referral: .
Date of Comment:
P.D.Date Received:= —�-- —
Comments: -
Signature of Planning Dept.-Staff Reviewer
1 incl Det6rMination
Date:
Decision:
Q;"nntirP of Ruildino Insnectcr
TOWN.3F- OUT'HOLD BUILDING£ `MIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL Board of Health
SOUTHOLD,NY 11971 4 sets of Building Plans
TEL: (631)765-1802 Planning Board approval
FAX: (631)765-9502 Spey
Southoldtownny.gov PERMIT NO. Check
Septic Form
N.Y.&D.E.C.
Trustees
C.O.Application
Flood Permit
Examined 20 Single&Separate
Truss Identification Form
Storm-Water Assessment Form
Contact:
Approved ,20 Mail to:
Disapproved a/c
Phone:
Expiration 2020
tS �U V Building Inspector
APR 1 9 2018 LICATION FOR BUILDING PERMIT
Date 20
BUILDING DEPT. INSTRUCTIONS
TOWN OF SOUTHOLD
a.This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
sets of plans,accurate plot plan to scale,Fee according to schedule.
b.Plot plan showing location of lot and of buildings on premises,relationship to adjoining premises or public streets or
areas,and waterways.
c.The work covered by this application may not be commenced before issuance of Building Permit.
d.Upon approval of this application,the Building Inspector will issue a Building Permit to the applicant.Such a permit
shall be kept on the premises available for inspection throughout the work.
e.No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector
issues a Certificate of Occupancy.
f.Every building permit shall expire if the work authorized has not commenced within 12 months after the date of
issuance or has not been completed within 18 months from such date.If no zoning amendments or other regulations affecting the
property have been enacted in the interim,the Building Inspector may authorize,in writing,the extension of the permit for an
addition six months.Thereafter,a new.permit shall be required.
APPLICATION IS HEREBYMADE to the•Building Department for the issuance of a Building Permit pursuant to the
Buildina Zone Ordinance of the Town of Southold,Suffolk Count},New York,and other applicable Laws,Ordinances or
Regulations'for the construction of buildings,additions,or alterations or for removal or demolition as herein described.The
apnt agrees to comply with all applicable laws,ordinances,building code,housing'code,and regulations,and to admit
authorized inspectors on premises and in building for necessary inspections.
( gauapplicant or name,ifa corporation)
ailing address of applicant) U J(9
State whether applicant is owner,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder
0hrn:rr-
Name of owner of premises 'C--
(As on the tax roll or latest deed)
If applicant is a corporation,signature of duly authorized officer
(Name and title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No. P
1. Location of land n which ;` e ,work wall b6-do K \ 1
� ��� .-•E� ate.
House Number Street Hamlet
County Tax Map No. 1000 Section Bloch Lot