HomeMy WebLinkAbout1000-53.-2-27.2 mimmimew
RECEIVE
SITE PLAN USE DETERMINATION �
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Initial DeterminzWon as to [rether,site plan is required: �
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P.D. bate Received Date of Comment:. ....
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Final Determination
Date:
Signature of Building Inspector
FOR INTERNAL USE ONLY RECEIVED
SITE PLAN USE DETERMINATION JAN 2 2 2024
Initial Determination Planning Board
Date Sent:
Date ��.1L
Project Name. I 1 LLC--
Project Address:
Suffolk County Tax Map No.: 1000- S 3 Zoning District:
Request: ,
(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:
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Initial Determination as to whether site plan is required: Lam"
;Signature of ding Inspector 'f
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Planning Department (P.D.) Referral:
P.D. Date Received:�_� Date of Comment:
Comments:
Signature of Planning Dept. Staff Reviewer
Final Determination
Date:
Decision:
Signature of Building Inspector
sr � 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) 765-95021i
Date Received
APPLICATION FOR BUILDING PERMIT
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For Office Use Only �r�m
PERMIT NO. _ Building Inspectoi,.w ...............�
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:3/7/2023-_,..�_.�,....,�� �� ......�........_�.�._...-
OWNER(S)OF PROPERTY:
Name:67480 Main Road LLC SCTM#1000-53.-2-27.2
Project Address:67480 Main Road Greenport, NY 11944
Phone#:631-734-5600
��Email:office@ co razziniasphalt.com
Mailing Address:PO Box 1056 Cutchogue, NY 11935
CONTACT PERSON:
Name:Trinit Fleischman/Richard Corazzini
Mailing Address:PO Box 1056 Cutchogue, NY 11935
one#: - ..._- 00 �l �� � Email: p
office@corazzlnlas halt.com
Pn... ..,..._.v631 734-56..�...... ..w�� _. ,.d �� �.��.� .� .....w
DESIGN PROFESSIONAL INFORMATION:
Name:
MailingAddress: w ,..._....._____..........�...�..............._...-..............-,_w
Phone#:
'T'Emaik_
CONTRACTOR
INFORMATION: � ..�........... „�. m... ._,. ......
Name:
Mailing Address
Phone#:
DESCRIPTION OF PROPOSED ...
CONSTRUCTION
-�
New Structure ❑Addition ❑Alteration ❑Re ..,..._....-..�. $stimat�-
pair ❑DemolitionEstimated Cost of Project:
DOtherUse Determination --
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Will the lot be re-graded? ^❑Yes *No Will excess fill be removed from premises? ❑Yes RNo
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_...._.._.w..�..... _ .�e_�,..�.�.._�......"�� PROPERTY INFORMATION
Existing use of property:Sterage „� � Intended use of property:AUtomeblle Repair
-_ .� „,fiw
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? ❑Yes ❑No IF YES, PROVIDE A COPY.
R 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 IS 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 a Class A misdemeanor pursuant to Section 21045 of the New York State Penal Law.
Application Submitted By(print e iCh Corazzini ❑Authorized Agent Date: Owner
Signature of Applicant: ���� ,0 i�
STATE OF NEW YORK) /
SS:
COUNTY OF
being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
:M
(S)he is
(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
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PROPERTY OWNER AUTHORIZATIONti�tj rllf01 <"0U11ay
(Where the applicant is not the owner)
I residing at
do hereby authorize „... „„„ _to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
Owner's Signature Date
Print Owner's Name
2
D er, Trace
From: Dwyer, Tracey
Sent: Monday,April 03, 2023 12:36 PM
To• office@corazziniasphalt.com'
Subject• Automobile Repair at 67480 mn rd
Please send me a brief description of the proposed Automobile Repair usage (via this email) so that I can submit the
information to the planning dept.for review.
Thank you, Tracey Dwyer
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