HomeMy WebLinkAbout52514-Z TOWN OF SOUTHOLD
BUILDING DEPARTMENT
SOUTHOLD, NY
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit#: 52514 Date: 12/05/2025
Permission is hereby granted to:
Constantina Keriazes
PO BOX 1450
Mattituck, NY 11952
To:
construct accessory in-ground swimming pool with spa as applied for.
Premises Located at:
1005 Capt Kidd Dr, Mattituck, NY 11952
SCTM# 106.-5-11
Pursuant to application dated 10/27/2025 and approved by the Building Inspector.
To expire on 12/05/2027.
Contractors:
Required Inspections:
Fees:
SWIMMING POOLS-IN-GROUND WITH FENCE ENCLOSURE $300.00
CO Swimming Pool $100.00
lbTotal $400.00
15—u—iTding Inspector
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 htts! �,,. ,,.South�7ldtql�1my 'oti�
Date Received
APPLICATION FOR BUILDING PERMIT
Li� „i
For Office Use Only
PERMIT NO. Building Inspector:.�w,, ITIT„„ �......._ � P}
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:
OWNER(S) OF PROPERTY:
L�,� �' i,il c� S SCTM# 1000-
Name: r0(v ~ O 5 v f )
Ke ,'Q z e
Project Address: 0075 Cc p,, ..-, Kidd L)r. /11 _ C/k
Phone#: Email: dC• 'o k n k e_,-is cL Ze S 6 rv►ti I c,C'Y1
Mailing Address: /0C3 3 C'X I L-(50 f'.c k ,
CONTACT PERSON:
Name:
Mailing Address: p6 r3 k !`i Sty
Phone#: 7 - (off Z_ZZZ S Email: /<e✓' C I-eS � ':✓ta[�.' �. Cc�✓I
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION:
Name: 1
Mailing Address: �0 �� L(6� Vt 6
Phone#: 6 -3 f - _ ��`t(� 4� Email: E,1 eP, �t - c, Pic, (S CGz�t
DESCRIPTION OF PROPOSED CONSTRUCTION
tion ❑iie'p Lion Estimated Cost of Project:
❑New Structure ❑Addition ❑Altera air ❑Demob
❑Other /8�° 3
Will the lot be re-graded? ❑Yes 9NO Will excess fill be removed from premises? Yes ❑No
1
PROPERTY INFORMATION
Existinguse of property: 2 Intended use of property: /'e5, Atc
P p Y C' QC.,Lc� c°
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? ❑Yes Mo 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 a Class A misdemeanor pursuant to Section 210.45 of the New York State Penal Law.
Application Submitted By (print name): C,1111 � 3 '� gAuthorized Agent ❑Owner
Signature of Applicant: , Date: ai/ Z I !2
STATE OF NEW YORK)
SS:
COUNTY OF
EJ V2 cif_ being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
(S)he is the �' � t '✓ r
(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
� day of ,2�� .. " Vol
Notary Public
,JES I A RATTTO-EVANS
NOTARY PUBLIC,STATE OF NEW YORK
Registration No.01RA6283041
PROPERTY OWNER A ITHORIZATIO Qualified in Suffolk County
Commission Ex ores �t 2ti, _,
(Where the applicant is not the owner)
residing at err.°r '
I,
en
X,3f
do hereby authorize "� "� ' �' to apply on
my ehal o the To of Southold Building Department for approval as described herein.
Owner"s Sit er Date
Print Owner's Name
2
LOT 185
MAP OF
CAPTAIN KIDD ESTATES
` A � �� BLOCK 95
T DRIVEFILE No. 1672 FILED JANUARY 19, 1949
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Lo BY THE L.I.A.L.S. AND APPROVED AND ADOPTED
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1 00.00' C,ERf FiCA1I NS, INDICATED HEREON SHALL„ RUN
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'11V0.E COMPANY, GOVERNMENTAL AGENCY AND �
JO Ar F, 'I Y N101F LENDING WISTITUT*N USTE:D HEREON AND
HANA WKIC TO THE ASSIGNEES OF THE. LENMNG INST1- PHONE 631`727-2090 Fax (631)727-1727
CUTION. ERDFE CATIONS ARE NOT TRANS1 ERAEII..E. ( /
OFFICES LOCATED AT MAI IN.O. ADDRESS
THE EX STENCE OF RIGHTS OF 'WAY
1586 Main Road P.O. Box 16
ANY/2R SHOWN ARE NOT GUARANTEED. P mesport, New York 11947
AND/OR EASEMENTS OF RECORD, NF James port, New York 11947 Ja