HomeMy WebLinkAbout52568-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#: 52568 Date: 12/22/2025
Permission is hereby granted to:
Nikolaos Katopodis
69 Castle Ridge Rd
Manhasset, NY 11030
To:
Legalize "as built"window and door replacements as applied for.Additional certification may be
required.
Premises Located at:
1540 The Strand, East Marion, NY 11939
SCTM# 30.-2-65
Pursuant to application dated 11/03/2025 and approved by the Building Inspector.
To expire on 12/22/2027.
Contractors:
Required Inspections:
Fees:
As Built Addition/Alteration $500.00
CO Single Family Dwelling-Addition /Alteration $100.00
Total $600.00
Building Inspector
TOWN OF STHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P.O.Box 1179 Southold,NY 11971-0959
Telephone(631)765-1802 Fax(631)765-9502 lift s://N F.sonti"oldtONN lln .'off
Date Received
BUILDINGAPPLICATION FOR PERMIT
For Office Use Only
PERMIT NO. G ��. __ Building Inspector N O V 3 2025
Applications and forms must be filled out in their entirety.Incomplete t n: meat
applications will not be accepted. Where the Applicant is not the owner,an hlll
Owners Authorization form(Page 2)shall be completed.
Date: l 3 L2-
OWNER(S)OF PROPERTY: ,J/
Name: t° ��Dli( l SCTM#1000-
Project Address:
5 oi esty G—�.s�- �-�on �. I) q,3
Phone#: 5 - ,j ' �o ((� Email: Y}r�j k,(t.f D /S l
Mailing Address:
CONTACT PERSON: D ° icy es
Name: L I
Mailing Address: )90 1)
Phone#: b 31 - Sf�LQ -C�1ld Email:
DESIGN PROFESSIONAL INFORMATION:
Name: 50 V YCL S So rG( 'ek1 "" S ,-y�m 5 ►p �'�
Mailing Address: j(2 D I1 1�G st�Li e 40 L-1 ' " r J�A4 s S-� "1
Phone#: sl�v 73-7Email:
CONTRACTOR INFORMATION:
Name:
Mailing Address:
Phone#: O 7�. � � Email:66 l :.r'
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition IJAlterati n ❑Repair ❑Demolition Estimated Cost of Project:
.5C�tkler �
Na
Will the lot be re-graded? ❑Yes No Will excess fill be removed from premises? ❑Yes ]
1
PROPERTY INFORMATION
Existing use of property: '� i m Intended use of property: 5 6(yl C;
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? E]Yes 1XNo 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 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 amply with all applicable lam,ordinances,building code,
housing code and regulations and to admit authorized inspectors on premises and in buildings)for necessary inspections.False statements made herein are
punishable as a Class A misdemeanor pursuant to Section 210AS of the New York State Penal Law.
Application Submitted By(print name): 0AUthorized Agent ❑Owner
Signature of Applicant: Date: ! 3 l Z
STATE OF NEW YORK)
S
COUNTY OF �.
°G « n 0 S/2 )6L- being duly sworn,deposes and says that(s)he is the applicant
(Name o individual sl Ing contract)above named,
k /
(S)he is the � ° ° '"/
(Contractor, en ,Corporate Officer,etc.)
of said owner or7,, ers,and is duly authorized to pe orm 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 202.E
ary Public
Fiv)L
" I' 1) EMILY TOTW,NOTARY PUBLIC
STATE OF NEW YORK.COUNTY OF SUFFOL
(Where the applicant is not the owner) REGISTRATION No.04 .i34
EXPIRES 04110 1cl 1 40% `S`f
residing at
do hereby authorize
/ o apply on
my behalf to Town of Southold Building Department for approval as described her in.
Ow er's Signature ate
Print Owner's Name
2
Buildiag DMIMent A119katiffla
A " C2 N
(Where the Applicant is not the Owner)
(trtla-Ir t� at �' '� residing at I ; `{a —v, S` "
%
(print property owner's name) (Mailing Address)
do hereby authorize
(Agent)
? S 6(3 L:1? to apply on my behalf to the
Southold Building Department.
(Owner's Si ature (Date
(Prin�e�r'sN