HomeMy WebLinkAbout52776-Z �,�QF�ouryo TOWN OF SOUTHOLD
BUILDING DEPARTMENT
SOUTHOLD, NY
G� G
i
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SETOF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit#: 52776 Date: 03/24/2026
Permission is hereby granted to:
Georgia Papadakis
406 Mark Tree Rd
East Setauket, NY 11733
To:
construct alterations to an existing single-family dwelling as applied for.
Premises Located at:
26165 Route 25, Orient, NY 11957
SCTM# 18.-3-23
Pursuant to application dated 01/22/2026 and approved by the Building Inspector.
To expire on 03/23/2028.
Contractors:
Required Inspections:
Fees:
Single Family Dwelling- Alteration $451.00
CO-RESIDENTIAL $100.00
r
Total $551.00
Building Inspector
� ° ,,� TOWN OF SOUTHOLD--BUILDING DEPARTMENT
� �k
` ° Town Hall Annex 54375 Main Road P. (J. Box 11 i 9 Southold,NY 11971-0959
`ar
Telephone (631) 765-1802 Fax (631) 765-9502 t ��'�, �� . � �; ,� �� �. w
Date Received
APPLICATION FOR BUILDING PERMIT
For office Use only
a u .
w
h
PERMIT No. Building Inspector,,-.
� � .....� �W�owowow00000000000�����wowow00000�� �n "
.......................................
r,
J A 111111111 2 2 2
Applications and forms must be filled out in their entirety.Incomplete
application's will not be accepted. Where the Applicant is not-the owner,an
Apr
Owner's Authorization'form(Page 2)shall be completed.
o
Date• ( l e
OWNER(S)OF PROPERTY:
Name:G EO RG IA PAPADAKI S SCTM# 1000-18-3-23
Project Address:26165 MAIN RD, ORIENT NY, 11957
Email-
Phone# 3 °Q E m i I:� �; o i.,�c.. "1 �4_P.VJ
Mailing Address: .
Yo
2
CONTACT,PERSON
Name:LEEEANNE LEGAKIS
Mailing Address:578 BELLMORE STREET WEST I SLI P NY 11795
Phone#:631-747-4629 Email:LLEGAKIS04@GMAIL.COM
,DESIGN PROFESSIONAL INFORMATION:
Name:LEEANNE LEGAKIS
Mailing Address:578 BELLMORE STREET, WEST ISLI P, NY 11795
Phone#:631-747-4629 Email:LLEGAKIS04@GMAIL.COM
CONTRACTOR INFORMATION,
a me: PA
,
/t f,
Mailing Address
M, t I —7 3.
Phone#: a :
DESCRIPTION OF'PRO'POSED'CONSTRUCTION
❑New Structure ❑Addition iRAlteration ❑Repair R Demolition Estimated Cost of Project,
❑other $
Will the lot be re-graded? ❑Yes ®No Will excess fill be removed from premises? ❑Yes *No
r
1
PROPERTY INFOMWION
w
Existing use of property.RESIDENTIAL HOME ' Intended use of property:RESIDENTIAL HOME
Zone or use district in which premises is situated' Are there any covenants and restrictions with respect to
R-80 this property? �rYes OiNo IF YES, PROVIDE A CDRY.
i
.. ` �•` 4W
s
tom► 2" o hi n#?wm!�ptww # zone
I 'I,�; � ►� � a r � for the cb�coa ,0`bumnss,
�y I +a►`
dbod.The'opp4c*it AgMetl I*011t*Wftkog**Ici Uws'ar4bAft 6u
� heir r+
y
i
LEEANNELEG Ki�
Application Submitted By(print name): Fs uthtorized Agent ElOwn'er
_ m a
Signature cif Applicant: Oa. e. �v 2,&
I
STATE OF NEW YOR K)
SS.
COUNTY OF SUFFOLK
r
LEEANNE LEGAKIS
being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
y is theA ENT (ARCHITECT)
(Contractor,Agent,Corporate Officer,etc.)
of said owner or owners,and is duly authorized to perform Dr have performed the said work and to mare 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 Barth in the application file therewith.
Sworn before me this
1
day of A 20
Notary P*EBRA ANN BROWN
Pd a r
y
NOTARY PUBLIC,STATE OF NEW R
PROPERTY c
T Registration No.01 BR.621 3
(where the applicant_ is not the owners qualified in uffol ur Iy,
My Commission Expires:
GEORGIA PAPADAKIS
i, residing at
k ` o hereby' authorizeLEEANNE LEGAKIS
to apply on
my be' ', tot Town of Southold Building Dez4artment for approval as described herein.
z,�w
Owh
erOs Signature Cate
GEORGIA PAPADAKIS
Print Owner's Name
2
WON