HomeMy WebLinkAbout52971-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#: 52971 Date: 05/13/2026
Permission is hereby granted to:
Parianos A &A Trt
79-21 21st Ave
East Elmhurst, NY 11370
To:
demolish (as per Town Code definition) and reconstruct an accessory structure with a new accessory
apartment as applied for per ZBA&SCHD approvals.
Premises Located at:
2720 Sigsbee Rd, Laurel, NY 11948
SCTM# 126.-5-13
Pursuant to application dated 05/12/2026 and approved by the Building Inspector.
To expire on 05/12/2028.
Contractors:
Required Inspections:
Fees:
Accessory Apartment in Accessory $531.50
CO Accessory $100.00
Total $631.50
7l --
Building Inspector
�p s TOWN OF SOUTHOLD—BUILDING DEPARTMENT
�4
Town Hall Annex 54375 Main Road P. O. Box 1 179 Southold,NY 11971-0959
_ Telephone (631) 765-1802 Fax (631) 765-9502 htta:` voutholdtonn .=ov
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APPLICATION FOR BUILDING PERMITi --
For Office Use Only
PERMIT NO. Building Inspector:
-hlbl
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:9/26/24
OWNER(S)OF PROPERTY:
Name:Maria Poubouridis SCTM#1000-126-05-13
Project Address: 2720 Sigsbee Road, Mattituck, NY 11953
Phone#:718-290-3772 JEmail:anthoulaparianos@gmail.com
Mailing Address: 2720 Sigsbee Road, Mattituck, NY 11953
CONTACT PERSON:
Name:Brooke Epperson
Mailing Address:PO Box 152, Mattituck, NY 11952
Phone#:631 603 9092 Email:bepperson@amparchitect.com
DESIGN PROFESSIONAL INFORMATION:
Name:Anthony Portillo
Mailing Address:PO Box 152, Mattituck, N.Y. 11952
Phone#:631 603 9092 Email:aportillo@amparchitect.com
CONTRACTOR INFORMATION;
Name:
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ®Alteration ❑Repair ❑Demolition Estimated Cost of Project:
❑Other Accessory Apartment within Detached Structure $150,000
Will the lot )e re-graded? ❑Yes ONo Will excess fill be removed from premises? ❑Yes BNo
1
PROPERTY INFORMATION
Existing use of property:Single Family Residence Intended use of property:Single Family Residence
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
R-40 NC this property? ❑Yes No IF YES, PROVIDE A COPY.
91 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 Cade.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 comtruction of buildings,
additions,alterations or for removal or demolition as herein described.The applicant agrees to comply with aB applicable laws,ordinances,building code,
housing code and regulations and to admit authorized inspectors on premises and in buiklingis)for necessary inspections.False statements made herein are
punishable as a Class A misdemeanor pursuant to Section Z10AS of the New York State Penal law.
Application Submitted B AMP Architecture
tint name): RAuthorized Agent ❑Owner
Signature of Applicant`j _ _ _ Date: 112
STATE OF NEW YORK)
COUNTY OF 0-���I�S 1
1 - being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the F
(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 1^
I2 day of �G' C� 1 D DC _�
fAdarytAblic
NOTARY PUBLIC,STATE OF NEW YORK
PROPERTY OWNER AUTHORIZATION Registration No.OiA00019644
(Where the applicant is not the owner) Qualified in suffclk county i
Commission Expires J,,nuary 9,2026
Maria Poubouridis residing at 2720 Sigsbee Road, Mattituck, NY 11953
I,
do hereby authorize AMP Architecture to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
3/8/24
Owner's Signature Date
Maria Poubouridis
Print Owner's Name
2
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