HomeMy WebLinkAbout52983-Z TOWN of SOUTHOLD
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BUILDING DEPARTMENT
Ae SOUTHOLD. NY
BUILDING PERMIT
(THIS PERMIT MIDST BE KEPT ON THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL 'FULL COMPLETION OF THE WORK AUTHORIZED)
Permit#: 52983 Date: 05/15/2026
Permission is hereby granted to:
Dimitris 2ouxias
141.53 South Dr
Malba, NY 11357
To:
Construct an inground swimming pool accessory to an existing single-family dwelling as applied for
Pool and pool equipment must maintain minimum setbacks of 10 feet.
Premises Located at:
475 Summit Dr, Mattituck, NY 11952
SCTM# 106.•1-42.2
Pursuant to application dated 05/08/2026 and approved by the Building inspector.
To expire on 05/14/2028.
Contractors:
Required Inspections:
Fees:
SWIMMING POOLS-IN-GROUND WITH FENCE ENCLOSURE $300.00
CO Swimming Pool $100.00
Total $400.00
Building Inspector
p N y M', P AI IYm1,v
TOWN OF SOUTHOLD--BUILDING DEPARTMENT
youth ld NY 11971-0959
Town Hall Annex 54375 Main Road P. 0. Box 1179' o ,
low
Telephone (631) 7+65-1802 Fax (631) 765-9502 ,1 t 3s:, ' �,",rvv.so, th,o d ow :. y,.t,
n.V
Date Received
APPLICAT10N FOR BUILDING PERMIT
1,777 L...,m ri e...
111d,
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For Office Use Only
9
Building i I d i n I s ��:PERMIT NO.
M
_ ,4.;u
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:O5/06/26
OWNER(S)of PROPERTY:
Name: loennis Zouzies SCTM# 1000-105-01-42.2
Project Address: summit Drive, Mattituck, NY 11952
Phone#:917-576- 995 Email.aouzia @0meil.com
Mailing Address:555 Summit Drive, Mattituck, N.Y. 11952
CONTACT PERSON:
Name:Brooke Epperson
Mailin g Address:
POBox 152 Mattituck NY 11952
Phone#:6-31 503 9092 Email:bepperson@amparchitect.com
DESIGN PROFESSIONAL.INFORMATION:
Name:AnthonyPortillo
Mailing Address:PCB Box 152, Mattituck, N.Y. 11952
FPhone#:531 603 9092 Email:aportillo@amparchitect.com
CONTRACTOR INFORMATION:
Name:
Mailing Address:
Phone# Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure [-]Addition DAlteration ❑Repair d Demolition Estimated Cost of Project:
0Other INGROUND SWIMMING POOL $120,000
Will the lot be re-graded? ❑Yes iRNo Will excess fill be removed from premises? Yes [:IN 0
No
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PROPERTY INFORMATION
nth Intended use of property: e, r
Existing use of prop":s i ng!q.F,� � �� ��I '
....
covenants and restrictions with respect too
Zone or use distract in which premises is situated: Are there any Love pact
this property'' Mes ji No IF YES,PROVIDE a COPY.
R40 Non-Conforming
............
C h+ec k 8 o x After R ea d i rt,g: The ow r f contnctair/desiRn pro span fiessbntwi Is ra sJbte lot 101 d rainago snd stern+wat+a"Lsswes as Pt ev/ad by
Building Permit srrt to the Zone
Building Department for the issuance of a� � P�
Clhapfier 2�l6 d'the Tovwrt Cade. 11l�uUT1�ON l5 HEREBY MADE fio the I � part
Ordbufte of the Tom of S+outhokl,5+u1'fok County,New York and,other applicable lam,ordinances or Resuistlons,forthe co of b�ul"IIffinp►, �
add Aftwatiom or far mri vml or demolition as herein described.The applicant e=rees to comply with ell spplksble laws,o rdbanc+es, +a,
hover
wade and regu ns latio and to admit mAhosited Inspectors on premises And In buliding1s)for necessary Inspectians.False ststeinents n"We her are
punishat*e a Mass A miaderneanor pursuant to Section 210.4S of the New York State Penal Law.
Appllr� I'll. n Submitted By(Ont nam+e)..A P ArchitectureN�Authorizedi,Agent 130wner
Date:
Signature of Applicant.
STATE OF NEW YORK)
Cowry OF � �'�--
A
being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
S he is the
Agent
(Contractor,Agent,Corporate officer,etc.)
of said d owner or owners and is dui authorized to perform or have performed the said work and to make and file this
, Y
application;that all statements contained in this application are true to the best of his/her knowledge and belief;and
' fie therewith.
application
Ica tlon
that the work well be performed in the manner set forth in the pp
sworn before me this
day of 2 0 m% .
Notary Public J
MARIA PRIKAS GANLEY
FMVy
Public-State of New York
PROPERTY NO.U1PR50U32i16
alified in Suffolk County
p026Where the applicant is not the owner rn�ss,on Expires Octoct 14,
� � � �'•.�..� �� 0 �-1 ,residing at Do5 -rot!, Summit Drive, Mattituck
. -I"I -"-Wi...........
AMP Architecture
do hereby authorize to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
C;Z'G
ow,in I natur Date
Print Ownees Name
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