HomeMy WebLinkAbout52984-Z TOWN OF SOUTHOLD
BUILDING DEPARTMENT
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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#: 52984 Date: 05/15/202E
Permission is hereby granted to:
Dimitris Zouzias
141-53 South Dr
Malba, NY 12357
To
Construct alterations to an existing single-family dwelling as applied for as well as window and door
replacements and resurfacing of existing decks.
Premises Located at:
475 Summit Dr, Mattituck, NY 11952
SCl'M# 108.-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:
Single Family Dwelling- Alteration $1,112.50
CO Single Family Dwelling-Addition /Alteration $100.00
Total $1,212.50
8u i Inspector
�� u TOWNC) ' SC�UTHC�LD_BUILDING DEPARTMENT
Town Hall Annex 54375 Main load P. ( . Box 1179 Southold,NY 11971-0959
c � Telephone (631) 765-1802 Fax (631) 765 9502 ht ,: w .so ho�.It ��a �� c°v
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Date Received
APPLICATION FOR BUILDING PERMIT
U I 'm
For Office Use Only
41,
PERMIT NCB.
5c� Building InspectoM AY 8 2026
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Applications and farms must be filled out in their entirety.incomplete
applications will not be accepted. Where the Applicant is not the owner,an
4,
Owner's Authorization form(Page 2)shall be completed.
Date:05/06/26
E
OWNER(S)OF PROPERTY:
Name:loannis Zouzip.0 sCTM#1000-105-01-42.2
I
Project Address�. Summit Drive, Mattituck, NY 11952
Phone#:917-575-3995 Email:izouzias@'gmail.com
Mailing Address: �
555 Summit Drive, Mattituck, N.Y. 1195
CONTACT PERSON:
Name:Brooke Epperson
Mailing Address:po Box 152, Mattituck, NY 11952
Phone#:531 503 9092 Email:hepporson@amparchitect.com
DESIGN PROFESSIONAL.INFORMATION:
Name:Anthony Portillo
Mailing Address:po Box 152 Mattituck N.Y. 11952
Phone#:531 603 9092 Email:aportillo@amparchitect.com
CONTRACTOR INFORMATION:
Name:
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUC"!'"`ION
❑New Structure ❑Additiien iRAlteration ❑Pepair D Demolition Estimated Cost of Project
other Interior Renovation ,85,000
Will the lot be re-graded? C-lYes R No Will excess fill be removed from premises? ❑Yes No
1
I,
PROPERTY INFORMATION
Ekistir*use of property:Slngl 1T1i1 F e ent Intended use of property ,]n', e mflv esidential
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
R40 NonmConforming this property? ❑Yes R No IF YES,PROVIDE A COPY.
0 Check Box After Reading: The owner/conbnctor/design professional is roMmsi Me for all drainage and sWm water Iawrs as pooW& by
O"W 236 of the Town code.APPuaTNON IS N'EREGY MADE to the Building Department for the ksuence of a 0uOdWS Pond pursuant to the SoOdIng Zow
Ordbunce of the Tom of SouotoK Su fok County,New York and other applicable Lsws,ordinances or Ite;uistlons,W the conshr�vn of buildings,
sddMNar�s,elteratiar or far removal or demoihion as he rehn deuribed.The appiirant esreas to comply wMth all appi ab a Maws,ordbunces,buNdkV coda,
houallng code+anal regulations and to admit wathorized Inspectors on premises and In buNding1s)for necessary Inspectkm False statenwib made milt r are ! �
punmabie as a Class A misdemeanor pursuant to Section 210AS of the New York State Penal law.
.AMA' Architecture
. E�Authonzed Agent C3C�rriwCr
Appl�corr Subnnittee'Iid�3x(print name):
AMP
Signature of Applicant ��o Date: 3L(z
'
j5TA-.of NEW YORK)
COUNTY OF
being du hsworn,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 owner or owners,and is duly authorized to perform or have performed the said work and to make and fide 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.
5wom before me this
day,of200
.... Ad, NN
Notary"Public
MARIA PRIKAS GANLEY
7Notar� Public-State of New York
PROPERTY OWNER,E � Na.09 PR50U32(l�
alified in Suffolk County
(Where the applicant is not the owner) mission Expires Oct 19, 2026
ummit Drive,. . �555Mattituck
110, I � residing at
. AN'li�' Architecture
WWWOW* --
o�hereby authorize,AMP apply on
my behalf to the Town of Southold Building Department for approval as described herein.
n �, hiature Date
Print Owner's Name
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