HomeMy WebLinkAbout52992-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#: 52992 Date: 05/19/2026
Permission is hereby granted to:
John Siderakis
74 Dover Rd
Manhasset, NY 11030
To:
legalize an "as built"finished basementto an existing single-family dwelling as applied for. Additional
certification may be required.
Premises Located at:
405 The Short Ln, East Marion, NY 11939
SCTM# 30.-2-6
Pursuant to application dated 02/26/2026 and approved by the Building Inspector.
To expire on 05/18/2028.
Contractors:
Required Inspections:
Fees:
As Built Alteration $1,280.00
CO-RESIDENTIAL o o
Total
Building Inspector
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`al TOWN OF SOUT:HOLD_BUILDING DEPARTMENT
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Town Hall Annex 54375 Main Road P. 0. Box 1179 Southold,NY 11971-0959
Telephone(631) 765-180 Fax (631) 765-9502 i t " " .s o 1,d,,,to . ,nn,y o
Date Received
APPLICATION
FOR BUILDING PERMIT
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For Office Use Only
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F E B
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PERMIT NO.
Building Inspector. r
Applications and farms must be filled out in their entirety.Incomplete
applications will not be accepted. Where the Applicant Is not the owner,an
Ownees Authorization form(Page 2)shah be completed.
Date.2.20.26
OWNER(S) OF PROPERTY:
Name:John Siderakis SCTM#1000-30-2-6
Project Address:
� 406 The Short Lame, East Marion, NY 11939
Phone#:917-957-9955 Email:siderakisj@yahoo.com
Mailing Address:74 Dover Road, Manhasset, NY 11030
CONTACT PERSON:
Name:Joan Chambers
Mailing Address:Pp Box 49 Southold NY 11971
Phone#:631-294-4241 Email:joanchambers10@9mail.com
DESIGN PROFESSIONAL NAL INFORMATION: �
Name:Lou Schwartz
Mailing Address: 7 Ridgewood St, Bay Shore, NY 11706
Phone#031) 410-6838 Email:tiderunnereng@9mail.colm
CONTRACTOR INFORMATION:
Name:
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
C-INew Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
Other as built finished basement was inspected for rental pe,rmit $
Will the lot be re--graded? C]Yes *'No Will excess fill be removed from premises? []Yes No
1
.................................................
PROPERTY INFORMATION
Existing use of propertY:single family Intended use of propertY:same
...............
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
R-40 this property? E]Yes *No IF YES, PROVIDE A COPY.
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Check Box After Reading: The owner/contractor/delp professional Is responsible for all drainage and storm water Issues as provided by
Chapter 236 of the Town Code. APPUCATION 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,Now 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 comply with all applicable laws,,ordinances,building code,
housing code and regulations and to admit authorized inspectors on premJses and In building(s)for necessary Inspections.False statements made herein are
punishable as a Class A misdemeanor pursuant to Section 210.45 of the U New York State Penal w.
..........— I I'll ..........................— I
Application Submitted By(print name):Joan Chambers UWAuthorized Agent [3 Owner
Signature of Applicant: Date:
STATE OF NEW YORK)
COUNTY OF
Joan Chambers - being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
Nhe 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 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 Ce Y1A-0LYr- 2Q "I . ..... • 0A...............
ota r,y P u b I i ii�c
T'FACEY L. DWYER
PROPERTY OWNER AUTHORIZATION NOTAFtY PUBLIC,STATE OF NtW YORK
NO.01 DW6306NO
(Where the applicant is not the owner) OUILIFIED IN SUPFOLK COUNTY
COMMSSION EXPIRESOJUNE 30,ZPA
John Siderakis residing at 74 Dover Road, Manhasset, NY 11030
do hereby authorize Joan Chambers t, o apply on
my behalf to the Town of Southold Building Department for approval as described herein.
ry
02/20/2026
.............................
Owner's Signature Date
John Siderakis
Print Owner's Name
2