HomeMy WebLinkAbout53270-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#: 53270 Date: 09/14/2026
Permission is hereby granted to:
Constantina Keriazes
PO BOX 1450
Mattituck, NY 11952
To:
construct an accessory outdoor shower as applied for.
Premises Located at:
1005 Capt Kidd Dr, Mattituck, NY 11952
SCTM# 106.-5-11
Pursuant to application dated 08/24/2026 and approved by the Building Inspector.
To expire on 09/13/2028.
Contractors:
Required Inspections:
Fees:
Accessory-New Structure $125.00
CO Accessory Structure $100.00
Total $225.00
Building Inspector
s
°t r � ti TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone(631) 765-1802 Fax (631) 765-9502 ht.tps://wwwsoutholtLto�viiLiy.gov
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only
PERMIT NO. Building Inspector; Y
Applications and forms must be filled out in their entirety.Incomplete
applications will not be accepted. Where the Applicant is not the owner,an Building Deip-arfrnent
Owner's Authorization form(Page 2)shall be completed. Tc)vu,no WM 1nuth old
Date: G( 4S1' Z 20
OWNER(S)' PROPERTY:
Name: n r/G{ 2-eS SCTM#1000-
Project Address: 0,05 � �h N"'Id { Drl V`� .A ..J � N l q �
Phone#:qj j r (-7 7/ Email: ��'Y1 CTY1
Mailing Address:
CONTACT PERSON:
Name; /110— 1< r! a-2-e S
Mailing Address: ,r Bo wh S Z
Phone#: —�� L� _ Email: • L4L) 1
DESIGN PROFESSIONAL INFORMATION: L
Name: A e dl S S7v-;,7,le-r /4550 6-1
Mailing Address. 4 v� &r e,, ct)e /`i /
Phone#: S —�Z��j -3� L� Email:
CONTRACTOR INFORMATION:
Name: e _
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
`,Kbther
Will the lot be re-graded? ❑Yes A`
Will excess fill be removed from premises? ❑Yes �60
1
PROPERTY INFORMATION
Existing use of property: Intended use of property:
Zone or use district `n which premises is situated: Are there any covenants and restrictions with respect to
Zone or use distr;ct'n which premises is situated:
this property? ❑Yes CIF YES, PROVIDE A COPY.
❑ 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 Code. APPLICATIONIS 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 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 premises 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 New York State Penal Law.
Application Submitted By(print name): "; ❑Authorized Agent []Owner
Signature of Applicant: Date:
CON BUNCH
STATE OF NEW YORK) Notary Public,State of New York
SS: No.01 BU6185050
Qualified in Suffolk County
COUNTY OF ) Commission Expires April 14,2 00�
being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
(S)he is the
(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
t� /,
day of j 20 -
'7) w µ 1 'C�� � L�3'J'ti
Notary Public
PROPERTY OWNER AUTHORIZATION
(Where the applicant is not the owner)
I, residing at
do hereby authorize to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
Owner's Signature Date
Print Owner's Name
2
E Survey for:
KONSTANTINA KERIAZES
Lot 185, "Captain Kidd Estates"
At
CAPTAIN KIDD DRIVE ti
$£ Mattituck
Town of
Southold
Suffolk County, New York
3.-- S86'OO'3O» S.C.T.M.: 1000-106.00-05.00-011-000
R=25.00'
403.73' E f'VY4'n�"",E.' 100.00' 20 20
1
L=46.49'
r ns�hs�* 1
ce,.tw.xr SCALE:1"=20'
i
l Lot 185 PROP E NOTES: t
C�T� O O 1. AREA = 12,000 S.F.
Z C - 2. ■= MONUMENT FOUND, O= PIPE FOUND.
N 3. SUBDIVISION MAP "CAPTAIN KIDD ESTATES" FILED
IN THE OFFICE OF THE CLERK OF SUFFOLK
- C) � COUNTY ON JAN 19, 1949 AS FILE NO. 1672.
E 1 STORY FRAME HOUSE
O
N
Lot 184cE
i3
- JUL 03, 2026 nU=_viceo ceanOcxn�
u Lot 186 DATE:JUL 01, 2026
JOB NO:2026-269
cc+vc CERTIFIED TO:
KONSTANTINA KERIAZES
a 3
Ecu'P L'
LOT COVERAGE: v
_____—_41.5--------_ £ce
HOUSE 1391 SF - PANEL
POOL & SPA 791 SF W ` s' -
TOTAL 2182 SF OR 18.1% M _ Poo M
00 00
Z to 1
SPA
I�t
'..... z$ DAMD H. FOX, L.S. P.C. N.Y.S.L.S. #50234
_ FOX LAND SURVEYING
64 SUNSET AVENUE I
N$6 0Q'3O"yf WESTHAMPTON BEACH N.Y. 11978
100.00' (631) 288-0022
now or formerly
Alexandra Pap ulos now or adopo � formerly
& Dimitri Popadopoulos Nana Ujkic Irrevocable trust 1.1 ,
-
DWG: 2026-269