HomeMy WebLinkAbout49027-Z TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, NY
441 " ,.
.a
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 #: 49027 Date: 3/14/2023
Permission is hereby granted to:
Kouvaras, George
29 Sunnyvale Rd
Port Washington, NY 11050
To: construct accessory pool house as applied for per SCHD approval.
At premises located at:
80 Soundview Ave
SCTM # 473889
Sec/Block/Lot# 100.-1-1
Pursuant to application dated 1/30/2023 and approved by the Building Inspector.
To expire on 9/12/2024.
Fees:
ACCESSORY $240.00
CO-ACCESSORY BUILDING $50.00
Total: $290.00
Building Wspector
. t ." 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 lett p ://www". otjtholdtowrin ".go
,a' "
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only p I g
PERMIT NO. f4 Building Inspector. (b7e
i
Applications and forms must be filled out in their entirety.Incomplete "
applications will not be accepted. Where the Applicant is not the owner,an SUILUINGOElyr
Owner's Authorization form(Page 2)shall be completed.
Date:01/30/23
OWNER(S)OF PROPERTY:
Name:George Kouvaras SCTM#1000-100-1-1
Project Address:80 Soundview Ave, Mattituck NY 11952
Phone#:917-592-8767 1 Email:george.kouvaras@kamconsultants.com
Mailing Address:80 Soundview Ave, Mattituck NY 11952
CONTACT PERSON:
Name:Michelle Sarabia, AMP Architecture
Mailing Address:P.0 BOX 152 Mattituck NY 11952
Phone#:631-603-9092 Email:msarabia@amparchitect.com
DESIGN PROFESSIONAL INFORMATION:
Name:Anthony Portillo, AMP Architecture
Mailing Address:P.O Box 152 Mattituck NY 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
Will the lot be re-graded? ❑Yes @RNo Will excess fill be removed from premises? ❑Yes RNo
1
PROPERTY INFORMATION
Existing use of property:Single Family Dwelling intended use of property:Single Family Dwelling
Zone or use district in which premises is situated. Are there any covenants and restrictions with respect to
R-40 NC this property? Dyes BNo IF 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. 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 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.
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Application Submitted (print name)"I ��` L YL @Authorized Agent ❑Owner
Signature of ApplicaftI Date: V 1 I�123
STATE OF NEW YORK)
SS:
COUNTY OF Suffolk
AMP Architecture, Jess Magee 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 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 mee�tl is
SO day of, , 20�3
NotaryPublis "
"
1 Deborah OrlowsM
s ..oma"
"�..�� Notary Public,9taN of&W Yofh
PROPERTY OWNER AUT110RI A 1 =* No.01OR6280392
_ PUBLIC t w
in Suflblk
(Where the applicant is not the owner ",>~� Ct„�nExpires0� Q2,
��'I+�Pd III EAM1IN"
\e I, ,residing at .,,
as to V_ AMP ARCHITECTURE, Jess Magee
do hereby authorize to apply on
my behalf to the n of SouthD wilding Department for approval as described herein.
Ow Ignature Date
nt Owner's Name
2
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