HomeMy WebLinkAbout51346-Z TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
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#: 51346 Date: 11/04/2024
Permission is hereby granted to:
Kominakos Family Trt
416 99th St
Brooklyn, NY 11209
To:
construct alterations to existing single-family dwelling as applied for.
Premises Located at:
2265 Stars Rd, East Marion, NY 11939
SCTM# 22.4-6
Pursuant to application dated 09/20/2024 and approved by the Building Inspector.
To expire on 11/04/2026.
Contractors:
Required Inspections:
Fees:
Single Family Dwelling- Alteration $250.00
CO-RESIDENTIAL $100.00
Total $350.00
fding Inspector
,aocum r
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
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' Telephone (631) 765-1802 Fax (631) 765-9502 It , a/www.sr tith ldtow ,o. o
Date Received
APPLICATIONI j
For Office Use Only -, S E L!a 2,4
, DD I
PERMIT NO. Building Inspector,
BTALIDTNG DEPT.
Applications and forms must be filled out in their entirety. Incomplete .) �s f"TOWN^'"p�' F 5 °4piw
applications will not be accepted. Where the Applicant is not the owner,an
Owner's Authorization form(Page 2)shall be completed.
Date: �.�3� .. . . ...�_.....�,.,..._...,� ...�..�..,�.�.. ..��..........
OWNER(S) OF PROPERTY:
Name:Dimitrios Kominakos � scTM# ioo0- -Z.-7 _ 4
Project Address:2265 Stars Rd., East Marion, NY 11939
Phone#:786-412-1758 Email:mangelakos@gmail.com
Mailing Address:408 Trolley Way, West Chester, PA 19382
CONTACT PERSON:
Name: Pea W �7&V-ri a/"
Mailing Address: P0 E)VX 67q J I,, !lI
Phone#: �o�jl ^��� - Email `....b.....w
DESIGN PROFESSIONAL INFORMATION:
Name: C►lCl✓IOVYIE{�S _. .
Mailing Address: PO f�0� 7 / arS- NY 1191y7
Phone#: 51I0— r7o Z_ 36719 Email: I,�10 V?'101� to 3061p1 LOM
CONTRACTOR INFORMATION:
Name: hi f"i ""Y")0S Koml naYoS � w,
Mailing Address: '7'��I e NPSt Chfs* d PA M36-41
Phone#: '78(O'�1�2—( 15"� Email: moon eIaKo�;
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition Alteration ❑Repair ❑Demolition Estimated Cost of Project:
[--]other- $
Will the lot be re-graded? ❑YescNo Will excess fill be removed from premises? ❑Yes $No
1
PROPERTY INFORMATION
Existing use of property: sivi Ie 17ami.11 Keck denu- Intended use of property: (�-
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? ❑Yes�$o IF YES,PROVIDE A COPY.
Check Box After ReadinXmmX: wThe owner contractor/desi n professional i n g / g p s 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.
Application Submitted By(print name): M e y jLv% CaVvIc Gv- Authorized Agent ❑Owner
Signature of Applicant: Date: `1/ZO/2T
CONNIE D.BUNCH
STATE OF NEW YORK) Notary Public,State of New York
SS: No.01 BU6185050
COUNTY OF ) Qualified in Suffolk County
Commission Expires April 14,2-62 k
being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
(S)he is the cat
(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 torth in the application the therewith.
Sworn before me this
dayof �IU/ r�i� "�
Notary Public
PROP ERTY OWNER 'TH "'t"I I
(Where the applicant is not the owner)M
nimitrinS Kominakos 2265 Stars Rd. East Marion, NY 11939
I, residing at
do hereby authorize L " to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
onµ 1 a- -2-j
Owner's Signature Date
Dimitrios Kominakos
Print Owner's Name
2