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43851-Z
��o�5UFF01,��p�y Town of Southold 12/30/2019 o � P.O.Box 1179 o _ 53095 Main Rd y p� Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 40967 Date: 12/30/2019 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 27475 Route 25, Cutchogue SCTM#: 473889 Sec/Block/Lot: 102.-1-13 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 5/29/2019 pursuant to which Building Permit No. 43851 dated 6/12/2019 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: "AS BUILT"INSTALLATION OF A WINDOW IN AN EXISTING ONE FAMILY DWELLING,AS APPLIED FOR The certificate is issued to Chrisafis,Jerry&Esther of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED IOUed ignature o�S�o�/co TOWN OF SOUTHOLD �� ay BUILDING DEPARTMENT CA 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#: 43851 Date: 6/12/2019 Permission is hereby granted to: Chrisafis, Jerry 52-28 Redfield St Douglaston, NY 11362 To: As built alterations to a residential building (east side) as applied for. At premises located at: 27475 Route 25, Cutchogue SCTM # 473889 Sec/Block/Lot# 102.-1-13 Pursuant to application dated 5/29/2019 and approved by the Building Inspector. To expire on 12/11/2020. Fees: AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $400.00 CO -ALTERATION TO DWELLING $50.00 Total: $450.00 Building Inspector Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings,property lines,streets,and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board'of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in,system contains less than 2/10 of 1%lead. 5. Commercial building,industrial building,multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings(prior to April 9,1957)non-conforming uses,or buildings and"pre-existing"land uses: 1. Accurate survey of properly showing all property lines, streets,building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant.If a Certificate of Occupancy is denied,the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1., Certificate of Occupancy-New dwelling$25.00,Additions to dwelling$25.00,Alterations to dwelling$25.00, Swimming pool$25.00,Accessory building$25.00, Additions to accessory building$25.00, Businesses$50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy-$.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential$15.00, Commercial$15.00 Date. May 29th 2019 New Construction: Old or Pre-existing Building: V (check one) Location of Property: 27475 Route 25 Cutchoque House No. Street Hamlet Owner or Owners of Property: Jerry and Ester Chrisafis Suffolk County Tax Map No 1-000, Section 102 Block 01 Lot 13 Subdivision Filed Map. Lot: Permit No. s) Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: `/ (check one) Fee Submitted: $ Applicant Signature ----- # # TOWN OF SOUTHOLD BUILDING DEPT. `ycou765.1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [XNSLATIOWCAULKING U /�- FRAMING/STRAPPING [ FINAL 'fes &Of [ ] FIREPLACE & CHIMNEY [ ] FIRESAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION- [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS:._ 1 DATE l _INSPECTOR_ l � ✓ 1 ESO --- -- # } TOWN OF SOUTHOLD BUILDING-DEPT, coum, '' 765■1802 INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] -FOUNDATION 2ND [ SULATIOWCCAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE,& CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT-CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: tvV' r DATE I INSPECTOR FMY,D YNSPtCTYON REPORT .DATE COMMENTS FOUNDATION(1ST) y .................................... 'FOUNDATION (ZND•) CIO ROUGH pFRAMING&LYJMBING y � INSULATION PER N.Y. 9 H STATE ENERGY CODE - IV FINAL ADDITIONAL COMMENTS . z -------------- rn b P TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HA ;L Board of Health SOUTHOLD,NY 11971 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631)765-9502 Survey SoutholdTown.NorthForkxet PERMIT NO. 1 o Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Examined 20 Single& Separate Storm-Water Assessment Form y q Contact: Approved 7 20 l 1 Mail to: Robert Wilson Disapproved a/c PO Box 49 Southold NY 11971 Phone: (631)504-8842 Expiration ,20 t� )6 MAY 2 9 2019 LICATION FOR BUILDING PE Date May 29th ,20 19 INSTRUCTIONS TOWN OF S(3UTi1'0�+ a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans, accurate plot plan to scale.Fee according to schedule. b.Plot plan showing location of lot and of buildings on premises,relationship to adjoining premises or public streets or areas, and waterways. c. The work covered by this application may not be commenced before issuance of Building Permit. d.Upon approval of this application,the Building Inspector will issue a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughout the work. e.No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the properly have been enacted in the interim,the Building Inspector may authorize,in writing,the extension of the permit for an addition six months. Thereafter, a new permit shall be required. 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, or 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 for necessary inspections. (Signa pplicant or name,if a corporation) PO Box 49 Southold NY 11971 (Mailing address of applicant) State whether applicant is owner, lessee,agent, architect, engineer, general contractor,electrician,plumber or builder Agent Name of owner of premises Ester and Jerry Chisafis (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: 27475 Route 25 Cutchogue House Number Street Hamlet County Tax Map No. 1000 Section 102 Block 01 Lot 13 7\. Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy Single family residential with accessory building Same with renovations to exiting accessory building including the following changes. Remove existing picture window. Repair double jack studs and window stool that rotten. Re-set existing b. Intended use and occupancy window in same opening. Repair siding adjacent to window.Add new CO2 and smoke det. 3. Nature of work(check which applicable): New Building Addition Alteration_ Repair Removal Demolition Other Work (Description) 4. Estimated Cost Fee (To be paid on filing this application) 5. If dwelling,number of dwelling units Number of dwelling units on each floor If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front 121-6" Rear 121-6" Depth 26-9" Height 13'-6" Number of Stories 1 Dimensions of same structure with alterations or additions: Front 121-6" Rear 12'-6" Depth 26'-9" Height 13'-6" Number of Stories 1 8. Dimensions of entire new construction: Front 12'-6" Rear 12'-6" Depth 26-9" Height 13'-6" Number of Stories 1 9. Size of lot: Front 50.00' Rear 50.00' Depth 100.00' 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated R40 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO V 13. Will lot be re-graded? YES NO V Will excess fill be removed from premises? YES NO 27475 Route 25 14. Names of Owner of premises Jerry and Ester chrisafis Address Cutchogue NY Phone No. (631)504-8842 Name of Architect Address Phone No Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES V NO * IF YES, SOU MOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES V NO * IF YES,D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey,to scale,with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below,must provide topographical data on survey. 18. Are there any covenants and restrictions with respect to this property? * YES NO_V * IF YES,PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF ) Robert Wilson being duly sworn, deposes and says tl t E j§.ftVp}icant (Name of individual signing contract)above named, Notary Public,State of New York No.01 BU6185050 (S)He 1S the Agent Qualified in Suffolk County Commission Expiry April, (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 knowledge and belief,and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this day of 20� Notary Public4919nature of Applicant InSIJFFQ Scott A. Russell 61, STO]KlMMA\T]E]K SUPERVIS®R � I��l[A\lam AG]EM]EN'7C" SOUTHOLD TOWN HALL-P.O.Box 1179 O 53095 Main Road-SOUTHOLD,NEW YORK 11971 Town of Southold CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT ) —_ DOES THIS PROJECT INVOLVE ANY OF THE FOLLOWING: G:� Yes No (CHECK ALL THAT APPLY) ❑[2] A. Clearing, grubbing, grading or stripping of land which affects more than 5,000 square feet of ground surface. ❑Q B. Excavation or filling involving more than 200 cubic yards of material within any parcel or any contiguous area. ❑® C,, Site preparation on slopes which exceed 10 feet vertical rise to 100 feet of horizontal distance. ❑® D. Site preparation within 100 feet of wetlands, beach, bluff or coastal ► erosion hazard area. ❑® E. Site preparation within the one-hundred-year f loodplain as depicted f on FIRM Map of any watercourse. ❑® F. Installation of new or resurfaced impervious surfaces of 1,000 square feet or more, unless prior approval of a Stormwater Management Control Plan was received by the Town and the proposal includes in-kind replacement of impervious surfaces. If you answered NO to all of the questions above, STOP! Complete the Applicant section below with your Name, Signature, Contact Information, Date & County Tax Map Number! Chapter 236 does not apply to your project. If you answered YES to one or more of the above, please submit Two copies of a Stormwater Management Control Plan and a completed Check List Form to the Building Department with your Building Permit Application. APPLICANT (Property Owner,Design Professional,Agent,Contractor,other) S.C.T.M. #: 1000 Date District I NAME Robert Wilson 102 1 13 5/29/2019 ,h Section Block Lot **** FOR BUILDING DEPARTMENT USE ONLY**** i{ Contact Information. (631)504-8842 ' - - — — — — — — — — — — — — — Reviewed By: Property Address/Location of Construction Work: — — — — Date- - — — — — — — — — — — — — 27475 Route 25 I Approved for processing Building Permit. Stormwater Management Control Plan Not Required. Cutchogue NY 11935 Stormwater Management Control Plan is Required (Forward to Engineering Department for Review.) FORM * SMCP-TOS MAY 2014 T ���.� .�Os�fFOt Town Nail Annex© G N Telephone(631-1802 S4375 Main Road 1 -�= Fax(631) 734-9502 P_ O. Box 1179 0C43 Southold, FAY 11971-0959 , i BUILDING DEPARTMMY' .r - NOTICE OF UTILIZATION OFTRUSS TYPE,CONSTRUG ON, PRE-ENGINEERED WOOD CONSTRUCTION AND1.ORt TIMBER,C.6 f.TRUCTION Dote: May 17th 2019 Owner: Jerry/and EsterjGhrisafis =? Location of Property: 27475 Route g5 Cufchogue•NY' P1 -lase ta �Z e ke noticethah,the)(check.applcabie line);";'; New residential'structure'eKi 'yAddition to existing reside `fiaUbtrticttire .y: V Rehabilitation to an existih' resid"a,Ntructc{cerA ' a to 13e constructed.-or performed at the,s-0ject,.properlyf*fv.nce move wilt ritdti;; (check applicable line): y}Y,, f;= Trcass.type-construction ) - sd,f: Pre-engineered wood construction{I?;(U} V Timber construction (TC) :3,' ,;, ' ',: �t.;,.„�:• :.;.,; ; , ; • 4 in the followin iocatiori s check a licable fine Floor framing, rs=ari Including girded'beams�{+t� - us Roof framing (R) #: Floor and roof Panning (FR)I t, Signature: w-t , � Ro6ertIsoiVamesbmtngtsorm):" ' I Oapacity(check applicable dine): ' Owner:rep'resentative- _A* TrussResReolS.doc ::,r, :,Effacti0e 1112015 ., ;s ®��aF S�r�'D Town Hall Annex 4 Telephone(631)765.1802 54875 Maim Road yg�g P.4.Box 1179 + �� roae��, r.richel t( p`Wtj soutli015.ny us Southold,NSC 11971-0959 BUH DING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL: INSPECTION REQUESTED BY: , Owner Date: May 29th 2019 Company Name: Name: License No.: Address: Phone No.: JOBSITE INFORMATION: (*Indicates required information) *Name: Chrisafis *Address: 27475 Route 25 Cutchogue NY *Cross Street: Cases Ln `Phone No.: (631)504-8842 Permit No.: � Tax-Map District: _ 1000 Section: 1o2 Block: Lot 13 *BRIEF DESCRIPTION OF WORK(Please Print Clearly) Extensive interior renovation. (Please Circle All That Apply) Is job ready for inspection: YES NO Rough in Final *Do.you need a Temp Certificate: YES! NO Temp Information(If needed) *Service Size: 1 Phase 3Phase, 100 950• 200 300 350 400 Other *New Service: 'Re-connect Underground ' Number of Meters Change of Service Overhead i Additional Information: PAYMENT DUE WITH APPLICATION B24Request for Inspection Form { i SURVEYED FC?R:- G. -S -•, LOCATED AT . TOWN OF .S�C./ 7'"f�Q G. ,� . 4UPFOLK COUNTY N.Y. LOT /5 MAR OI: SCALE t" CO. G.K. NC}, FILED SUFFOLK CO. TAX MAR DATA: DIST. ../000 ,SEC. /0,Z,p(p SLK. �o/pG> LOT � b � AzAe�,Al-4. /TS 50CCE55cAv5 4vo ae 4s.51ams f.s�►-Y. .4 �-k'.o C•4.�..! y i�L E /�v5 '.4 A_I C,� SURVEYED .�'��T. /� 1956 BY I WILLIAM R. SIMMONS JR. o A 1A�'�S7-A7-"rl `` Rl0 SOX 377 G,5 JAMESFORT, L.L. N.Y. 11947 i i 21�: FILE NO. 11�, 7l,,3' PAGE GRID 3 RESIDENCE 27475 MAIN RD EXIS '1 CUTCHOGUE N.Y. 9x52 29xEXIST ii �' : '' d`'' 3OOST. �+ UNDER -� ©® �� EXISTING: SINGLE FAMILY RESIDENCE C.T• I DATE: _ R•P•# SCTM# 1000-102-1-13 /�/�/\) REF. `� SINK i — � FkE:.a.., B�":�- _ ZONE R-40 .11 ACRES NO CHANGES I NOTIFY BUILDI'l G DEPARTR?ENT AT x I PROPOSED: EXIST,KITCHEN I 65-1602 8 AM 10 4 PM FOR THE NO CHANGES ' FOLLOWING iNSPEC T IONS: REMOVE EXIST. PICTURE WINDOW. REPAIR DOUBLE JACK +� 1, FQUPIDAT'.ON - TWO REQUIRED STUDS AND WINDOW STOOL THAT ARE ROTTEN. RE-SET FOR POURED CONCRETE EXIST. WINDOW IN SAME OPENING. REPAIR SIDING pADJACENT TO WINDOW. �' ooxro 2. ROUGH - FRAMING & PLUMBING CLOSET w CJ li 3. INSULATION ADD NEW CO2 AND SMOKE DET. @INTERIOR U 4. FINAL - CONSTRUC T IOPl MUST I BE PLE T E FOR C 0. I ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW FLOOR PLAN & ELEVATION YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. SCALE AS NOTED MAY 2019 CQMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES Fess -� 101 EXIST. ROOF REQUIRED w NO CHANGESAS �" ;- NS OF ' T STUDIO LIVING SPACE � � O F BEDROOM/LIVING RM. rns q 1 - Dfe E:9'. f; r,`rrtf�N't x.s::Cfltlflr� 98'CEIL. HEIGHT Q118 ADD NEW CO2 DET. & - SMOKE DET. ; Cpl I�eTe�@ PO BOX 49 R'tPIEh7lLW JOAN CHAMBERS SOUTHOLD NY 11971 631-294-4241 AS EXIST. PAS ICY O x REMOVE. REPAIR WALL 5m `�� �® �� ni &RE-SET WINffi/`AY DOW E L S UNLAWFUL C@41fication T H0 U T C E 19—11 F KAT E y, u!re-do EXIST.HEADER 51-6,. EXIST.SIDING TO BE REPAIRED ' O OCC PANCY REPLACE DOUBLE JACK STUDS& •�, WINDOW STOOL DUE TO ROT I EXIST. 55x58 FIXED PIC.UNIT 1 FLOOR PLAN SOUTH ( FRONT) ELEVATION 1 /4" = 1'-0" 5.24. 19 1 /4" = 1'-0" 5.24. 19 OF NEW y DEE 0�'� t 09 w A "' Z�FQ 072 AROFESSk �,