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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-20676 Date APRIL 27, 1992
THIS CERTIFIES that the building ADDITION
Location of Property 2295 STILWATER AVE. CUTCHOGUE N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 103 Block 8 Lot 51
Subdivision Filed Map No. Lat No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 4, 1991 pursuant to which
Building Permit No. 19766-Z dated APRIL 5, 1991
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy far which this certificate is
issued is SCREENED IN PORCH (DECK) ADDITION TO EXISTING ONE FAMILY
DWELLING AS APPLIED FOR.
The certificate is issued to THOMAS & ELIZABETH BURKE
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NfA
UNDERWRITERS CERTIFICATE N0. N/A
PLUMBERS CERTIFICATION DATED NJA
Buildinq Inspector
Rev. 1/81
maw[ xo. a
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N°_ 19 7 6 6 2 Date .....~~-s' 19
Permission is hereby granted :-~//~.j~ ~Jj~~( r~J~j®/ ~~l x/~~>3 ~ ~
1~'
l~~~/~rq ~,Q
f....K .........~if~(.
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' of Premises located at ...°~.,.2:.~.~..~
......~...1.~Y.~~ .......sr~ur4
.................................................................4~,,..~~...
County Tox Map No. 1000 Section .......~lr...:.~. Block ............Q....... Loot No.......~..7.../.../.....
pursuant to application doted .....~.~.~j~ 19.~,/.., and opproved by the
Building Inspector.
p r7
Fee S.~Q
f~
ing for
Rev. b/30/80
LJ \,(!'~~L~~~L~ Form No. 6
c:~..
TOWN OF SOUTHOLD
' MAR 2 31997_ BUILDING DEPARTMENT
TOWN HALL
i~, ~ 765-1802
1 OVvl~ ~ -
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APPLICATION FOR CERTIFICATE OF OCCUPANCX
A. This application must be filled in by typewriter OR ink and submitted to the building
inspector with the following: 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 Chat the solder used in system contains
less than 2/10 of ly 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 property showing all property lines, streets, building and
unusual natural or topographic features.
2. A properly completed application and a 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 - $5.00 over 5 years - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $/15.0/0, Commercial $15.00
Date .....~f.`?.v'!•%.Z
New Construction........... Old Or Pre-existing Building
Location of Property..c,~l,a„~;~ . ?~.T/LL ~ ;/3Ti~r(~ , , , ~}U,~t , , , ~ v.TG'f/oG v ~ . /Y-.'`/..... .
House No. Street Hamlet
Onwer or Owners of Property..T~'~Uf??,~g;5,,,8U~6t;F„d..~4(L?/,3r'T/~ /3iJ.Ld~.
County Tax Map No 1000, Section... ~dr~......Block...... 0 Cy ......Lot..,~~
jJRO.~,F.2T'~ - BF
SubdivisionsSFv.Gr:4~ .............m:~:~~~v~....Filed Map..~.°.~~!~....Lot..9l.-.Y :3.............
Permit No.. ! 9.76.~''.......Date Of Permit. ~(s./ v~ ......ApplicantT~d.'~~g 5 QCJ/L~l'c
Health Dept. Approval ..........................Underwriters Approval.........................
Planning Board Approval
Request for: Temporary Certificate........... Final Certicate...x,......
Fee Submitted: ~?~~L>.L~
(~,,eee, y3~~ .
.APPLICANT
co ~a667~
C~'~-~
765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION i5T [ ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ FINAL
REMARKS:
DATE YY INSPECTOR
765.1802
BUILDING DEPT.
f NSPECTION
[ ]FOUNDATION i5T [ ] ROUGH PLBG.
[)FOUNDATION 2ND [ ] IN ELATION
FRAMING FINAL
[7
REMARKS: _j r~
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DATE ~ ~"S~INSPECTOR
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FOUt1DATI0N._.. (1st) ~y~\t
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FOUNDATI011 ( 2nd ) '-'„(per
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ROUGH FRAME &
PLUMBING V`
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I1ISULATION PER N. Y.
STATE ENERGY
CODE
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FINAL '-``3---
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ADDITIONAL COMMENTS: x~
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;'~':;~~E;"+((~,' S1; (~,3-'^,~ BOAFD OF HEALTIi
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~~,\.;,~L___. I ~k ` d SETS OF PL.1YS
'I~~~~~4f FORM NO.1 -~$URVEY
~~I }i° TOWN OFSOUTHOLD -~CiICCt:
! F3UILDINGOEpARTMENT SEPTIC FOR:1
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~4~j_- _,OI l:!~ TOWN HALL .
6 r;'t-'r, " ` ~ $OUTHOLII_ DLY. LLff71 t:p'"' FY
( 1`Ctil'"i'i't~ ;,:"r is! 1.
' TEL., 7G5~tII02 CALLf1
Exatnincd . 19 ~ MA L T0:. • • . • . • • . • • .
Approved 19~~Pcrmit No.. ~1..7G . .
DisapprovcdaJc
APPLICAT1ON FOR BUILDING PERI411T .
Date Icf.~I
INSTRUCTIONS
a. This application must be completely tilled in by typewriter or jn ink and submitted to the Building Inspcctnr, wiL
Sets of plans, arratrate plot plan to scale. Fee zccorrting to schedule.
b. Plot plan showing location oC lot and of buildings on premises, relationship to adjoining premises or public strc:
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is pare of this app
cation.
c. The work covered by this application may not 6e commenced before issuance of Building Permit.
~d. Upon approval of tltis application, the Building Inspector will issued a Building Permtt to the applicant. Such perr.
shall be kept on the premises available Cor inspection throu_}tout the work.
e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupant
shall have been granted by the Building Inspector.
APPLICATION IS HERESY MADE to the Building Department for the issuance of a Building pe^:it purrsant to t:
Huilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws. Ordinances r
Rc_ulatians, for the construction of buildings, additions or alterations, or removal or dcmolitio , as rein describe;
The applicant aerees to comply with all applicable laws, ordinances, bu' cod ho sin; de, gulations, and t
admit authorized inspectors on premises and in building for necessary i ons.
(Signature appli nt, or na a corporation)
(I`Iailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
NameoCowncrofpremises ......,!Y[OC'f~s _.,k~l'ttz.IC~r
.
(as on the tax roll or latest deed)
lCapplican[ is a eorporaNion~,
signature oCduly authorized officer. '
• ~ ~ • • ~ (Name and ~titfe of corporate officer)
Builder s Liccnsc No_ . _ ~'N,k,~d, wN _ _1'i_rT"~f15 7j?V7~
Plumber's Liccnsc No. , , (1//f
L, , , , , , _ , , , _ ,
Electrician's Liccnsc No. , ; , l~//~} , , , ; , , , ; , , , , ,
Olltcr Trade's Liccnsc No. Nr~ , . • , , , _ ,
- Location of land on which proposed work will be dorc;
ilouscNuntbcr ~ Strcct ~
ff Hamlet '
County Tax \lap No. 1000 Section ....4~.......... Bluuk , , , ,
• Lot , S,
Subdivision ,2, ~pQ_91~ j'~,~, F-{RND.. F.iIcJ Ala r • • • • • • • • • • • .
( ttttcj ' I No. ,~28C~ Lot .~'::93 • ,
Stztc existing use and occupancy of premises and intended use and occu a '
r~ P ncY of proposed construction:
A. k:xisting use and occupancy....S-e:t:'°..!:~1:~1\~ •,~~,~'~~/~1C.lrj.
1~4n'1~`[J~•
B. Incended use and gccuPancy .:..................:.C,• ~5~~'•vW
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' SURVEY FOR ,
JON f!. CHITUK 4 HENRIETTA CHITUK
REVISIONS: LOTS 81 THRU 83E"MAP OR SECT. TWO, PROPERTY OF M.S.HAND"
AT C1ITCH000F DATE 1 OCT. 14, 1982
JAN. 3,1886 SCALE 1 I" = 40~
TOWN OF SOUTHOLD
SUFFOLK COUFITY, NSW YORK N0. 1 82-589
N UNAUTIIONI2E0 AI:fEIlAT10N Ot ADDITION TO TNIt GUARANTEED T0~ _
aUAVEY It A VIOLATION Of tECT10N TtOf Of TN[ CHICAGO TITLE
NEVI YO'i% tTATE COUCATION UW.
n tOnEi Of TNIt tVAVEY NOT tEARINt THE LAND EASTEi11i F£D L18 8r 1
9UNVEY011't IN%ED TEAL Olt [MtOttED tEAL {MALL LOAN N W' YOV
NOT tE CONt10EME0 TO A VALID TIIUE CO/Y. O r I ~
MOUAl1ANTEEt INOIC.:iEO NENEON {MALL RUN ONLY TO YO o
THE PE090N 1011 wNON THE tUt VEY 1! /tE/AHED, ~
AND OA Nlt tENALf TO THE TITLE CON?ANY,OOVEIIN• ~ , • ~
MENTAL AGENCY AM)LENDINO INSTITUTION LItTEO gg I~i~1: ~••{,r,„• ~ '
NEIIEON.AND TO THE A9010MEEt Of THE LENDING 9 ~tl~d;p{{~1~ ,o ~ i
INSTITUTION. OUASANTEEt ARE MOT TNANSfE11ASLE !
TO ADf•ITIONAL INSI•ITUTIONt 011 tUSSEOUENT ~O ~ ~ I
1 ~ MONUMENT p OItTANCEt {MOWN IIER[ON itON ?FtO?ENTY LINE{ ~~.r N 0~0
UBDIV SIGN MAP FILED IN THE OFFICE OF THE CLERK OF /UM/O!! ANO AME NOT TO tE
U CD TO EETAtILItN `,J~ON,11 EM Ir~~~'/
UFFOLK COUNTY ON NAY 12, 1939 AS FILE N0.1280 /NO?ENTY LIN[S 011 FOt THE [IIEOTION Of fEMCp. ~
UFF. CO.TAX MAPS DIST. SECT. BLK. LOT
1000 103 0e YOUNG a YOUNG ao00STA NOERAVENUE
RIVERHEAD, NEW YORK
ALDEN W. YOUNG,PROfESSIONAL ENGINEER
ANO LANG SURVEYOR N.Y.S.LIC£NSE N0.12G4y
IIOWARD W. YOUNG, LAND SURVEYOR
N.Y.S. LICENSE N0.45893
DYNE 1051 NDU~I R:d :kti4CL', ' •