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Home My WebLink About8944-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~=qTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z- 7442 ~te: 01/04/77 THIS CERTIFIES that the building ADDITION TO DWELLING Location of Property: 530 OLD ORCHARD lANE EAST MARION (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 31 Block 6 Lot 19 S%~odivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 3, 1976 pursuant to which Building Permit NO. 8944-Z dated NOVEMBER 4, 1976 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 PRIVATE ONE FAMILY DWELLING WITH ADDITION (GARAGE). 4/7/11 THIS CERTIFICATE OF OCCUPANCY HAS BEEN UPDATED FOR DATE CORRECTION ONLY. The certificate is issued to KING, HOWARD F of the aforesaid building. (OWNER) SUFFOLK COUNtrY DEPART~T OF HEALTH APPROVAL EI~Cr~ICAL CERTIFICATE NO. PLD]~BERS CERTIFICATION DA-l-~u N/A N/A N/A Rev. 1/81 NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificete Of Occupnncy THIS CERTIFIES that the building located at . ~/$..0lcl..Or. ohard .Lane... Street Map No....x.x. ....... Block No.Y. xAt ....... Lot No, X;~... Ea$~;. t'{al'~.ort ............ conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ 1~0¥ .....~., 19.7~. pursuant to which Building Permit No. ~$~. ~ dated ........... ~ ..... ~..., 19.~., was issued, ~d conforms to dl of ~e requffe- ments of the applicable provisions of the law. The occupancy for which this certificate is ~u~d ~ .~. ~. ~ .~. ~. ~,..(,~r~ .......... The certificate is issued to . .Hg~d. ~g ....... ~9~ ............................ (owner, lessee or ten,t) of the aforesaid building. Suffolk County Department of Health Approval ~ ~;~.' ............................... UNDERWRITERS CERTIFICATE No. ~O~B~ .................................... HOUSE NUMBER. ~30 Street Old O~ehard Lane Building Inspector TOWN OF $OUTHOLD · BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date .....................~O.~'OI'~.~O~......~ ......... Permission is hereby granted to: ~o~t..Koz'klt~....A/g..~w~,~....K,'t,n~ ......... ............... 0~.t, ezat ................................................... ~o ...~.u..~..Z...c!..~..n... ~.d. ~.~.,~ .~ ...om.e.;~J, ~ .¢..~.r~.. a~m ~.tn~ .............................................................. at premises located at .M/.S...O[Lr~.,...O.~e..hc.~.d...La~e .......................................................................... .................................................... Ea~t..Eem. i~n ...................................... ~ .......................................... pursuant to opplicotion dated ............................. !FiO~. ....... .~ ........... 19.~..., and opproved by the Building Inspector. Fee $ J. ~,~.C)O. ........... TOWN OF SOUTHOLD Building Inspector's Office Town Clerk Building 5outhold, N.Y. 765-2660 A TOWN ~ ~THOLD~ BUlLiNG DEPARTMENT TOWN CLERK'S OFFICE~ MUTHOLD, N. Y,~ ~//~ ~x~mined . ....................... INSTRUCTIONS O- This application must be completely filled in by typewriter o¢ in ink and submitted in triplicate to the Building Inspector, with' 3 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 giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this app cat on c. The work covered by this application may not be commenced befoJ'erissuance of'Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such 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 whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for fhe issuance of a Building Permit pursuant to the Building Zone Ordinance O~ the Town of Southold,. Suffolk County, New York, .and otheFapplicoble ,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 buildings for. necesson/ inspections. . (Signatl~e of applicant, or name, if a cOrporation) (Address of applicant) State whether applicant is owger, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nome of owner o.~ premises ........................................ i .................. , ...................................... If applicant is a corporate, signature of duly authorized officer.. (Name and title of corporate officer) Builder's License No .... ...~.....o..... ..................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trode's license No ............................................... 1. location of land on which p.rgpg~ed work willie done. ,Map~J~lo.: ............... ~ ...................... Lot No. i ....................... Street and Number ~.~..~.~....~ ............. ~...~ ............... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. ExisJting use and occupancy .~.: .................................................. 3. Nature of work (check which applicable): New Building.. ................. Addition / Alteration Repair .................. Removal .................. Demolitior .................... 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 ..../~...~. ............... Rear ......~....~....~ ................. Depth . ..~.....~..../. ...... Height ..... ./...~...~. ........ Number of Stories ...... !. ..................................................................... i .................................. Dimensions of same structure with alterations or addLtig.ns: ~ront .... ..~'....~. ...................... Rear ...~.....~. ................. Depth ..... ~......~. .................. Height ...... ./...~... ............. Number of Stories ................................ 8. Dimensions of entire new construction: Front ....~....~..'.!......:.:....;.: ...... Rear.../. ....................... ~.. I Depth ...~.....(~....I. .......... Height .....J.../'/.../. ...... Number of Stories ..... / .............................................................................................................. 9. Size of lot: Front ........ ~....~.Z../. .................................... Rear '~ ~ ! Depth ~:~ 10. Date of Purchase ........ J ............................................... N,~. of Former Owner ........................................................ 11. Zone or use district in which premises are situated .......~..~..: ............................................................................... t2 Does proposed construction violate any zoning law, ordinance or regulation: ...'~ ........................................ 13. Will lot be regraded ....~ .......... Will excess fill be removed from premises: (~) Yes ( ) No 14. Name of Owner of premises 2/~...:..Z~ ........................ Address .~'...'~ ..... Phone Address ............................... Phone No ....................... Name of Architect ............................. ~.~,~. ........... Address ...~...~ ........ Phone No.~....~..~.:...~...?...~.ff J'.!ome of Contractor ...................... .~....~..:...'f~....'r~....~.'~..': ......... Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. 0 o lF -I-t A /f'l;, LA, STATE OF NEW' YOB, K I c S uOL, N ~ , OF ..... .~ ........... t~'. ........ f ................ '~...~...~...~.....~....~..~....~..~......~..~.. ............................. .,.....being duly sworn, deposes and says that he is the appliconL (Name of individual signing contract) above named. Fie is the (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have perfbrmed the said work and to rr~ke and fife this application; that all statements contained in this applicction are true to the best of his knowledge and belief; and tha~ the work will be performed in the manner set forth in the application"filed therewith. Sworn to before me this da of. /~a~' .......... .......... ..... , Nota Pub,,c,. ....... . ................ ........................... FLOYD F~ KINO, JR, Notary Public State of New York No. 52-7267800 Suffolk County Term Expires M~rch 30, 197~