HomeMy WebLinkAboutZ-20938 FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office 'of the' Building Inspector
Town` Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z720938 Date AUGUST 12, 1992
THIS CERTIFIES that, the building ONE, FAMILY DWELLING
Location of Property 120 OLD MAIN ROAD LAUREL, N.Y.
House No. Street Hamlet..
County Tax Map No. 1000 Section 126 Block 2:. Lot 2
Subdivision Filed Map No. Lot No.
conforms substantially to the Requirements for a One Family Dwelling built
Prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z-20938 dated AUGUST 12, 1992.
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 ONE FAMILY DWELLING, METAL MOBILE HOME & ACCESSORY' GARAGE
The certificate is issued to MILDRED LAUBENGEIGER & GILBERT KOLLOFF
(owners) .
of the aforesaid building..
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE •NO. N/A
PLUMBERS CERTIFICATION DATED N/A
*PLEASE SEE ATTACHED. INSPECTION REPORT.
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ildi g Inspec or
Rev. 1/81
BUILDI:•:G DEP:u T7`1E T
T0.•+ 1 OF SOUTHOLD, N. Y.
' HOUSING CODE INSPECTION REPORT
Location 120 OLD MAIN ROAD MATTITUCK, N.Y.
mummer & street (i•iunicipaiity)
Subdivision i,iap No . Lot(s )
Name of Owners ) MILDRED LAUBENGEIGER & ANO
Occupancy 1 FAMILY RESIDENCE & MOBILE HOME OWNERS
hype owner-tenant
Adnmitted by: OWNER Accompanied by: SAME
Key available 7:Suffolk Co. Tax No. 126-2-2
Source of request WICKHAM,WICKHAM 6 BRESSLER P.C. Date JULY 13, 1992
. DWELLING
Type of construction FRAME rstories 2
Foundation BLOCK (MASONARY) Cellar 507- Crawl space 50Z
Total rooms , lst. Fl 2 2nd. F1 2 3rd. F1
Bathrooms) 2 Toilet room(s)
Porch, type STOOP WOOD Deck, type WOOD Patio, type_
Breezeway Garage Utility room
Type Heat ELECTRIC Warm Air Hotwater
Fireplace(s) No. E:cits 3 A.ircor_ditioning
Domestic hotwater Kg - Type heater ELECTRIC
Other METAL MOBILE HONE
ACCESSORY STRUCTURE'S:
Garage, type const. FRAME Storage, type const. FRAME
Swirm;�ing pool Guest, type const.
Other
VIOLATIONS: CHAPTER 45--N.,Y. STATE UNIFORM FIRE PREVENTION S, BUILDING CODE
Location Descrintion � Art. Sec .
BP.:!#4326Z-CO Z-20937 for Add., BP #20887Z-CO Z-20936 for Deck Add.,
Remarks. BP #20887Z- CO Z-20935 for A Shed.
Inspected b Date of Insp. 7/29/1992
TH �J. SHER Time start 11:00 end 11:25
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL 11
765-1802 j1
JUL 221992
APPLICATION FOR.CERTIFICATE OF ,OCCUPANCY 3t;-T '
TOVVN OF,SOU?h. +LD
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 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 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 $15.00, Commercial $15.00
Date . . . . . . . July. /:3 :..1992. . . . . . . . . . . . . . . . . . . .
New Construction. . . . . . . . . . . Old Or Pre-existing Building. . . . . X (2 story frame house)
.Location of Property„120.Old.Main_Road, ,Mattituck . . , . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . ... ... . .... .
House No. Street Hamlet. . . . . . . . . . .
3nwer or Owners of Property. . , , . ,Mildred Laubengeiger and .Gilbert .Kolloff
county Tax Map No 1000, Section. ,126._OO. . , , ; ,Block. . . . , , ,02:00 . . . .Lot. . . 002;000 . . . . . . . . . . .
subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map.. . . . . . . . . . .Lot. . . . . . . . . . . . . . . .
'ermit No. . . . . . . . . . . . . . . .Date Of Permit. . . . . . . . . . . . . . . .Applicant. . . ... . . . . . . . . . .
. . . . . . . . . . . . . .
[ealth Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . .
'lanning Board Approval. . . . . . . . . . . . . . . . . . . . . . . .
tequest for: Temporary Certificate. . .. . . ... . . . Final Certicate. .4. , , , , , , ,
.ee Submitted: $, 100,.00
V t Cd�a 09 M. d
3$' I APPLICANT_. yed' �ubengeiger
CONSENT TO INSPECTION
Mildred Laubengeiger the undersigned , do ( es ) hereby
Owner ) Name ( s )
state :
That the undersigned ( is ) ( are ) the owner ( s ) 'of the premises in the Town
of Southold located at 120 Old Main Road, Mattituck, New York 11952
Which is shown and designated or. the Suffolk County tax map as District 1000 ,
Section 126.00 , Block 02.00 , Lot 002.000
That the undersigned ( h'as ) ( have ) filed , or caused to be filed , an applica-
ticn in the Southold Town Building inspector ' s Office for the following :
Certificate .of Pre-Existing Use
(2 story frame house)
That the undersigned do ( es ) hereby give consent to the Building Inspectors
of the Town of Southold to enter upon the above described property, including
anv and all buildings located thereon, to conduct such inspections as they
may e'eem necessary with respect to the aforesaid application, including inspec-
ticns to cetermine -,-at said premises comply with all of the 'laws , ordinances ,
rule-s 3.,.. reQ _ la _ _ons o. t`e
n _e r.de_ s ig::ed , .n ccnse.. _ ing to such inspections , 5c ; es ) so wi _h the
kncw :edce any: uncersta^ding that any information obtaine•5 .n -:-e conduct of
such inspections may 1e used as evidence in subsequent prosecutions for vio-
laticns cf tine laws , ordinances , rules or regulations of the Town of Southold .
Da t e : July /3 1992
Signature
Mildred Laubengeiger
Print name
Signature
Print name
PLEASE CONTACT MILDRED LAUBENGEIGER AT 298-4308 FOR ACCESS
JUL 221992
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SURVEY FOR
RICHARD E. ODDON, & EILEEN E. ODDON
A T MA T TITUCK
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N. Y.
1000 - 126 - 02 -.02
Scale: 1"= 30'
Jul. 6 1992
'k JUL 2 21992
tv� F9 C -TOVVN O �}t3" -�—'
S. LIC. NO. 49618 , Prepared In accordance with the minimum
P , P.C. standards�for title surveys as established -
i5/6 by the L.I.A.L.S. and approved and adopted
P. O for. such use by The New York State Land
MAIN ROA Title Association.
SOUTHOLD, N.Y.- 11971
92-21 O
BUILDI:`G -DEP:u T -=. T
TO?-41Td OF SOUTHOLD, N. Y.
HOliSIidG CODE IiiSPECTION REPORT ,
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Location
�numoer 6( ' freer ,iu icipaiity)
Subdivision Map No. Lots)
Name of Owner(s ) �
Occupancy
AVY04b. Owner-Lenanz
Admitted I Accompanied by:
Key available Suffolk Co. Tax No.
Source- of request Date Z.
--------------
M.'ELLING
Type of cons/�r ct'on Ae- rst•ories
Found ation/% Cellar space Crawl —�-
�
Total rooms, 1st. Fl 2 2nd. F1 3rd. F1
Bathrooms) Toilet room(s) _
Porch, type J Deck, type Patio typ-E_ —'
Breezeway Garage Utility room -- ,
Type Hea " ' 'alarm Air ` Hotwater
Fireplace(s) No. E:cits`3 Aircond•tioning�
Domestic hotwater Type heater
Other -
i
ACCESSORY STRUCTURE'S:
Garage, type const. Storage, type const.
Swizmming pool . Guest, type const.
Other 06
VIOLATIONS: CHAPTER 45--N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
Location Description � Art. � Sec .
2-G Co
Remarks:
Inspected by: Date of Insp.
Time star 00 end $-
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TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER STREET' _0 VILLAGE DIST. SUB. LOT
No. F
/ Z
FORMER OWNERFA
S: W TYPE OF BUILDING ,.
�G it ;4
RES. . SEAS. VL FARM COMM. ' CB. MISC: ` Mkt.`Value T
N IMP TOTAL _ DATE REMARKS `
1
Aml , LA Q3 =n14E'i "tR` %o_/4I,Lqu13tniG i,Gr-K
D o .i&0�d Q 70 8 8G 155 1 Z .. wOD�7 ty �f y
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AGE .- BUILDING CONDITION ;
NEW NORMAL' ' BELOW
FARM Acre Value Per Value x y
Acre .ail
Tillable 1
1 ;
Tillable
t. airy.
Till
able 3; %•
Woodland
1.
Swampland FRONTAGE ON WATER
c.
F
Brushland FRONTAGE ON ROAD �0, a
House Plot DEPTH ws
". . BULKHEAD r `2
jTotal4—
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Extension 'Basement Ij / Floors K. ? .
Extension Ext. Walls �J) S`f, Interior Finish 2 LR.
Extension Fire'Place
Heat 7 DR.
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T-b& e F 1st Floor s"'
Porch Recreation Roo Rooms 2nd Floo FIN. B.\; ,
Porch;.: Dormer '
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Breezeway °, Driveway
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