HomeMy WebLinkAboutZ-41123 �p�gllFF04�Ori Town of Southold 3/7/2020
y� 53095 Main Rd
co Southold,New York 11971
o � �
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: 41123 Date: 3/9/2020
THIS CERTIFIES that the structure(s)located at: 200 Sixth St, Laurel
SCTM#: 473889 Sec/Block/Lot: 126.4-12.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the requirements for a built prior to
APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 41123
dated - 3/9/2020 was issued and conforms to all the requriements of the applicable provisions of the law.
The occupancy for which this certificate is issued is:
wood frame one family dwelling accessory wood frame shed.*
Notes:BP 7601 addition/alteration COZ-6425; BP 14154 addition COZ-15943
The certificate is issued to Loschen Caroline Fmly Trt
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT. `
tho ' d S ature
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 200 Sixth St,Laurel
SUFF.CO.TAX MAP NO.: 126.-1-12.1 SUBDIVISION:
NAME OF OWNER(S): Loschen Caroline Fmly Trt
OCCUPANCY:
ADMITTED BY:
SOURCE OF REQUEST: Loschen Caroline Fmly Trt DATE: 3/9/2020
DWELLING:
#STORIES: 1 #EXITS: 2
FOUNDATION: cement block CELLAR: partial CRAWL SPACE:
BATHROOM(S): 1 TOILET ROOM(S): UTILITY ROOM(S):
PORCH TYPE: DECK TYPE: PATIO TYPE:
BREEZEWAY: FIREPLACE: wood burning stove GARAGE:
DOMESTIC HOTWATER: x TYPE HEATER: electric AIR CONDITIONING:
TYPE HEAT: oil WARM AIR: forced hot air HOT WATER:
#BEDROOMS: 2 #KITCHENS: 1 BASEMENT TYPE: unfinished
OTHER:
ACCESSORY STRUCTURES:
GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST: wood frame shed
SWIMMING POOL: GUEST,TYPE OF CONST:
OTHER:
VIOLATIONS:
REMARKS:
INSPECTED BY: JOHNJ DATE OF INSPECTION: 3/4/2020
TIME START: 9:15am END: 9:37am
Form No.6 /�}1
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. or existing buildings(prior to April 9, 1957)non-conforming uses,or buildings and "pre-existing"land uses:
Accurate survey of property 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$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00,
Swimming pool $50.00,Accessory building$50.00,Additions to accessory building$50.00,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
New Construction: Old or Pre-existing Building: (check one)
Location of Property CS C� fp 1� C--�^ UM&W —
House No. nStreet Hamlet
Owner or Owners of PropertyP 1� !/y fL��� 4'yk PS L/_ o S'G CA
Suffolk County Tax Map No 1000, Section ( dib Block Lot
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: check one)
Fee Submitted: $ t o ��
U4 a_a&ig3a pplica i ture
CONSENT TO INSPECTION
SG4 e-01, , the undersigned, do(es)hereby state:
Owner(s)Name(s)
That the undersigned (is) (are) the gWner(s of the premises in the Town of
Southold, located at .2 op � �— ,
which is shown and designated on the Suffolk County Tax Map as District 1000,
Section r 2( , Block_I, Lot /2--
That the undersigned (has) (have) filed, or cause to be filed, an application in the
Southold Town Building Inspector's Office for the following:
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 any and all
buildings located thereon, to conduct such inspections as they may deem necessary with
respect to the aforesaid application, including inspections to determine that said premises
comply with all of the laws, ordinances, rules and regulations of the Town of Southold.
The undersigned, in consenting to such inspections, do(es) so with the knowledge
and understanding that any information obtained in the conduct of such inspections may
be used in subsequent prosecutions for violations of the laws, ordinances, rules or
regulations of the Town of Southold.
Dated: - D 2-�
(S'gna&e4
7-4
(Print Name)
(Signature)
(Print Name)
v r
a
coo (0
Cl t
a
room
o
Lo&rtr4o NAT IIA49
d
9 � 1
f
•� 1 . � !
1ST' L6locillill- f4*%1-111qq8
�:'�._-,..._ria_--. ,._.,,�.>_.;_-_n�-,.�_--.--�-.��.- •--- ------ - --'-. - "`,- -=-- -�----� --- .�t--^�- - - - - ---- - - - --- -- --�- =tea---- --- ---�� — ------•_--. - ,
iTOWN OF SOUTHOLD' PiRopmairy ca .
V
OWNER '' % - STREET VILLAGE DISTRICT SUB. LOT Ole = 3s
,L(r)
,,.'FORMER OWNER N E i ACREAGE o 3 J
b � 5 ]1 S W TYPE OF BUILDING 7 J
RES. /!� 'SEAS. VL. FARM COMM. IND. I CB. I MISC. I `�
If
; 'LAND f ' IMP. TOTAL DATE - REMARKS -
z
7j
- � r 0,
7-L! �I7o l f h. �' �1�2� n t_��Yl����� �7 SC✓l��1 � ;, f IYc�S `'
300 1,z o a /.1 O o !< ,/��`7�� tt �'d �D .L o Y5 a 5 97
aA9E _a � ® BUILDING,CONDIN Gl 3 D�— Y E!1`"I'" flU rlI �` �U�C�I�� F 1'A Y S�
N_EW, NORMAE BELOW] .5. BOVE
Va r Iue 10 —� 5 h h I(J Ja' n&19
Tillable, 1
Tillable' 2
Tillable_ 3
Woodland -
j Swampland LS
5 =
t .B rushland,:`
Hous I
r,'i9'�.y�q�`2 t ��.'SL�y c� it !G �-�}f r�t.Y +�r`rf `> - b' c'` rR✓A, f f•.
L+
Wil-
17,
i{- ki+r �¢, }a3f r1�.,tayf,S"T? rCfh7- F �•
if
' :;� �. _ ,;�, � �. -.:'''^�.-- ,tea. •� yi
; `�� - - - - ,i_ 4 . ■■■� ■■ OMENOMEN ■ ■
����: , �.�.�� � w .. ■■■�. � IEEEEM■ ■■
in
MMMMMM
.■��■■■ � "` ■ MOMM OMEN M MENMI ■
-ice F ka. ��M■■�■■ `f, M■M■■■■
WN
i 1
. •. ••
17.51
i
L
I '•
I
26
AOR
AT
MAT TITUCK
` � �Cni. t'�. ` "`" --- ---— i4w'N Of� SC.atJ'I-;Gi...C�,.►�t.Y.
i" --_ I- +
Motqu�;Iic tC 0-07M ALTEMMOM OA AMTW►.
1_SrY• V V I __,.— ,--_ _— �p,FIs SURVEY IS A VIOLATION Or �
I�l�rid'N 7299 Of THE NEW YORK STATE
EDUCATION LAW.
COPIES OF THIS SURVEY MAP NOT DEARING
THE LAND SURVEYOR'S iM.'D SEAL OR
-D ! EMBOSSED SEAL SHALL NCT BE CONSIDERED
.:J
TO BE A VAUD TRUE C:PY.
GUARANTEES INDI'4'.0 ff:F:OM SHALL RUN
ONLY TO TH2 F;`R 4.,C'M THE SURV-
{ IS PREPARTD,A•' I-S".,,U FO THE
j Z CN. C.1 N. ul TITLE COMANY,G,V n,M-ZiZ A,AL"a-VCY A
--- —
j'ST
�r?C.:JC``-i�d•G TO BRAY N.E.- ' LENDING 1 S'a,[ti:-. TV! r;.wCC]:C.AND
3 L 3 I+/. �+ "` TO THE ASSs.:;c:s ii'E :wDa.,;avStF
TUTION.GUARANTLES A:b.•.:iT Gt/UaSFSM
=5
Sl XT H r�?F TO,ADDITIONAL INS]ITUT10;VS of SWASSW
OWNERS.
TO THG
Crjl.::Av1 'ITI-r (NSUR.t-,N C0Mr)P%-N%;,
NO 71E; LO :�tUM4" -�iS (?EFf»� TO ":i1BDi�'IS3�:y +°MLV- 4>r-
-C Q -�- G.f.�.1""l�it_L a o'Rs:'
SC TION INE:',PRUPI~R C� G , t2Jr`:� VAN T; YI— , P.C.
F=ILED IN T14E SUP-MLK CO. CLERK'S 0f=RC-15 �_�•
AS MAP NO. 6�01 .
SUFP'=OLK CO. TAX MAP C.GZl',aNATI0D3: LICE=+ ZED LAND 5URVS"-VZZ5
UIsT. 000; 5ECr. 12:0 . BtbOCK t , ,PcL-5. I t ,; I2. GRE-ENt✓ RT NEW YOPK
i
• J
5LU2v-=�=-0 FUk
I
I J i I AT
1v',A T TITUCK
_ �__ --- -- ----
Tpwt4 D50u '- HGLLN.Y.
ILI :
z
r , _ r1 SCALE- • ¢:''-1'
.V~,� , ,���-.r''�;y Jam: z+ _ j, (�—{"�Jt`•tU�TsuaiTao'uliEn ALTERARou oR ADD�iKM• '
' SYY, SLMY oc� p --~ - - -- Q= If�C tJ E(iT 14 7 99 OFSTHE NEW YORK SA VIOLATION TATE
' z Z EbLICATION LAW.
/ COPIES OF THIS SURVEY MAP NOT HEARING
J - THF LAND SURVEYOR'S IMTD SEAL OR
i Lr} m
7 EMBOSSED SEAL SHALL NOT BE CONSIDERED
i-f TO BE A VAUD TRUE C:PY.
GUARA14TEES INDI'470 H:C:^N SHALL RUN
uO U_ L1 1 " ONLY TO TH2 FOR'.f•CM THE SURV
15 PREPARED,A,- 5 V-.?Lf EO THE
I Z I'll. TITLE COMPANY,G,`r R,1:Ttt AL AGENCY A
LENDING I:'STrtUcf',t'STZ,K_.LOa.AND
w.09 13 V�' ti+I i-C.Cr-'150.0 M BRINY A:'F..- "' TO'THE ASSG-['-1 or TI:E LEwmu a4fs-
TUTION.GUAKANT;ES w:E,.-Qj TWUaSFERM
25 S I X T H r'�t': TO ADQITIONa Iasi ITUrIoxS CM 34ASK34P
ovvNEas.
CFI':Av- TsTi_t= INSL;RF
NO: . SAT NUMOE-RS P.EFl;K TO
SECTION OING PROPwR?•\' QI+ 6.f.-f'U'n4IC_L a C'RS: A=' _ c�- �1G. ?✓'i�778.
F!!_ED IN 7144 SUF--FCLK CA, CI_CRi S Of=FtGI; ROED rt;CK VA.fti
AS MAP NO. &al . �• �j%^-�--- may" �C
SUF�=7LK GO. MAX MAP DEs1'3NA' ION : LICENZ D LAND 5URYE;'UCZ5
UI ST. IOW, Sm-'T. 12:G , BLbCK t , PCL-5. I 1 a 12. aRE-ENPORT NEW YOPI<
n.
"D (o y��OF SOUTyo�� �' �v V \ • ` `�• L
* # TOWN OF SOUTHOLD BUILDING DEPT.
courm, 765-1802
IN-SPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] -FOUNDATION 2ND [ -] 'INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY - [ ] FIRE SAFETY-INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ECTRICAL (FINAL)
[ ] CODE VIOLATION [ PRE C/O
REMARKS:
DATE ?v INSPECTOR Vv
ALOCATION; ktTo W"q-
(number & street) ' (municipality)
SUBDIVISION: MAPWO.: _ LOT(S):
NAME OF OWNER(S)':
OCCUPANCY; . n W ll W o
(type) (owner-tenant)
ADMITTED BY: ACCOMPANIED BY:
KEY AVAILABLE: SUPF. CO. TAX MAP'N , 1000^ , —1 !Z
SOURCE OF REQUEST; DATE:
DWELLING
TYPE OF CONSTRUCTION: V STO•RIES:' ` # EXITS: !/
FOUNDATION: V AS lti'ILN ': 1 'CRAWL SPACE:
# OF BEDROOMS: 18T FLR '. 2ND FLR: � 3RD PLR: .
BATHRO'OM(S)i TOILET ROOM(S): UTILITY ROOM:
PORCH.TYPE: DECK, TYPE: PATIO,TYPE:
uv�ir�
BREEZEWAY: I4,CEAI2AGE:
G
DOMESTIC HOTWATER: TYP9 HEATt L,-XIRCONDITIONING:
TYPE HEAT: Ol WARM AIR: wj HOTWATER:
# OF KITCHENS:
FINISHED BASEMENT:- YES NO
OTHER:
ACCESSORY STRUCTURES '
GARAGE; TYPE OF CONST.: _ STORAGE,TYPE CONST.: —wid
SWIMMING P'O-OL: GUEST,'T'YPE CONST:
OTHER:
VIOLATIONS: CHAPTER]44 &N.Y. STATE:UNIFORM F;RE PREVENTION & BUILDING CODE
LOC TION DFSCRIPTIQ4 ART. SEC.
r
REMARKS:
INSPECTED BY. �A111h �.�1�✓S�1DATA OF INSPECTION: � D
TIME START: 1' END: