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Home My WebLink About20887-zFORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20935 Date AUGUST 12~ 1992 THIS CERTIFIES that tke building. Location of Property. 120 OLD MAIN ROAD House No. County Tax Map No. 1000 Section 126 Subdivision ACCESSORY LAUREL ~ N.Y. Street Block 2 Lot Filed Map No. Lot No. Hamlet 2 conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 11¢ 1991. pursuant to which Building Permit No. 20887-Z dated AUGUST 12t 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 ACCESSORY S~ED "AS BUIL~" The certificate is issued to MILDRF~ LAUBENGEIGER & GILBERT KOLLOF (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF H~-2tLTHAPPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20936 Date AUGUST 12¢ 1992 THIS CERTIFIES that the building Location of Property 120 OLD.MAIN ROAD House No. County Tax Map No. 1000 Section I26 ADDITION L~URELt N.Y. Street Block 2 Lot Hamlet 2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST !lt %992 pursuant to which Building Permit No. 2~887-Z 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 COVERED DECK ADDITION "AS BUILT" TO AN EXISTING ONE FAMILY DWFXJ.INGo The certificate is issued to MILDRED LAUBENGEIGER & GILBERT KOLLOF (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATKON DATED N/A Rev. 1/81 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Yo BUILDING I'ER~IT ~HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N ".~N'? 2o88'~r z Permission is hereby granted to: ....... ~ ....... ~....:..4~,~ ....... ~ .......... ~ ~ ...4~e ....... ~.4&.....~/~....~, ......... ~,r~ · - /~ ................................... ~..~ ......... Z .......... ~...~ ........ ~ .......... k~.g ....... :~.~:~ ....... ~:~ ~:. ~....: .~:~ ~....: ..... ,~ .................................................... :~ ............. : ..................................... . - ....... ~ ..................... ,,,,,~,,,,~ed ~ ................................. z~ ....... ~....~ :~..~,. ................................................................................... ~ :~:~ ......... ~.~: ...................... .................................................... ~.~:....~..~.....:..:~ ......... ~.¢.~.~ ........................................ Coun~ Tax Map No. I000 S~ction ..... ~ ......... Bl~k ..... ~.~ ........ Lot No ....... ~ ...... pu~uant to application dat~ ............................................... , 19..~...., and appr~ ~ the Building Insp~tor. Building Insi~ector Rev. 6130/80 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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: I. 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 i% 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 (~rior 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 i. 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 ...... New Construction ..... ~... Old Or Pre-existing Building ................ Location of Property~ 120 Old Main Road, Mattituck, New York {~%~ .............. ,~ House No. Street Hamlet p~^~ ~,, Mildred Laubengeiger and Gilbert Kolloff ' Onwer or Owners of ~e~ ...................................................... · · --- -- · -- -- County Tax Map No 1000, Section.~2~'00.............~1o¢k..9~:97..... .... ~ot..qq2'~.. .. ......... .. Subdivision Filed Map Lot Permit No Date Of Permit Applicant .............. Health Dept Approval ......... Underwriters Approval Planning Board Approval ...................... . . Request for: Temporary Certificate ........... Final Certicate. x Fee Submitted: $ .... :2~5...0.0 .................... . ................ ...... Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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: I. 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. Conunereial 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 Vpre-existing" land uses: i. 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 Certifisate 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...,...........August 10, 1~2. ....................... New Construction ....... ~... Old Or Pre-existing Building ................. Location of Property; 120 Old Main Road, Mattiguck~ New York 11952 ............ '. House No. Street Hamlet ~ ..... ~ Mildred Lauben~ei~er and Gilbert Kolloff Onwer or Owners of ~.~ .................. . ................................. County Tax Map No 1000, Section..............126'00 Block...P~:Pg........Lot..QQ~QQ ............. Subdivision .............................. .. . . .. Filed Map ......... . .. Lot ..................... . P it D Of Per it Applicant Mildred Laubengeiger Healt~ Dept. Approval ....................... .. Underwriters Approval ............ .... ....... .. Planning Board Approval ................. .,. . . . Request for: Temporary Certificate .......... Final Certicate .... ~ ...... Fee Submitted: $...2~:.0.0 ...................... qq.st,,C ............ ~ APPLICANT Mild~e'd Lalfosngsiger INSPECTORS (516) 765-1802 VICTOR LESSARD, Principal CURTIS HORTON, Serdor VINCENT R. WIECZOI{EK, Ordinance ROBERT FISHER, Assistant Fire Building Inspectors THOMAS FISHER GARY FISH SCOTT L. HARRIS, Supervisor Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD August 5, 1992 Wickham, Wickham & Bressler, P.C. P.O. Box 1424 Mattituck, N.Y. 11952 Attn: Helen Re: Application for Pre CO property of Mildred Laubengeiger ~ 120 Old Main Road, Laurel, N.Y. Suff. Co. Tax Map ~1000-126-2-2 Dear Helen: As per my telephone conversation with Mr. Wickham yesterday, in order to issue the Pre CO for Mrs. Laubengeiger, we will need the following: 1. Building Permit and CO required for rear deck on second floor. $50.00 for permit, $25.00 for CO. 2. Building Permit and CO required for Accessory shed. $25.00 for permit, $25.00 for CO. 3. CO is required for Building Permit ~4326Z dated June 5, 1969 for an addition. - $25.00 Please send us your check in the amount of $150.00 so that we may process the CO's. If you have any questions, please do not hesitate to call me. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. Georgia Rudder, Secretary CERTF'IED TO' RtCH~RD E. ODDON EILEEN E. ODDON SECURITY TITLE AND GUARANTY COI~ANY NIO~b AREA-- I1,010 sq. fL SUR V£ Y FOR RICHARD E ODDON & EILEEN E, ODDON P~c P.O. MAIN ROAD SOUTHOLD, N, Y. 11971 A T MA TTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, N Y. 1000 - 126- 02 - 02 Sca/e: 1"= BO' July 6, 1992 LIC. NO. 49618 Prepared in accordance with fha minimum standards /or t/fie surveys os es/obi/shed ~; fhe L.LA.L.S. and approved end adopted r such use b.y The New York Slate Lend Title Associotiom 92-PI ~ FORM NO. 1 TOWN OF SOUTHOLD :c.~ TOWN HALL DECK ., r . ~. SOUTHOLD, N.Y. 11971 ~ : TEL.: 765-1802 Disapproved a/e ..................................... · . (Bu/ding Inspector) APPLICATION FOR BUILDING PERMIT BOARD 0F HEALTH ........ 3 SETS OF PLA?IS ........ SURVEY ................. CIIECK SEPTIC FOR,q ............ CALL ................. HAIL TO: Date ..... .A.ug .u .s .t ......., 19 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 2ts 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 street r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli ation. 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 issued a Building Permit to the applicant. Such permi ~all be'kept on the premises available for inspection throughout the work· c. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupan% :-all Ptave been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances ',egulations. for the construction of buildings, additions or alterations, or for removal or demolition, as herein described 'he applicant agrees to comply with ali applicable laws, ordinances, building code, housing code, and regulations, and tc Limit authorized inspectors on premises and in building for necessary,4nspections. ~ , -- (Signature of ap[~licant, or narh~, if ta~,Orporation) Mildred ~aubengetger (Mailing address of applicant) ;tare whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. · oleo. er APPROVED AS NOTED ,. .................................................................. amc of owner of premises ...I:i.&]41 .r .e.~.., ~,.a.ub. ~ .ng~ .ig~t:. ~. ~$$~ .~9~f f .... ~:~' ~"~' · O~' ~ ~ ~ (as on the tax roll or latest de~l~ BUILDING D~PARTM~N~ ~ applicant is a corporation, signature of duly authorized officer. ........... 6¢ CUPAMCY Other Trade's License No ...................... Location of land on which proposed work will be'done. 120 Old ~in Road, ~ttituck, New York 11952 765-1802 9 AM TO 4 PM FOR TH FOLLOVVtNG INSPECTIONS: I, FOUNDATION - TWO REQUIRE FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBIN 3. INSULATION 4. FINAL CONSTRUCTION MU-c BE COMPLETE FOIl C.O, ALL CONSTRUCTION SHAD- MEI! THE REQUIREMENTS OF THE N, STATE CONSTRUCTION & ENERG CODES. NOT RESPONSIBLE FO DESIGN OR CONSTRUCTION ERROR tlouse Nmnber Street Hamlet County Tax Map No. 1000 Section . . ;[;Z¢,OO .......... Block ...0.2:0..0 ........... Lot..0. q2...qqq .......... Subdivision ................................ Filed Map No. ~' Lot (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: E residence .of ap. plicant , a. xisting use and occupancy ............................. ..... '., -' ' b. lntended use and occupancy. .resideqce...... ..........Df appli, cant...........with deck 3. Nature of work (check which applicable): New Building .......... Addition .x .( .d ? .c .k ). . . . Alteration ...... Repair .............. Removal .............. Demolition .............. Other Work ........... . (Descriptio /~/4 Estimated st ~t~.~ol e e. · Co ...................................... Fee .................................. (to he paid on filing this application) $. If dwelling, number 6f dwelling units ..... :vd.& ...... Number of dwelling umts on each floor ............ · If garage, number of cars ............... .nJA ................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ................. 7. Dimensions of existing structures, if any: Front.. 26,2 ......... Rear 2.4.: 2. .......... Depth .2.0...2. ...... Height ............... Number of Stories .................................................... Dimensions of same structure with alterations or additions: Front ................. Rear .............. Depth ...................... Height ...................... Number of Stories .............. ..... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ........... Height ........ Number of Stories ....... ' ..... ................. ~6ig7 ~ed~ .................. 9. Size of lot: Front ...62,8Q Xqe.~. ...... Rear ...................... Depth 179.78' west side 1 I. Zone or use district in which premises are situated .................................................. 12. Does proposed construction violate Jny zoning law, ordinance or regulation: ............. .r~o... ............ 13. Will lot be regraded .no ......................... Wiil excess fill be removed from premises: Yes 14. Name of Owner of premises .lli~.lOr.~d..Iv.a.u.b.e.n.~e.t.g.?13,.ddress .!2.@.ql.d..M.a.i.q.R.q,..PhoneNo. 2.9.8.253.0.8. .... b~m~a~ex~h~t & Gilbert Ko.llof.f Address ............... Phone No. Name of Contractor .......................... Address ................... Phone No ............. 15. Is this property within 300 feet of a tidal wetland? *Yes ........ No. no *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions property lines. Give street and block number or description according to deed, and show street names and indicate whel interior or comer lot. SEE ATT~CHEU SURVEY STATE OF NEW YORK, S.S COUNTY OF..SP.~.~gL.~. ·: ....... · Mildred Laube.n~geiger being duly sworn, deposes and says that he is the applic (Name of individual signing contract) above named. He is the ...................................................................................... (Con[ractor, agent, corporate officer, etc.) x~xaa/fl owner or owners, and is duly authorized to perform or have performed the said work and to make and file ~pplication; that all statements contained in this application are true to the best of his knowledge and belief; and that .york will be performed in the manner set forth in the application flied therewith. ;worn t.p before me this ....~. ..... .//..-~-7 ........ day of ..... bu. gu.s.t. .......... ,19.9.2. . ,4 ' su£folk ' otary PubhbM/, 4.4-fa. ...... ,.~ ............. .C°unty , ~, ~o .~ · ~ . ~(~ ~-$,~m~.~, /~.n Mildred Laubengeiger ~ignatureofapphc,