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Home My WebLink About26972-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27472 Date: 12/18/00 THIS CERTIFIES that the building HEATING SYSTEM Location of Property: 285 AKA #6 MIDDLETON RD. GREENPORT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 33 Block 5 Lot 20 sLfbdlvision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 14, 2000 pursuant to which Building Permit No. 26972-Z dated DECEMBER 14, 2000 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 INSTALLATION OF NEW HEATING SYSTEM & FUEL TANK AS APPLIED FOR "AS BUILT" The certificate is issued to R WILLIAM MUELLER (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPART~ENT OF ~IEALTH APPROVAL ELECT~IC2%L CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N/A FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 26972 Z Date DECEMBER 14, 2000 Permission is hereby granted to: R WILLIAM MUELLER 6 MIDDLETON RD GREENPORT,NY 11944 for : INSTALI~ATION OF NEW HEATING SYSTEM & FUEL TANK AS APPLIED FOR 'AS BUILT' at premises located at 285 AKA #6 MIDDLETON RD County Tax Map No. 473889 Section 033 pursuant to application dated DECEMBER Building Inspector. GREENPORT Block 0005 Lot No. 020 14, 2000 and approved by the Fee $ 75.00 Authorized Sight ute Rev. 2/19/98 ORIGINAL Form No. 6 TOWN OF SOUTIIOLD 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 inspector with the following: for new building er 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. &. 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. .:k For existing buildings (prior to April 9, 1957) non-conforming uses, buildings and "Pre-existing" land uses: or 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 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 dwellin~ $25.00, Swimming pool $25.00, Accessory building $25.00, ~-~Additions to accessory building $25.00. Businesses $50.00. ~__a~ Certificate of Occupancy on Pre-existing Building - $i00.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $i0.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $i5.00 Date December 11, 2000 Location of Property .... ' · ' ..ew Construction ........... Old Or Pre-existing Building. ...X ........... lLs .................. . AclCAe. .o.n · * *-.........House Greenport No. Street .......... ~ ........ Hamlet Oawcr or Owners of Property... Mary A. Mueller Cou,ty Tax Map No 1000," tion 033.00 05.00 ~ec .............. Block· . 020. 000 :;ubdivision .................................... Filed Map Lot Permit No~.~.~ .~.. ..... Date Of Permit ................ Applicant ........................... Health Dept. Approval ......... ................. Underwriters Approval~. ...... ' ~'laneing Board Approval ..................... ~.. Reguest for: Temporary Certificate ........... ~inal Certicate ..... ~. .... Fee Submitted: $.. ~..... ~.~ ~ .~. .......... APPLICANT William H. Price, Jr. BUILDING DEPARTMENT TOWN HALL sOUTHOLD, NY 11971 TEL: 765-1802 . exam/ned !/¥". ,20 Od ApproVed 1.9--}/~-/ , · Disapproved a/e ". I:;UILDIINt../I°I::KIVIII AI°PLICAA'K)N CHECKLIS' Do you have or need the following, before applying Board of Health 3 sets of Building Plans Survey. Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: -" Building Inspector APPLICATION FOR BUILDING PERMIT :': D c._ / ,20 ~ INSTRUCTIONS a. This applicaiion MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 sets of plans, accurate..'plot plan to scale. Fee according to scl~edule. b. Plot plan showing location of lot and of buildings on'premises, relationship to adjoining premises or public streets or ar?as, and waterways.' 'c. The work qpvered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughout the work. e. No buildin~ shall be occupied or used in whole or i~a part for any purpose what-so-ever until a Certificate of Occupan is issued by the Buildihg Inspector. APPLICATI~SN IS HEREBY MADE to the Building. Department for the issuance of a Building Permit pursuant to the · Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or .'. Regulations, for the construction of buildings, additions, or alterations or for removal or demolition as herein described. The applicgnt agrees to comply with all applicable laws, ordinances; building code, housing code, and regulations, and to admit authorized inspectors, on premises and in building for neeessai'y ihspectio~-~~/. ', ~d/~ ~/ff/~/~ (Signature of~'~pt/cant or name, ifa corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, archite~t, engineer, general contractor, electrician, plumber or builder (tis. 01{ the tax roll or latest deed) .'. If appiicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builddrs License Nb. Plumbers License N9. Elect~cians License No. Other Trade's License No. 1 .~,Locat. ion of land on which proppsed.~vork_w~ll be doneF-'~ House Number ' Street . ~' Hamlet County Tax Map No. 1000 Section_. ~ Block me) State existing use and occupancy a. Existing use and occupan, b. Intended use and occupan Nature of work (check which app Repair Removal Estimated Cost of premises and intended use and occupancy of proposed construction [icable): New Building Addition Demolition . Other Work Fee Alteration (Description) , (to be paid on filing this application) If dwelling, number of dwelling u fits. Number of dwelling units on each floor If garage, number of cars l£business, commercial or mixed )ccupancy, specify na:t~re ~.nd extent of'each type of use. Dimensions of existing structures~ if any: Front ! Rear Depth Height. Number of Stories Dimensions of same structure Depth Dimensions of entire new constru~ Height Size of lot: Front 0. Date of Purchase 1. Zone or use district in which pren: 2. Does proposed construction violat 3. Will lot be re-graded 4. Names of Owner of premises Name of Architect Name of Contractor ~ith alterations or additiens: Front {eight " Number of Stories ;tion: Front Rear Depth. Number of Stories Rear ·Depth Name of Former OCher ises are situated ' ' any zoning law, ordin.ance or regulation: Roar Address Phone No. Address Phone No Address.. Phone No. 5. Is this property within 100 feet oft tidal wetland? *YES NO · IF YES, SOUTHOLD ~ ~OWN TRUSTEES PERMITS MAY BE REQUIRED 6. Provide survey, to scale, with accurate foundation plan and distances to property lines. 7. If elevation at any point on propert TATE OF NEW YORK) SS: TY;F _ .-.-~ ~ amc/of indi~idu'al signing ~)He is the (Contract said owner or owners, and is duly authc mt ali statements contained in this applic erformed in the manner set forth in the a worn tp before me this ~.~ay of~ v -(~ Notary Public LYNDA M. BOHN NOTARY PUBLIO. 8rate of New Yo¢ No. 01 BO6020932 Qualified in Suffolk Coun~t Term Expires March 8, 20~O.~[ ¢ is at 10 feet or belo~, 'must provide topographical data on survey. ,! being duly sworn, deposes and says that (s)he is the applicant above named, . .. ir, Agent, Corporate OffiCer, etc.) rized to perform or have performed the said work and to make and file this application; [tion are true to the best of his knowledge and belief', and that the work will be )lication filed therewith. :'* :0 6C~ Will excess fill be removed from premises: YES NO