HomeMy WebLinkAbout26236-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-27441 Date: 12/01/00
THIS CERTIFIES that the building REPAIR
Location of Property: 285 AKA 6 MIDDLETON RD GREENPORT
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 33 Block 5 Lot 20
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DECEMBER 29, 1999 pursuant to which
Building Permit No. 26236-Z dated DECEMBER 30, 1999
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 FOUNDATION REPAIR OF EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to R WILLIAM MUELLER
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
t rized Signature
Rev. 1/81
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 26236 Z Date DECEMBER 30, 1999
Permission is hereby granted to:
R WILLIAM MUELLER
6 MIDDLETON RD
GREENPORT,NY 11944
for
FOUNDATION REPAIR AS APPLIED FOR.
at premises located at 285 MIDDLETON RD GREENPORT
County Tax Map No. 473889 Section 033 Block 0005 Lot No. 020
pursuant to application dated DECEMBER 29 1999 and approved by the
Building Inspector.
Fee $ 75 . 00
Authori ed Signarture
ORIGINAL
Rev. 2/19/98
Form No. 6
r i SOUTHOLD
Nov 2 9 2050 UILN OF DEPARTMENT
_i4 )„ Z0 f� Q
BUILDING DEPARTMENT CO � /��l v�
3 _ k TOWN HALL
81.06.DEPT. 765-1802
MO'A'N OF SOO'fFiOt.
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:
1. Final survey of property-w1Lh-arcura-Li--iucuftzn 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 - .2541
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Resident�ia'l� a$115.00, Commercial $15.00
Date . P. ::::�:�. .
New Construction.. . . . . . OldOrPrre/-exist'ng*Date Building
. 4 . .
Location of Property. . . . . . . . .. . .. . c �?. ' :. . . . .
Housef o. St
re Hamlet
Onwer or Owners of Property. ° ..1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
County Tax Map No 1000, Section. . V. . . . . . .B1ock. . . . . . . . . . . . .Lot. �. . . . . . . . . . . . . . . .
Subdivision. . . ...J. . .. . . . . . . . . . . . . . . . . . . . . . . . . . ..Filed Map. .:... . . . . . . .Lot. .
Permit No.�241.� . .Date Of Permit. !:/�(. . . . . . . .Applicant.'��.-
•�
Health Dept. Approval. . . . . . . . . . .... . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . .. . . . . . . . .
Planning Board Approval. . . .'.. o: . . . . . . . . . . . . .
Request for: Temporary Certificate. . . . . . . . . . . Final Certicatel. .-__.�. . . . . .
Fee Submitted: $. . . . . . . a: ...:. . . . . . . . . . . . . . , . . . . .
C'� cc SBs 3� APPLICANT
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FIELD—INSOIEC'tION REPORT DATE --- -- ------=====COMMENTS1___ �? f
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ADDITIONAL
ADDITIONAL COMMENTS:
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Timothy John Mueller
134 Tenth Avenue New York, NY 10011-4727
TEL 917 699 5805
December 26, 1999
To Whom It May Concern:
Regarding: R. William Mueller Property
285 Middleton Road
Greenport, NY 11944
Tax Map No.: 473889 31-5-20
Please be advised that Mary Anthea Mueller and Timothy John Mueller of the above said property
have engaged Lawrence Tuthill, Sr. to act as an Agent for the above parties regarding the application
and execution of necessary building permits and management services for the purposes of excavation,
construction, and, correction of the above Tax Map property's east foundation wall.
Mr. Tuthill's services will be in effect from December 1, 1999 to December 31, 2000.
Should you have any questions, please contact me directly at the above phone number.
R�5s,p tful y'�submitted,
Timy John Mueller
081-48-2049
MCDONALD
GEOSCMEVCE
Box 1000 • Southold,New York 11971 • (516)7653677
TEST HOLE DATA SHEET'
Name: T Mueller
Surveyor:
Location: Greenport
Tax Map Number: 1000-33-5-20
x_ cjct.0esc�iption; EPS {<
Date: 12/7/99
MIxed sand, fines, and loam
-------- 15'
Water in mixed sand, fines, and loam
'� 41° , r . g1a .,..y� s+
a ee pale r— fine to coarse sand SW
20'
Comments: Water encountered 15' below surface
i
1
1
(
1
70-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] I LATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE S CHIMNEY
REMARKS:
DATE / INSPECTOR
.v.u. RJ. • J J.i1Y Vl tL[1l\J . . . . . . . . . . . . . . .
TOWN OF SOUTHOLD SURVEY
. . . . . . . . . . . . . . . . . . . . . . . .
BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . .
TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . .
SOUTHOLD, N.Y. 11971
TEL: 765-1802 NOTIFY:
��l/ 9�J CALL . . . . . . . . . . . . . . . . . . .�.
E�mined..^J,"I)..... 2.7....I 19/Qlg. MAIL TO: . . . r
Approved.. :.7.:...0..., 19 f Permit No. ..c#1?. .z� ..............1�r .............
Disapproveda/c .................................. ....................................
(Building I tor)
ur_G Z 9 1999
, ...P
PPLICATION FOR BUILDING PERMIT
f...... T Date. . . . . . . . . . . . . . . . 19. . . .
INSTRUCTIONS
a. •this application must be completely filled in by typewriter or in ink and submitted to the Building Inspector wit
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 of property must be drawn on the diagram which is part of
this application.
c. The work covered by this application may not be conmenced before issuance 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 1EIM MNE 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 time construction of buildings, additions or alterations, or for removal or demolition, as herein
described. The applicant agrees to c mply with all applicable laws, ordinances, building code, housing code, and
regulations, and t rssttho ' tors on premises and in buildi for necessary inspections.
p
f .. ......d.!... ............
ignature of applicant, or name, if a corporation)
.............................1� ..................
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
.............A eh .......�*****"...^...-Nf"e /�{v.....
Nage of owner of premises .......... /1 APPROVEDAS NOTED
(as on the tax roll or latest deed) DATE: �� B.P.# '
If applicant is a corporation, signature of duly authorized officer. FEE: BY....
L_.___. BY:
NOTIFY BUILDING DEPA ENT T
......................................................... 765-1802 8 AM TO 4 PM FOR T E
(Name and title of corporate officer) OCCUPANCY OR FOLLOWING INSPECTIONS:
t FOUNDATION - TWO REQUIRED
VZ NCRETE
Builders License No. ............... J$ UNLAWFUL 2 ROUGHFORURE FRAMING PLUMBING
3. INSUATION
Plumbers License No. ................ CERTIFICATE 4. FINAL - CONSTRUCTION MUST
Electricians License No. ............ F.jOCCUPANCYE COMPLETE FOR C.O.
ALB CONSTRUCTION HALL MEET
Other Trade's License No. ....................
THE REQUIREMENTS OF THE N.Y.
`t, STATE CONSTRUCTION & ENERGY
N. Location of land on which proposed work will be done... .CODES...UOT..RESPONSIBLE.-FOR....
2 / ' //.e. DESj. NQSTF;LCTION ERRORS
............................ .'(° .y.l...... ............................
04... ..........................
House Number Street Hamlet
County Tax Map No. 1010 Section .. "7 3........ Block ........ Lot ........
Subdivision .......:.............................. Filed Map No. ............... lot ...............
(Name)
" 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. tbcisting use and occupancy ....................Fc rH. ti eCt/h C.
....... .......................................
b. Intended use and occupancy .............................................................................
sm
l i �h id x c 7i�x3 muff
Nature of work (check Atidu app IIcable): New Building .......... Addition .......... Alteration ..........
Itepair A...... Removal ...... Ikmolition ............ Other Work ..... ... .... ...............
(Description)
Estimated Cost ....�.7: fee ........................
(to be paid on filing this application)
If dwelling, nuuber of dwelling riErits ............ lkrriuer of dwelling units on each floor
... .... .... ... ..
Ifgarage, ru:ber of cars .......!,...............................
If business, commercial or mixed pccupancy, specify nature and extent of each type of use......................
1 440
Dimensions of existing structures', if any: Front................ Rear ............... Depth ...... ...........
Height ............. 2-6�...... Nmber of Stories .....!................
Dimensions of same structure caul% alterations or additions: Front ............... Rear ... ..:.........
Depth .................... Heighe .................... Nu:ber of Stories ...............
Dimensions of entire new construction: Front ................ Rear ............... Depth .......... ....
Height ......................... timber of Stories .....................
Size of lot: Fruit ............ i....... Rear .................... Depth ....................
p
1. Date of Purchase ........(.. 5/1li..... Name of Former Owner ....7'dh..........a.........................
I. Zone or use district in which ises are a.lusted n P3� d ` / b
.,............................................. ..............
!.,
Does proposed construction violae arty zoning law, ordinance or regulation: ...N�.................
S. Will lot be regraded ..... ........ Will excess fill be removed fr�°� mhises: YES N]
1. Names of Owner of premises M4^i 5 . /yv r ... Z $i11�(l x rra .� . b B3
premr ......,..................... Address ............... .P... Pi)ahe No. �7..........
Name of Architect .. ..... Address .............................. Phone No. .............
Nae of Contractor ...lYa-07e ............ Address Phone No.
o e .......
i. Is this property within 300 feet !,of a tidal wetland? * YES .......... NO ..........
*lF YES, SOEM D MM T[d*L6S PEIM MAY HE MVM.
PLOT DIAGRAM
locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions
rom property lines. Give street and 1}lock number or description according to deed, and show street names and indicate
)ether interior or corner lot. /
secvrti frD 6 v Bvl//��i%�/
c
�avh dle w
w ll
MIE W HN-YOM,
S.S
..........::.:........................i...................being July sworn, deposes and says that he is the applicant
Ime of individual signing contract)
cave named,
is tine ............. ......... ................ ......................................I.........
(Contra t , agent, orporate officer, etc.)
I
f: said caner or owners, is July ar�thorirxd to perform or have performed the said cork and Co make and file this
pplication; that all statements contail'ned in this application are true to the hest of his knowledge and belief; and
hat the work will be performed in the 'Imanuer set forth in the application filed therewith.
worn to before me this
............Q... ...day of Se. 19.E
Notary Public .. ublicr ete o Naw. or ... G,' `� ✓ v�%Y/ —
u fled in Suffolk C iAunty ......................................
No.O1SC472 (Signature of Applicant)
Term Expires May 31,
BUILDING MR-MA I RE
Applicant/ M r / � [)atc 01197
Owners Name: h�U -i ll_i_G(Y� l�_�t1�_l k�'i1 — Reviewed3
Architect) Date f
1 I
Engineer: --'r-tl� -1_(ti +�t L --- -- - _ _ Submitted
SCTM #:
District: 1,000 Section: t3locL `D -_ Lot: - L'--
Project ;> Subdivision
MM l ! -
Location �5_I__`_�IG�( f 6Y� �� + l Name _
Single& separate Required
certification Yes/No
Req Req.
Lontng District (l.ot size Actual _–.- J Il of covcrage — Piopowd_.
Req Req Req
(Front Yard Proposed J (Side Yard Proposed ] (Rear Yard 1'rolx)sed
Project Description:
AGENCY PERMITS Permit
REQUIRED FOR REVIEW N.A. NO YES Number
Suffolk County Health Dept. /
New York State D. E. C. ✓
Town Trustees
Town Zoning Board approval:
Town Planning Board approval:
Flood Plane Elevation ???
Flood Zone:
to •