HomeMy WebLinkAbout28024-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-28245 Date: 03/06/02
THIS CERTIFIES that the building ACCESSORY
Location of Property: 1625 YENNECOTT DR SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 55 Block 4 Lot 22
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JANUARY 22, 2002 pursuant to which
Building Permit No. 28024-Z dated JANUARY 22, 2002
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 STORAGE SHED AS APPLIED FOR.
The certificate is issued to RICHARD F MULLEN, III & ANO
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
;4 V'�"
7 Authorized gnature
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. 28024 Z Date JANUARY 22 , 2002
Permission is hereby granted to :
RICHARD F MULLEN, III
PO BOX 1408
SOUTHOLD,NY 11971
for
CONSTRUCT ACCESSORY STORAGE SHED IN REQUIRED REAR YARD AS
APPLIED FOR. (REPLACES BP #25717-Z)
at premises located at 1625 YENNECOTT DR SOUTHOLD
County Tax Map No. 473889 Section 055 Block 0004 Lot No. 022
pursuant to application dated JANUARY 22 , 2002 and approved by the
Building Inspector.
Fee $ 75 . 00
Authori ed Signature
COPY
Rev. 2/19/98
• Form No.6 ( ��
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL s
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY-Y...
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. 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- $100.00
3. Photocopy of Certificate of Occupancy-$ 0.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy- Residential$15.00, Commercial$15.00
Date. 34�31-o-
New Construction: Old or Pre-existing Building: (check one)
Location of Property: 16"2.5 C 6 2�v_et 2.
House No. Street Hamlet
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section 2 � OSS Block 00344/ Lot
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant: oGde-1 F1jLjf��-V
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ o ,00
`�� Applicant Signature
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Town Hall,53095 Main Road • Fax(631)765-1823
P.O.Box 1179 ,ji Telephone(631)765-1802
Southold,New York 11971-0959
BUILDING DEPARTMENT
January 17, 2002 TOWN OF SOUTHOLD
Richard Mullen III
1625 Yennecott Drive, PO Box 1408
Southold, NY 11971
Dear Mr. Mullen,
Please take notice that in review of Building Permit Number 25717-Z, dated May 11,
1999, for construction of an accessory storage shed at 1625 Yennecott Drive, Southold,
NY.
Suffolk County Tax Map Number 1000-55-4-22
It has come to our attention that the permit has expired and, without a certificate of
occupancy from this office, any use is a violation of Southold Town Code (45-15) and
New York State law.
In order for us to help you to rectify this matter the following action is required:
1) Immediate renewal of the expired permit: Please submit a check for
$75.00, made payable to the Town of Southold, noting the original permit
number on the check.
2) Final inspection required: Once you have renewed your building permit and
completed construction, it is your obligation to schedule a final inspection of
the above referenced property.
3) Certificate of Occupancy required: Once your property has passed
inspection, you may apply for a certificate of occupancy.
If you have any questions, please feel free to contact this office at(631) 765-1802
between the hours of 8:00 a.m. and 4:00 p.m.
zRe�sRes fully Y rs,
mo
Building Inspector
CC: File
�UILDING PERMIT REVIEW CHECK- LIST
Application Name: t A LK ` `-e- v--
Architect/Engineer: fJ l
SCTM #: District: LM Section: S-5 Block: Lot: 22
Subdivision Name:
Req eq' _
Zoning District: (Lot size: Proposed: ] (Lot coverage �o,T LProposed: J 3 ]
Req. ReqReq.
(Front Yard Proposed: ] [Side Yard Proposed: ] [Rear Yard Proposed: J
Project Description:
AGENCY PERMITS Permit
REQUIRED FOR REVIEW LIQ/ Number
Suffolk County Health Dept. l
New York State D. E. C.
Town Trustees
Town Zoning Board approval:
Town Planning Board approval:
Flood Plane Elevation???
Flood Zone:
O� Wim— 1
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BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] 1 ON
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE Z---" INSPECTO
de
oYJ 6�7�
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ j INSULATION
[ ] FRAMING [ } F�L
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE INSPECTO
ERLD INSPECTION REPORT DATE COMMENTS `gyp
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FORM NO. 3 a ` r /�c
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. 25717 Z Date MAY 11, 1999
Permission is hereby granted to:
RICHARD F MULLEN III
1625 YENNECOTT DR
SOUTHOLD,NY 11971
for
CONSTRUCTION OF AN ACCESSORY STORAGE SHED IN THE REQUIRED REAR
YARD AS APPLIED FOR.
at premises located at 1625 YENNECOTT DR SOUTHOLD
County Tax Map No. 473889 Section 055 Block 0004 Lot No. 022
pursuant to application dated APRIL 1 1999 and approved by the
Building Inspector.
Fee $ 35 .00
r--
At4th rized Signature
ORIGINAL
Rev. 2/19/98
[� h
BOARD OF HEALTH
FO .
" �• ° �� ' ' RM N0 1 3 SETS OF PLANS . . . . . . . . . . . . . . .
� .. pkr,G �c�q TOWN OF SOUTHOLD SURVEY . . . . .. . . . . . . . . . .. . . . . . . .
BUILDING DEPARTMENT CHECK . .. . ... . . . . . . . . . . . . . . . . . .
BLDG CEP7 TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . .
TaWN OF SOUTHOLD SOUTHOLD, N.Y. 11971
TEL: 765-1802 NOTIFY: C/
Q CALL . . . . ... . . . . . T.
Examined..S 1........., 19Q!. r� MAIL TO: . . . . . . . . . . . . . . .. . . . .
Approved.......5 l« 191�. Permit No. .................. ....................................
Disapproved a/c .................................. ....................................
........................................ .............
(Bui di Inspector)
APPLICATIO FOR BUILDING PERMIT
Date. . . .
INSTRUCTIONS
a. This application most be completely filled in by typewriter or in ink and submitted to the Building Inspector wi
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 commenced 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.
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 HOMY M41K to the Building Department for the issuance of a Building Permit puramt to the
Building Zone Ordinance of the Town of Southold, Suffolk Canty, 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 applicant 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 necessary inspections.
......JVA! .,�R,,,.�:�.�. ,�:............
(Signature of applicant, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is ower, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
, '.nom Vis::•_ q •�`i.
....OeA.192T.................................................................... ... . t•�fK. ....................
C
Name of owner of premises � .... :: R . � Q-
.........
(as on the tax roll or latest deed) e) B.P.- �J
If applicant is a corporation, signature of duly authorized officer. 7 gy
;.
r;N SUR.DNt DEOARTMENT AT
......................................................... 17W .9 MR„TO 4 PSM:FOR THE
(Name and title of corporate officer) OCCUPANCY O R
211 R . TWO REQUIRED
U)E ES UNLAWFUL
Builders License No. ............ .. 1, • FIIMAINti • PWMBINP
Plumbers License No. .............. . , o i.+ M
OUT CERTIFICA� � E; UCTION UST
A
Electricians License No. ..........O�..LLCUPANCY T.
�.m1�1+�` ONSTRUC� ILL MEET
Other Trades License No. .................... ` THE REQUIREMENTS OF THE N.Y.
4ATE CO AUCTION & ENERGY
1. Location of land on which proposed work will be dare........................ VES ` �E9POS1BtF.M_R'.
„ c� 1 CONSTRUCTION ERRORS
�sSY:`: .....................Ye/U.Iu�G.D.tq.�Tl�le, ........................ ......................
House Number Street L/ Hamlet
Canty Tam Map No. 10``00 Section .....f.J....... Block ..... T......... lot ...;.#'L........
Subdivision .:�s�Joa . ./!G &AJ .......... Filed Map Nn.. ..540.T7..... Lot ...ao........
(Name)
2. State existing use and occupancy ooccupancy f premises and intended use and occupanof proposed construction:
a. Existing use and occupancy .. of ..................................................................
b. Intended use and occupancy -;%C4 ....................................................
3. Nature of work (check which applicable): New Building ..N ..... Addition .......... Alteration ...... .
Repair ............ Removal .w.
Demolition ............ Other Work
..............
-01
(Description)
i.
Estimated Cost
� ........... f
(to be paid on filing this application)
i. If dwelling, ember of dwelling units /...... Number of dwelling units on each floor ..........
Ifgarage, number of cars .....................
i. If business, commercial or mixed occupancy, specify nature and extent of each type of use......................
' Dimensions of existing structures, if any: Front...
' .:........ Rear ............... Depth .................
Height ..... Number of Stories ..
e s
Dimensions of same with alterations or additions: Front ............... Rear .........
Pt .................... Height .................... Number of Stories
...............
3. Dimensions of entire new construction: Front .....!.Q .... Rear ....... Depth ..l44i�......
Height .......�P A ............. Nmnber of Stories .. /.................
1. Size of lot: Front ....A 4........ Rear .....//.V,5�.... Depth ....974. R� :.....
10. Date of Purchase ..................... Nae of Former Owner
If. Zane or use district in which premises are situated ... /
............................................
12. Does proposed construction violate any zoning law, ordinance or regulation: ../b.
................
13. Will lot be regraded ..../ l.0............ Will excess fill be removed from premises: YES ®'
14. Names of Owner of premises . d%=LY,tJR6i.CAA.A/Address .16'2F-hG4 + ,,0 ..Imhweie No. '750-. 3.
V.
Nameof Architect .................................... Address .............................. Phone No.
..............
Name of Contractor ................................... Address ...............................Phone No. .......
15. Is this property within 300 feet of a tidal wetland? * YES ..4.......
*IF YES, SOI MD 1U?N TRDSIFE.S PffiAIIT MAY BE Wl imm.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions
From property lines. Give street and block number or description according to deed, and show street names and indicate
ahetber interior or corner lot.
/0f
44042h6N
16V -
tezjk
)UMIY OF
u q�Z =�...................being duly sworn, deposes and says that be is the applicant
;Name Of,� iiriI81S�I. g' )
hbove named, Mtt7f rTAj
A 4t`�k� .,�cn�3a
le is the .. _17 A7 .......................
(Conkractor, aht3orporate officer, etc.)
hf said owner or owners, AM 49 rir�rm hthorized to perform or have performed the said work and to make and file this
hpplication; that'& 'statements'c4;6ianed in this application are true to the best of his knowledge and belief; and
10
that the work will be ". t a"fmtfR runner set forth in the application filed therewith.
Woorn to before me this
I "r ^ II
C..............day of ..TI ?C!.5......19.9.�...
Notary Publi ... ..e
..'�WJ66,.Ac.
SUSAN M.JACOBS (Signature of Applicant)
Notary PuNo..St Of NOW YQ*
Qua,Wm in lea N v.8 ry
Cmmmhrsion Ems