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Home My WebLink AboutZ-24967FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF No Z-24967 Date APRIL 7, 1997 THIS CERTIFIES that the buildin~ Location of Property 1065 HU~OiEL AVENUE House No. Street County Tax Map No. 1000 Section 63 Block 2 subdivision Filed Map No. ONE FAMILY DWELLING ~OI/THOLD, N · Y. Hamlet Lot 26 Lot No. conforms substantially to the Requirements for a One Family Dwelling built Prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z-24967 dated APRIL 7, 1997 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 ONE FAMILY DWELLING WITH ACCESSORY GARAGE * The certificate is issued to K~NNETHLEE DI~RSON (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PT.~SE SEE ATTAuflKO INSPECTION REPORT. Rev. 1/81 LOCATION: BUILDING DEPA~I]4ENT TOWN OF SOI~FHOLD ROUSING CODE INSPECTION REPORT 1065 ~L AVE. SOUTHOLD, N.Y. (number & street) SUBDIVISION MAP NO. NAME OF OWNER (s) K~MMETH LEE DICKERSON (municipality) LOT(s) OCCUPANCY S~N~ FAHILY DWELLING (type) (owner-tenant) ADMITTED BY: KENMETH DICKERSON ACCOI~ANIED BY: SA~E KEY AVAILABLE SUFF.CO. TAX MAP NO. 1000-63-2-26 SOURCE OF REQUEST: GARY FLAI~R OLSEN, ATTY DATE:I~CH {8~ 1997 DWELLING: TYPE OF CONSTRUCTION WOOD FRA~ { STORIES 2-{/l ~ EXITS_~2 ...... FOUNDATION BRICK CELLAR XX CRAWL SPACE TOTAL ROOMS: l ST FLR. 4 2ND FI,R. 3 3RD FLR. BATHROOM (s) I TOIleT ROOM (s) UTILITY ROOM PORCR TYPE CO. RED & EMCLOSED BREEZEWAY FIREPLACE DOMESTIC HOTWATER OIL TYPE HEATER TYPE ltEAT OIL WARM AIR OTHER: DECK, TYPE PATIO GARAGE HOT WATER (OIL) AIRCONDITIONING HOTWATER XX ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST. SWIMMING POOL OTHER: WOOD FRA{~ STORAGE, TYPE CONST. · GUEST, TYPE CONST. VIOLATIONS: CHAPTER 45 N.Y. STATE RNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. REMARKS: INSPECTED BY DATE OF INSPECTION MARCH 25, 1997 TINE START 12:55 PM END 1:45 FORM NO, 6 TOWN OF SOUTHOLD · Building Department Town Hall Southold, N.Y. 11971 765- t802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m Im....em. to the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal}. 3.Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5.Submit Panning Board approval of completed site plan requirements where applicable. B. 'For existing buildings (prior to April 1957). Non-conforming uses, or buildings and "pre-existing" land usas: 1. Accurate survey of pgoperty showing all property lines, streets, buildings and unusual natural or topographic features. 2.Sworn statement of owner or previous owner' as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: h Certificate of occupancy $25:00 -- BUSINESS ~;50.00 2. Certificate of occupancy on pre-existing dwelling $ 5 0.00 3. Copy of certificate of occupancy $*5/00. ovec $ 'yea£s $10.00 4.Vacant Land C.C. $20.00 5.Updated C.C. $"50.00 Date March 18, 1997 NewtOns f;ruct, ton ...... Old or Pre-exi~ting Building X. ........... Vacant Land ............. New York Location of Property .... ~vr~] '. ~,¥~rj~l~ ~ .~(~t~l;~c~].d. ~ ....................................... HouM N~ Street Ham/at Owner or Owners of Property Kenneth Lee Dickerson, as Executor of the Estate · '6{' ~t~l~ '0 .' 'D fdR~f ~d ,' 'd~¢~a's'~¢.' ........................ nty Tax M 1000 S cfi 63 2, Lot .2,5. & 26 Cou ap No, e on ............... Block ............... -~ubdivision ................................. Filed Map No ........... Lot No .............. Permit No Date of Permit Applicant ' Health Dept Approval / Labor Dept Approval " ' Unden~riters Approval ........................ Planning Board Approval ...................... Fee Submitted $ ............................. // Construction on above described building and permit e s al ' hcable code ' , ' ~'~/a~p~p lic sand re~ulatmns. PP . .'. w.~f,,,f, ./~/./ ..... ; ...... ~ CONSENT TO INSPECTION Kenneth Lee Dickerson , . the undersigned, Owner(s) Name(s) do(es) hereby state: That the undersigned ((s) (are) the owner(s) of the premises in the ToWn of Southold located at Hummel Avenue, Southold, New York , which is shown and designated on the Suffolk County tax map as District 1000, Section 63 , Block 2 , Lot 2,5 & 26. That thc undersigned (has) (have) filed, 'or caused to be filed, an applica- tion in'th~ Southold Town l~uxlaing lnsp~,~ .~ c, tr~.~ to.~ +h, following: Two and one-half story frame house with attached shed 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 w/th the knowledge and understanding that any information obtained In the conduct of such inspections maybe used as evidence in subsequent pro~tlons for rio- / lotions of the laws, ordinances, rules or regulations of t]~'~ Town of Southold. Dated: March 18, 1997 ~,, .~ ~ ~ , -'~/ (s/i/~ n_a_t u r e) .-. . Gary Flanner Olsen, Esq. as Attorney for Kenneth Lee Dickerson (print name) (signature) (print name) --% 70'-'¢~' ID~ ¥~ J-~ !.J t CLI~ E L .AT ~ QLJ T/--/~) L D ..S u ~F~a LK COUNTY' J. H. GEIDEMAN _ NEW YO~]~5~. o~.,G .... ~...~~...~ ..... ~N. ~/State Lic. Land Surveyor.