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Home My WebLink AboutZ-9181F0RK NQ 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. ...29189 ... Date .. August ... 22 119 19...7.8 THIS CERTIFIES that the building located at ...595. F.egvash . Avq ....... Street No conforms substantially to the I pa� fated An-ril ......... 19-57. pursuant to which OCCUPANCY0. Z'9181- dated .. August .22.........., 19.7&, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ...... Prtvate..One. F..anily. .Dwell:Lng.................................. The certificate is issued to .... Doro+why . A..Xubacki ............................. . (owner,�� of the aforesaid building. Suffolk County Department of Health Approval......Pre•-11,b:isting................ UNDERWRITERS CERTIFICATE No . .............. Pr.Q-71�X�A.UDF ............... HOUSE NUMBER .... 59.5 ...... Street ........ r egi.as 4 . Ave .................... ............................................... .................. Building Inspector Housing Code Inspection August 14, 1978 595 Pequash Ave R-1 Cutchogue, N.Y. Tax Roll: Dorothy A. Kubacki occupied Upon receipt of an application for a Pre -Existing Certificate of occupancy, I made an inspection of the dwellin on this premises. I began this inspection at approximately 11:30 A.M. with Mr. Kubacki. Located on this property is a two story, wood framed structure, there is also a one and one half car garage and a above -ground swimming pool. Cellar is a cement block full cellar no outside entrance. The walls of this cellar are insulated with one inch styro-foam. Pump and water tank, electric hotwater heater are located in the cellar. First floor of this dwelling consists of living room with fire- place, sun porch, dining room, kitchen and half bath. Second floor of the dwelling consists of three bedrooms and a full bath. .The entire dwelling is heated electrically. The outside of this dwelling is in good condition with the ex- ception of the back porch and steps. The one and one half car garage is in fair shape, swimming pool has recently been constructed --Certificate of Occupancy # Z7913. The following violations of the Housing Code, Chapter 52, Code of the Town of Southold, N.Y. were found: Back porch - deck and steps- in very poor shape. Article III, ection -30 A. Cellar steps - no railing. Article II, Section 52-27. Inspection completed at 12:30 P.M. Respectfully submitted, C. 7 CURTIS HORTON Building Inspector FORM NO. 6 TOWN OF SOUTHOLD Building Deportment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building Inspector 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 installations, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning 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 uses: 1. Accurate survey -of property 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 in- formation required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 August 8, 1978 Date................................................ New Building ................ Addition ................ Old or Pre-existing Building ... Y.......... Vacant Land .............. Location Of Property .kdSt..S ..A .k'�f. '.S.A�idS.. ..i> lc�Sh. F„i...MtChogm*.mX........... Owner Or Owners Of Property .........??4 1X.A,.. ?........................ ....................................................... Subdivision................................................................Lot No............. Black No............. House No............. Permit No ..................... Date Of Permit ....................Applicant.................................................................. HealthDept. Approval ............................................Labor Dept. Approval ................................................ Underwriters Approval ..............................................Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ............. X.......................... Fee Submitted $ .......5.00 ..................... Construction on above described building and permit meets / o� ble c es a� �tix�r�r�-� Applicant ...................... ............ �.:...... �: Sworn to before me this �.��?..... day of ... tt..1978................. JOAN H► (stamp or seal) Nota Public ...... folk County '�.ser�URLIC aRMof k ......' ............... //f� @uenfisd e2-005650 °~ 1`ark Suffom i �J, C l.�a Vim-- Te.� Zf. 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