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TOWN OF SOUTHOLD
BUII.DING DEPARTMENT
Town Clerk's Office
Sonthold, N. Y.
Certificate Of Occupancy
No. L7?_6i'....... Date Oet 19 76 .
THIS CERTIFIES that the building located at P®q~sh. W11~.aN , , , , , , , , Street
Map No. xx Block No...?~ .....Lot No.. su, , , _CutchogUe , , , , , , , , , , , , ,
r®quirsnents for o Tani y dwll na cods
conforms substantially to the
bxilt before cert S aat '~o! ocaupanay
dated AP?' , 19.57. pursuant to whichJ®r16T~~No.Zg26$ . .
i
dated , .Oct 4 1976.., was issued, and conforms to al$ of the require-
ments of the applicable provisions of the law. The occupancy for which ~ certificate is
y~u~ ~ . , }?rlvats.onc~ .fanily. dwelling, &,acceeaorl+,puild
The certificate is issued to .Robt.. J.. Ennis Ano.. orraer, oY re~orA, , , , , , , , , , .
(owner, lessee or tenant)
of the aforesaid building.
p ~xistia
Suffolk County Department of Health Approval r " .
i
UNDERWRITERS CERTIFICATE No. Ere-, existing, , , , , , , , , , , , .
HOUSE NUMBER ....112 .....Street . ~'~gU~si~ .
2g ldillor Bt
uilding Inspector
HOUSING CODE INSPECTION
October 1, 1976
1125 Pequash Ave., 25 Willow St. R~1
Cutchogue, N. Y.
Tax Roll: Robert J. Ennis & ano.
Unoccupied
Upon request of Gary Olsen, Attorney, Mattituck, for a Pre-
existing Certificate of Occupancy, I made an inspection of
this one and one-half story, framed dwelling. I picked up
the key from the Russell P. Silleck Agency, Cutchogue. I
began this inspection at approximately 2:00 P.M.
The first floor consists of a kitchen, full bathroom,
dining room, and living room. Front entry on Pequash Avenue
is protected by enclosed porch. Side entry from Willow Street
has a vestibule entering kitchen. Second floor has three bed-
rooms. Heat is furnished to the first floor of building from
a gas-fired, warm air furnace with heat outlet located in living
room floor approximately centrally located in building. The
building's foundation is clay block and provides a.full cellar.
The following violations. of the Housing Code, Chapter 52,
Town of Southold, New York, were found:
Front and Rear Entrances - no lights on entry, Article V,
Section 2- 6 B .
Heat - no heat provided to second floor rooms. Occupancy
permitted on a seasonal basis only, Article V, Section 52-53 A1.
Accessory building on property is a wood framed, one-car
garage located in side yard facing Willow Street. Buildings and
grounds in good condition. This inspection completed at approxi-
mately 230 P.M. Key was returned to office of Russell P. Silleck.
Respectfually submitted,
Edward Hindermann (A1,D,
Building Inspector
EH:med
¦YISI[ NQ •
TOWN OF SOU71ilOLD
D~rtereat
Tewrr Clerks ONke
SarthoW, N. Y. 11971
AF?LICATION FOR CERTIFICATE OF OCCUMNCY
Iwstruetieu
A. This application must be filled in typewriter OR ink, and submitted in DUPLICATE to tM Building
Inspector with the following; far new buildings or new use:
1. Final survey of property with accurate lacotion of oil buildings, property lines, streets, and
unusual natural or topographic features.
2. Final approval of Health Dept. of water supply and sewerage disp~ol-(S-9 form or pool).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Raidsnces and .similar bulldirr~ and
installations, a certificate of Code compliance from the Architect or Engineer b for
the building.
5. Submit Planning Board approval of completed site plan requiromerrts where applicable.
B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pn-existing"
land uses:
1. Accurate survey • of property showing oil property lines, streets, buiklirps and unusual natural
or topographic featurrs.
2. Swam statement of owner or previous owner as to use, accupanry and condition of buildings.
3. Date of any housing code or safety inspection of buildings or promises, or other pertinsrrt in-
formation roquired to proparo a certificate.
C. Fees:
1. Certificate of occupancy 35.00
2. Certificate of oeeupanry on pre-existing dwelling or land use ;5.00
3. Copy of certificate of occupancy 31.00 1_
Date ..~~`.~'~'.1.R
New Building ition Oid or P sting Building Vacant Land
Location Of Property ............~It,,,>.:~ ..........6.A(Y~(L~~/~~~ll~..._.........;......
Owner Or Owners Of Property ~ ~~~M,... ~~!4~.~.....~sr...ld~~flMQ\l...^.........................
Subdivision ................................................................Lot No............. Block No............. House No.............
Permit No Dote OF Permit ....................Applkant
Health Dept. Approval ............................................Labor Dept. Approval
Underwriters Approval ..............................................Planning Board Approval
Request For Temporary~rtificate Final Certificate
Fee Submitted 3
Construction on obese described building and ~ applicable c rogulotiorn.
Applicant
Sw~~o//rn to before ms this L~
day of (stamp or asol)
Notary Public County