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Home My WebLink AboutZ-10810FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hall Sou/hold, N.Y. Certificate Of Occupancy No... ~ ] 0.~.1. 0 ........ Date ...... p.e.c.~r~ THIS CERTIFIES that the building ................................................ Location of Property 740D..Ma;rix .ttoa.d.. ( ~ 0.5..OJ.~t..H~.I1..l~o~.d.).: .......... ha. ~.e.~ .... House No. Street Ham/et County Tax Map No. ] 000 Section . 1 2 2 ........ Block .. ~ 7 ........... Lot .Q 0.1 ............. Subdivision ..... X ........................ Filed Map No... ~( ..... Lot No .... ~ ......... Requirement~ for commercial property built prior conforms substantially to the .~p~E~t,~ Certificate of Occupancy · .gP../~ P r~-.~. ~ 3 ........ 19.5 7 pursuant to which ~:tffRing' Pelm'tt No ............ ~ .1 9.8. ! 0... dated ....... ~ e.c e m bern. 9 ......... 19.8 1, 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 ......... ......... ~. ¢~..~iD.d..s.¢ t?y.i.q~..s.t.a, t). ~. 9.n. ,. ........................................ The certificate is issued to ......... P~.ger. ,J.,. Wa~.ce n..and. L.&nda..I,,. [Y.~n .......... of the aforesaid building. Suffolk County Department of Health Approval ......... N/.R ............................. UNDERWRITERS CERTIFICATE NO ........... N 32t 6 7 .4 9. .............................. Building Inspector Rev. 1/81 STATE OF NEW YORK ) COUNTY OF SUFFOLK ) SS.: PETER 3. WARREN, being duly sworn deposes and says: That I am currently the owner of the Hobil Gas Sta- tion located on the corner of Route 25 and Bray Avenue, Laurel, Town of Southold, New York. I have owned this property since 3uly 21st~ 1969 and am familiar with the property since 1967. I have spoken to Mr. Rambo, a resident of the town of Southold~ for 70 years , with reference to my property and he told me that the property has been continuously in use since the early 1920's as a gasoline station~ and is the oldest gasoline station on the north fork. lhe existing building was built for Shell 0il Company I by Roy Reeves and Sons of Hattituck, prior to April of 1957 and in excellent condition having been maintained by the Peter 3. Warren corporation since 1969. lhe attached survey represents an accurate stateof facts as of today. day of December~ 1981. * ,taryPubllc Staeof NY ,~u ~!MC4567614, Sulf. Co. ~m Extorts Mar. 30,198(Z..' Co FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted in duplicate 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 Planning Board approval of completed site plan requirements where applicable. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty 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. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 New Building ............. Old or Pre-existing Building .X..XzX ........ Vacant Land ............. ~TL/C,o Location of Property CorAe, r. P.f..F~g ~.t.e~ lg,5..~. I~¥Dl¥.. ~y.el:., .L .a.u.t'.e. 1. :[ .N.e.w...Y.o.~.k. ........... House No. Street Ham/et /,-~- ~ f County Tax Map No. 1.000 Section ...; .,,'.. '~ ...... Block ........ ,./. ..... Lot .... ............ !, ,~ ~ 15,/,? Subdivision ........ i. ........................ FUed Map No ........... Lot No. Permit No ........... Date of Permit .......... Applicant . .P.E..T.E.R..3. ;..W.A.R..R .E.N ............... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval . ,~.'~... ,;. '~ .Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate Fee Submitted $ ........ -~, 0Q ................. Construction on above described bui~c~N~e,s :d regulations. ) /' ";" Applicant ~~~ ................. . ' · · 'Rz ' ' ..,. ~o-:o-~a .. C O. '- / .. ~, PE'TE R~' ~':-' SCALE , ' .~ 20 GUARANTEED TO, JULY I , 1969