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Home My WebLink AboutZ-22424FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-22424 Date JUNE 30, 1993 THIS CERTIFIES that the building. Location of Property 9705 MAIN ROAD (RTE 25) House No. Street County Tax Map No. 1000 Section 122 Block 6 Subdivision Filed Map No. BUSINESS STRUCTURES MATTITUCK~ N.Y. Hamlet Lot 11 Lot No. conforms substantially to the Requirements for Business structures built Prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z-22424 dated JUNE 30, 1993 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 THREE BUSINESS STRUCTURES * The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. DALE M. & EILEKN M. BERGEN N/A N/.~ Buiidin~ ~s~ector Rev. 1/81 TOWN OF oOoT,l~D, N. Y. iNSPECTION RE~ORT 9}05 ~AIN ROA~ (RUU~ 25) HATTIT~CK~ N.Y. Nap No. Lot(s) ?brae 0£ O.mcr(s) DALE H. & EILEEN H. BERGEN Occupancy. ,',dm±~ cea by: B-ZONE t~R~ BERGEN O~NER & TENANT ( owner-%enamv ) Accompanied bt': ~. BERGEN Key available Suffolk Co. Tax No. 122-06-11 SouPoe of request DALE BERGEN Date JUNE 17, 1993 'rtl~R~ ARE Tli~E (3) BUILDINGS ON Tills PROPERTY. BUILDING NO. I: T~o bay cement block building being used as a repair garage. Just au open building with no bathroom. Need minor repairs, such as painting and some repair work. BUILDING NO. 2: T~o rooms with a toilet room and basement. This building is being used as an office sales building. Needs some major repairs, painting, roof, door repairs. BUILDING NO. 3: A 20' x 30' metal building in very poor shape is being used as a storage building needs to be completely rebuilt or torn do~n. It is in an unsafe condition. CURTIS I4. UORTON Time start I0:00 end 1993 II:00 Form No. 6 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN tlALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new nse: 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 iastallation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of I% lead. 5. Commercial building, industrial building, multipIe 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. 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 featnres. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the BuJlding luspect'or shall state the reasons therefor in writing to the applicant. C. Fees i. 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 Buiiding - $I00.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occnpancy - Residential $15.00, Commercial $i5.O0 l ate .... ! ?.,. J .................... New Construction ........... Old Or Pre-existing Building..~ .............. Location of Property.(~P. #1 /Main Road (NYS Route 25), Mattituck NY ... ltouse No. Street llamlet Onwer or Owners of Property.. PAI . pg q p ......................... County Tax Map No 1000, Section .... ].~ ....... Block..PP.-.qq ........ Subdivision .................................... Filed Map ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicant ............................. Dealth Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certlcate..X. ........ Fee Submitted: $. ~.00..0.0 ~ TO IN.~I I5C l ION DALE M. BERGEN , the undersigned, Owner(s) Name(s) do(es) hereby state: That the undersigned (is) (are) the owner(s) or the premises in the Town ofSouthold locatedat Main Road (N.Y.S. 25), Mattituck, N.Y. · which is shown and designated on the Suffolk County tax map as District 1000, Section 122 , Block 06.00, Lot'Dfi4~.~000 That the undersigned (bas) (have) filed, or caused to be filed, an applica- tion in the Southold Toy. q1 Building Inspector's O£fice for the following: Application for CertificaLe of Occupancy ( pre-existing certificate) lations of the laws, That the undersigned do(es) hereby give consent to the Building Inspectors of the Town of $outhold to enter upon the above described property, including any and all buildings located thereon, to conduct such inspections as they may deem necessary xvithrespect to ',he aferesaid application, including inspections to determine that said premises comply with all of the laws, ordinances, rules and regulations of the Town of Soulhold. The undersigned, in consenting to such ~spections. do(es) so with the knowledge and understanding that any information obtained in the conduct of such inspections may be used ns evidence in subsequent prosecutions for rio- ordinances, rules or regulations of the Town orSouthold. Dated: June 17 , 1993 (signature) Dale M. Bergen (print name) (signature) (print name) or forr~erlY Mo t t i tuck CO' Truckir~g SURVEY FOR t?OB£t?T I. BEt~GEN OIL COMPANY, IRC AT MATTITUCtC DATE : DEC. I~,~ 19~1'8 I" $O ' NOTE TOWN OF SOUTNOL. D SCALE: o : PUMPS SUFFOLK COUNTY, NEW YORK NO. : 7'8 - 7'98 *U.AUT.O.~ZED A.TE.AT,O. O.'~;DO,T,O'~;'TO T.,S I GUA.~.TEEO ~o-'' SURVEY IS A VIOLATION OF SECTION 7209 OF THE ! ROBERT/. B£RG£N OIL COMPANY/INC. NEW YORK STATE £DUCAT~ON LAW. NORTH B~NK T~MST COMPANY ~coP~s Dy ~H~S SUrveY NOT 8~AmN6 THE LANO SUrVEYOr'S ~NK~O SEAL O~ EaBOSS~O S~AL SHALL / ~MEBIC~N T~~NCE COMPLY NOT a~ CONSIDERED TO a~ A VALID ~EUE CO~Y, ~ ~UA~AN~EES mmCATED H~ON S~ALL ~UN ONLY~O / ~ ~ THE PERSON FOR WHOM THE SURVEY IS PREPARED, m ~?~ AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERN- m //~ w MENTAL AGENCY AND LENDING INSTITUTION LISTED. [/zT/~- · - · ,~ HEflEON,AND TO THE ASStGNEES OF THE LENDING . ~[~/,~- ~ -~, .~ INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE / ~w~]~& ~ ~ TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT / ~ ~ ~ O~NERS. ~ / II ' I-- F~;~:~A I II ' * DISTANCES S~WN H~EON FROM PROPERTY LINES I 1[ [ ~; ~ _ / JJ TO EXISTING STRUCTURES ARE FOR A SPECIFIC m ~ ~ ~/ PURPOSE AND ~RE NOT TO BE U$ED TO E~TABLISH I · ~ ~ ~ ~ / /~,~// - YOUNG ~ ~ II - ~ m I ALDEN W. YOUNG,PROFESSIONAL ENGINEER mm m[ LAND SURVEYOR TOW'~'~ L;~: ~- -: : - ' . ~~ N.~S. LICENSE N0.45893