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Home My WebLink AboutZ-9608FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No. .291i08.......... Date ........ July. .31 ................ 19.79 THIS CERTIFIES that the building ................................................ Location of Property9.7.05 ......... Min. Rd...... .. .. X4Attttuo)c ......... . . House No. Street Ham ei County Tax Map No. 1000 Section ..122 ......Block ..06 ........... Lot ...01.1 .......... +► X conforms substantiallyto nu�7'f;Pr,ial:f.3 T:S a'f ll.(lG'!'i CHARM"'rrh't'i . dated .................. Jj y:. 31.. 19.79, 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 ......... . Service . Station with Repair . Shap . and .storage. building ............... The certificate is issued to ..... Getty..Oil..CompRrsy .................... . Towner, l� J of the aforesaid building. Suffolk County Department of Health Approval ..... N/.R................................. UNDERWRITERS CERTIFICATE NO ............. N/.R................................. .... ......... Building Inspector Rev 4/79 s s Location, BUILDING DEPARTMENT OI-J'N OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT stre Subdivision Nap No. Name of Qiiner(s) occupancy�- �.) tYp e uriicipality) Lots) owner - Admitted b *�- r�-•+tG Accompanied by: Mr CouttG Y=_ Key available Suffolk Co. Tax No. X22-nh- I Source of request ,ram Flanner Olsen. Attorney at Date 7/30/79 Law ery ce a ion Type of construction cement block �C wo�� framed stories_ orP Foundation r P ��+ �� u Cellas"ls,tCrawl space a. Total rooms, 3rd. F1 Bathroom(s) Service Station Regj'41TAh¢$om(ses rn Porch, type Deck, type Patio, type Breezeway Garage Type Heat floor furnace,.�larm Air g Hotwater oil fir Fireplace(s) No. Exits 3 Airconditioning Domestic hot rater none Type heater Other ACCESSORY STRUCTURES: Garage, type const._ Swimming pool Other wood framed w/ Large Storage, type const. metal Cheating Guest, type const. VIOLATIONS: Housing Code, Chapter 52 Location- Description Art. Sec. 1-D1 38dip'9 rm,j no-ha� tpr V i52 -51 -DI �M. Remarks: ----- Inspected by: ��Date of InsP-�� O � % Time start, -0-3-0— etid_a j /S� /?M FORM NO. 6 TOWN OF SOUTHOLD Building Department 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 II 7 Date....... .4 J ..................... New Building .................... Old or Pre-existing Building ........ �(............... VacantLand. Location Of Propier q....1.:...!.,^ ..• :•"tla...� .9 .T-1,.V.44........................................................ Owner Or Owners Of Property ..... ��,,,�i� t,,( 1,., 1 c Subsler+ .....^-:.O./..%..................Lot No............. Block No............. House No ... Permit No ..................... Date Of Permit ....................Applicant.................................................................. Health Dept. Approval .................Labor Dept. Approval ........................................................................... Underwriters Approval ............ ................................. Pla Board Approval .......................... Request For Temporary Certificate ....................................... Final Certificate .......................................... _4n Fee Submitted $ ..�J. ................. Construction on above described building and Applicant .....�f Sworn to before met s qq ee .....e.1..... day of .. ..//...�1......... . .1140, .. . Notary Public ......... . ...... County MECISIAUS WIN Notary Public Sate of New /� �. 52-9703725 Suffolk County ffomm. Erohree Murch 30 1 :1 Ki sand regulations. (stamp or seal) or rIo%4 for ,erli Mptti tLICK E. N 10*43 00``'~i- � R� s v t 6%. -oma Mp�.6 11 0 ra Z o 0* N NOTE a = PUMPs 0 0 0 2'4 Co. Tru cKirig D s* a C.ONc.c O NC.•r_O L4 ° ytP?.oN s� P a V 0.. HOp ., ° CA y ha 0 0 SURVEY FOR ROBERT L. BERGEN OIL COMPANY, INC. AT MATT/TUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK *UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. is COPIES OF THIS SURVEY NOT BEARING THE LAND SURVEYORS INKED SEAL OR EMBOSSED SEAL SMALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. *GUARANTEES INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED, AND ON HIS BEHALF TO THE TITLE COMPANY,GOVERN- MENTAL AGENCYAND LENDING INSTITUTION LISTED HEREON,AND TO THE ASSIGNEES OF THE LENDING INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS. *DISTANCES SHOWN HEREON FROM PROPERTY LINES S�ptE OF /V,, /01' D ly X01+ aii l�' W O BOG F z } \�sr 45893 14N8 SURV%l5"' DATE DEC. /5, 1978 SCALE: / � = 50 NO. 78 - 798 GUARANTEED TO ROBERT L. BERGEN OIL COMPANY, INC. NORTH FORK BANK B TRUST COMPANY AMERICAN T/TLE INSURANCE COMPANY TO EXISTING STRUCTURES ARE FOR A SPECIFIC - PURPOSE AND ARE NOT TO BE USED 70 ESTABLISH _- PROPERTY LINES OR FOR THE ERECTION OF FENCES. / � � r (C/; / 07.0 400 OSTRANDER YOUNG a YOUNG RIIVERHEAD,,NEW YO KUE ALDEN W. YOUNG, PROFESSIONAL ENGINEER AND LAND SURVEYOR N.Y.S.LICENSE NO.12845 HOWARD W. YOUNG, LAND SURVEYOR N.Y.S. LICENSE NO. 45893