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HomeMy WebLinkAbout3202-zIrO~M NO. · TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No.Z?.~..8 ....... Date ............ ~a.~....1.6. ......., 19..~.? THIS CERTIFIES that the building located at 1~/.1~. P~I,&~1;..R.o. ad ........... Street Map No.. ~ ........ Block No...X~:. ....... Lot No. ;11;~.....0~$.e~t~.. N.o.Y., ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ &.l~ .2c)..., 19.6.6. pursuant to which Building Permit No..~.2.0.~... dated ............ .Aug.....~.0.., 1966 .... , 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 .. p~ .va..t~..o..n.c..f..a~. l~y.. d~.e.],~-l~C ...................................... The certificate is issued to .C.o..n.s.t.a.n..t..~.e.. &. R.o..s.a.l.~.e...B?.n.5.e.r.e.~..~' ..... .0~...e?.s. ..... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .~&r...~. 6...~.~77...bY..~.:. UNDERWRITERS CERTIFICATE No..96..nd..L~.g ................................... HOUSE NUMBER ..... 6.2Q.. .....Street .. p~..t..t..R.o.~d .....Qr.~er~ ................ ..... Building Inspector FORlVI NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3202 z Permission is hereby granted to: ....... _a~...wXgr~m..St.~ ............................. at premises located at ....~!a~lll~J:..lll4J~J..JP~tdla~,t.JJOla~,...Oat:LlJltt:,. ]j~l~ .~03¢3~; ........................... pursuant to application dated ................................... ~13~l.t,..~,., 19{ii..., and approved by the Building Inspector Fee $ .......~LO, JO~ .... SUFFOLK COUNTY DEPARTHENT OF HEALTH EASTERN DISTRICT County Center, Riverhead, New York PA 7-4700 H.D.Ref. No. 50--~30 APPLICATION FOR APPROVAL OF INSTALLED PRIVATE SEWAGE DISPOSAL AND WATER SUPPLY SYSTEMS Inspection for approval is requested, pertinent installation data herewith, ~dress ~/~- ~ ~/~.~. Phone~4-Section No. 2-Name of Build6.~ ~:.:~ .'([.~ ~ -Phone~5-Lot N~ber Address ~ ~6~ ~ ~ ~ 6-Bldg.Pemit No. 7-Sewage Syst~ inst~lled by~ ~D , Q~ p~ Phone g~ Address ~/~ ~ ~/~ ~. 8-(a)Deed location of propertj ~.~ ' P/~ (b)H~let or Village ~/~ (c)Town 9-Septic tank-Gal L f~,U f~.Ll~,i~ Da~l, ' lO-Cesspools-(a)No.pools~(b)Bloc~ %elow in~t-1)~2)~3) (c)Block size-L ]~ im~ ~ in.H % in.(d)Precast poo~ (~11 (f)~ ft, .in; Di~ ft. in. (g)Finished grade to cover /~ ~t. (h)Backflll Material $~ ~ . ll-~ater Supply: Public Syst~ ; Private ~ell ~ If Private, the following questions are to be answered: 12-Privatt ~atel Supply Sy~t~ installed b~e ~~ Phone ~1' Address V ll e. 13(a)-Total Depth of Well ~ ~ / (t)~=~[;,';~ ~ta~iq ~'~%r ~vcl. i 14-Diameter of well pipe -- ~ ~ ~ ~ 15-Name of Laboratory ./ ~ i~-~:hoa of D~feci~n ~ ~ 17-Date ready for inspeciion ~//~/Lg · The undersigned CERTIFIES: Above~t~s have been constructed and are in compliance with the Suffolk County Health D~a/tmen='s current Standards, Bulletins and ~endments ~hereto. ~ . /~ // f z ~ I I '--~- Builder 19-Insert sketch of location of Water & Sewerage Facilities with accurate dimensions. Inspected by ~ ~.% Date Eased upon the info~ation stated above, satisfactory fu g of the above syst~SDateCanbe 3/]~ h? expected with proper matnte~nce andApproved ~ ~e.~ ~Y2_ S-5e Instructions for Submission of Installed Private SewaKe Disposal and Water System Application Applications are to be submitted in duplicate. Required information should be typed or lelibly printed in ink. Inspectors are not permitted to make inspections of installations until applications have been submitt,ed to and accepted by this de- patient. The item number on the aPpli~aiion form and itemnumher lis~ed below are the 1. Owner's name and address - if owner and builder are same, so indicate. Builder's name and address - approvals will be mailed to this address. 3. Give name of filed realty subdivision map. Section number of realty subdivision map. 5. Lot number of plot on which disposal unit is constructed. 6. Building permit number assigned by the Building Department. 7. Hame of person or firm who actually constructed the sewage disposal facilities. 8. (a) For example: s/s Jones St., 100~ e/o Smith St. (b) Hamlet, (unincorporated area in township), for eaample: East Moriches. Village (incorporated area), for example: Horthport. (c) Township,.for example: Brookhaven, etc. 9, Give inside length and width in feet. Liquid depth is measured, infeet from bottom of outlet pipe to bottam of tank. 10. (a) State number.of pools. (b) Stat~ number of blocks'below inlet pipe for each pool. / (c) State length, width, and height of cesspool blocks in inches. (d) Indicate by check if precast sections are used. (e) Give number of leach- ing sections per pool. (f) Give height and diameter of each leaching section. (g) Give depth in feet from finished grade to cesspool cover. (h) Describe backfill material used. Indicate by check if water supply is public or private. 12. Name of person or firm who actually installed the water supply facilities. 13. (a) Give depth in feet.il~o~ top of well pipe or casing to well point. (b) Depth in feet from top of well pipe or casing to water level in well. 14. Inside diameter of well casing. 15. Name of laboratory performing the examinations. 16. Describe method of disinfection, for exemple: quart of laundry bleach in ten gallons of water poured into well and allowed to stand six hours. 17. State date on which installation will be ready for inspection. 18. Application must be signed by builder or owner. Signatures of subcontractor, superintendent, etc., will not be accepted. 19. Indicate location of Water & Sewerage Facilities with accurate dimensions on sketch. ACCUSATORY INSTRUMENT iNFORMATiON - GENERAL C P.L 100 15 FORM NO. 256 ~LL~*aSDN LAW SOOKCO .OC~LST£~ ~, ~ STATE OF NEB YORk COUNTY OF ..... S~£~.o.l.~ ................................... _ _~E~.~.~_ ...... C 0 U R T ..... ~o_L!p .......... 0 F ....~_o_~.%b.9. _Z..~. .............................. Constantine & Rosalie Bondarchuk Defendant nft rmalbJn Howa=d Terr~_~___B__u._i_l__d_.i__n_~L__I_n_spector _, resl, _~R~_~.Y___g__~___D_X_~__Y~__~_9_g.~_Q.%~.~_.~ ._~.~.~ .................. , b y th i s informa t ion written accusation as follows' That ..... _g_P_.n~._~.~_~__.a_~__._~_g_~.~-_$.e__J~on~,~mh~. ................... , on t he__~ da) of____N__o_y.2 .... 19___7_6 ..... at ...._6__2__0___P_l_a..t_t___R_o_a__d_ ..................................... (Locatmn) in the ...... _H_.a..m_.l_e_ _t_ .................... of ..... Q.r_ _i__~_n_~_ ............................................... Count)' of ..... _S_u..~.f_.o__l._k_ ......................................................................... ,Ne~ Ye commit the offense ~---°-~g~u-~-~&~-q.~-.a~-d~?-~e-~.-l~.g-cZ-w~.~-h-~-~u-~-~3J~B~-~~ ....... a (~rlsdera~rror) (violation) in violation of Section ............ k0_0._-.1.4_4._.%._.C13 ................ Chapter 100 .of t~h,e qode _..-_-_-_~_-__-__-_'_'_-_-__-'_t-aw-~rl-tl'rer'b~'te-ot-P+ew-a/o~, in that {,s/ne 616, at the aforesaid time and Count One: Occupying a single family dwelling at 620 Platt Road in the hamlet of Orient in the Town of Southold for which no Certific of O~cu~ancv has. be~n .r~guested,or ~ramte~. I ne facts u~on wmcn tins mlormatlon ~s pasco-are as lOllOWS: Building ~ermit #3202Z, dated July 30, 1966, was issued to construct this house. The house was completed, and notiae was sent to Constantine Bondarchuk on numerous occasions that the Building Department had not received the Health Department approval for the water supply and the sewerage system. This approval is necessary in order to obtain a Certificate of Occupancy. Wherefore, Complainant prays thaL~.C--~--n--s-t--a-.n-.t--i-n--e--~-&---R-~--s-a-~-.i-e~--B-~--n--d-a-r-g.-h~-~- .... be dealt with pursuant to law. T~tle or Offme Complmn~mt / · set forth statutory language constituting the offense The foregoing factual ollegat,ons are based upon personal knowledg, of the complainant (and upon in[ and belief, the sources of complainants informat,on and belief be,ng, ACCUSATORY INSTRUMENT INFORMATION - GENERAL C P L 'J0g 15 FORM NO. 256 STATE OF NEll YORk __.J_~.s_.t:__i c e ...... COURT_ COUNTY OF ..... ~££~,k ........................................ Town ._.OF ...._s_ _o_ _u_ _t_ _h_g_~_~_ .................................. ~l!e ~eople of fi.u' ~/ale of ~ew t~ork ; a~amst Constantine & Rosalie Bondarchuk ( 3nf rmatim Howa=d Terrz_,_.B_~i_l_d_i_n_g__i_nsDector _, resl, --J--q-q-k-9~y--~g--r~9~e-~.k---D--r--i-v-e-~----s~Q~-u-k~3-Q~.~-.N-~--~-9x~ .................. , by this information written accusation as follows' That ..... ._c._o._n._s_e_An_t_.i..n_e___.a. ..................., on the__.5 day of__.N_R.v_. .....19__7__6_ .... , at ...._6__2__0___P._l_a_.t__t___R_.o__a__d_ ........................................ (Locatmn) in the ...... .H_a__m__l_.e_~ .................... of_____Ox.i_e__n_t_ ............................................... County of ....._S__u_.f._f._o._l__k. .......................................................................... , New Yo, commit the offense ~f---~-q-q~uj~Xi-n-9~.a-~-d.w.p-~.~.i~.n-g-~-w-~i-~-h-~-u.A-hg~Y~$~~ ....... __~._~=~i~kg~e__o2_Oc~pi~m. cy ............................................................ a (-m'i~d'ettz~nor) (violation) in violation of Section ........... _k0_0..-.Z.4A._~_.il~ .............. Chapter ZOO.of %.h.e ~ode ~o~ t~%e,Tow~ o~ ,~oq.~hold .._-_-_-_-__-.r_-__-_-_-_r_-b-aw-crr~n~e-braee-ot-N-ew-~o~, ,n that Ls)ne ma, at the aforesaid time and I Count0ne: Occupying a single family dwelling at 620 Platt Road in the hamlet of Orient in the Town of Southold for which no Certific of O~ou~ancv has. be~n.r~uested,or~ramt~, lnemcts ~on ~c~t~]SmlO~at~on~soasen-areas~onows: Building ~ermit ~3202Z, dated July 30, 1966, was issued to construct this house. The house was completed, and noti~e was sent to Constantine Bondarchuk on numerous occasions that the Building Department had not received the Health Department approval for the water supply and the sewerage system. This approval is necessary in order to obtain a Certificate of Occupancy. Wherefore, Complainant prays thaL~~~-c--~-.n-.s-t--a--n--t---i--n--e---&-~--R~--s-a-~-i--9e~~-B~n-d--a-r.-c--h-u--k-- ..... be dealt with pursuant to taw. "Subscrlbed and Sworn to before me on ....................................................... , 19 ....... Complamant T~tle or Office *set forth statutory language const~tuting the offense **use only one The foregoing factual ollegat,ons ore based upon personal knowledge of the compla,nont (and upon and belief, the sources of complainants information and belief being, I~O~M NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined.... ~, ~/~/¢.......~. k~'. ...... Approved ..... G,k..C/~<~j....~ .,~... ........ , l~/..~:...Permit No....~>,.,.~....:.:,m ........... Disapproved a/c .........~ ............................ ~ ............................. ......................... ................................. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of propertymust be drawn on the diagram which is part of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordig~nces, building code and regulations. ~. ........ /~ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................... .................................................................................................................................................... Nome of owner of premises ~'..~.~.~.~.~.~k~' .~.Z'~'~.~.....~......~.~.~.~'....~.....~../...~.].~...~..~...~...~.(~C~ ............ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: ............................................ Lot No: .................... Municipality 2. State existing use and occupancy of premises and intended use and OCcupancy of proposed construction: a. Existing use and OCcupancy ....................................................................... .......~.~...~,..~../ b. ntended use and occupancy ..~..~...~'~ .~...~..~ ......................................................... 3. Nature of work (check which applicable): New Building .......'6:~.. ......... Addition .................. AIteration'.....':~. Repair .................... ,Removal .................... Demolition .................... Other Work (Describe) ...................................... 4. Estimated Cost ..........z,~. ............................................ Fee .......................................................................................... (to be paid on filing this application) ,5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number of cars ..................... z'. .................................................................................................................... 6. If business, commercial or mixed occupancy, specify,~ature and/extent of each type of use ................................ ..../.Re :.'.../..D 7. Dimensions of existing structures, if any: Front .. ../.~ ar . ./..~. epth ............. Height ............................ Number of Stories ...... ./... ...... ./....Z,,fi .................. : ............. .~. ............................... ; ................ Dimensions of same structure with alterations or aad t ans. Front Rear ................................ Depth .............................. Height .............................. Number of Stories ........................................ 8. Dimensions of entire new construction: Front ....~./ .................. Rear ..... ~.¢/...~.~...~.( ....... Depth ......~.~. ............... Height ............................ Number of Stories .......... /. ............... 9. Size of lot: Front ..... Z'-f..-..O...~ .......... Rear ...../2.?....'i ........... Depth .....~....~..~..~ ............. 10. Date of Purchase ....~Y,~.~ ........ K'.;Y.~ ......................... Name of Former. ,Owner ....V.~.tL..,~.,.....~.,.~./~.. ................ 1 1. Zone or use district in which premises are situated .......................................................................... ./~/... , ................ 12. Does proposed construction violate any zoning law, ordinance or regulation? ....Z~.~ .......................................... N o.~../..'.~...,0,, :~ :?.:~.. 13. Name of Owner of premises~;~,:~,./hr.,:r.~.~.'..~/,;':~;2~?,!~:~'~'~ddress -'~.Z/..£~.6,~Z,'~/~.~;'-..~)~. .............. Phone Name of Architect ...................................................... Address ............................ ................ Phone No ..................... Name of Contractor .................................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oil set-back dimensions from property lines, Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. ~ STATE OF NEW YORK, ~ S S CQUNTY-z'~ __ OF ................................_,.,._.~__//, ~...,.._._~----[ ~'Y-~:~-~-- ~ ~.~.'~~('"'~'~' ............ being duly swornl deposes and says that he is the applicant .... iName of individual signing application) above named. He is the ........ ~ ............................................................................................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ......................... .... .....