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HomeMy WebLinkAbout44345-Z OS�F ' Town of Southold 2/28/2021 P.O.Box 1179 C* • 53095 Main Rd ygjQl �a�� Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 41855 Date: 2/28/2021 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 2655 Wickham Ave, Mattituck SCTM#: 473889 Sec/Block/Lot: 139.-2-5 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/22/2019 pursuant to which Building Permit No. 44345 dated 10/28/2019 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: "as built"water heater and oil to gas conversion as applied for. The certificate is issued to Agarabi Ali Revoc Trt of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 10/18/2019 o Meq&anical Co ho ' e ature Sv EEo�� TOWN OF SOUTHOLD o`A °may' BUILDING DEPARTMENT 0 TOWN CLERK'S OFFICE �� • SOUTHOLD, NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 44345 Date: 10/28/2019 Permission is hereby granted to: Agarabi Ali Revoc Trt PO BOX 101 Mattituck, NY 11952 To: legalize "as built" alterations (water heater and oil to gas conversion) as applied for. At premises located at: 2655 Wickham Ave, Mattituck SCTM # 473889 Sec/Block/Lot# 139.-2-5 Pursuant to application dated 10/22/2019 and approved by the Building Inspector. To expire on 4/28/2021. Fees: AS BUILT - SINGLE FAMILY ADDITION/ALTERATION $400.00 CO -ALTERATION TO DWELLING $50.00 ELECTRIC $-8� tal: 453 -80 Building ector _ Form No-6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building 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 from Health Dept_ of water supply and sewerage-disposal(S-9 form). 3_ Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead_ 5_ Commercial building, industrial building, multiple 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_ B. 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 features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1_ Certificate of Occupancy-New dwelling$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00, Swimming pool$50.00,Accessory building$50.00,Additions to accessory building$50.00,Businesses$50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy-$.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential$15.00, Commercial$15.00 Date. d L� Old or Pre-existing Building: (check one) New Construction: y Location of Property: fie5��� W f COL-,x 4-W fm t l Nl House No. /gyp Street Hamlet Owner or Owners of Property: I-rL� Suffolk County Tax Map No 1000, Section Block 3 Lot Subdivision Filed Map. Lot: Permit No. �J`(� Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ ��/ A4 4 Applicant Signa LtV GI/� OF SOUTyo`�� Town Hall Annex Telephone(631)765-1802 54375 Main Road m' Fax(631)765-9502 P.O.Box 1179 G Southold,NY 11971-0959 �Q�yeQUNSY,� � BLTILDING DEPARTMENT TOWN OF SOUTHOLD r CERTIFICATION 0 Date: I Z'0 / Building Permit No. l Owner: } (Please print) i Plumber: (Please print) I certify that the solder used in the water supply system contains less than 2/10 of I% lead. , A-ki (Pl ers Signature) 44- Swornto before me-this l day of O L-�abp-r- , 20 19 , i " �WWyo ..d SHARON L.TUTHILL NOTARY PUBLIC,STATE OF NEW YORK Registration No.01TU6074477 ! f� Qualified in Suffolk County Notary Public, S U, J of County Commission Expires May 20,2022 I i i i `l l /Li O�aOF SOUTyOI # # TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION. [ ] FOUNDATION 1ST [ "] ROUGH PLBG. [ .] FOUNDATION 2ND [ ] SULATION/CAULKING [ ] FRAMING /STRAPPING [ FINAL Di` 71060d (.0n(INJIM4 [ ] FIREPLACE & CHIMNEY [ ]' FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: f i _ DATE / INSPECTOR �F SOUTyolo # # TOWN OF SOUTHOLD BUILDING_DEPT. co 765-1802 INSPECT-ION = [ ] FOUNDATION 1ST [XROH PLBG. [ ] _FOUNDATION 2ND [ ATION/CAULKING, FRAMING/STRAPPING [ [ ]"FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE-RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: cQ �- DATE INSPECTOR 11)4 FIELD INSPECTION REPORT -DATE COMMENTS FOUNDATION (IST) V�y ------------------------------------ fb FOUNDATION (2ND) AA z � o Uk On ROUGH FRAMING& t� PLUMBING tiro y i r^rig,ate•/ Irh INSULATION PER N.Y. ! H STATE ENERGY CODE + %[j k 04 FINAL ADDITIONAL COMMENTS (� PA"� 1G L �. ,m z t� x + �6' �b+ tomer hear - of ( 4­�j6s --as t3ua�- TOWN OF SOUTHOLD L100 BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT � Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD, NY 11971 es- k iow m "*f0_5 • se ns TEL: (631) 765-1802 1 Planning Board approval FAX: (631) 765-9502 -rj'�js Survey Southoldtownny.gov PERMIT NO. "�� Check Septic Form iy � N.Y.S.D.E.C. Trustees 4. U � NL VNFUL C.O.Application -Examined 20 F � .Flood Permit 1 � � gSingle&Separate FCC U PA Y Truss Identification Form F Storm-Water Assessment Form Contact: Approved 20 Mail to: Disapproved a/c Phone: Expiration _,20 E =,', _.� z �, ;', i ing Inspector OCT 2 , 2019 APPLICATION FOR BUILDING PERMIT Date p /e , 20 /9 P7 117-sem111s +',F INSTRUCTIONS a. This application MUSE be completely-filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises,relationship to adjoining premises or public streets or areas, and waterways. 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 a permit shall be kept on the premises available for inspection throughout the work. e.No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim,the Building Inspector may authorize,in writing,the extension of the permit for an addition six months.Thereafter,a new permit shall be required. 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 emoval or demolition as herein described. The applicant agrees to comply with all applicable laws, ordinances,building code, ou ' code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. Q P• -`� "`- " (Signa e of a r name,if a corporation) DATA; � C.ACC'-1' � � ttr If f C:11 UIL`l-,V 4%�- ' FUR THE (Mailin address of applicant) OZ a AT1� u a P L State whether, pplicant,is nwn�ei ;e'sic 4ca e'nt;�archAect-e i er, eneral contractor, electrician lumber or builder © � 1, '`< ,� cTg G rstt�3?g? g p .- &��l glR1G Name of owner,of premises a(�U ����f , &Vr)"-75 L6 (�Ws7 3. 11\1SULAMIN �SiRUc��vQn�the�_tax roll or latest deed) If applicant is a corporation, sigRgffih'dPdf tlEf�authontcgdoofficer st: comptF IlYlr-_ET TKF- CC;I,,'PLY WITH ALL Cn )ES OF (Name and title of corporals otffi'ce,,ry-��. ``of i H� C���OF II`�AIIVEW YORK STATE & 7 .��iv CODES sA Builders License No. ;GC!UtR .NIS i ��SPONSIBLE FOR S REQUIRED �F Plumbers License No. Z 0 7S ' �; Ut%1 r" RO� S �THOLC);(1,:,1h 3A Electricians License No. NTNG BOARD Other Trade's License No. SOUP ` UTHOLD TOWN TRUSTEES 1. Location of land on which proposed work will be done: Y.S.DEC House Number Street Hamlet County Tax Map No. 1000 Section � Block c, Lot T , Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost 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 6. If business, commercial or mixed occupancy; specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height - Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories i± ?' ? TT' 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO 13. Will lot be re-graded? YES NO Will excess fill be removed from premises?YES NO 14. Names of Owner of premises Address Phone No. Name of Architect Address Phone No Naive of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. 18. Are there any covenants and restrictions with respect to this property? * YES';' NO * IF YES, PROVIDE A COPY. CONNIE D.BUNCH Notary Public,State of Now yoo STATE OF NEW YORK) No.01BU618s®Sa SS: Qualified in Suffolk©:rtcounty C7 COUNTY OF ) Cmi8,810n Exolro"Aptil 14, being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)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 t before me thi• w o� day of Q4_9--t _ -20-J-01----_. Notary Public Signature of A#Iicant >`3 INSTALLATION , OPERATING AND a SERVICE INSTRUCTIONS FOR �y RM �Ky 4 B, rot C us IsTsTaFny` �$4 tel A (I 9�7 � . For service or repairs to boiler, call your heating contractor. When seeking information ort-b6 ler, provide Boiler Model Number and Serial Number as shown on Rating Label Boiler Model Number Boiler Serial Number Installation Date 1 , ZogNcL, &51D 019 -1.,oi7,-7 Heating Contractor Pho a Number' -Address _ (oS s C1 k*VK -4V C- dkt N. [9' f Z. K-"haat 0 H� roni cs U.S.Boiler Co.,Inc. 3� 81417032822-9/07 Price-$3.00 Residential Gas ' Water Professional Classic Atmospheric Water Heaters The new degree of comfort' Professional Classic°Atmospheric gas water heaters are engineered for more hot water at a low operating cost Efficiency Altitude Certification r �, • .58- .66 UEF •All models certified up to 5,999 above sea level,some certified up feet . • More hot water at a low operating cost to 10,000 feet.Consult factory for Performance specifications • FHR•51 -87 gallonsPIuS... ' - Valve on Se I lect Models• Recovery:30.3 to 40.4 GPH at a • Easy to light—no matches required i. 90°F rise,depending on model e EverKleen`'patented system fights %' Y Guardian System"&Sensor sediment build-up •Exclusive air/fuel shut-off device •Exclusive Rheemglas®tank lining resists corrosion and prolongs tank life •Maintenance free—no filter to clean �, 1 ' -•i •Protective control system that • Enhanced flow brass drain valve disables the heater in the presence of •Temperature and pressure relief valve flammable vapor accumulation Included •Factory installed temperature and pressure relief valve on select models •Low lead compliant Combustion Shut-off System Flame Arrestor Plate •Standard replacement parts Warranty o �I •6-Year limited tank and parts warranty* Mamtenance Free .With ProtectionPlus-the 6-year limited tank warranty becomes 10-year Professional Classic Low Emissions 'see Residential Warranty Certificate for Atmospheric •Eco-friendly burner,low NOx design complete Information 29, 30, 40 and •Meets 40 ng/J NOx requirements Units meet or exceed ANSI requirements and have 50-Gallon Capacities been tested according to D O E procedures Units U to 40 000 BTU/h Longer Life meet or exceed the energy efficiency requirements p r •Premium rade anode rod provides of NAECA,ASHRAE standard 90,ICC Code and all Natural and LP Gas g p 0long-lasting tank protection state energy efficiency performance criteria *LEED Point=1 See specifications chart on back. COMFORTINTEGRATED HOME PRINTED IN U S A 03/18 WP FORM NO PROG RH N COM80 Residential Gas ' r Water Professional Classic Atmospheric Water Heaters Professional Classic®Atmospheric Specifications DESCRIPTION FEATURES ROUGHING IN DIMENSIONS(SHOWN IN INCHES) ENERGY INFO. GAS INPUT RECOVERY UEF HT TO T IN THOUS. I N G PH. FIRSTHR. HEIGHT HT.TO WATER SIDE WATER UNIFORM Y NOMINAL RATED BTU/H 90°F RISE DEL G PH TO TANK GAS VENT CONN TSP CONN. SHIP ENERGY P GALLON GALLON MODEL VENT HEIGHT DIAM CONN. SIZE CENTER VALVE SIZE WT. FACTOR E CAPACITY CAPACITY NUMBER NAT LP NAT. LP NAT LP A B C D E F G H (LBS) (UEF) Tall 29 28 PROG29-32N RH63 32 - 323 - 63 - 59-3/4 56-7/8 16-1/2 14-1/4 3 or 4 8 50-3/4 3/4 110 060 Tall 29 28 PROG29-30PRH63 - 30 - 303 - 63 59-3/4 56-7/8 16-1/2 14-1/4 3or4 8 50-3/4 3/4 110 1 060 Tall 1 40 38 PROG40-36NRH62t 36 - 364 - 64 - 61-1/2 58-1/2 19 14-1/4 3or4 8 52-1/4 3/4 127 058 Tall 40 38 PROG40-38NRH621' 38 - 364 - 64 - 61-1/2 58-1/2 19 14-1/4 3or4 8 52-1/4 3/4 127 056 Tall 40 38 PROG40-40NRH62T 40 - 404 - 84 - 63-1/4 60 19-1/2 14 3or4 8 53-1/2 3/4 135 066 Tall 40 38 PROG40-36PRH62t - 36 - 363 - 84 63-1/4 60 19-1/2 14 3or4 8 53-1/2 3/4 135 066 Tall 40 38 PROG40-32PRH62t - 32 - 323 - 67 61-1/2 58-1/2 1 18-1/2 14-1/4 3or4 1 8 52-1/4 3/4 125 0.59 Tall 50 48 PROG50-40NRH62t 40 - 404 - 76 - 62-1/2 59-1/4 21-1/2 14-1/2 3or4 8 52-1/2 3/4 165 1 065 Tall 50 48 PROG50-36PRH62t - 36 - 364 - 76 62-1/2 59-1/4 21-1/2 14-1/2 3or4 8 52-1/2 3/4 165 065 Tall 50 48 PROG50-38NRH60t 38 - 384 - 85 - 61-1/4 58-3/8 20-1/2 14-1/4 3or4 8 51-3/8 3/4 150 064 Tall 50 48 PROG50-36PRH60t - 36 - 364 - 85 61-1/4 58-3/8 20-1/2 14-1/4 3or4 8 51-3/8 3/4 150 064 Short 30 29 PROG30S-30N RH63 30 - 303 - 51 - 49-7/8 47 19-3/4 14-1/4 3 or 8 40-3/8 3/4 112 060 Short 40 38 PROG40S-40N RH62t 40 - 404 - 52 - 53-7/8 50-1/2 23 14-1/2 3 8 44 3/4 135 0 58 Short 40 38 PROG40S-36P RH62t - 36 - 364 - 52 53-7/8 50-1/2 23 14-1/2 3 8 44 3/4 135 058 Short 40 39 PROG40S-38NRH62t 38 - 384 - 65 - 53-1/4 50-1/4 21-3/8 14-1/4 3or4 8 44 3/4 125 1 058 Short 40 39 PROG40S-35P RH62t - 35 - 354 - 65 53-1/4 50-1/4 21-3/8 14-1/4 3 oro 8 44 3/4 125 058 Short 50 48 PROG50S-40N RH61 t 40 - 404 - 87 - 54-1/4 51-1/8 23-3/4 14-1/4 3or4 8 44 3/4 186 063 Short 50 48 PROG50S-36PRH61t - 36 - 364 - 87 54-1/4 1 51-1/8 1 23-3/4 1 14-1/4 3or4 8 44 3/4 186 063 li�odels with Installed Top T&P Valve Tall "40 38 PROG40-38NRH62TT 38 1 - 13841 - 1 64 1 - 61-1/2 1 58-1/2 1 19 1 14-1/41 3or4 1 8 - 3/4 1 127 1 058 Tall 40 38 PROG40-40N RH62TT 40 - 40 4 - 84 - 63-1/4 60 19-1/2 14 3 or 4 8 - 3/4 135 066 Tall 50 48 PROG50-40N RH62TT 40 - 404 - 76 - 62-1/2 59-1/4 21-1/2 14-1/2 3 or 4 8 - 3/4 165 065 Tall 50 48 PROG50-38NRH60Ti 38 - 384 - 85 - 1 61-1/4 58-3/8 20-1/2 1 14-1/4 3or4 8 - 3/4 150 064 Uniform Energy Factor and rated gallon capacity based on Department of Energy(DOE)requirements 0. FLUE O ANODE ROD FLUE ANODE ROD tLEED Point=l H O HOT O COLD HOT O Q O H WATER LD WATER Q CONNECTION WATER ; WATER CONNECTION CONNECTION , r CONNECTION INSTALLED ' FI T&P VALVE F ' ilEla rE ) TOP T&P �� � 3/4"N.P.T. 1-1/2"ABOVE RELIEF TOP PAN TO VALVE CENTER OF OPENING OPENING 0 C C A B A B 1/2" 1/2" G D ( D (� Top T&P models In keeping with its policy of continuous progress and product improvement,Rheem reserves the right to make changes without notice Rheem Water Heating • 1115 Northmeadow Parkway,Suite 100 Roswell,Georgia 30076 • www rheem.com INTEGRATED • • •- PRINTED IN U S A 03/18 WP FORM NO FROG RH N COMBO