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Home My WebLink About16649-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z]6479 Date December ]5, ]987 THIS CERTIFIES that the building .. ~ W. 9p.d...b p.r.n.i..n~g..s.t..o y.e.. ....................... 145 Teepee Trail Southold Location of Property t:t[~tJs~ 'N'o ............... Street Hamlet County Tax Map No. 1000 Section . 08 7 .Block 0 2 .... Lot 3 2 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... N. py.....2.0.,. , 1..9 .8.7... pursuant to which Building Permit No. 16649 z dated .... N..o y.... 2. .5 .,.. 1.9. .8 .7 .......... 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 ......... .... ~-B.s.t, ~-~ J-..xq99.d..b.u..r p.i.n.g..s.t, qv..e..(.U.L...a.p.p.r. ?v.e.d ) The certificate is issued to RUTH & ROBERT G. KASSNER ..................... /oh;,,;;, if iro:x& iOk ..................... of the aforesaid building. Suffolk County Department of Health Appro,~al ...... N/A UNDERWRITERS CERTIFICATE NO, N / A PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 6649 z Permission is hereby granted to: ........... ../..~.~.......z-~,~,,,.....~.,~32 ........................ ...~.~.,...~:..~.:.J/...~.~.t ............ ,o IV · . ~ I at premises located at ......~...~........-_.~....J../~s~-~. ...... ...-~..~g~.~-~z.-va~. ........................... County Tax Map No. 1000 Section .... ...(~....~...'~ ....... Block ...... .~..~ ....... Lot No....~'~.?.,..~ ........... pursuant to application dated ...~.&~,~:~O.~d.,..~...O. .............. , 19.~.~...., and approved by the BuiJdlng Inspector. Fee $.~ .................... Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N,Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A, This application must be filled in typewriter OR ink, and submitted m ~ 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 topograph c featu res 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. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and .... pre-ex~stmg'" 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 informa- tion required to prepare a certificate. C. Fees: Additions $25.00 POOLS $25.00 1. Certificate of pccupancy New Dwelling $25.00, Accessory ,$I0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certiflcate of occupancy $ 5.00, over 5 years $]0,00 4.v~o~t ~d c.o. S ~o.oo //_ ~ ~ 5.Updated C.O.' $ 50.00 Date ....1~>~...~. .............. NewC~mstpucti°n ...... or Pre~existing Building ............ Vacant Land ............. Location of Property../.~/. ~. ... .~.~..~'~.~..~. . .~.~..~.//..L;T-.. c~-¢'/--/7z'~b-~)'. .. · . Owner or Owners of Property .......... ~ .............................. cou,ty Ta× No. 000 Sect,on ..... ..... ...... ....... .... Y. ........... Subdivision ................................. Filed Map No ........... Lot. No. _../ ............ Permit No. /.~,~. ,~. ?, .~. Date of Permit /,~. ,o.~..~.~ ?Ap~plicant, .~.~, .~,' ./, .,..~,~. Health Dept. Approval ................ '.; ...... Labor Dept. Approval ........................ Underwriters Approval ' Planning Board Approval Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. ~'iELD i~STECT!ON FQUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING 3. INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONA'L COMMENTS: Specifimtions & Clearances The Tile Fire--Standard Model Over'all Height: 27¼" Overall Width: 21" Overall Depth: 27,~" Weight: 231 lbs. Flue Opening Diameter.' 6" Heating Capacity: 50,000 BTU's/hour Maximum lx)g Lengah: 19" Optious: Flue Screen, Emissions Kit .The Tile Fire---Outside Air Model Overall tleight: 27¼" Overall Width: 21" Overall Depth: 28¼" Weight: 246 lbs. Flue Opening Diameter: 6" Heating Capacity; 50,000 BTU's/hour Maximum Log Length: 19" Options: Flue Screen The Sherwood--Standard Model Overall Height: 3OW' Overall Width: 17W' Overall Depth: 25" Weight: 197 Ihs. Flue Opening Diameter. 6" tteating Capacity: 50,000 BTU~;/hour Maxinltan Log Length: 19" Optious: Side Heat Shields Flue Semen Gold 'Ibm Kit Gold Door The Sherwood--Outside Air Model Overall Height: 3OVa" Overall Width: 17½" Overall Depth: 25:Y4' Weight: 208 lbs. Flue Ope~g Diameter: 6" Heating Capacity: 50,000 BTU's/hour Maximum Log Length: 19" Options: Side Heat Stfields Flue Screen Gold 'l~n Kit Gold Door The Sherwood---Hearth Model Overall Height: 20" Overall Width: 17W' Overall Depth: 25" Weight: 209 lbs. Flue Opening Diameter: 6" Heating Capacity; 50,000 BTU's/hour Maximtm~ LOg Length; 19" Options: Gold D(x>r Clearances to combustible materials vary de The lz~g Fire--Fireplace Insert Tbe Log Fire is designed with a sloping-back cabinet which is 22" bigb at front, 2G¼" high at mar mid 22" wide. Tbe unit's front fascia is d[sigmed to sit flush against your fireplace. The front fascia is 33½" wide and 25½" high and extends 2" from the face of your fireplace. A 4" deep spacer frmue, which can fit betweeu the fascia and fireplace ope~fing, is also available to suit shallow £uxeplaces. It measures 241½" wide x 25W' lfigh. Bacldng phte surrounds are also avail- able in 3 sizes to allow covering larger fireplace openings. The Small Surround measures 40:Y4" wkle x 29' high. The Medium Surround ~neasures 46" wide x 32" high. 'llm Large Surround measures 52" wide x 35" high. ending on c~rnney ~ystems, placement configuration and other variables employed during installation. Below are the clearances for conventional home single wall pipe installations: Conventio~ml Home Installations Tile Fire file Fire Sherwood Sherwood (Standard) ((h~tside Air) (Standardl (Outside Air} USA CANADA USA CANADA USA CANADA USA CANADA Side 12" 12, 12, 12' 30" 30" 30" 30" Back 11" 14}5" 11" 14½" 12" 17" 12" IT' Comer" 12" 12" Iff' Iff' 30' 17" :',0" 17" These clearances can be reduced ~y using alternate ddmney systems and Kent accessories. For detailed clearance information on all models (including the Log,l, k~ and Sherwood Hearth models), ask your ,~ Kent dealer for the KENT SPECIFICATION AND CLEAI{ANCES GUIDE. YOtJR DEALER IS: ' ~;'l~ SOUTHOLD STOVE WORKS Printed in Canada August, 1986 FLOOR PROTECTOR AND WALL SHIELD INSTALLATION INSTRUCTIONS tot WON DER-BOARD® Glass Mesh Concrete Panels LISTED 857Y iMPORTANT- TO THE CONSUM ER: O FoEy.g~own safety and protection, these instructions must be read and followed. TECT~_.v__...~ ~'"~ Caution- The floor protector must -- '~,.~darC"T~Listed by Underwriters not be cut or trimmed to an Laboratories, Inc,, for use as a Fl~:)r Prolector n place of one layer of 3/8" asbestosr~jlJb~a~[d · Listed solid fuel room heaters and · Listed fireplace stoves when millboard is specified by the heater or stove maoulacturer and when installed according to these instructions. fa) Area Covered -The mimmum area covered by the floor protector must be that spec~hed in the L~sted heater or stove manufacturer's Installation Instructions. (b) Floor Surface-The"Wonder-Board" floor protector must be installed on a flat, sol~d surface; there shall be no carpet, rug or padding under the floor protector. fa) Joints - Where two or score pieces of "Wonder-Board" are used to provide the floor protector area less than the minimum specified by the heater or stove manufacturer. 2. WALL SHIELD "Wonder-Board" ~s Listed by Underwrders Laboratories Inc., for use as a Wall Shield to prowde a reduced clearance of a Listed solid- fuel type room heater or fireplace stove from a combusbble wall surface, -- when installed according to the Installatioe Instructior~s of the manufacturer of the Listed room healer or fireplace stove, and those of Modulars, Inc. fa) Clearance - The clearance or dmt aece between a room heater or fireplace stove and a combustible wall surface, can be reduced a maximum of 1/2 (50 percent) of the clearance specified by the manulacturer of the Listed room heater or hreplace stove. - where a"Wonder-Board" Wall Shield (d) ?~ortland cement mortar and shall be covered WitCh--at ed ~r lape, 2" or wider, embedded in, and covered with, h"~" e r~r~ ar~ th'~monar must be allowed to cure at least 3 days before placing the heater or stove on tire floor protector. where conditions permit, ~s where floor protectors are fabricated in a plant, the tape and mortarm-~l ~O hnth facesQf th~ ~ Ceramic Tile Facings- Cerace, thru brick or other.on-come're material may be a~plied over the "Wonder-Board" IfEe i~ installed o~er the "~onder- ~e~"~ ar app~h e trowel to provide a la,er of mortar at ~fa~ ol the tile, thin brick or lhe like after the tiles or the hke have been beat into the mortar. - tt~e installed hie, brick, or the like, should be grouted w~th a latex modified grout. a spacing of 1/8" shall be left of the proper size is installed between ail "Wonder. Board" panels. ' all joints between the "Wonder- . ~11~1~ correctly, according to these Board"pane~l!be[ edsolid ..~.~fllll~l~mmmj~''''~ ~ wilh a sanded lal~x mnd~f~l '~"~ ~ . (e) C.~tti_~..~."Wonder. Board" is cut to s~ze by scodng through the membrane on one side with a carblde-tip[~ed scoen t~q.~ snapping t h e-'-~ eT~'~ d-~'.t~ ~ ~ tbe r ~membrane. Aisc, [t c~¢l~'~ut with a masonry saw. ' ..... ~ instructions. All clearances are measured from the b~ck or side ct the heater or stove unit to the combustible surface. In the case of a unit with a rear flue p~pe the clearance ~s measured from the back of the flue. See the attached diagrams. (b) Clearance Reduction Chart · The chart, next page, gives the allowable reduced c~earance of 50% (maximum) when a "Wonder-Board" Wall Shield is installed: th~s 50% reduction is from the clearance specified by the Listed beater or stove manufacturer. (c) Size and Location of the Wall Shield- The "Wonder-Board" Wall Shield shall be a minimum of 4'x4' in size and shall be centered in back of the heating unit (on a back Wall) or centered to the side of the heating unit {on a side wall)· Where the heating umt is placed diagonally in a corner the Wall Shields must extend into the corner. - The minimum size of the Wad Shield is further identified in the attached diagrams· For example, with a heating unit w~th a Top Flue Ex~t, the Wall Shield must be wider than the heating umt by at least 8" on each side of the unit and musl be at least 8" higher then the umt. · With a Rear Flue Exit unit the Wall Shield must extend to within 12" of the ceiling (refer to the d~agrams); however, a spacing of at least 1 must be left between the top edge of the shield and the ceiling. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ~- ] ROUGH PLBG, REMARKS: FOUNDATION 2ND [ ] INSULATION FRAMING ~INAL BOARD OF HEALTH ..~.. 3 SETS OF PLANS ....... FORM MO. I SURVEY .......... TOWN OF $OOTHOLD CHECK 'l~tK)- :3-%~7f~,~-~2~j $0 13U~LD~NG DEPARTM~=NT SEPTIC FORM ............. TOWN HALL gOUTHOLD, N,Y. 11971 TEL.: 765-1802 CALL ................ Examined .~. · · .~'2:~....~...~'..~., 19 .~.~. Approved tO .o'~2,~.D74....~..~., 191F7 Permit No. /. ~.{~.~ .c~ ~-~ Disapproved a/c ..................................... ~0V 2 0 I~{ (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ................... 19... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showhig 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 property must be drawn on the diagram which is part of this appli- cation. 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 issued a Building Permit to the applicant. Such 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 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 applica¢le Laws, Ordinances or Regulations, for the construction of buildings, additions or alteratioJlscv~fo,~rer~oval eL dera/o!iffon, as herein described. The applicant haree,s to comply with all applicable laws, ordinanc,~, build, l~4~/cofle, hog'frog 9to)~, and regulations, and to admit authorized inspectors on premises and in building for neces c ~'(8ignature of ~amp,~if a ~/ (Mailing address' )f applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .... d~ ...................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) · ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location o2and on which proposed work ycill be done .... ;.. .... ,... ~ ....... // ........ .~..~.~..,~. · ....... .......... : .... .......... County Tax Map No. I000 Section . . ~2 Block Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 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 ......................... ' .; ; ;'.~ .............. ~ Nature of work (check which app lcable): New Building .......... Additmn .......... Alteratlon ........... Repair ............... RemOval ............. Demolition .............. Other Work .... ~. ........ 4. Estimated Cost...~...O..O..i ....................... 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 ~. ~: .... '.. i ........... 7. Dlmensmns of emmng structures, if any Front ................ Rear .............. Depth.... ............ Number of Stories : ...' ..... [[eight .............................................................. Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ........... :O....,.'2! .!.. Height ...................... Number of Stories ...................... ---8. Dimensions of entire new construction: Front .......... . ..... Rear ............... Depth ............... 'ghtI ' rfib ' Hm . .. ........... Nu er of Stories ........................................................ 9. Size of lot. nt ............ : ......... Rear ......... Depth ...................... 10. [)ate of Purchase ........... . ................. Name of Former Owner ............................. 1 1. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ......... , ................... Will excess fill be removed from premises: Yes No 14 Name of Owner of premises i Address Phone No Name of Architect .......... : ................. Address ................... Phone No ................ Name of Contractor ......... ~ ................. Address .... ; .............. Phone No ............ 15. ls this property located i'within 300 feet of a tidal wetland? *Yes ..... No *If yes, Southold Town Trustees Permit maybe required. PLOW DIAGRAM Locate clearly and distinctly alll buildings, whether existing or proposed, and~ indicate all set-back dimensions from property lines. Give street and block interior or corner lot. number or description according to deed, and show street names and indicate whether STATE OF NEW YI~2RK,//.,, , ....... .f~.~/~.~. . ~. . . ~. , .... ,~Z-~. r<,[.~. - .~. . . . . being duly sworn, deposes ana says that he is the applicant . (Name of individual sigfiing contract) 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· Sw°rn t° bef°re me t~A i ~/h'~! ' ~. ,~ay o! ....... !oGid. ,~ ,19~7 · .............. ..... Notary Public .... ;.. oun ..~ .,,...,.....,,,.." Oualg{lK{ in Su~olk Countv ~ (Signature of applicant) Commission Expires December 8, 1