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HomeMy WebLinkAbout14603-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z14969 Date October 7,. 1986 .................................................. 19 ... THIS CERTIFIES that the building . .¢]oQ.d.. St.p.v.~ .................................. Location of Property ..... 1. 0.5..B.r. 9.w.n' .S..t.r.e.e.t. ....... Greenport House IVo, Street Hamlet County Tax Map No. 1000 Section .... 0.4.8. ..... Block 03 ...... Lot 027 Subdivision.. 9P.t.-. . .D.r.i.v..i .rig..P.a..r.k ......... Filed Map No. 369 .... Lot No. 12 conforms substantially to the Application for Building Permit heretofore tided in this office dated .... .Ffih....4 ........... 19..8.6pursuant to which Building Permit No. 1 datedM~g:.qb..3 ..................... 19..8 .6, 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 ......... · WO.Qcl. ~.t.o.v. ~, The certificate is issued to ...... .P.E.T.E.R. KRASNOW (owner, of the aforesaid building. Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO ................ .N./.A. .............................. Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERN[IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereb/granted to: ~...~.~.../~.x.~..~...~......¢~.....~.~ ..~.~.7...~ ......... .~.~..~.~........~ ........ .~..~....%~....~......c/.:.. j..~.~..~...~. ........... . ............ i .................................................... Z; ....................................... ~ ....................... :'": ............. at prem,ses located at ,../..~...~.....~.:.-.~.~.......~.,~ ........... ~t.f~. .................. County Tax Map No. 1000 Section ..... (~...~....~.. .... Block ...... ..0.....~. ....... Lot No ..... ..~1...~.~. ...... pursuant ,o appJicotion doted ..~~~..~ .................. , 19.~.~.,~-- and approv~ by the Building Inspector. Building I~tor Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall $outhold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~ ~ 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 topographic featu res. 2. Final approval of Health Dept. of water supply and sewerage disposal--(S-9 form or equal). 3. Approva{ 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-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 informa- tion required to prepare a certificate. C. Fees: ~ 1. Certificate of occupancy (' $5.00 ' J 2. Certificate of o~cupancy oJ%pre-existingjdwelling $ [].5.0 0 3. Copy of certificate of occup cy'aqp_~_~-$1.00 4.Vacant Land C.O. $~.00 NewC°nstruction ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property . .' .... Owner or Owners of Property ................................................... .'..: County Ta× Map No. 1000Section ..... .~.?. ...... Block ...0-3 ......... Lot....(~'..~./. Subdivision ................................. Filed Map No ........... Lot No./ ............. Permit No. I.z~..~, 0, ?..7/(.. Date of Perm t .......... Applicant~.. ?.~ ~.~.. ~ ............. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Bequest for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and pe~r~e_e~~odes and regulations. ~¢'6(/-. WO0¢ ~ Applicant ...... ~.;: ...................................... Rev. 10-I0-7a c. 6 .~IELD INSFECTION ~OUNDATION (1st) COMMENTS ~OUNDATION (2nd) {OUGH FRAME & FLUMBING 3. INSULATION FERN. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved . .fJ.~.c~ .., Permit No. Disapproved a/c ..................................... . =(Buildin} Inspector) ' ' APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by Wpewriter 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 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 property must be drawn on the diagram which is part of this applb 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 applicaut. 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 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, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspectio~ ~¢rs~_.~.6~ ~"t;¢/~. L~.. (Signature of applicant, or name, if a corporation) .ex...w..4 X/. !f.X./. ¢.o../Z .... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...... 4qx./T1...e ............................................................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. House Number Street Hamlet County Tax Map NO. 1000 Section ....... p)./.~. ..... Block .... 0..3. ........... Lot. 'O Z, 2 ........... l/ (Naghe) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ............ ~¢.4 .i .d?.~..~. ~ ............................................. b. Intended use and occupancy ................................................................... "3. Nature of work (check which applicable): New Building .......... Addition.. I ........ Alteration .......... Repair .............. Removal .............. Demolition ........... i... Other Work ' (Description) 4. Estimated Cost. ..... ....'--' ........................... . Fee ......... ~ ........................ ' (to be paid on filing this application) I 5. If dwelling, number o f dwelling units ............... Number o f 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 ....... i ....... Depth ............... Height ............... Number of Stories ............................ ............................ Dimensions of same structure with alterations or additions: Front ............ i ..... Rear .................. Depth ...................... Height ...................... Number of[Stories ...................... · 8. Dimensions of entire new construction: Front ............... Rear ........ i ....... Depth ............... Height ............... Number of Stories ............................ i ............................ 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: .... i ............................ 13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .................... Address ............... 1 .... Phone No ................ Name of Architect ........................... Address ............... .... Phone No ................ Name of Contractor .................. : ....... Address ............... ..... Phone No ................ PLOT DIAGRAM I Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions i¥om property lines. Give street and block number or description according to deed, and sho~ street names and indicate whether interior or corner lot. HELEN IL DE VOE NOTARY PUBLIC, Stde of New Ye~ STATE OF NEW YORK, COUNTY OF ....... S.S ......... · ~ca}'~t{..~.. ~ 01.~ ~l ................... being duly sworn, deposes and says that he is the applicant (Name of individual signing 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 s~id" worlU'fi-nd to make and file this application; that all statements contained in this application are true to the best of h~s[khhwledge and bfhe? and,that the work will be performed in the manner set forth in the application filed therewith. ' Sworn to before me this ' · ' .................... day of .............. , . . County ' 1: .... i ' ~ ,~ ~(~!~alnr~,o~p, phcant) SPECIFICATIONS Height. 27 V4" Width' 21" Depth: 27V~" _Weight: 231 lbs. Flue Opening Diameter (Internal Measurement). 6" Heating Capacity: 50,000 BTU's/hr Maximum Log Length: 19" Options: Emissions Kit SIDE WALL/BACK WALL INSTALLATION CORNER INSTALLATION MINIMUM CLEARANCE TO COMBUSTIBLE.< A B C D I E F STOVE PIPE OPTIONS Single Wall Connector 24" 31~"__j.4~W'_..1..1~.12" 2 I' SPECIFICATIONS Height. 27~A'' Width 21" Depth: 27V2" Weight: 246 lbs. Flue Opening Diameter (Internal Measurement): 6" Heating Capacity: 50,000 BTU's/hr Maximum Log Length: 19" Optional Flue Screen SIDE WALL/i3ACK WALL INSTALLATION CORNER INSTALLATION STOVE PIPE OPTIONs MINIMUM CLEARANCE TO COMBUSTIBLE'. Conventional Home Instal,lation A B C D E F G Single Wall Connector 12" 19' 14V2" 11" 10" 19" 27" Single Wall Connector w/listed flue screen 13" 20" 8V2" 5" 6" 15" 23" Double Wall Connector 12" 19" 12V2' 9" T' 16" 24" Double and Triple Waft Connector w/listed flue screen 12" 19" 6V2" 3" 3" 12" 20" 12" 19" 6W' 3" 3" 12" 20" Mobil: Home Installatiol 15" 22" I1V2' 8" 6" 15" 23" 14" 21" 7V2" 4" 6" 15" 23" 12" 19" 6V2' 3" 3" 12" 20" Insulated Connector with UL103HT down to stove Double or Triple Wall Connector Double Wall Connector w/listed flue screen Insulated Connector UL103HT down to stove INSTALLATION: A Key to Safety and Efficiency There's more to proper installation than allowing for enough clearance to combustible wa~s. The heating efficiency and effectiveness of Kent stoves de- pend upon you or your professional installer following the of- ficial Installation and Operation Instructions to the letter. A copy of these instructions can be found inside your stove when you buy it. The Kent Installation and Operation instruc- tions have been developed from years of research and expem ence. Follow them and you'll enjoy a completely safe and satisfying wood heat experience. CLEARANCES TO NON-COMBUSTIBLES The data included in this brochure states minimum dis- tances to combustible walls resulting form testing supervised and certified by Underwriters Laboratories. Clearances will be lower to non-combustible walls. How- ever, these distances can vary by jurisdiction. We urge you to contact your Kent dealer or local building code authonty. They can give you rules of thumb on clearances to non- combustible walls. CONSULT YOUR LOCAL WOOD HEAT EXPERT Authorized Kent dealers have been painstakingly chosen because they are among the most experienced and knowl- edgeable wood heat experts in their community. Consult them with any questions you may have. Their sug- gest~ons and recommendations will help you enjoy the unique warmth offered by wood wh~le seeing to it that you do so safely and economically. The name of your local dealer should be stamped on the back of this brochure. If not, dial the number below: U.S.A.: 1 ~$00~547~4577 CANADA: 1-800-547-6169 INOTE: These clearances are specified by Underwriters I_abora- tory We strongly suggest that you use a professional installer and that the installation and operation instruc- tions which come with each stove are expressly followed. YOUR DEALER IS; KENT The flame of the future RO. Box 40507 Portland, Oregon 97240 .! rt~r '3