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Home My WebLink About27055-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27584 Date: 03/23/01 T~IS CERTIFIES that the building ADDITION Location of Property: 670 WEST CREEK AVE (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 103 Block 13 subdivision Filed Map No. __ Lot NO. __ CUTCHOGUE (HAMLET) Lot 5.3 conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 9, 2001 pursuant to which Building Permit No. 27055-Z dated FEBRUARY 9, 2001 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 INSTALLATION OF A GAS FIREPLACE AS APPLIED FOR. · ~ne certificate is issued to DEBORAN DOTY of the aforesaid building. (OWNER) SUFFOLK COUIFISf DEPARTMENT OF HEALT~ APPROVAL N/A ELECTRICAL CERTIFICATE NO. H-070885 03/19/01 PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 27055 Z Date FEBRUARY 9, 2001 Permission is hereby granted to: DEBORAH DOTY WEST CREEK AVENUE CUTCHOGUE,NY 11935 for : INSTALLATION OF A GAS FIREPLACE AS APPLIED FOR & TO MANUFACTURERS SPECS. at premises located at 670 County Tax Map No. 473889 Section 103 pursuant to application dated FEBRUARY Building Inspector. WEST CREEK AVE CUTCHOGUE Block 0013 Lot No. 005.003 9, 2001 and approved by the Fee $ 75.00 Rev. 2/19/98 ORIGINAL ao 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 in~ and submitted to the building inspector with the following: for new building or new use: I. Final survey of property with accurate location of ali 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). Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statemant from plumber certifying that the solder used in system contains lass than 2/10 of 1% land. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificata of Code Compliance from architact or enginear responsible for the building. Submit Planning Board Approval of completed site plan'raquiraments. For existing buildings (pripr to April 9, 1957) non-conforming uses, or buildings and Vpre-existing" land uses: 1. Accurate survey of proper~y showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed.by the app~icant. If a Certificate 6f Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Faes 1, Certificate of Occupancy - New dwelling $25.00, Additions to dwalltng $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accassory building $25~00, Additions to accessory building $25.00. Businesses $50.00. 2.Certificate of Occupancy on Pra-axisting Building - $100.00 3.Copy of Certificate of Occupancy - $5.00 over 5 yaars - $10.00 4.Updated Certificate of OccUpancy - $50.00 5.Temporary Certificate of Odcupancy - Residential $15.00, Commercial $15.00 Date New Construction.~%~9~%qq Old Or Pre-existing Building..~ ...... ~., ..... Location of Property ~%qMqsA,.Cr..e~,,Avenue. Cutcho~ue House No. Street Hamlet or Owners of Deborah Property County Tax Map No 1000, Section.....1.0~. ...... Block. PP~ ........... Lot............005-003 ., ....... . Subdivision ' Piled Map Lot Permit No ................ Date Of Permit ................ Applicant ................... ,., ....... Health Dept Approval Underwriters Approval Planning Board Approval ............. ~ .......... Request for! Temporary Certificate ........... Final Certicate.~..~ .... Fee SUbmitted.' $.. 25,00 .......... ; ........... . 5 'f O ........ CO ~ ~3.~g'~-- APPLICANT THE NEW YORK BOARD OF FI'RE UNDERWRITERS 808~188 BUREAU OF ELECTRICITY ~- 40 FULTON STREET, NEW YORK, NY 1~038~ 1~, 20~L't THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of DEBORAH DOTY, 67~ WEST CREEK AVENUE, CUTCHOGUE~ NY *: in the foliowing location: [] Basement [~ 1st FI. [] 2nd FL Section Block Lot Mg~RCH was examined on and found to be in compliance with the National Electrical Code. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. ~ SYSTEMS AMT. WATTS AMT. K,W. OIL H,P, GAS H.P. AMT. NO. A,W,G, AMT. AMP. AMT. AMPS. TRANS. i I NO. OFEEET SERV CE D SCONNECT NO. OF .... S -E - - R' V I C ..... Am,. ^M,. wp, ~ ~, ~w , ~ ~w ~, ~w ~ ~w .o.o~cooo.~. ^.w.o. ^.w.o. .o.o,.~u,,^u ^.w.o. P~R ~ OF CC. COND. NO. OF HI-LEG OF HI-LEG O~ NEUTRAL OTHER APPARATUS: - m P 0 BOX 1t81 CUTCHOGUE, NY, 11935 GENERAL MANAGER This cerflBcate must not be altered In any manner; return fo the office of the Board If incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT., THIS COPY OF CERTIFICATE MUST NOT" BE ALTERED IN ANY MANNER. 765-J.802: BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGHPLBG. [ ] FOUNDATION2ND [ ] INSULt.AT ! ON [ ] FRAMING ['P-]~FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ~ INSPECTOR FOUNDATION (IST) FOUNDATION (2ND) ROUGE[ FRAME & ~t t ~ COI'R4ENTS '__2 PLUMBING INSULATION PER N. Y. STALE ENERGY CODE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUr, ION 1ST [ ] ROUGH PLBG. [_~ATION2ND [ ] INSULATION ~*~-4=~i]ING [ ] FINAL [ ~-FIREPLACE & CHIMNEY REMARKS: ~DATE 6000TR 36" ToP/REAR VENTED DIRECT VENT GAS HRF, PLACE Model 6000TR 6000TR-DSI Product Direct Vent Unit Direct Vent Unit with Direct Spark Ignition Suggested Retail · Seven Glowing Ceramic Fiber Logs and New Patent Pending Stainless Steel Pan Burner · 21,000- 31,000 BTU Input/Hr[5 · Variable Valve · High Thermal Efficiency · Sealed Combustion Chamber · Three Optional Log Sets NOTE: Fronts Not Included - Order Separately on Following Page · The Most Realistic Burn Available · Brick Pattern on the Refractory Hearth · Optional Firebox Refractory C US LISTED · Generous Flames & Heat Output · Vary Flame Height & Heat Output · Keeps You Warm & Cozy · Works In Negative Pressure Situations & No Cold Drafts · Recreate the Look & Feel of a Traditional Fireplace · Realistic Fireplace Look · Enhanced Realism · Safety Tested, Approved for Installation in Aftermarket Mobile Homes & UL Listed to UL307B SPECIFICATIONS 4/00 HEAT-N-GLO A-I VENTING WITH THREE (3) 90° ELBOWS V (FT,) H (FT.) 1' MIN. (305 mm) 2' MAX. (610 mm) 2' MIN. (610 mm) 4' MAX. (1.22 m) 3' MIN. (9t 4 mm) 6' MAX. (1.86 m) 4' MIN, (1.22 m) 8' MAX. (2,48 m) H = 8' MAX. (2.48 m) NOTE: V + V~ + H + H~ = 40~ (t2.2m) MAX. H + H~ (FTc) 4' MAX. (1.22 mm) 8' MAX. (2.48 m) t2' MAX. (3.72 m) t6' MAX. (4.8 m) 16' MAX. (4.8 m) Use D-Series components only. H VENTING WITH THREE (3) 90° ELBOWS V (FT.) H (FT.) H + H1 + Hz{FT.) 1' MIN. (305 mm) 2' MAX. (610 mm) 4~ MAX. (1.22 mm) 2' MIN, (610 mm) 4' MAX. (1.22 m) 8' MAX. (2.48 m) 3' MIN. (9t4 mm) 6' MAX. (1.86 m) 12' MAX. (3.7 m) 4' MIN, (1.22 m) 8' MAX. (2.48 m) 16' MAX. (4.8 m) V+H+H~+Hz=40'II2.2m) MAX. H=8'MAX. 12.48m) H+½+H~=16'MAX.(4.Sm) 23 Figure 19, Venting with three 90° elbows -FORIq NO. TO~q OF SOUTIiOLD HUILOING DEPAETFffiNT TOI~I HALL SOUTROLD ~ lq.Y TEL: 765- ]802 Disapproved a/c .................................. BOARD OF HEALTH ............... 3 SETS OF PLANS ............... SURVEY ........................ CHECK ......................... SEPTIC FOR~i . . . NOTIFY: CALL .................. HAIL TO: ...... APPLICATION FOR BUILDING PERHIT INSTRUCTIONS Date ~/~/~f .... ,19. a. ~his applicatim ~mst be eaupletely filled in by typewriter or in ii ad su~itted to the lhilding Inspector 3 ~ts of pl~, ~ate plot pl~ m ~ale. F~ ~mdi~ m ~le. b. Plot plm ~ l~tim of lot ~ of ~ildi~s m ~s, ~latio~ip to ~joini~ pr~s or ~lic struts or a~, ~ gi~ a &tail~ &~ri~im of l~t of ~ ~t ~ ~ m fie di~ ~i~ is ~rt of Mis ~liati~. c. ~ ~ ~ ~ ~is a~li~tim ~ ~t ~ ~m~ ~fo~ isle of ~ildi~ Pemit. d. ~ ~ of ~is ~liatim, t~ ~ildi~ ~ctor ~11 is~ a ~ildi~ ~t to the ~liat. ~t ~11 ~ ~ m ~ ~s ~il~le ~r i~ti~ ~t ~ ~k. e. ~ ~ildi~ ~11 ~ ~i~ ~ ~ in ~le ~ in ~ far ~ ~ ~at~r ~til a ~rtificate of ~I~ IS ~ ~ to t~ ~ildi~ ~t ~r ~ is~ of a ~ilding ~C ~t to ~ldi~ ~ ~im of ~ T~ of h~ld, ~ffolk ~, ~ Yo~, ~ o~er ~li~le ~, ~i~es'or ~ati~, for ~ mtmti~ of ~ildi~s, ~iti~ or alterati~, or' for r~al or ~litia, a ~rein ~ri~. ~ ~li~t ~s to ~ly fi~ ~1 ~li~le 1~, ordi~s, ~ildi~ ~, ~i~ c~, ~lati~s, ~ to ~it ~ri~ ' ' ..... O~A~ O~ l~tors ~ ~s ~ in ~lldl~, for ~s~ lnS~tl~S. C FlCA ...... (~ili~ ~mss of OF OCCUP CY 5tate~r ~t[~[ xs ~r, tes~, ~u~, ~it~t, ~i~r, ~raZ ~tractor, eZ~trici~, ~t~r or ~i]~r . .................. ..................................... , ......................._ :. ' ' Grim si ~ of ~1 ~t~cer. ~ fi~Ti~'BUILDiNG '2 .......... 1'2'"2' '[ f~. ( ...... ~ ......... 2/ ~ ~/ / % [OUNDITION.,~0 (~ ~ tltte ot ~ra~e o l~r, / ~ ~', /' / ~RPOURED~NCR~ . / I //~- / ~ INSU~TION . I TI / ALL CONSTRUCTION ~HALL 8l~tric,~ Li~ ~ ......... { ........ U.. / THE RBGUIREMENT8 OF · ---, --- ~ . ~ / STATE CONSTRUCTION & ENERGY ~-l~ s b~. · ........ ~ ...... ~ CODES. NOT RESPONSIBLE FOR ]. ~rim of 1~ m ~ ~ ~ ~ ~ ....................... B~IGN*~ST~{J~{R~R~' '* I~cate clearly and distinctly all property lines. Giw street and ~hether interior or corner lot, Nature oF ~ork (c]~ck vlfid, a icable): ~ Bui!dinE .......... /klditio~ .......... Alteration .......... I~pair ............ lh~l . .~ ......... I)e~olitzo~ ............ Other l~ork .,/~.~..~.~....~.~.~.. ~..~.~.~/..~.~...~..... . ~ ~rlpti~) 000 [ f~ ............................ Es~i~m/~ ~s~ ..... ~ ......... 1 .......................... [ (to ~ ~id ~ [iliq this a~li~ti~) If ~lli~ f ~lli~{ ' ~ ~ ~ Iii it I~ ~rage, ~r of ~rn ...... I ................................ If I~i~ss, ~rcial or ~ ~, ~i~ ~mre ~ ~tenC of ead~ ~ of u~ ...................... Di~mnsi~s of alsti~ stx~, if ~: ~t ................ ~ar ............... ~pth ... .............. t~i~t ................... · · . .. . ~r of ~toriea ...... 9i~nsi~ of ~ st~ ~t alterati~s or ~iti~s: ~C ............... ~ar ............... ~ptl ~i~' ~r o[ S~ories Di~nsi~ of entire ~ ~n ~i~: ~C .......... ~ar ......... ~p~ t~i~r ............... ~r o~ Stories Si~ o[ 1o~: ~C ................ . . .. ~. ........ ... .. .. .. . . ~pth ................ . . .. ~e o~ ~dm~ ............... . ...... ~ of Four ~r ........................................ ~ or u~ dis[rict in ~i~ ~, mi~s a~ si~td ...... ~s ~o~ ~[~[i~ violate a~ ~i~ 1~, o~i~ or re,latin: ........................ ~ill lot M ~ ................... ~ill mss fill ~ ~ ~ ~i~s: ~ ~s o~r o[ ~s ............ . ........... .. ~ress.. .................... .. . .. . .. ~ ............... ~ oi adfit~t ............ ~ress ............... ~ ~ .............. ~ of ~[r~or............. ....... .... .. ... ... .. ~ress ............................... ~ ~ .............. Is this p~r~ ~thiu ~ f~ o[ a ~i~t ~tl~] * ~ .......... ~ .......... PLOT DIAGRA~ ~ildi~s, ~r ~is[i~ or p~, ~ i~icate all ~-~ d~nsions ~ ~r o ~scrlpt~ ~co~l~ to ~, ~ ~ st~t ~s ~ i~icaCe . J WA. U 81 ^ORITR33 TUOHTIW · -': -' ;:: ......... : ................................................ a~l.lca~[~; ~aC atl s~at~nts c~tai~ in this a~llca~i~ are t~ to the ~s~ o[ his ~1~ a~ ~lie[i m~ that the ~rk ~ilI ~ ~r[o~ in tl~ ~r ~t forth ia ~e a~l. ica~i~ fil~ ~. · C~orn to I~ffore.~ this { GERARD M. ~NG [ Note~ Publio. State of N~ (Sigi~a~-ure o,[/'A~pt i.cau 0