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Home My WebLink About17529-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20466 Date J~/qUARY 10~ 1992 THIS CERTIFIES that the building ADDITION Location of Property 160 LAKEVIEWTERRACE~ EAST MARION, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 31 Block 9 Lot Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 7, 1988 ~ursuant to which Building Permit No. 17529-Z dated OCTOBER 14, 1988 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 SOLID FUEL WOOD STOVE SYSTEM AS APPLIED FOR. The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A NORMAN & JUNE WOODCOCK Rev. 1/81 ~uilding Inspector 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) N9 ~17529 Z Permission is hereby granted,to: .... ...,...~..~..L~.'.~...~....~ .............. ' ...~-~...~.~......u,:.q ...... L..~,/...o.. ............. ,o..~~....~......~....~....~.~ ....... ~....~.~ ........ at premises I~ated at ..,~.~.~....~.~.~...~.~.>....~.~...~~ .... Co,nt¥ To,< Map No. mOO Section ...... ~..~.~. ....... mo~k ...... ~.5 ......... Lot No ..... I...'l ............... pursuant to application dated .... .(~...~..~ ....... .~. .................. , 19.~.~.., and approved by the Building Inspector. Fee $ ........... ; .......... Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTIiOLD BUILDING DEPARTMENT TOWN IIALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with tho following: 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: I.Accurate survey of property 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 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 $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.O0, Additions to accessory building $25.00. Businesses $50.00. 2.Certificate of Occupancy on Pre-existing Building - $i00.00 3.Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4.Updated Certificate of Occupancy - $50.00 5.Temporary Certificate of Occupancy - Residential $[5.00, Commercial $15.00 . zl ............ " Const uction ..ow r ........ Old Or Pre-existing B ildi Location of Property...f~.~ ttousc No. Street Hamle~ Jnwer or Owners of Property. :ounty Tax Map No 1000, Section..~ ....... Block .... ~ .......... Lot .... YZ ............... ;ubdivision ...... . . . . .......................... Filed Map ............ Lot ...................... ........ Date Of Permit. · .... Applicant .... ~7~C.,~~ .... ;ealLb Dept Approval · ' ....................... Underwriters Approval ' !arming Board Approval ..................... eq.est for: T'emporary Certificate ........... Fieal Certicate..~ ....... ~e Submitted: $ C -zc. ....... , KemStone Wall Shield Installation Instructions I CAUTION: Make certain existing wallboard is fastened securely to stud wall before fastening wall shield, J®s LISTEDJ Take your wall shield and measure in from each side near corners approximately 6", and approximately 1 2',', from L//' sides for center holes. Note Illustration A. Use 3/16 steel bit and drill hole through wall shield. Then use 1/2" steel bit and very, very carefully drill recessed hole 3/8" deep directly in hole just drilled. Note Illustration C. 3 Place waif shield against wall in desired location, resting on floor, Then using a small pointed object, insert it through holes in wall shield marking each location on wall Then remove wall shield and drill 5/8" hole through wall board at each marked location. 4 Position wall shield back in place. Then, leaning wall shield forward, insert 3/16" toggle bolts through holes in wall shield and screw toggles on ends of bolts. Then starting at bottom, guide toggles through holes in wall. Note Illustra- tion B, Then tighten snugly with screwdriver. Note Illustra- tion D. Illustration A 5 Make sure all toggle bolts are tightened moderately. Then using touch-up material provided with wall shield fastening kit, fill each hole evenly with putty knife or finger. Note Illustration C. Any other type of securing device must be countersunk and covered by an insulating material such as KemStone putty. NO AIR SPACE NEEDED. DO NOT USE SPACERS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE Fi'NAL/ ADDITIONAL COMMENTS: KemStone Floor Mats Installation Instructions and Specifications The KEMSTONE FLOOR PROTECTOR is designed for use under solid fuel type heaters and fireplace stoves and is in- tended to be used in place of a 3/8 in. non-combustible in- organic millboard equivalent to a millboard having a thermal 'conductivity - K=0.21 btu=in/fi 2.h,' F". The KemStone floor protector is intended only for use with UL and ULC listed solid fuel type room heaters and listed fireplace stoves listed in accordance to UL1482 and ULC627 standards. Floor protectors must be installed on a flat solid surface and any masonry or metal cutting device may be used if it is necessary to cut. NOTE Contact your local building official before insta~{ing your floor protector, FLOOR PROTECTOR & WALL SHIELD CONNECTOR INSTRUCTIONS When joining 2 or more KemStone boards together, KemStone connector mouldings must be used - See II1. C Illustration C Lay floor protector A and floor protector B in place, leaving enough space to sllp connector molding onto either one of the floor protectors A and B. Be sure to install the connec- tor molding with the insulated rope side up, as in illustration C. Then, after connector molding is in place, slide floor pro- tectors A and B tightly together, INSTALLER Please check with the Fireplace Stove er Room Heater's In- stallation instructions for minimum area required for the floor protector. WARNING DO NOT SLIDE STOVE ON FLOOR PROTECTOR. If stove' legs are sharp or pointed, we recommend using a non- combustible caster cup. ' Floor Protecto~ This product is Listed by UNDERWRITERS LABORATORIES and Bears the Mark: The ULC label or listed marking on a product is the only evidence provided by Underwriters Laboratories of Canada to identify products which have been produced under the listing and follow-up service and Bears the Mark: This product contains no asbestos. *There will be a slight weight variation on all sizes. BoxCanadian KemS!one Mats. Inc. 3, Glencalrn (Ontario) Canada, L0M 1K0 705-466-2908 ~ O~soum ~ FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 BOARD OF HEALTH ............ 3 SETS OF PLANS .~. ......... SURVEY ..................... CHECK ........ ~ ............ SEPTIC FORM ................ NOTIFY CALL ..................... MAIL TO: Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT 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 showing location of lot and of buildings on premises, relationship to adjoining premises or public streets · or areas, and giving a detailed description of lhyout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by tkis 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 applicable Laws, Ordinances or Regulations, for the construction of buildings, a.4ditions 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 inspectom on premises and in building for necessary insnections. 7 ~f .... ....... (Signature or applicant, or name, if a corporanon) ' /~..~..c~.,q.~./y~ 4eq ~ . ;r : ~. ./ ~ ;q ~,,O .w / /d.. . ,. &. ~ /./ .(/. .o - . (Mailing address of applicant) State wl}ether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..../7/q..,g&/..c-~/.r.../. ~.. ~,..~.~.~ ................................................................. Name of owner of premises /q. ¢~.r~4..~.d~... ~t/~ .~..o.(2,0. G.O ~'/'('. ........................................... - (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..0. ?..,,;..~. ................ Plumber s Lmense No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ................ '. ................................. ... J.g..o... 3./;/da .~./~ . ~'n.d/~...~ ...... /. ~.:. z ~.~ ...................... House Number Street Hamlet County Tax Map No. I000 Section ...O..ff. [ .......... Block ....c/ .............. Lot...l ~. ............. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises a~d intended use an,d occupancy of proposed construction: a. Existing use and occupancy .,~.J:../)...c?..qd. ff~/ff-/fl~ ~'~ ............................................. b. Intended use and occupancy .(W.*.°.O.-('y?L/~-&¢-. .~. ~5'...,~. ~.~../~.U../°.. ff.~ .7~. .............................. Nature of work (check which applicable): New Building ..... ' ..... Additio~ .... Repair .............. Removal 4. Estimatdd Cost ...ff./. W.o..q ...... 5. If dwelling, number of dwelling units 15. *If yes, .... Alteration ......... Demolition i Other Work i (Description) Fee (t~ be paid on filing this application) ................ Number of dwelling[units on each floor ' If garage, number of cars ...................... , 6 Ifbusin rci I ix d ................... i ............................... · ess, comme a or m e occupancy, specify nature and extent of each type of use .... · m:ensonso existing structures, any: ront .... ~ ........ 'Rear ../. ' Depth 3.p ' e it .. ~ ..... um er o o es ..................... ] .................. Din sio f ith It rio additio s: F ............. ~en ns o same structure w a era ns or n ront Depth lteight .................. Rear .................. 8 ...................... ' ..................... Number of Stories ..................... · Dimensions of entire'new construction: Front Rear Depth Height Number of Stories .................... ......................... 9. Size of lot: Front .... ~.' ........ Rear (~ /.'..g. ......... !. Depth ~/ &...~..~ I0. Date of Purchase ./ '/~? ~' ...... ................ ........................ Name of Former Owner ~?~/~/~,~ ~..~. .... ' 11. Zone or use district in which premises are situated /. p.o, p. ~ ........... 12. Does proposed construction violate any zoninn law ordinance or r ' . ' Will lot be reeradecl ~ , . egulatlon. ~. ~. ............................. 13. x~ ...... ~ T '.' · ':.' '.' .: ',..,.,, ............ Will excess fill be rembved from premises: Yes Name of Architect ............... Address ......................... Name of Contractor ........... Address ..... } .... Phone No ............ i... Is this property located within 300 feet of a tidal iwetland? ~YES .... NO~f... $outhold Town Trustees Permit may be requxred. ... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and~.indicate · "property lines. Give street and block number or description according to deed, and show interior or corner lot. all set-back dimensions from street names and ,indicate whether STATE OF NEWr~ORI~,/' //~, S S COUNTY OF. ,~.-'/~r?./../5..... · .................... ; .......... ~ ............. being duly sworn, deposes and says that (Name of individual signing contract) above named. , He is the (Contractor, agent, corporate officer, etc.) of said owner or owner~, and is duly authorized to perform 9r have performed the~sald work and to m~e and file th s application; that all stateinents contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the rammer set forth in the application filed therewith Sworn to before me this ' he is the applicant (Signature of applicant) 76S-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [.] ~JLATION []FRAMING [/-~FINAL REMARKS: DATE/,/~/~/~ INSPECTOR ~~~ C ~) APPROVED AS NOTED NOTIFY BUILDING DEPARTMENT A1- 765-1802' 9 AM TO 4 PM'FOR ~E FOLLOWING INSPEC~ IONS 1. FOUNDATION TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSU~TION 4. FINAL CONSTRUCTION MUST BE ~MPLETE FOR C.O. ~ CON~U~ON SHALL MEET ~E ~BUlR~ OF THE N.Y, ~TA~ ~N~U~ON & ENERGY COES, ~ RB~SlBLE FOR DESIGN OR ~~ON ERRORS Phmte 4774)400