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29988-Z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30219 Date: 06/02/04 THIS CERTIFIES that the building ADDITION Location of Property: 900 BIRDS EYE RD ORIENT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 17 Block 2 Lot 1.9 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 2, 2004 pursuant to which Building Permit No. 29988-Z dated JANUARY 2, 2004 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 THERAPEUTIC EXERCISE POOL INSTALLED IN AN EXISTING ENCLOSED PORCH ON AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to CARL THOR HANSON & ANO (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N 300787 12/30/93 PLUMBERS CERTIFICATION DATED N/A Authorized Signa re 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. 29988 Z Date JANUARY 2 , 2004 Permission is hereby granted to : CARL THOR HANSON PO BOX 112 ORIENT,NY 11957 for INSTALL A THERAPEUTIC EXERCISE POOL IN AN EXISTING ENCLOSED PORCH AREA OF A ONE FAMILY DWELLING AS APPLIED FOR. THIS PERMIT REPLACES BP#24660 . 900 at premises located at BIRDS EYE RD ORIENT County Tax Map No. 473889 Section 017 Block 0002 Lot No. 001 . 009 pursuant to application dated JANUARY 2 , 2004 and approved by the Building Inspector to expire on JULY 2 , 2005 . Fee $ 150 . 00 Authorized Signature ORIGINAL Rev. 5/8/02 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) Date......FE>PRUAR Y......I Q.......................... 19...45... 24660 Z Permission Is hereby granted to; ........QA F3J....T.H.G R..HA N.S ON.......................................... ........PA...SAX...112......................................................... ........ARj9N.T..,NY...1.19.57.............................................. to......1.111.STATJ—AN...A.....X..1S.....X..a:....THFRAP..E.01.I.G.,.P.XERC.T.S.E.,P..OAL....IN..AN...EXISTING ............ ...AF....A..SxNGI^E...EAr1.I.t..Y.,.IDWF4.J-ING,..AS..AP.P..t-.I.E.U..FOR. ..... ......................................................................................................................................................... .............. .... . ............................................................................................... . ......................... ...............................................................................................................................................I...........I...... at premises located at................1 5.15. ......B.I.RDS. ..EYE. RD....................................RR.�.E.NT................ .. . .. .. . .... .. ... .................................................................................... ......................................................................... County Tax Map No. ... 473889 Section ...41.7.............. Block .. .,4QS?. ,. ..... Lot No. .fJQ.l...QSJ�.... Pursuant to applicotlon dated ....JANUARY........21 19......48...., and approved by the Building Inspector. Fee$; ......75.00 .... . ..... .. r .�... ......I........................... ullding Inspector Rev. 6/30/80 • Form No.6 �,� -- -- TOWN OF SOUTHOi n ------- ---- J b - -- 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$25.00,Additions to dwelling$25.60,Alterations to dwelling$25.00, Swimming pool$25.00, Accessory building$25.00, Additions to accessory building$25.00,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. �� 4- New Construction: Old or Pre-existing Building: (check one) Location of Property: 96 0 r v'p)s AN (0 CE (- !� House No. Sheet Hamlet Owner or Owners of Property: C&e.L %,it A f C A 46.,to � � ,,,/�e Suffolk County Tax Map No 1000, Section 01 -7 Block 6 8 ip _> Lot m B!_ D B q Subdivision Filed Map. Lot: Permit No. 01 8 Date of Permit. Applicant: V of x ey-X Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ a� fLG U/ON�) '-Applicant Signature iq�r THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 10@0121 ESUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK. NEW YORK'10038 DECEMBER 3@ 1993 , '' "83171653193 E 300787 Date Appitcation IYo.on flip n; " THIS CERTIFIES THAT only tha s4cirlcal qTs inewt at dsicrFbsd biloio oAcE iwtrodtie�et by tl ie appl at named on the above`appUcatiew number In drip pmmiaes of ?", THO$ NAltsof- 9@Q BIR SllYB "Ra 1tRS Ii'P—�# l �Y S na tlie}rllo�esee Co�a�Sion; � Boseine tt - lsr FT. [J Ynd�!"I �eruon �Block Lot Iisiix ner'ed on -fiSC&MBI t 27 i-1993 �'s jb�iatd rn co t�scat to A>apNares wide the 1VadoLilsc Cods. a M a 11XTiME � - -,-=111(TURES --RANGES NODECKS OVENS DIS14WASHERS EXHAUST FANS .. OUT4Tf...• - MXWMCEW "" OTHER AMT:...._....ILI W. .. AMT.. `It W. - AMT:_. ..[:W. AMT, IG W. _ AMT. K P. ?s " J 4 4A Q 'QR7!!RS Rx*ucE'N=RS FUTURE.A/RIANCI PUNK FIC1Al Mc,"`TIM CLOCKS UNIT MNtT S ��= MMMERS :S `pt: ' H.r GRAS; f!F. x:AMT.. ANO. w.W.G: AML AM►. AMT.. "AiiYs :TRANS_.`.AMr "--IG►,. NO'Of FEET '3.:3 3. - +?.. .� . air. .. .,. ; ....cam-n •qy; ;.R,� � � ,Fa.,..� _ . AMi 'AAAI..„ `TtTE�. Rp(� T,I 2W�j 3W 3 L 3W'3 i1[.IW CC CCmID A.W Q NQ Qi iMdEG.. _.. A.TY;G ;..NO.Of ME(FtRAIS As MF G. IdA♦ 0►CC.COND. CI HFlK3 0►HEI1TRAt ("M A/rARAT11s rY SftKNIIIG POOL=1 4CONTACTOR".-ASSISTED H'YDROLIC PVNP-1 0-DINRSt:1414 4 BAftKBp4 TO BA5BKER? . ' ; FFEDBR8a1-3 # 12 BASEMENT TO BASEK,ENT f IiQ#6Rsr1'ift .P. ° di. K .4't1f1L.) Th: �ertf i�f cate fs ""wEINE sY CHECK OR MONEY TO THE OF THE NEW YE a r is i:`n e 1 c . p a s1. ttte .dale o€ YcacEOAwofIRIS 1INOERwRITa" MAR, WNL EE AT �,. AS CASH EENT<rr <c< Continued ou Fage 2. a» . am a sw+oElr. A - Per. THIS IS YOUR aLL FOR SERVICE N NOERED AND K NOTA". .. OF COMMLIANCt.THIS IRL FAYAM AT THI NEW YORK OFFKE,85 JOHN STREET,NEW YORK,N.Y.10038 • 43 -`�� THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 2 1000121 BUREAU OF ELECTRICITY 85 JOHN'STREET. NEW YORK.NEW YORK;10038 ; Doig'" DBC&!L$$A " � PPl 30 1993 icatio�eNo.o�fte . '$31.71693/93 R 300787 �TFI15 CERTIFIES 'TFI%rT' , . � _. . 'oal tlii eGetrtcaf igutpArmsord�Mcai6�Ea./aosd iwtriv br�ht�ppliaws no+nodae tll+tobaae y�pbesto�s numer bus tJwpnnriaer of ` H R l a :900' BIffD'd81 BoiiSH4 Y _tom s� � . ierltl�•�e�a" ttactEiors; ' �8$ww�snt ' arl�i:" Q tad.FT Sercw. Block Loc C' DBCBKBIR 27 1593 3yrentene�'m '� r 1Vetlo ��lsdrscol Code. acrd Aa bo cowrrplrancs t� r' a _ RAA16iS. '` COOKR�6 DECKS OVlNS WASIIBIS EXHAUST FANS ".... FUlORMCtMFr OTHER AML K.W::, AMT. K.W, AMT. - 19t.1M "AMT: K.W. AML R F:' !UIlNACE M�hORS'-' MTM AMANMFIMMU MIC" TIMiCIOCKS. M .UNITIRATIM M DIMMERS 1s Id MF Olt` Kr►F tiMl IIw R AAW, NO.: A:W.O. '.AMT.. AMP, AMS: ` AM/S TI(ANS. AMT, 11 T; NOl Of FBT. AMT: WAR& }; 7Mf 1.VLjW'1JF4W MM CGCON0. Ax.W.Ck -. ....NMC*MFtEG. W. NO.OFNE ft-W A.W.M + Mme: .. FER' CC.CCM. Ot NFIw OF N[UM a. n ectton only..' Because of dadsual ra ronants' !t I'f's 'advisable ta' ` fregient te.st/aad or repairs AN �;`f a ': 8 j rm SY CTIICK O�MOIMt �' $?5.7 5 w�c IT u (w Nar .,:..:_. _.c.ewd...'F ?A L. R. '$URNS`_, LIC. 282 AS�"M SENT s1r MAI ,MML°ie�T EIMc cF somm, ' 275 .T016`HARBOR LABS t SOUTHOLD, 1��C, 11971 _ 11 Psr TNIS IS YOUR SU FOR SERVICE ROM=AND K NOTA ATE TM MLL MYAMt AT THE NEW YOU OMM AS JOHN STMAT,NEW YORK,N.Y.10098 ! WNO , OF SOUTHOLD PROPERTY RECORD CARD 000 - 7- ? -> OWNER STREET U(� VILLAGE DIST. SUB. LOT 7v �.evT OStnS6n 4 wf �0004�(VA #Z- O ieyr Z Discv1'.0 U E `. r _ F WNER1 `�/ N E ACR. -= ► ief- --7) JTZ�fl Sn U ND /lD�hsk(2 a 2 S W - TYPE OF BUILDING mon Ct (n RES. SEAS. VL. FARM COMM.. CB. MICS. Mkt. Value LAND IMP. TOTAL DAVE REMKS t tic, SLI 403 000 1 o Soo /8 ,�'o0 4 /8 79 .� .�3 7 soL ya oo® s 2so, M% >.?8o Ac FLRrz 'Tit �IJF P. rets /F /J" 75p 1 l i L., io7-9 SA-e r n I CS 6 - 4n 0 3 - 1_ l I VO 2 5-75- S r) +-n S""-' 2 em env 85 1 L ?J1 lo # (000Ie� Pool ,:►� £wc k_�©ve� g2 , 12 0� 2 48 km,, d ).5 .rte Tillable FRONTAGE ON WATER Woodland 1,o2-(,p -750 FRONTAGE ON ROAD Meadowland DEPTH House Plot Z p p r 2 0 01-9 BULKHEAD Total COLOR TRIM t M.*,Bldg.- - extension Extension Extension Foundation Both Dinette Porch Basement Floors K. Porch Ext. Walls Interior Finish LR. Breezeway Fire Place Heat DR. Garage Type Roof Rooms 1st Floor BR. Patio Recreation Room Rooms 2nd Floor FIN. B O. B. Dormer Driveway Total ■■■■■■ ■■■■■■■■■■■■■■■■■■■■ • •' ■■■■■■■ ■■■■■■■■■■■■■■■■■■■■ �■■■■■� ■■■■�■_■_�_■■■■■■■■■■■■ ■■■■■ ■■!■:M20M■:■■C�■■■■■■■ OnFAR .117AISSEM ForEQN70MR,WON CNENO _.._. ■m■■t�R►��I �I�l�■��war■�;%f�■■■■■■ ■■■■■■■■■ ■■■■ai■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■ Foundation Basement Interior Finish ■ t o Type Roof Rooms lst Floo r _ Rooms 2nd FI e ' r ERtY RECORD CARD - OWNER STREET VILLAGE DIST. SUB. LOT S ORMER OWNER N ACR. 6 IPS . +W ✓ TYPE OF BUILDING -, RAWAFF"Y 64S' - RES. SEAS. VL. FARM COMM. (26. MISC. Mkt. Value :.3 i LAND IMP. TOTAL DATE REMARKSY / 3 J _ . .. 0 /O 12/27/27 --B , 10fr/P 0 110vE G�i(�s7',wo 3-10. 0- cvx. �O� I ,fj WAI'17kS'oL SS000 $PLi ;r l•01 AG io E 89c'oKs bio 0-0 k' # 6 Svi i, x'041 o - ✓ / yDvr7 © O (0D j � Xd / 16-4 4 L IdN� NDITION NEW NORMAL tj ELM U"/31 f E FARM Acre Value Per Value Acre Tillable 1 Tillable 2 d i Tillable 3 Woodland Swampland FRONTAGE ON WATER - o o. X30 °te 'ell ' 6 Q.•e-� . Brushland FRONTAGE ON ROAD / d House Plot 0j.�/ / 1L. A 0 0 0 a--o DEPTH fool, BULKHEAD .�� _ Total DOCK ELIJOTT J. HOWARD, M. D. F.A.C.F.. F.A.C.C. 894 MADISON AVENUE NEW YORK.N. Y. 10021 (2121 249.7272 July 5, 1994 Re: Admiral Carl Thor Hanson To Whom It May Concern: As Vice Admiral Carl Thor Hanson's cardiologist since 1985, when he suffered a severe myocardial infarction, I have prescribed routine physical exercise and recommended swimming, at which he is proficient and which is an ideal regimen for one with a heart condition. The benefits of this type of exercise were evident when in 1988 he underwent a double bypass operation to remedy clogged arteries that were causing an increasing angina condition. His surgeon and I noted during the operation that his heart muscle on the side of the heart affected by the attack was in good condition and that the exercise had helped to open up alternative paths for blood circulation. I thus encouraged that he continue swimming following the operation and have monitored his progress through quarterly examinations and annual treadmill stress tests. This he did with discipline during his residence in Manhattan until October of 1993 when he retired as President of the National Multiple Sclerosis Society and moved from the city to Orient at the eastern end of Long Island. When Admiral Hanson informed me that no indoor swimming pool was available on the North Fork of Long Island, we discussed installing one in his home, particularly an indoor "Endless Pool" swimming exercise "treadmill." I believed this to be an ideal solution for two reasons: It is a serious exercise machine and it is small enough to fit in his available indoor space. Swimming is particularly suited to his exercise needs as a patient with a heart condition because he requires regular aerobic exercise without the strain on his damaged knee joint. Sin erely, Ott J. oward, M.D. Ir suiLDiNa DEPT. INSPECTION [ j FOUNDATION 1ST [ ] ROU PLBG. [ ] FOUNDATION 2ND [ ] 1 CATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNE ) REMARKS: 3 DATE D INSPECT 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ J ROUG LBG. [ ] FOUNDATION 2ND [ ] 1 CATION [ ] FRAMING P,[ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARK DATE INSPECT r D t;:S.'EC:IUti 111) E COMMENTS FOUNDATION ( 1st ) FOUNDATION ( 2nd ) _ m 2 . ROUGH FRAME & O .PLUMBING * H 3 . rn (1} IJJSULATIOPJ PER N . Y. STATE ENERGY CODE 4 . FI;JAL . I O z DDITIONAL OMME S : x • n 00-1 X HG Ov Z I T A r t� m H t BOARD OF HEALTH . . . .. . . . . . . . . . . FORM NO. 1 3 SETS OF PLANS . (!n i f�' TOWN OF SOUT110LD SURVEY . . . . . . . . . . . . . . . .1- . . �• ,} � BUILDING DEPARTMENT CHECK . . . ... . . .... . . . . . . . . . . . . . . . . t,;'• TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . �,��f; �r,i� SOUTHOLD, N.Y. 11971 t I TEL: 765-1802 NOTIFY: BLDG. EPT. CALL i A 3.-. 13 F bj . . . . TOWN 9UMOLD Eamnn ....... ....., IV. . . . . . . . . . 'alApproved.....:/s!�....., 191. Permit No. .1C2 ........... Disapproved a/c .................................. ...:.::............................. ...................................................... .. .(Ifuil ns1 ........ APPi.ICAT10 FOR BUILDING PERMIT pp Date. . . l.r�?.I. . . . . . . . , 19I¢. . INSTRUCTIONS a. 'lhis application must be conpletely filled in by typewriter or in ink and submitted to Lite Building Inspector wit. 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 adjoinitq} premises or'public streets or areas, and.giving a detailed description of layait of property not be,drsiwn on the,diagram which is part of this application. If. '!he work covered by this application may not be comenced before issuance of Building Permit: ' d. Upon approval )of this application, the Building Inspector will issue a�nuilditg Pemmit to the applicant. Such permit shall bekept on the premises available for inspection througixmt the work. Ae. 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. . '01 " _' '' APPLICA UN IS HEREff MALE to the Building Department For the issuance of a Building Permit pursuant to the fl<uilding Zone Ordinance of the Twin of Southold, Suffolk County, New York, and other applicable Iaws, Ordinances or Regulations; for the construction of buildings, additions or alterations, or for removal or demolition;,°ihs herein described. The applicant agrees to comply with all applicable laws, ordinances'j' building,oode,*housing'code, arxl regulations, and to admit authorized inspectors on premises and in building for� necess�aryI spections: ........ (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State wimther applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ..... � :W&Ar ........................:..�................................. .......:........... Name of.owner`of premises ...� 14"1494..On,.4�(�t '1�. :!^,d /Jx:ll. N........ (as on the tax roll or latest deed) If applicant is o'corporation, signature of duly authorized officer." (Name and title of corporate officer) Builders License No. Plumbers License No. .... ................... ` Electricians License No. Ilme..� ?Pogojs.. Other Trade's License No. C. ..Vim►.Pv;a m 1 1, ation of land on which proposed work wivu done.........................:.............. :. ..................... ,05,-5).. e ' .!z � 4 � ..:':'?................. douse Number Street 11aidetI County Tax Map No: IOQO Section ......J,.1,-�.j Block ........Z....... int :..: .h. :.fh/ "`` Subdivision ...................................... Filed Map No. ............... Lot ....... .... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........ ..................................................... ..... .. 1 .. r L r L b. Intended use and occupancy ..17u.4 f K >?E2 fr�/!e�.t?d v!...A�..Q.t4t I.!..NtL..1L 1 d ... ... e Inutl�htK�1u8 .. r�..I,.?1 rehigx;t aoiwtmn+a0 3. Nature 6f work (dileck'vAiid► applicable): New Iluildiuu; .......... Addition .......... Alteration ` itepair :::.'.:::.::. 13ehndal ti' i;*....... llemIition .......... Other Work ;/r!S,7 Am4> •/,�;�K .X91„ ►h; • +a(F► '~ �� (Description) I�XpilG(.ff 4,91 4. Est imated Cost ...'? ..f.",.. ......... . , fee .......................................IA/ Oytirl J& Qoo►y (to be paid on filing this application)•.• 5. if dkaelling jnuiiuer'o'E.dwellIng unit's ............ timber of duelling units on each floor .:. .If garage, tanner of cars l.:!.... b. if business, .drnrrercial or mixed occupancy, specify nature and extent of sato type of use..:..,'..................... 7. Dimensions of existing structures, If any: Dont................ Rear ............... Depth ................. Ileiglnt ............. ....,,. . Nuniner of Stories ...................... Dinnensiona of some structure with alterations or additions: Front ............... Rear Depth ................ ... Ileight ............. Nnner of Stories .•.•••. ........ ............... .,• 8. Dimensions of entire new construction:• Front .......r......... Rear ............... Depen .............. lleight ..................! .!. . turner of Stories ', ....... 9. Size of lot: Font .. .............. Rear ............... . .} . ,; ... Depth ................... 10. Date of Rurinase ..................... Harm of Fonrer Owner .................................. II. Zone or use district in which premises are situated .............................................................. 12. Does proposed construction violate any zonlhjg law, ordinance or regulation: 13. Will lot be >:egraded„ *,.y. t.,!.,�,t,,, Will exce s fi ,,, enoved from premises.,. , ..YF..S HD t �rti a 11 Ue.r �• 14. ' Naures of Owner of prbwseat,IQl A TA! $-C.6KL—C779... Aciclreas '... 'eD.0.c 1!!f�£ .4©.dl&fflione No. .���':� .. Nae ofArdhi SAI-`r✓S /dge%sAn/ ,:•. 1, '•.;,u t *••. •! .• ,.., , Address ...... ........... ,., Phone No. ...�t.. Name of Contractor t:l�d.S!'.T1�11 ��:`td7lr,f. .' .:. .. Address ..pQl.�4 x:,t .y..�-:t .Cd...Phase No 15. Is this property;wit111n jW feet: of;a tidal wet]and?,.,* YES ...... NO , . ., t *IF YES, S0l,IIKID 713I,1N IR Sl10S FE-il`Iff MAY ne RgRRM. P1.O•r DIAGRAM Locate clearly and distinq]y s11 buildipga, whether existing or proposed, and indicate all set-back dimensions frau property linea.., Give street.:and block mmi)er or description according to deed, and slxxa street names and indicate ubaher interior or corner lot. M1 ITC.. ,fes ��`d'� �f � Lj,v-•K,dc * ,l „e �v f-�✓� e�t SI'Alli U NSI YU K, SS Q111N1Y (A? l�f.F'N� .......... ""'�•� -` •• ••-•••�Q�.�.5•t�} ..............beir% duly sworn, delxuses and says that he is the appl.icatiL (N-v a of hidividkual signing contract) above named, Ile is the .. ..... ..................t.. .. (Contractor, agent;corporate . e officer, etc.) , of said darner or owners, aril is duly audxnrized to perform or have performed the said work and to make and file this applicatioan; that all statenenl¢ contained in this application are' tnue to the best of his knowledge and belief; mid that the work will be perfonmi l in the aaw*r set forth in the application filed therewith. :worn to before this Notary Pk ...... .. . .. 1 1 . C�- r . .. . ...... (Signature of•Applicant)Ark . fk ( . �,\,IBIENT TEMPERATURE. RATING OF HEATER Method for Providing a Non-combustible Base. _OMPONENTS Millivolt Heater with Honeywell Gas Valve Heater +32°F to+175°F 12"Min. Millivolt Heater with Robertshaw Gas Valve 0°F to+175°F 1 \ 0 i -ectronic Ignition Heaters' Q -32°F to+175"F "requires 120V or 240V power supply O® Sheet Metal Q 24 Gauge Min. Rated inputs suitable for up to 2000 feet elevation. =:r elevations above 2000 feet, reduce input 4% for 4"Min. i Hollow concrete cinder Bch 1000 feet above sea level, as high elevation block,align holes and Educes combustion performance. leave ends open. Fq.r 914e.os 4ZSCTION 3/ INSTALLATION CLEARANCES NSTRUCTIONS ALL HEATERS IWPORTANT NOTICE For clearances from combustible surfaces, see These instructions are intended for the use of chart below. ualified personnel only,specifically trained and expe- .enced in the installation of this type of heating equip- Clearances from Combustible construction. .Tent and related system components.Installation and Indoor Installation: ,a.vice personnel may be required by some states to Top'(Drafthood) -35"; Vent- 6"; .e licensed. If your state is such,be sure your contrac- Back-2"; Right Side- 6"; -::r bears the appropriate license. Persons not qualified Left Side-6"; Floor-0. ,:all not attempt to fix this equipment nor attempt Outdoor Installation: pairs according to these instructions. Top'(Stackless Top)- unobstructed; Back-2";Sides-6". NARNING: Improper installation, adjustment, a/tera- Clearance from Top of Vent Terminal :cn.service or maintenance may damage the equip- nent.create a hazard resulting in asphyxiation,explo- For servicing, provide at least 24" in front of the i scn or fine, and will void the warranty. heater for burner tray removal,and at least 18"on the SDE REQUIREMENTS left side of the heater to inspect and delime the heat exchanger. v0TE: The heater should not be located in an area .vrere passible water leakage will result in damage to OUTDOOR HEATERS • ire area adjacent to the appliance or to the structure. These heaters are designed certified by A.G.A.for Mhen such locations cannot be avoided, it is recom- outdoor installation,when equipped with the approved mended that a suitable drain pan,adequately drained, top designated for outdoor use. • -e installed under the appliance. The pan must not Estrict combustion air flow. Heater with Installation must be in accordance with local outdoor Top vides, or, in the absence of local codes, with the vational Fuel Gas Code, ANSI 2223.1-1988, and the rational Electrical Code, ANSI/NFPA 70-1987. 1 _ASE INSTALLATION Heater must be mounted on a level base,such as mment slab,cement blocks or other non-combustible ~:.face. A method for providing a base for combustible o • 'ccrs is illustrated. Heaters may not be installed on _ o O-sDebnS Fq.08139 Ids 7 Heaters must not be installed under an overhang of less than three(3)feet from the top of the heater. Three under the overhang. Roof water drainage must be diverted away from the ,►�;ides must be open m the area u im 9 • ..,,,Atars installed under overhangs with the use of gutters: f he point from where the flue products exit the heater must be a minimum of four(4)feet below,four(4)feet aontally from or one(1)foot above any door,window or gravity inlet to a building. The top surface of the heater r,All be at least three(3)feet above any forced air inlet,or intake ducts located within ten(10)feet horizontally. 4' �— Min 4' Min 4'�Min 1'Min r X Min 7 ' 10' Min F4/8245.0 -110H WIND CONDITIONS(OUTDOOR UNITS ONLY) COMBUSTION AIR (INDOOR UNITS ONLY) In areas where high winds are frequent,it may be Air For combustion And Ventilation ,x-essary to locate the heater a minimum of 3' from (Indoor Units Only) tign vertical walls,or install a wind break so the heater The heater must have both combustion and venti- a not in direct wind current lation air. Minimum requirements for net free air supply ,,iDOOR HEATERS openings,one 12 inches from ceiling for ventilation and The design is certified by A.G.A.for indoor installa- one 12 inches from the floor for combustion air as :Qn when equipped with the approved draft hood. outlined in 7223.1-1988 and any local codes that may -ovate heater as close as practical to a chimney or gas have jurisdiction. ant. Heater must always be vented to the outside.See .ent Piping Section forventing details. Minimum allow- CAUTION: Combustion air must not be contaminated ;ole space is shown on the nameplate. by corrosive chemical fumes which can damage the heater and void the warranty. ,eater with a. All Air From Inside The Building: ndoor Top Each opening shall have a minimum of 50 net free square inches. b. All Air From Outdoors: When air is supplied directly from outside of building,each opening shall have a minimum of 13 • net free square inches. :�\ /► %/ F4 a 8138 8 . VENTING CONNECTIONS VENT TERMINAL(Indoor) Locate and assemble as shown. Secure with VENT TERMINAL(Outdoor) screws supplied in envelope inside carton. i STEP 1: Remove the(4)screws which fasten jacket top to heater. ' STEP 2: Lower outdoor top onto unit lining up Draft Hood slots in outdoor top with screw holes in , jacket top. , STEP 3: Reinstall(4)screws to secure jacket top and outdoor top to unit. Mounting Outdoor Top s s Jacket Top W GQ O 140 • O Fs 0 8143 Fs 08137 t t a 9 VENT PIPING 10 or less I Vent Cap WARNING: Indoor boilers require a draft hood that / must be connected to a vent pipe and properly vented to the outside. Failure to follow this procedure can 2'Min. cause fire or fatal carbon monoxide poisoning. 2'Min. Vent piping the same size or larger than the draft hood outlet is recommended, however,when the total 00 s' Min. vent height is at least ten (10) feet (draft hood relief opening to vent terminal), the vent pipe size may be reduced as specified in Appendix G of the National Fuel z Gas Code,ANSI Z 223.1 -1988. As much as possible avoid horizontal runs of vent pipe and too many elbows. Vent Pipe If installation requires horizontal runs, the vent pipe must have a minimum of 1/4 inch per foot rise and should be supported at not less than five foot intervals. Plumbers tape,Criss-crossed,will serve to space both horizontal and vertical piping. Gas vents supported only by the flashing and extending above the roof more Draft Hood than five feet should be securely guyed or braced to withstand snow and wind loads. We recommend use of insulated vent pipe spacer through the roofs and walls. For protection against rain orblockage by snow,the vent pipe mustterminate with aventcap which complies Heater with the local codes or,in the absence of such codes,to the National Fuel Gas Code, ANSI Z223.1-1988. // The discharge opening must be a minimum of two feet vertically from the roof surface and at least two feet F4 18119.0 higher than any part of the building within ten feet. Vent stack shall be at least five feet in vertical height above the draft hood outlet. The vent cap location shall have a minimum clearance of 4 feet horizontally from,and in no case above or below, unless a 4-foot horizontal distance is maintained, from electric meters, gas meters regulators and relief equipment. The weight of the vent stack or chimney must not rest on heater draft hood. Support must be provided in compliance with applicable codes. The heater top and draft hood must be readily removable for maintenance and inspection. Vent pipe should be adequately sup- ported to maintain proper clearances from supported to maintain proper clearances from combustible construc- tion. Type "8" double wall or equivalent vent pipe is recommended. However single wall.metal vent pipe may be used as specified in the National Flue Gas Code ANSI Z 223.1-1988. O 10