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Home My WebLink About30208-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUP~/~CY No: Z-3121~ Date: 10/13/05 THIS CERTIFIES that the building FIREPLACE Location of Property: 75 KINGFISHER LANE GREENPORT (HOUSE NO.) (STREET) (HAMLET) County Tax Nap No. 473889 Section 35 Block 1 Lot 25 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in tb/s office dated APRIL 1~ 2004 ~u~s~t to which Buildi~ Petit No. 30208-Z dated APRIL 2, 2004 was issued, and conforms to all of the retirements of the applicable provisions of the law. The occupancy for which this certificate is issued is INSTALLATION OF NEW GAS FIREPLACE IN UNIT #75 AS APPLIED FOR & AS PER CERTIFICATION OF FRANK W. UELLENDA}{L~ ARCHITECT DATED 10/12/05. The certificate is issued to PECONIC LANDING AT SOUTHOLD (OWNER) of the aforesaid building. SIIFFOLK COI~FI"f DRPARTMENT OF HF~a_LTH AP~O~ N/A EI~-xKICAL c~TIFICA~ NO. 97466C 04/08/05 PLUMBERS C~KTIFICATION DA£~ N/A Rev. 1/81 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 ink and submitted to the Building Department with the 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 Underwtiters. 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. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey o f property showing atl 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. 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, 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. (~-0/-0~~ New Construction: Location of Property: 7~''' House No. Owner or Owners of Property: /'J~ Suffolk County Tax Map No 1000, Section Old or Pre-existing Building: L,"'" (check one) Street Hamlet Block / Lot c2Q~qf Subdivision Permit No. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ OO 30~O ~>- "L Date of Permit. Filed Map. Lot: Applicant: ~.'.~ /,dv~ /A/~'//c(~7~o.A/ Underwriters Approval: t~ 'Tt//~9 6 Final Certificate: f (check one) Issue Date 4/8/2005 Electrical Inspection Certificate Electrical Inspection Service, Inc. Application Number 375 Dunton Avenue 97466C East Patchogue, New York 11772 (631) 286-6642 Issued To: Street: 75 King Fisher Lane Village: Greenport Zip: Section: Block: Lot: Contractor: Elec-Tec Electrical Contracting Lic.# 4814-E was examined and found to be in compl[anca with the National Electrical Code. 11944 Town: Southold [] Commercial [] NVDefects [] Pool [] lstFIoor [] Indoor [] Basement [] HotTub [] Residential [] Det. Garage [] Attic [] 2nd Floor [] Outdoor [] Addition [] Survey Switches Receptacles Fixtures GFI Heaters 1 Dishwasher Washer/Amps Dryer/Amps Oven Range/Amps A/C Fans Microwaves Furnace Oil Gas Circulators Smoke Detector Bell Transformer Meter Amps Phase UG/OH Jacuzzi Television CO Detector / Bldg. Permit: Other Equipment Switch for Fire Place President Rough InspeclJon: Inspector: Final Inspection: 04107/2005 Inspector: John Mc Mahon III This certificate must not be altered in any manner. Inspectors may be identified by their credentials. Frank W. Uellendahl Architect PO 8o'~ 316, Greenport, NY 1 lg44, tel: 631.477.8624 f~c: 631.477.2~7 emeil..fueilend@optonllne.net October 1~), 2005 Client: Peconic Landing 75 Hlngflsher Lane Greenport, NY 11944 BUILDING PERMIT # 30~08-Z Gas Fireplace Installation In Cottage # 75 at Peconic Landing, C.-reenport FINAL INSPEO'I~ The owner of the above mentioned cottage was issued a building permit to add a 36" Top Vented Direct Vent Gas Fireplace, Type HERT-N-GLO SL-750 'R/in their riving room. The General Contractor Island Installation hired PICONE ENERGY SYSTFJ~4S LLC from Hottsvllle to perform the installation of the fireplace as well as the vent system. PlCONE installed DVP-series direct vent components and a vertical termination approved for the selected fireplace model. The pipe Is tested and listed as an approved component of the fireplace. I performed the final inspection of the above referenced flrepiace installation. RII work was executed according to NVS codes and the menufacturer's specifications. I hereby state that the information provided above is true to the best of my knotul~dge. an ,,ndah, ¢~ ~u~c~ng D~pa~n~nt ~and Stap 3. Installing the Vent System A. Vent System Approvals These models are approved to use DVP-series direct vent pipe components and terminations (see Figures 4 and 5). Approved vent system components are labeled for identffi- cation. This pipe is tested and listed as an approved com- ponent of the fireplace. The pipe is tested to be run inside an enclosed wall. There is no requirement for inspection openings at each joint wilhin the wall. There is no required pitch for horizontal vent runs. NO OTHER VENTING SYS- 'rEMS OR COMPONENTS MAY BE USED. Detailed irtstallation instructions are included with each vent termination kit and should be used in conjunction with this Installers Guide. Identifying Vent Componante The vent systems installed on this gas fireplace may in- clude one, two, or three 90° elbow assemblies. The rela- tio~-,,hips of vertical rise to horizontal run in vent configura- tions using 90° elbows MUST BE strictly adhered to. The rise to run relationships are shown in the venting drawings and tables. Refer to the diagrams on the next severa~ psges. NOTE: Two 45' elbows may be used in place of one 90' elbow. Riee to run ratios in the vent ~ystsm must be followed if 45' elbows ere used. This model has vent stortJng collars on both the top and the back of the unit. Depending upon the installation, decide which ONE set of starting collars will be used to attach the vent system. The starting collar sealing cap must remain on the starting collar NOT used. Termination Kits Figure 5. Vent System Components and Termination Kits 13 Frank W. Uellendahl Architect PO Box 316, Greenport, NY 11944, tel: 631.477.86~4 fox: 631.477.2997 emall:fuellend~optonllne.net May 6, 2004 Client: F~conic Landing 75 Kingfisher Lane Gr~nport, NY 11944 BUILDING PERMIT ~ 30208 Gas Fireplace Installation in Cottage # 75 at Peconic Landing, Gre~nport FIFIEPLFICE INSPECTION The owner of the above mentioned cottage is requesting permission to add a 36" Top Vented Direct Vent Gas Fireplace, Type 6000TRI in their living room. inspected the framing on March 3 and found that the work was done according to code. The framing wos executed in accordance with the manufacturer's specifications. I hereby state that the information provided above is true to the best of my knowledge. ~nk Uellendohl Copy; I~ulk~ing Department ~stand Instolla~!on 6000TRI 36" TOP/REAR VENTED DIRECT VENT GAS FIREPLACE 50-7~8 [1293] ,= ~ r~---,~-~61143~7~-~ 40-1/32. [1017t~ ~ ] 23-1,5/32 '5061~1(~7'4b'~~ ~6-1 ~1/2 14,-114~ | 204] 41 ~ 11o4o] ._~] 2-1/2 DIMENSIONS IN [1 ARE MM SPECIFICATIONS BTU Input Hdght Front W',:~t h ~ ~ Depth ~e /~=al F~ Actual Flaming Ad=al Fra'ning Actual Fral'ring 38 38-/2 41 42 28-/2 42 2-1/2 22 36 X 24 3/4 20-30,000 Inche~ Reference dimembns only. We recommend fl',easumg ~ivid~ units at inst~iaOon, 07/03 HEAT-N-GLO * (952)985-6000 · www.heatnglo, com A~2 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. 30208 Z Date APRIL 2, 2004 Permission is hereby granted to: LANDING AT PECONIC 1500 BRECKNOCK ROAD GREENPORT,NY 11971 for : INSTALLATION OF GAS FIREPLACE AS APPLIED FOR AT 75 KINGFISHER LANE at premises located at 1205 MAIN RD County Tax Map No. 473889 Section 035 Block pursuant to application dated APRIL 1, 2004 GREENPORT 0001 Lot No. 025 and approved by the Building Inspector to expire on OCTOBER 2, 2005~._-~ 0.oo lze gnature ORIGINAL Rev. 5/8/02 FIELD INSPECTION REPORT ] DATE COMMENTS FOUNDATION (1ST) FOUNDATION (2ND) PLUM~ING INSULATION PER N. Y. STATE ENERGY CODE TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.netJSouthold/ Examined Approved Disapproved a/c 20('-"- PERMIT NO. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 3 sets of Building Plans plarmmg Board approval Survey. Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: Phone: Building Inspector APPLICATION FOR BUILDING PERMIT Date ., 20 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 prenfises or public streets or areas, and waterways. 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 issue a Building Permit to the applicant. Such a 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 what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an addition six months. Thereafter, a riew permit shall 6e required. 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 inspections. (Signature of applicant or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ?ff~OOA,"/C L ~b ,A,'~ (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. ~-- oO ~ g't/O -/-./',,,,~ Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: House Number Street County Tax Map No. 1000 Section Subdivision (Name) Block Filed Map No. Hamlet State existing use and occupancy of premises~and in,tended use and occupancy of proposed constructior,: a. Existing use and occupancy /~f5 ! f)£~J7-,~t/~ b. Intended use and occupancy ~---~ .5 [ ~Fn/x/7/)~ Nature of work (check which applicable): New Building Repair Removal Demolition Estimated Cost If dwelling, number of dwelling units If garage, number of cars Addition Other Work Fee Alteration ~'~ (Description) (To be paid on filing this application) Number of dwelling units on each floor If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if any: Front ~-2- Rear Height Z. 7.-/? ~' Number of Stories Dimensions of same structure with alterations or additions: Front Depth Height_ Number of Stories Rear Dimensions of entire new construction: Front Height Number of Stories Rear .Depth Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated //q~d 12. Does proposed construction violate any zoning law, ordinance or regulation? YES__ 13. Will lot be re-graded? YES NO [//Will excess fill be removed from premises? YES__ 14. Names of Owner of premises ~/£Oo.~tc Address Phone No. Name of Architect Address Phone No Name of Contractor :75 ptr~ NO V/ 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES__NO __ * 1F YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES__ NO ~ * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OF ~C*O(~.~/~ ) (Name of individual signing contract) being duly sworn, deposes and says that (s)he is the applicant above named, (S)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 tree 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. Sworn to before me this ~-, /_0~'t''- dayof 20C / Signature of Applicant SUSAN J. NAQY Notan/Publle State of New York No. 4896735 Qualified in Suffolk Oounty Commission Expires May Model: 6000TV-OAK 6000TV-OAK-IPI COMPLY WITH ALL COD NEW YORK STATE & ' AS REQUIRED AND COND - I !dll SOUT, OLOi WARNING: IF THE INFORMATION IN THESE INSTRUCTIONS IS NOT FOLLOWED EXACTLY, AFIRE OR EXPLOSION MAY RESULT CAUS- ING PROPERTY DAMAGE, PER- SONAL INJURY, OR DEATH. - Do not store or use gasoline or other flam- mable vapors and liquids in the vicinity of this or any other appliance. What to do if you smell gas · Do not try to light any appliance. · Do not touch any electrical switch. Do not use any phone in your building. immediately call your gas supplier from a neighbor's phone. Follow the gas supplier's instructions. If you cannot reach your gas supplier, call the fire department. - Installat/ibn and service must be performed by a qualifl.~e'd installer, service agency, or the gas supplier. OCCUPANCY OR USE IS UNLAWFUL OF'FIDE HEAT-N No one builds a better fire T CERTIFICAT nstallers Guide APP, ROVED AS NOTED DATE' '/'///~/qBP# ~ NOTIFY BUILDING D~ENT AT 765-1802 8AM TO~JI~JiF~=~,,[HE FOLLOWING INSpE~TT~__J. uo 1. FOUNDATION - TV~.~;~IIIRED FOR POURED COI',I~REI'E- . 2. ROUGH - FRAMII~e~G 3. INSULATION Laboratories Listed 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. READ THIS MANUAL BEFORE INSTALLING OR OPERATING THIS APPLIANCE. THIS INSTALLERS GUIDE MUST BE LEFT WITH APPLIANCE FOR FUTURE REFERENCE. WARNIN/G: IMPROPER INSTALLA- TION, ADJUSTMENT, ALTERATION, SERVI{;E OR MAINTENANCE CAN CAUSE INJURY OR PROPERTY DAM- AGE. REFER TO THIS MANUAL. FOR ASSISTANCE ORADDITIONAL INFOR- MATION CONSULT A QUALIFIED IN- STALLER, SERVICE AGENCY, OR THE GAS SUPPLIER. Please contact your Heat-N-Glo dealer for any questions or concerns. For the number of your nearest Heat-N- Gto dealer, please call 1-888-427-3973. Printed in U.S.A. Copyright 2004, Heat-N-Glo, a brand of Hearth & Home Technologies Inc. 20802 Kensington Boulevard, Lakeville, MN 55044 ~--'--UNOERWRffERS CERTIFICATE REQUIRED Thisproductiscoveredbyoneorrnoreofthefollowingpetens Un edStates 4112913'4408594-4422426-4,424792.4,520791;4,793322;, , , , 4,852,548; 4,875,464; 5,0001162; 5,016,609; 5,076,254 5,191,877; 5,218,953; 5,328,356; 5.4:29,495; 5,452.708; 5,542,407; 6,613,487; (Australia) 543790; 566383: (Canada) 1,123,296; I 297,746; 2,195,2~4; (Mexico) 97-0457' (New Zealand) 200265; or other U.S. and foreign patents pending. 384-900K 2/04 1