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Home My WebLink About29591-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-31210 Date: 10/13/05 THIS t~KTIFIBS that the building FIREPLACE Location of Property: 95 THOMPSON BLVD. GREENPORT (HOUSE NO.) (STREET) (HAMLET) County Tax Map 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 th~s office dated JULY 217 2003 pursuant to which Buildin~ Perm/t No. 29591-Z dated JULY 22? 2003 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 NEW GAS FIREPLACE IN UNIT #95 AS APPLIED FOR & AS PER CERTIFICATION OF FPJINK W. UELLLENDAHL~ ARCHITECT DATED 10/12/05. The certificate is issued to PECONIC LANDING AT SOUTHOLD (OWNER) of the aforesaid building. SUFFOLK COUNTYDHPART~T~ OF~ALTHAPPRO~AL N/A EL~C-£KICAL u~KTIFICATH NO. 84548C PLUMBERS U~U{TIFICATION DA'£~U N/A 02/04104 /~/~/d~ignat.re Rev. 1/81 Form No. 6 TOWN OF SOUrliOLD 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 pmpert3' 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/I 0 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. Ifa 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 $25.00, 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 - l~-esidential $15.00, Commercial $15.00 New Construction: Location of Property: House No. Owner or Owners of Property: Old or Pre-existing Building: Street Suffolk County Tax Map No I000, Section 3 ~'~ p/'- (check one) Hamlet Block Lot Subdivision Permit No. 9 ~ ~ Health Dept. Approval: Date of Permit. Filed Map. . Applicant: Underwriters Approval: Lot: Plarm/ng Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~Z~'~, O O Final Certificate: (check one) Appli6ant Signature Issue Date 2/4/04 Issued To: Street: Village: Section: Electrical Inspection Certificate Electrical Inspection Service, Inc. Application 375 Dunton Avenue 84548C East Patchogue, NewYork 11772 (63t) 286-6642 Sullivan 95 Thompson Blvd Greenport Zip: 11944 Town: Southold Block: Lot: Contractor: Elec-Tec Electrical Contracting Lic.# 4814-E Was examined and found to be in compliance with the National Electrical Code. [] Commercial [] NVDefects [] Pool [] lstFIoor [] Indoor [~ Basement [] HotTub [] Residential [] Det. Garage [] Attic [] 2nd Floor [] Outdoor [] Addition [] Survey Switches Receptacles Fixtures GFI Heaters A/C Pans 1 Dishwasher Washer/Amps Dryer/Amps Oven Range/Amps Microwaves Furnace Oil Gas Circulators Smoke Detector Bell Transformer Meter Amps Phase UG/OH Jacuzzi Television CO Detector / Bldg. Permit: Other Equipment NSPECTION FOR GAS INSERT :IREPLACE Hugo S. Surdi President Rough Inspection: 02/03/2004 Inspector: Eddie Rodriguez Final Inspection: 02/03/2004 [nspec~or: Eddie Rodriguez Thia certificate must not be altered in any manner. Inspectors may be identified by their credentials. FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 29591 Z Date JULY 22, 2003 Permission is hereby granted to: LAI~DING AT PECONIC 1500 BRECKNOCK ROAD GREENPORT,NY 11971 for : INSTALLATION OF A NEW FIREPLACE IN UNIT 95 AS PER MANUFACTURER'S SPECS at premises located at 1205 MAIN RD GREENPORT County Tax Map No. 473889 Section 035 Block 0001 Lot No. 025 pursuant to application dated JULY 21, 2003 and approved by the Building Inspector to expire on JANUARY ~~ Fee $ 150.00 ~ ~d' ~ ~Signature ORIGINAL Rev, 5/8/02 Frank W. Uellendahl Rrchitec PO Box 316. Gr~nport, NY 11944, tel: 631.477,86~4 fo~: 631.477.~)997 emoil:fuellencl~optonline.net October 12, 2005 Mr. and Mrs. Sullivan Peconlc Landing 95 Thompson Bird C,-reenport, NY 11944 BUILDING I~RMIT # 29591 -Z Gas Fireplace Installation in Cottage # 95 at Peconic Landing, Greenport FINRL INSt~CCTION The owners of the above mentioned cottage ~ issued a building permit to add a 36" Top Vented Direct Vent Gas Fireplace, Type HEAT-N-GLO SL-750 'IV in their living room. The General Contractor Island Installation hired PlCONE ENERGY SYSTEMS LLC from Holtsvflle to perform the Installation of the fireplace as well as the vent system. PlCONE installed DVP-s~ltes 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 fireplace installation, fill work was executed according to NYS codes and the manufacturer's spedfkations. I hereby state that the bove is true to the best of mV knowledge. Copy: ~uilding DspQrtrn~m Island Insta!la~lon Step 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 identifi- cation. This pipe is teated and listed as an approved corn- portent of the fireplace. The pipe is tested to be run inside an enclosed wall. There is no requirement for inspection openings at each joint within the well. There is no required pitch for horizontel vent runs. NO OTHER VENTING SYS- TEMS OR COMPONENTS MAY BE USED. Detailed installation instruc~ons are included with each vent tem~ination kit and should be used in conjunction with this Installers Guide. Identifying Vent Componente The vent systems installed on this gas fireplace may in- clude one, two, or three 90° elbow assemblies. The rela- tionships of vertical rise to horizontal run in vent configura- tions using gO° elbows MUST SE strictly adhered to. The rise to run relationships are shown in the venting drawings and tablas. Refer to the diagrems on the next several pages. NOTE: Two 4~' elbowl may be uead in place of one 90' elbow. Riss to mn ratios in the ve~t system muet be foflov~d If45° elbows are ueed. This model has vent starling collars on both the top end 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 Kite PvK-~o DEGREE ELBOW Figure 5. Vent S/stent Componente and Termination Kits 13 Frank W. Uellendahl Architect PO Box 316, Gr~nport, NY 119~4, tek 631.477.8~4 ['c~x: 631.477.~7 May 10, ~ (.'lient; P~conic Landing 9S Thompson Boulevard Greenport, NV 119~, BUILDING PERMIT .ff~9591 -Z Gas Firel:~ace Installation In Cottage #95 at Peconk Landing, Gr~npor'c FII~PLRCE INSPC-CrlON The owners of the above mentioned cottage are requesting permission to add a 36" Top Vent Gas Fireplace, Type Heat-n-glo SL--750TV in their living room. I inspected the framing and found that the ~.uork was done according to code. The Framing as u~ll as the gas line access and the electrical access u~em executed in accordance ,,,ith the manufacturer's specifications. I hereby stat~ that the Information provided above is true to the best of my knouuledge. Copy: Buiidlng Departrne, nt Island Installation 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] FRAMING [ ] INSULATION [ L/~NAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION DATE INSPECTOR~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATIO.~i~ID [ ] INSULATION [ ].~MI~IG [ ]FINAL [ ,~rF'FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION DATE INSP ~~ Model: 6000TV-OAK HEAT-N- No one builds a better fire Installers Guide GAS-FIRED LISTED Underwriters Laboratories Listed WARNING: IF THE INFORMATION IN THESE INSTRUCTIONS IS NOT FOLLOWED EXACTLY, A FIRE 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. - Installation and service must be performed by a qualified installer, service agency, or the gas supplier. READ THIS MANUAL BEFORE INSTALLING OR OPERATING THIS APPLIANCE. THIS INSTALLERS GUIDE MUST BE LEFT WITH APPLIANCE FOR FUTURE REFERENCE. WARNING: IMPROPER INSTALLA- TION, ADJUSTMENT, ALTERATION, SERVICE 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- Glo dealer, please call 1-888-472-3973. Printed in U.S.A. Copyright 2003, Heat-N-Glo, a brand of Hearth & Home Technologies Inc. 20802 Kensington Boulevard, Lakevillel MN 55044 This product is covered by one or more of the fei&owing patents: (~lnited States) 4,112,913; 4,408,594; 4,422,426; 4,424,792; 4,520,791; 4,793,322; 4,852,548; 4,875,464; 5,000,162; 5,016,609; 5,076,254 5,151,877; 5,218,953; 5,321~,356; 5,429,495; 5,452,708; 5,542,407; 5,613,487; (Australia) 543790; 5863B3; (Canada) 1,123,296; 1,297,746; 2,195,264; (Mexico) 97-0457; (New Zealand) 200265; or other US. and foreign patents pending. 384-900G 4/03 1 TOWN OF ~OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southoldl Examined ., 20 Approved ,20___ Disapproved a/c Expkafion ,20__ PERMIT NO. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 3 sets of Building Plans planning Board approval Surve~ Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: Building Inspector APPLICATION FOR BUILDING PERMIT IOVED AS NOTED Date I~'ffi: ~[~ B.P. # ~q INSTRUCTIONS Phone: ,20 2 a. ~ll!~M~l~l~lffi~ly filled in by typewriter or in ink and submitted to the Building Inspector with 3 sets of pla~fl#~aV~t~e~ccording to schedule. b. ~j~l~ql~a~ of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and ~llll~l~fTlO~ - c. Tl~l~llo~ffiplication may not be commenced before issuance of Building Permit. d. ~ll~[~ro~lll~,~the Building Inspector will issue a Building Permit to the applicant. Such a permit shall be ke~.t ~ses_ a.v_a_i~a_b_le fOr inspection throughout the work. e. ll{cF~l~ttia~'~l~.~ll~ used in whole or in part for any purpose what so ever until the Building Inspector issues a Certi~llllF~l~l:ffil~yO.O. f. ~,2t~ 1~ work authorized has not commenced within 12 months after the date of issuance o~~ths from such date. If no zoning amendments or other regulations affecting the property h~lh~ot~i. _ ~{~~_. _~lding Inspector may authorize, in writing, the extension of the permit for an addition si~l~~~[l~l~ll be 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 /~7('o ~t ~. ~t-~/ffw~ (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..~_.S//h~A~ Plumbers License No. Electricians License No. Other Trade s License No. Location of land on which proposed work trill be done: House Number v Street ltlamlet County Tax Map No. 1000 Subdivision (Name) Section ~ ~'~ Block / Lot Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy 3. Nature of work (check which applicable): New Building_ Addition Repair Removal Demolition Other Work Estimated Cost -~OlSOr.)O~'''''Z 5. If dwelling, number of dwelling units If garage, number of cars Alteration Fee ~[~-/~q-~O ~ (Description) (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of~xisting structures, if any: Front. _~ · Rear ~"-~- · .Depth Height 2-~-' ~7" Number of Stories Dimensions of same structure with alterations or additions: Front ~-~ Rear Depth. J"q '(~ ~' Height ~,~,' 8. Dimensions of entire new construction: Front Height Number of Stories Rear 9. Sizeoflot: Front Name of Former Owner 10. Date of Purchase 11. Zone or use district in which premises are situated Rear --.---.---~ ¢ ~ ~enth - ¢Jl'/~O 12. Does proposed construction violate any zoning law, ormnance or regmauon: · ~HT 13. Will lot be re-graded? YES NO .Will excess fill be removed f~ 14. NamesofOwnerofpremises ~C 6~0 Address ~ /n~,~rN~;,~~C Nme of ~chitect Address Phone No , N~e of Con,actor Z3[~ ~3~/~0~ Address / ~¢3~/~o~ J~Phone No. *~/q~ ~ ~/~ 15 a. Is this prope~ within 100 feet of a tidal wetl~d or a ~eshwatg wetl~d? YES NO * IF YES, SOUTHOLD TO~ TRUSTEES & D.E.C. PERMITS MAY BE ~QUIRED. 9' b. Is this prope~y wi~in 300 feet of a tidfl wetlmd. YES ~ NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED· 16. Provide survey, to scale, with accurate foundation plan and distances to propexty 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) COUNTY 0 F.~"O~ ~.d.,S¢: ~e ~i~. Vt '~'l~t' being duly swum, d~oses ~d says ~t (s)he is the applic~t ~me of individual si~ing contract) above nmed, (S)He is the ~l 6~r' (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 true 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. Sw°rs;~°~l~tyrr;;his ~)~, 20 t~ No~ Public State of N~ York No. 48~735 Qual~ In S~olk Ooun~ ~ C~m~sion Expires May 20~