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HomeMy WebLinkAbout31792-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y~ CERTIFICATE OF OCCUPANCY No: Z-31433 Date: 02/14/06 T}{IS CERTIFIES that the building GAS FIREPLACE/CHIMNEY Location of Property: 455 TUCKER LA (HOUSE NO.) County Tax Map NO. 473889 Section 59 Subdivision SOUTHOLD (STREET) (HAMLET) Block 11 I~)t 6 Filed Map No. __ Lot No. -- conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 10, 2006 pursuant to which Building Permit No. 31792-Z dated FEBRUARY 10, 2006 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 "AS BUILT" GAS FIREPLACE & MASONRY CHIMNEY IN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to STANLEY & TERESE RAKOWICZ (OWNER) of the aforesaid building. SUFFOLK COU1FrY DEPARTMENT OF HEALT~ APPROVAL N/A ELEC'fRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ~/~h~ized Signature Rev. 1/81 Form No. 6 ~-/~-~ TOWN OF SOUTHOLD ~ ,, BUILDING DEPARTMENT :~ TOWN HALL 765-1802 FEB I APPLICATION FOR CERTIFICATE OF O(~cupAI~I42Y ' : ~ '~:~_ ,J 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. 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 - Residential $15.00, Commemial $15.00 Date. Feb. l, 2006 New Construction: xx Old or Pre-existing Building: (check one) Location of Property: 455 Tucka r..,~ane, House No. Southold, N.Y. Street Hamlet Owner or Owners ofProperty: STANLEY & Terese Rak0wicz Suffolk County Tax Map No 1000, Section 5 9 Block I 1 Lot Subdivision Permit No. 31792-Z Health Dept. Approval: Planning Board Approval: Date of Permit. Filed Map. 2/ 10/06 Applicant: Owners Underwriters Approval: Lot: Request for: Temporary Certificate Final Certificate: xx (check one) Fee Submitted: $ 2 5.00 - '~kpp 1 .loga/nt ~1 gnat ur eJ 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. 31792 Z Date FEBRUARY 10, 2006 Permission is hereby granted to: STANLEY & TERESE RAKOWICZ PO BOX 447 SOUTHOLD,NY 11971 for : INSTALLATION OF AN "AS BUILT" GAS FIREPLACE AND MASONRY CHIMNEY IN AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. at premises located at County Tax Map No. 473889 Section 059 pursuant to application dated FEBRUARY 10, 2006 and approved by the 455 TUCKER LA SOUTHOLD Block 0011 Lot No. 006 10, 2007. .~--~'~. uthori d~ Signature Building Inspector to expire on AUGUST Fee $ 150.00 ORIGINAL Rev. 5/8/02 -.. Fie Vew Toolbar , Help" .~ u! ,'! ~t~.,li~':is,~= ~iil .!,ih: ~:I!~ ! :.: ~ ~' ~ ~i'> · i: ~,~,~ ..... ~[l .:::.. T' ..... .-...,,:.:.. ':?~ .~,, .u.;~,~ ~:~¢~,~ ~:,..,~2~t ~,l, ~.. ,.....; ...... ,..~ ......... ~ ..= 1.~ Rakowicz. Stanley RollYear: 12ooE Hext Y, I Family Res 455 Tucker Ln LandSize:O~14;6~e~ ~:~;~ Owner Total: 2 ~ Taxable Value Neme: 5tanle~ Rakowicz ~ County: 3.075 AddlAddr: Street: 455 Tucke[ t.n PO Box: 447 Ci(v: Southokl. NV Zip: 11971- Sale Total: 0 Book Page SaleDate SalePrice Owner Exemption Total: 2 Term Code Amount Year 41131 COMBAT VET 1.025 0 41834 STAR (ENH} 1.450 2049 Muni: 3.075 School: 4.1 O0 ~. Schlafter Star: 2.650 S:jte:lofl Land OotO Prpcls: 1 Family Re~ N bhd Cd: 0 SeweJ: V/ater: Utilities: O~n Buildin§ Total: [} Pct 0 0 S¢iloul: Suuthuld 5.;huul Lar'ld AV: 400 Totai A',/: 4.100 Bock: Z Pago: 00148 ~Aortg: Bank: Acct No: 08 Special District Total: 4 Value/__i~ lmprovemenl Total: 0 Code Unit~ Pct Type MovaTax ~Type Name Diml Dim2 FD028 Southold FO .00 .OO .00 PK070 Southold Pa¢ .00 _00 .00 ip SQFT Yr Buii~ --J' I~ ~, V'~,,.~ T,-,~lh~r' Hoe ' ~. ~.;-.-.~,.~:: ~':'~'?,~! ...=. ~'~.: .-'.. - ,%::' .?;:-{~-'~.j'-:"~? ~ :~'' '.': '- '' · m..e~ ..r, I~ · ,t. ,~.. ~,: ~,..~ i'~ ~11 ~ ~..-..~ li59 [; -' - 47308'.J 5uuthuld Achve ~q,~ 1 I I Rakowiczo Stanley RollYeer: ~'~t~ Next Yr I Family Res 455 Tucker Ln Land S ,.e.~',~.~,~J~ ' Owner Total: Name: Teresa Rakowicz Addl Addr: Street: 455 Tucker Ln PO Bo~: 447 City: : Southold. NY Zip: '11971- Sale. Total: 0 Book Page Sale Date SaleP~ice Owner Exemption Total: 2 Term Own Code Amount Year Pct 41131 COMBAT VET 1.025 8 ID 41834 STAR (ENH} 1.450 2049 0 Taxable Value County: 3.075 Muni: 3.075 School: 4,100 $chl after Star: 2.650 ~1 e~l Prp~b: 1 Family Res N bhd Cd: 0 Sewer: 'V,/ate~: Utilities: Building :~,c. i.." o ,'-;oulhold uan0 Ag. 400 Total AV: 4,100 Mie,oellaeeoua Book: 2 Page: 00148 lviort ~: Bank: Acct No: 08 Land 0 o! 0 T oral: 0 Special District Total: 4 Value/ ~ mmprovemcn! Total: 0 Code Units Pct Type MoveTa~ ~TyPe Name Diml Dim2 SQFT YrBuilt FDO28 Southold FD .00 .00 .00 PK07'O Southold Park .00 .00 .00 ~, __ Specifioations Wonderfire Gas Room Heater Model 2610 Fuel: Natural Gas with NG MATRIXTM Burner 5090 Propane with LP MATRIXTM Burner 5091 Manifold pressure, NG: Min.- 2.2" Max. - 3,5" Manifold pressure, LP: Min. - 6.4" Max. - 10.0" Minimum inlet supply pressure for the purpose of input adjustment, NG ............................. 5,0" Minimum inlet supply pressure for the purpose of input adjustment, LP ............................. 11.0" Maximum inlet supply pressure: NG ......... 11.0" Maximum inlet supply pressure: LP ......... 13.0" Input, BTU/hr., NG: Min. - 24,000 Max. - 30,000 Input, BTU/hr., LP: Min.- 24,000 Max. - 30,000 Output, BTU/hr., NG ........................ 23,000 Output, BTU/hr., LP ........................ 23,000 Steady-state Efficiency ................... 76% w/optional fan ...................................... 80% Glass panel ............................. Hi-temp ceramic Weight ...................................... 400 lbs. (181 kg) Ignition .............. Standing pilot with Piezo ignition Clearances Side ......................................... 6" (150 mm) Rear .......................................... 6" (150 mm) Corner ....................................... 6" (150mm) Hearth Requirements This appliance must be installed on rigid flooring. Any carpeting or other combustible matedal under the unit must be removed. When the heater is installed directly on any combustible surface other than wood flooring, a metal or wood panel the furl width and depth of the unit must be used as a hearth. There are no other hearth requirements. AGA Design Certified to ANSI Z21.11.1b -1995 and CGA approved to CAN/CGA 2.1-M86 for Vented Room Heaters. 30" (770 mm) L~I~I~[~ (715 mm) II = 29" (740 mm) 372" (90mm)~ "_,, , ,~, r, (612~'r~m) 15" (380 mm) Rear Exit 3 72' (90mm) 20 72" (510mm) Top Exit 2374" (587 mm) II I1[I II Illl II IIII II Z © ~wO ZN~ ~--~zO%~ ~Omm ~N ~o< <~ TOWN OF SOUTHOLD BUILDINC~D}~ARTMENT TOWN HAILL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Examined ,20 Approved __ ,20__ Disapproved aJc Expiration ,20 PERMIT NO. ~ lq ~q BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planning Board approval Survey Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: Phone: ~ ~ / O(~ Building Inspector ~ cB I ~)h~ APPLICATION FOR BUILDING PERMIT Date ~v~// 20 o~ INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 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 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 al~er 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 new permit shall 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. (Signa~&e of applicant c~itame, ifa corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nameofownerofpremises 5,/;q,¢/~'/)/ ~- ~7'~?,e (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. 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 Hamlet County Tax Map No. 1000 Section Subdivision (Name) Block ff Filed Map No. 2. State existing use and occupancy of premises and intended use and occupancy of proposed constn,ction: a. Existing use and occupancy b. Intended use m~d occupancy 3. Nature of work (check which applicable): New Building__ Repair Removal Demolition 4. Estimated Cost 5. If dwelling, number of dwelling units If garage, number of cars Fee Addition Other Work Alteration (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 existing structures, if any: Front Height Number of Stories Rear Depth __ Dimensions of same structure with alterations or additions: Front Depth Height Number of Stories Rear 8. Dimensions of entire new construction: Front Height Number of Stories Rear Depth 9. Sizeoflot: Front Rear Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO 13. Will lot be re-graded? YES NO Will excess fill be removed from premises? YES NO.__ 14. Names of Owner of premises Name of Architect Name of Contractor Address Phone No. Address_ Phone No Address Phone No. 15 a. Is this property within 100 feet ora tidal wetland or a freshwater wetland? *YES NO * IF 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 ) 2m~e/qoA/f (:d~ivld3~n:~ :;'n(r:c~above namedbeing duly sw°m' dep°ses and says that (s)he is the applicant ( .... g ' g ) (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 ^ Notary Public Signatu~ of Applicant UNDA S. TAGGART Publi%~ of New York NO. 948506 OUali~d in SUffolk Cour'ty ~ ¢. p Marc, 202 .....