HomeMy WebLinkAbout33995-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
Date: 06/26/08
No: Z-33122
THIS CERTIFIES that the building GAS FIREPLACE
Location of Property: 7617
(HOUSE NO.)
county Tax Map ,No. 473889 Section 59
SOUNDVIEW AVE
(STREET)
Block 6
SOUTHOLD
(HAMLET)
Lot 14
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
JUNE 9, 2008 pursuant to which
Building Permit No. 33995-Z
dated
JUNE 19, 2008
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 A GAS FIREPLACE AS APPLIED FOR.
The certificate is issued to PAM MAINO & RICHARD JOHNSON
(OWNER)
of the aforesaid building.
N/A
SUFFOLK COUIIITY DEPARTMERT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
N/A
N/A
PLUMBERS CERTIFICATION DATED
~.
Au horize~ature
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.
33995 Z
Date JUNE
19, 2008
permission is hereby granted to:
PAM MAINO & R JOHNSON
7617 SOUNDVIEW AVE
SOUTHOLD,NY 11971
for :
INSTALLATION OF A GAS STOVE AS APPLIED FOR
at premises located at
7617 SOUNDVIEW AVE
SOUTHOLD
County Tax Map No. 473889 Section 059
Block 0006
Lot No. 014
pursuant to application dated JUNE 9, 2008 and approved by the
Building Inspector to expire on DECEMBER 19, 2009.
Fee $
200.00
4-;'/...... ~
/M~
Authorized Signature
ORIGINAL
Rev. 5/8/02
.
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TOWN OF SOUTHOLD
.BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SoutholdTown.NorthFork.uet
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
Flood Permit
Storm.Water Assessment FOfDl_
/1 ?:fJ -
PERMIT NO. )' 7~ '(:...
Examined
20(){
20C~
Contact:
Mail to:
Approved
Disapproved ale
Phone:
t'"
'1120Jt;-
..i'7 Hl r~
1.0
Expiration
/c.#
Building Inspector
r~ n
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_9
APPLICATION FOR BUILDING PERMIT
Date']U jfJ -'l
, 20.QB.
q
_-.-----....J
INSTRUCTIONS
.'q.;,':~s~plicaf n MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
sets ofp ans, - t 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 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 new permit shall be required.
APPLlCA nON IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of South old, 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 inspecti ns.
ALLCONSTRUCT!C"~'1Juk C...t ~r-""""Av,llf IJ1 "738
ME~~~~;~;~~\(1 . (~31)'11?J ?>71(qaili:1~lo)"tCi8)_.4.{,2E.
State whether applicant is owney,'I1!II's'I!~ all~nl,'~hitect, ,,)}gineer, general contractor, ~V;OOi>PrSrN@'f<ED
OWn-e...... DATE: relrrv f'" # 33'1153-
Nameofownerofpremises PCll..--eJ4I M.a.., h (,) Itl""\d ~\c..~ ~o""..,r:~:
lIN~RWRmR~\lII;,\IlX roll or latest Y BUILC;~'IC ,;Ni IME;T AT
If applicant is a corporation, signature ol'gitlY.'l.iUliol'fz\!li'OI1f~\ff\ 765-1802 8 AM TO '; DM FOr; THE
I1tQUIRED FOllOWING INSPE'TIONS'
(Name and title of corporate qlficer) , NC 1. FOUNDATION. TV. ';0 RE'Q' ":>=
. 'vur'/,,\ Y OR FOR' v ,~D
Builders License No. POURED CUCRETE
Plumbers License No. 2. ROUGH - FRAMiNG & PLUMBING
Electricians License No. . 3. INSULATION
Other Trade's License No. I;, IT~ ,;'i-T}OrJ 4. FINAL . CONSTRUCTION MUST
. . n~ f\ - BE COMPLETE FOR C.O.
1. Locallon ofland on WhlCh'Propo~€. !i ,~O~ S ION SHAll MEET THE
H"'l'let" " ,; 'r''''~'l:'''~:
Block ~DE;;'I"" loot '." J,l+ ..i trlRORS.
Filed Map No. Lot
County Tax Map No. 1000 Section
Subdivision
~Gj
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy g#"..A~~n Q I pe.-r (#ucV"II,\n.+ L~
b. Intended use and occupancy y ~ ~ VI.. , Po. y
3. Nature of work (check which applicable): New Buildin~
Repair Removal Demolition
Addition Alteration
Other Work c.;clcl. ho"l at h...n!-.
(Descnption)
4. Estimated Cost
Fee
5. If dwelling. number of dwelling units
If garage, number of cars
(To be paid on filing this application)
Number of dwelling units on each floor
6. Ifbusiness, 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 Rear
Depth Height Number of Stories
8. Dimensions of entire new construction: Front
Height Number of Stories
Rear
Depth
9. Size oflot: Front
Rear
Depth
10. Date ofpurchase
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
~...l:. 'h~ -f"Wl-CIA ? ~~I4>C+ 11~Jlb?1 bq~lU.,-d
14.NamesofOwnerofpremises::r.....""'h~ 1"lA.Jl.dltressfO~rm'"'}"dJ,,l:l'(honeNo. b?l '-11-:>' 7,"7'1
Name of Architect Address Phone No
Name of Contractor Address Phone No.
IS a. Is this property within 100 feet ofa tidal wetland or a freshwater wetland? 'YESL-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. Ifelevation at any point on property is at 10 feet or below, must provide topographical data on sUlVey_
18. Are there any covenants and restrictions with respect to this property? . YES_NO_
. IF YES. PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY OF )
being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contTact) above named. <;ONNIE D.IlUNCH
Notary PubfiCIlState of New York
(S)He is the No.01 U6185050
(Contractor. Agent, Corporate Officer. etc.) Qualtlled In sutftjlk County, 1'1
Commission Expires April 14. ZO~
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.
s~ to before me this f"I c;;.
-l+I day of CO uN 20.-\La
~~ I~ tSu I\oi-
Notary Public '
/;3 ;7~-:t:;
TOWN OF SOUTH OLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] ~LATION
[ ] FRAMING I STRAPPING [v(FINAL
[ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENEmAnON
REMARKS: l')~ ~ e.,O.
II
DATE Ohty;{8
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INSPECTOR ~Lf
,
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FIELD INSPECTION REPORT DATE I
COMMENTS
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FOUNpATION (1ST)
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FOUNDATION (2ND)
ROUGH FRAMlNG &
PrlUMBING
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INSULATION PER N. Y. f-----
STATE ENERGY CODE
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TOWN OF SOUTHOLD PROPERTY RECORD CARD
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STREET
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Lol{I~ G <t Ranieri' fft-JP
RES.;v" SEAS. VL.
, LAND
IMP.
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AGE
NEW
FARM
NORMAL
Acre
Tillable
Woodland
Meadowland
House Plot
Total
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FARM
TOTAL
DATE
BUILDING CONDITION
BELOW
ABOVE
Value Per
Acre
Value
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VILLAGE
(A TL<1.c/rf
DIST. SUB.
LOT
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ACR.
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TYPE OF BUILDING
COMM. CB. MICS. Mkt. Value
REMARKS
/i1-3 g
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l.o
FRONTAGE ON WATER
FRONTAGE ON ROAD
DEPTH
BULKHEAD
DOCK
COLOR G ','
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TRIM <-<..J H "(::
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M. Bldg. /1../ ~'1 " ~3~ \ If "-
Extension 1.1 ./ 1 Ii' c.~ J I j 76 f .)....7~ /
2} I ~
Extension
Extension
Foundotion Cl3 Both ( Dinette
Porch 9~(i? /r;.~ .;- /.... 1-' Basement Pd Floors rl Ie K.
" 7":'
Porch 'I .;J Ext. Walls Interior Finish LR.
II,) I)' 1:." S, t>. " lVj-J
Breezeway Fire Place ./1:5 Heat DR.
Garage Type Roof 0" Rooms 1 st FI oor BR.
".)c e.
Patio Recreation Room Rooms 2nd Floor FIN. B
O. B. Dormer , Driveway
Total .n... J' JI /
ASHWOOD STOVE & FIREPLACE CO. INC.
1075-7 PORTION ROAD
FARNUNGVILLE,NYI1738
P-631-716-2949 F-631-716-2942
SERVICE DEPT. 631-563-1011
E.mail: ashwoodmail(al.aol.com
Wood & Gas stoves. Cultured Stone. Marble & Mantels. BBO Parts. Custom BBO Islands. Gas Serv;ee Denartment
Pam Johnson
3 Duke Ct
Farmingville, NY 11738
Re: Southold Home
June 5tb, 2008
Dear Ms. Johnson
This letter is for the purpose of stating that Ashwood Stove & Fireplace supplied the
thermostatically controlled gas furnace at 7617 Soundview Ave, in Southold NY 11971. It was
installed by a licensed contractor in November of 2007.
Attached is information concerning The IDV490 insert by Monessen. At 40,000 BTUS and a
thermal efficiency of 80%, the insert has the capacity to heat an open area up to 1500 square
feet. I hope this information is useful.
Regards,
Q)~
--
Brian Dutton
Ashwood Stove & Fireplace Co. Inc.
ASHWOOD STOVE & FIREPLACE CO. INC.
1075-7 PORTION ROAD
FARMINGVILLE, NY 11738
P-631-716-2949 F-631-716-2942
SERVICE DEPT. 631-563-1011
E.mail: ashwoodmailra2aol.com
Wood & Gas stoves. Cultured Stone. Marble & Mantels. BBO Parts. Custom BBO Islands. Gas Service Denartment
Pam Johnson
3 Duke Ct
Farmingville, NY 11738
Re: Southold Home 7 b I 7 S ~ 'oJ, .fI.vJ
June 51b, 2008
Dear Ms. Johnson
Attached is information concerning The IDV490 insert by Monessen. At 40,000 BTUS and a
thermal efficiency of 80%, the insert has the capacity to heat an open area up to 1500 square
feet. I hope this information is useful.
Regards,
C75~
Brian Dutton
Ashwood Stove & Fireplace Co. Inc.
PRODUCT FEATURES AND CODE APPROVAL
PRODUCT SPECIFICATIONS
. This appliance has been
certified for use with either
natural or propane gas. See
appropriate data plates.
. This appliance is not for use
with solid fuels.
. The appliance is approved
for bedroom or bedsilling
room installations.
. The appliance must be
installed in accordance with
local codes if any. If none
exist use the current instal-
lation code. ANSI Z223.1I
NFPA 54 in the USA, CAN/
CGA B 149 in Canada.
. The appliance must be prop-
erly connected to a venting
system.
This appliance may be installed
inanaftennarker,pennanenUy
located, manufactured
home, where not prohibited
by local codes.
Hi/Lo Knob
Off/Pilot/On Knob
Gas
Shutoff
Valve
/
On/Off/
Remote Switch
. Aftennorket: Completion of sale, not for
purpose of resale, from the manufacturer.
Figure 1 - lOV490NV, lOV490PV, lOV380NV, and l0V380PV Inserts
The efficiency rating of this appliance is a product thermal efficiency rating determined under continuous operating condi-
tions and was determined independently of any installed system.
Thermal Efficiency = up to 80%
CODE APPROVAL
These appliances have been tested by CSA and found to comply with the established standards for VENTED GAS ARE-
PLACE HEATERS in the USA and Canada as follows:
LISTED VENTED GAS FIREPLACE HEATER
TESTED TO: ANSI Z21.88-2002/CSA 2.33-2002 STANDARDS
ATTENTION MASSACHUSETTS RESIDENTS:
This product must be installed by a licensed gas filler.
5700016
5
PRE-INSTALLATION INFORMATION
INSTALLING ABOVE 2000 FEET
. In the USA, the appliance must be derated 4% for every 1,000 ft above 2,000 ft elevations.
. In Canada, these appliances are certified for altitudes of 0 - 2000 ft, and must be de-rated by 10 percent for installations
between 2000 and 4,500 ft. (derate an additional 4% for every 1,000 ft. above 4,500 ft. elevations).
ORIFICE SIZES, PRESSURES AND BTUs
NATURAL GAS PROPANE GAS
Manifold Press: (W.c.) 3.5" Manifold Press: (W.c.) 10"
Maximum Supply Pressure lOS' Maximum Supply Pressure 13"
Minimum Supply Pressure 4.5" Minimum Supply Pressure II"
Model Number IDV490NV IDV490PV IDV380NV IDV380PV
NATURAL PROPANE NATURAL PROPANE
Max. Btulhr Input 40,000 37,500 30,500 28,000
Min. Btulhr Input 26,500 29,000 20,500 22,000
Orifice sizes (as shipped) #30 #50 #32 #51
The IDV490NV, IDV490PV, IDV380NV, and 380IDVPV are equipped with a variable output gas control.
NOTE: lOV490NV, l0V490PV, l0V380NV, and lOV380PV inserls work without any electrical supply.
Slower must be attached to 110/120 VAC.
INSTAllATION PLANNING
Plan for the installation of your insert. This includes determining the size of fireplace in which unit is to be installed, length of
venting to be used, and finishing details, and whether any optional accessories (i.e. wall switch, or remote control) are desired.
Consult your local building code agency to ensure compliance with local codes, including permits and inspections.
6
57D0016
FORM NO. 4
TOWN OF SOUTllOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
NO: Z-
32421
Date: 06/21/07
THIS CERTIFIES that the building
DWELLING
County Tax Map lIIo.
SOUTHOLD
(HAMLET)
Lot 014
Location of Property
7617
(HOUSE NO.)
473889 Section 059
SOUNDVIBW AVE
(STREET)
Block 0006
SUbdivision
Filed Map No.
Lot No.
conforms substantially to the Requirements for a ONE FAMILY DWELLING
built prior to APRIL 9, 1957 pursuant to which CJmTIFlCATB OF
OCCUPANCY IIlOMIlBR z-
32421 dated JUNE
21, 2007
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
SEASONAL ONE FAMILY DWELLING>
The certificate is issued to LOUIS G & ALICE RANIBRI
(OWNER)
of the aforesaid building.
SllFFOLIt COIJBTY DBPAR'DIBIIlT OF BBALTII APPROVAL
Ill/A
ELECTRICAL CJmTIFlCATB Il1O.
N/A
PLUMBERS CBRTIFlCATION DATED
N/A
.PLEASE SEB ATTACHED INSPECTION REPORT.
~~~-
uthorized Signature
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LQCATI.OB :
7617 SOUNDVIEW AVE
SOUTHOLD
SOBDrvISlaf :
MAP JIO. :
rDr(S)_
MNKB OF ONKBR (8): LOUIS G & ALICE RANIERI
QCCUPAJrCY: ONE FAMILY DWELLING (SEASONAL) LOUIS G " ALICE RANIBRI
AmII'l"J'BD BY: JOY LEO ACCaIPAIIIBD BY:
BY AUV.a.'IIT.Iil:
SIJPlI'. CO. DZ MAP m.; 59.-6-14
SCJORCB OP RBQOBS'I': ALICE RANIBRE 6/18/07
DA'I'B; 06/21/07
DWELLING:
TYPE OF CC88"l'1mCTI0II:
WOOD PRAMS
. S'l'OIUKS I ...l..:..Q. . grrs: -l.
PODIIDATIar s CEMENT BLOCK
CBLL1tR: CRAIIL SPACK:
'J.'O"J'AL 1lomIS: 1ST PLR.; ....!
2IID FloR.: ~ ]1lD PLR.: ....Q
BA'l'IIIlOOM (S), -LJ!
'l'OILBT ROClII (S), ---LJ!
U'1'ILITY ~(S) I
PORCH TYPK: SCREENED
DBCK T!PK:
PATIO TYPB:
aD~:
PIIIBPLACB ,
YES
GIWlGB,
IXMBSTIC BO'I"D.TBIl:
TYPB BB&'l'BR:
Al:RaBlDITIOIIDIG:
TYPB IIBAT: NONE
_ AIJl.
1IO'l'lIllDIl'
YES
O'DIBR.: CELLAR ENTRANCE. HOT WATER HEATER
ACCESSORY STRUCTURES:
GAIUWDI. TYPB OF CCIrS"J'. =
S'l'OltAGB. 'IYPB cors'I'.;
~-".UIIU-.:i POOL:
GUBS'J'. TYJIB camrr.:
0l'IIBR ,
VIOLATIONS: CHAPTER 45 N.Y, STATE UNIFORM PIRE PRBVENTION '" BUILDING CODE
LOCATION
DESCRIPTION
ART.
SEC.
lUEIIaD..a:
msPBaBD BY, 1::1: ~
GBORGB LLIlII
DraB c:. IBSPBCTI08: 06/14 / 07
TDIB SDIlT:
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