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HomeMy WebLinkAbout34172-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~RTMENT office of the Building Inspector Town Eall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33410 ~te: 11/25/08 THIS CERTIFIES that the building WOOD STOVE Location of Property: 1900 PINE NECK RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) Co%k~ty Tax Map NO. 473889 Section 70 Block 9 Lot 3 subdivision Piled Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 17, 2008 pursuant to which Building Permit No. 34172-Z dated SEPTEMBER 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 WOOD STOVE IN AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to THOMAS F PASSANANT & GIORGI ALYCE (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF H]~ALTH APPROVAL ELB~-r~IC2%L C~-rIFICATH NO. PL~ C~ERTIFIC3%TION DATHD N/A N/A Rev. 1/81 " ' ~ 765 1802 ~_._~.~?~_~£~_~'I]~LI~TION 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 naturalor topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal ($-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. 8ubmit Plarafing Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) nou-conforming uses, or buildiugs aud "pre-existing" land uses: 1. Accurate survey of propel%,' showing all property lines, streets, building and uuusual natural or topographic features. 2. A properly completed applicatioa aod consent lo respect sigmed by the applicant. Ifa Certificate of Occupmcy is ~ denied, the Building Inspector shall state the reaso~s Iherefor in writing to the apl~licant. C. Fees ' 1. Celtificate of Occupancy - New dwelling $25.00, Additions to dwelling .$25.00, Alterations to dwelling $25.00, Switmning pool $25.00, Accessory huddling $25.00, Additions to accessot~ building $25.00, Businesses $50.00 2. Ce~xificate of Occupancy on Pre~existing Building - $100.00 3. Copy of Ce~ificate of Occupancy - $.25 4. Updated Ce~ificate of Occupancy ~ $5000 5. Temporary Certificate of Occupancy - Residential $15 00, Conmaercial $15.00 New Coustm~tion: __ Old or Pre-existing Building: Loeation of Property: ~Z(.q'OO t~dJ't/¢--,,o~c ,,U ~__~ House No. Street Suffolk C;unty'r mp No 000, S tiou_ 0.7 tO _ Subdivision Permit No Health Dept. Approval: Plalming Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~_~". ~ Dale of Pemait. Date. ~ - (check one) Hamlet Filed Map. Lot: Applicant: Underwriters Approval: Final Certificate: ~ _ (check one) pplican~-~~ 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. 34172 Z Date SEPTEMBER 19, 2008 Permission is hereby granted to: THOMAS F PASSANANT 1900 PINE NECK RD SOUTHOLD,NY 11971 for : INSTALLATION,PER MANUFACTURES,SPECS OF AN INTERIOR WOOD BURNING STOVE AS APPLIED FOR. at premises located at 1900 PINE NECK RD SOUTHOLD County Tax Map No. 473889 Section 070 Block 0009 Lot No. 003 pursuant to application dated SEPTEMBER 17, 2008 and approved by the Building Inspector to expire on MARCH 19, 2010. Fee $ 200.00 Authorized Signature ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined q hc~ , 200~ Approved O~ ltq ,200~ Disapproved a/c Expiration PERMIT NO..~q[ 7~ Building Inspector 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 Pemait Storm-Water Assessment Form Contact: Mail to .'~O.n,~q2 APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS ,20 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 cowanenced 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 tlu'oughout 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. 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 nX~e, if a corporation) (Mailing ~td&ess of applicant)//f.~j State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises .~. o,~$ ~{~ ~.~ ~$ c,~. e.v ,~ (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 Location of land on which proposed work will be done: ~I6u~e Number Street Hamlet County Tax Map No. 1000 Subdivision Section d/'?30°oOff :. Block:70o - 2 Lot- ~ ";i .~;'~i. Eiled Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ,/ ~',-"-'-'-':~,//), ~e ~ .,o//-,, ~. b. Intended use and 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 Alteration Other Work~'~// c.~,,,o,/ ~'3,.,,-....,..~,--~-/-'o,,~ (Description)'---J (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. Size of lot: 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 premise's///a~x?~'(~..//.~Xl/R,c~'Address//7o~,/7;',~ t-~,~,¢ _/"~,,~_, Phone No. Nme of Architect Address Phone No N~eofContracto~.~,,~ ~,,~'=o Address~o~. /2¢ PhoneNo. 15 a. Is this prepay within 100 feet of a tidal wetl~d or a ~eshwater wetl~d? *YES__NO * IF YES, SOUTHOLD TO~ TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this prope~y within 300 feet of a tidal wetland? * YES~ * 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. 18. Are there any covenants and restrictions with respect to this property? * YES · IF YES, PROVIDE A COPY. NO j STATE OF NEW YORK) COUNTY OF..~-f~/X~S: O,~ O-~a ~"'/~dd/';,,~,-~,-,,;"" being duly sworn, deposes and says that (s)he is the applicant '(Name of individual ~ignJng contract) above named, (S)He is the t/)~./..., .,,,-, (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. Sworn to before me thjt% ~'~~~~ /(j~ day of ,.~2~ 20 ~ Notary ~N]~?~ Y0~ ~ignature o f ~.l~pl]cant Qualified hi Su(qlilk ~ ~, _ 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] [ ] FRAMING / STRAPPING [ ~,,,]'~FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION I 1 ,IRE,~S,ST~ C0.ST.~0. I 3 Frae RF.S,STA.T P~.~TRAT~0N REMARKS: f/~~ ~ DATE /~~,/~///~ ~ INSPECTOR ~~ ?ml,D INSPECTION REPORT I DATE [ FOUNDATION {1ST) FOUNDATION (2ND) ROUGH FI~4aM~I~G & pLt~I]BING ENSL-LATION PEiR N.Y. -- STATE ENERGY CODE FFqAi, ADDITIONAL FiLE NO. .'~, ~.7 PAGE To order this item online visit: www.northemtool.com and enter Item# 158976 I Print this oaoe } Back to aroduct aaQe NORTHERN® TOOL 4- EQUIPMENT Drolet Wood Stove -- 95,000 BTU, Model# HT2000 OCCUPANCY OR deE IS UNLAWFUL i iTHOUT CERTIFICATE -"- OCCUPANCY Description Extra-large stove heats up to 2700 sq. fi, Boasts 5/16in. steel plate on top, Firebox is lined with firebricks and has a king-sized ash drawer. Will accept logs up to 19in, long, Heavy-duty cast iron door has adjustable handle. SIng~e easy-to-operate air control. Optional biower available I~n~ 1589681 (sold separately). BTU rating is related to seasoned cord wood, the more common fuel burned in this stove. Key Specs s BTU Output: 90,000 · Heating Capability (sq. ft.): 2,700 · Blower ~ncluded: No · Blower {CFM): N/A · Blower Power Supply (Volts, Amps): N/A · Heat Settings: I ,- · Fuet Type: Wood · Igniter: Manual · Thermostat Included: No · Door Opening W x H (in.): 17 3/4 x 9 · Firebox Size W x D (in.): 22 1/2 x 18 s Flue Collar Size (in,): 6 ..... · Max. Log Size Accepted (L in,): 19 · EPA Exempt: No · Dimensions L x W x H (in.): 30 x 29 1/4 x 34 COMPLY W~TH ALL CODES OF NEW YORk~ ~"ATE & TOWN CODES AS REQUI~E:; .A~D CONDITIONS OF _ SOL%IOLD TOWN ZBA ........ S3~JTHOLD TOWN FL~NNI~ 8Ok, D SOUTHOLD TOWN TRUSTEES N,Y.S, DEC Genoret Specs In Stock Ship Wt. 503.0 lbs, Iterm~ 158976 Discount Price $1099.99 Available Accessories For: Drolet Wood Stove -- 65,000 BTU, Model# HT2000 1,~=440 MEECO'S RED DEVIL Chimney Brush -- 6in. Round, 1/4tn. NPT, Modem 30600 177445 HY.C Company Floor Protector/Wall Shield -- Black 177444 HY-C Cornpeny Floor Protector/Wall Shield -- Bdck Pattern 177445 HY-C Company Floor Protector/Wall Shield -- Walnut Woodgrain 173617 Vogelzang 5-Pc. Ail-Black Ftreset, Model# BL20T 173615 Vogeizang 3-Qt. Teakeftle, Model# TK-02 17~l~1~ Vogelzang Ash Can and Shovel Kit, Model# 1508 1750i~:~ Meecos Red Devil Multifuel Firelighting Pellet~ 1 [~,43 Meeco Red Devil Glass Dear Cleaner-- 16-Oz. Model~ 701C 173623 Ecofan Airplus Heat-Powered Fan for Wood Stoves, Model~ 802CA-KBX 1~.46 MEECO'S RED DEVIL Pipe Deflector-- l-Pc., 38in. L, ModeY~ DEFL-1PC APPROVED AS NOTED DATE: ~i I~ct I c:~_ ~.p. ¢r=¢~//7 ~ NOTIFY BUILDI;~O ¢::?.RTMENT AT 765-1802 8AM ~'~) 4::,t FOR THE 1. FO~,.~OA,ION TWO REQUIRED FOR POURED CO;4CRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONST,~CTION MUST BE COMPLETE F~R C.C. ALL CONSTRUCTION SHALL ME~ THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. I of 2 8/29/2008 12:51 I Customer Service: 1-800-222-5381 (8-5 CST M-F) F./'nall Technical Support: HalQno~themtool.com Retail store Iocetor: www.no~hemstofes.com 2800 Southcross Drive West Bumsvllle, Minnesota 55337 Phone: 952-894-9510 ~. of 2 8/29/2008 12:51 PM Tow n o_f Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF ~ Item N umber: PROP TY LOCATION: S.C.T.M. #: strict Section Block Lot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW (NOTE: A Check Mark(~)for each Question is Required ¢or a Complete Applicatij)n}/'V~///~ ~- -- --Y~es .o 7 ........................ .s y ' leadn9 and/or construction activities as we as all S e -- Improvements and the permanent creation of impervious surfaces,) 2 Does the Site Plan and/or Survey Show All Proposed Drainage S~ructures Indicating Size & Location? This Item shall include all Proposed Grade Changes and Slopes Controlling Surface WaterFIow! -- 3 Will this Project Require any Land Filling, Grading or Excavation where there is a change to the Natural r~ Existing Grade Involving more than 200 Cubic Yards of Matedal within any Parcel? -- 4 Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five Thousand (5,000) Square Feet of Ground Surface? __ 5 Is there a Nalural Water Course Running through the Site? E~ Is this Project within the Trustees jurisdiction or within One Hundred (100') feet cfa We land or Beach'~ -- 6 Will there be Site preparation on Ex[sling Grade Slopes which Exceed Fifteen (15) feet of Vedical Rise to E~ One Hundred (I00') of Horizontal Dislance? __ 7 Will Driveways, Parking Areas or other impervious Surfaces be Sloped to Direct Storm Water Run-Off into and/or in the direction of a Town right-of way? __ 8 Will this Projoct Require flle Place entoittaterial, RemovalofVege~ation and/or the ConstFucfion of any Item Within the Town Right-of-Way or Road Shoulder Area? -- (This item will NOT include the Installation of Driveway Aprons.) 9 Will this Project Require Site Preparation wilhirl the One Hundred (100) Year Floodplain of any Watercourse? E~ -- NOTE: If Any Answer to Questions One through Nine is Answered with a Check Mark in the Box, aStorm.Water, Grading, Drainage & Erosion 6ontrol Plan is Required and Must be Submitted for Review Prior to Issuance of Any Building Permit! EXEMPTION: Ye~s N~o Does Ihis project meet the minimum standards for classi~ca on as an Agdcuftural Project? Note: If You Answered Yes to this Question, aStorm-Water, Grading, Drainage&ErosionControiPan s NOT RequiredI STATE OF NE\Y YOP, K. ~(l that he/she i* fl~c .... O~.~,~.~ ..... . ........................................................ (Owner Con ac o , Agent Corporale O~icer, otc } Owllel- and/ol representative of the Owller of Owner's, atd is duly authorized to l)erforlll or have perk)rmed file s~d work alqd Io tm~e m~(t file this application; fl~at idl smtemen~ confined in d~is applicaOon are ~e to t]ae best of his ~owledge ired heliefi and flaat tim work will he perlbrlned m fl~e rammer set forfl~ in the application fi]ed herewifl~. Sworn to befcme me d~is: .................... Z..O .............. ...................