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Home My WebLink About34295-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33463 ~te: 12/23/08 THIS CERTIFIES that the building WOOD STOVE Location of Property: 2745 WICKHAM AVE MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 139 Block 2 Lot 3 Subdivision Filed }{ap No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 7, 2008 pursuant to which Building Permit No. 34295-Z dated NOVEMBER 13, 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 DAVID P SCHULTZ (OWNER) of the aforesaid building. S~]]~OI=~ C~)L~l"f DEP~/~q~4EI~T OF }~ALTH APPROV2%L ELEC~RIC~%L C~TIFICA~ NO. PL~ C~TIFIC3%TION DA'r~u N/A N/A N/A Rev. 1/81 Et .1[i : TOWN OF SOVTHOLD , ',; II ~, Ii BUILDING DEPARTMENT 2 2 2008 765-1802 / ~_~ DEPT / ~ ....TQ_WN O ~_F S '~0~ O ~PPLICATION FOR CERTIFICATE OF OCCUP~CY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: Ao 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. 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. If a 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, Commercial $15.00 New Construction: Old or Pre-existing Building: V~ (check one) LocationofProperty: ~-.'795 /~t16/C'~4'~7 t~d'~r2g4te House No. Street Hamlet Owner or Owners ofProperty: ~t::/~/d ~ ~,171~-~ Suffolk County Tax Map No 1000, Section ! B a] Block 0 Subdivision Filed Map. Lot: eermitNo. ~Z~5 Z DateofPermit. //,//~/~7~ Applicant: .~ld/'l~/t~,&/vtt/2 Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ 2~t 0O Final Certificate: (check one) [/'"'--Applicant Sign~ature FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL COMPLETION OF THE WORK AUTHORIZED) FULL PERMIT NO. 34295 Z Date NOVEMBER 13, 2008 Permission is hereby granted to: DAVID P SCHULTZ PO BOX 624 MATTITUCK,NY 11952 for : INSTALLJtTION OF A WOOD STOVE PER MANUFACTURE'S SPECS TO EXISTING SFD AS APPLIED FOR. at premises located at County Tax Map No. 473889 Section 139 pursuant to application dated NOVEMBER Building Inspector to expire on MAY 2745 WICKFIAM AVE MATTITUCK Block 0002 Lot No. 003 7, 2008 and approved by the 13, 2010. Fee $ 200.00 /'-- Authorized Signature ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY REMARKS: [ ] ROUGH PLBG. [ ] INSULATION ~FINAL ] FIRE SAFETY INSPECTION ] FIRE RESISTANT CONSTRUCTIO~E~/c~O.~ RESISTANT~..,,PENETRATION FOLrNI)ATION (1ST) FOU1WDATION (2ND) ROUG~ F~G & PL~G ~S~ATION PER N. Y. STATE ENERGY CODE TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined I * I I .5 ,20 0~5 Approved I t I I ~ ,20 O~ Disapproved a/c Expiration 2.~ ~ I ~ ,20 l O PERMIT NO. ~4~ 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 Flood Permit Storm-Water Assessment Form ~LDG. DEPT. TOWN OF Contact: Mail to: Building Inspector APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS 7,20 08 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 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. OCCUPANCY OR ALL CONSTRUCTION SHALL I I,ql:;:: I.q HKI/fiWI:'///(Signa~urd of applicant oran]e, ifa corporation) MEET THE REQU;REMENTS OF THE ".~._- '"' '-"'~.,,,,-,-,,- 27?',5' CODES OF NEW YORK STATE. W THOUT CERTIFICAC E vx OF OCCUPANCY State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electr/c'ian, plumber or builder Nameofownerofpremises ~,~W/g~/ ~ ~&~~ DATE: /7//~/~ B.p.~?/~¢'5~ (As on the t~ roll or lat~deed~dP: ,O0 BY: ~ '~ If applicant is a co~oration, si~ature of duly authorized officer NOTIFY BUILDING DEPARTMENT AT (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 propoged work will be done: House Number Street County Tax Map No. 1000 Section /~ Block ,, ,2<..~_ . Subdivision Filed~q~ No. 765-1802 8AM TO 4PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO rtEQUiRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3.INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE ,/~ ~pI~.ME~N~,~ OFTHE CODES OF NEW ~i'II~Iil~JM~ZT~::NOT RESPONSIBLE FOR H[i~,.~I~N OR CONSTRUCTION ERRORS. Lot '~ ' "~:'~ Lot ¸.3 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~rd~///r"J,..~ b. Intended use and occupancy ~t~f/-3 / ~"/-~F~/)~ 3. Nature of work (check which applicable): New Building Repair Removal Estimated Cost If dwelling, number of dwelling units If garage, number of cars Demolition Fee Addition Alt, e, ration Other Work ,t:t~t~tl ~l e, t' (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 8. Dimensions of entire new construction: Front Rear 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 Address Phone No. Name of Architect , ,~A, ddress Phone No Name of Contractor //~4~ ,~t~ Y't~,~lress ,~ ~'O~ /~t~-~tPhone No. 7~ 15 a. Is this property within 100 feet of a 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 ora 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. 18. Are there any covenants and restrictions with respect to this property. YES * IF YES, PROVIDE A COPY. NO STATE OF NEW YORK) COUNTY OF~S: ~Vld ~ (l.Sc~t.~!/~- being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the ~ (gl//) ~'//~ (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.~o before me th$ ! , ' No/a-- ~''blic ' "- r~ie ~0.~ ~ax y~u ~t~Y PUBLIC, State of N~ No. 01D04634870 Qualified in Suffolk C0u~ ~ ~ ~/tl ~~~ ~acan Signature of t TOWN OF SOUTHOLD PROPERTY RE(:ORD CARD OWNER STREET '~'7 fl~' VILLAGE DIST SUB. LOT ACR. J RES. RI~ SEAS. VL FARM COMM. CB. MISC. Mkt. Value LAND IMP. TOTAL DATE REMARKS AGE BUILDING CONDITION NE~/ NORMAL BELOW ABOVE FAJM Acre Value Per Volue Acre Tilloble Tillable 2 Tillable 3 Swampland FRONTAGE ON WATER Brushland FRONTAGE ON ROAD House Plot DEPTH q"~' ~ ~ ~ BULKHEAD Total DOCK · f /V~ Bldg. Extension Extension ~ Extension ~orch i~terch Foundation ~_~/~:;~. Bath / Dinette Basement ~:~'~ Floors K. .~o7 Ext. Walls Fire Place Type Roof Recreation Room Dormer Driveway i~Garage ~Pat~o Total /8' o Interior Finish LR. Heat Rooms 1st Floor Rooms 2nd Floor I Me( }ntpelier ;dium Insert Homeowner's Installation and Operating Manual For Use in North America SAFETY NOTICE: IF THIS APPLIANCE IS NOT PROPERLY INSTALLED, OPERATED AND MAIN- TAINED, A HOUSE FIRE MAY RESULT. TO REDUCE THE RISK OF FIRE, FOLLOW THE INSTALLATION INSTRUCTIONS. FAILURE TO FOLLOW INSTRUCTIONS MAY RESULT IN PROPERTY DAMAGE, BODILY INJURY OR EVEN DEATH. CONTACT LOCAL BUILDING OFFICIALS ABOUT RESTRICTIONS AND INSTALLATION INSPECTION REQUIREMENTS IN YOUR AREA. NATIONAL We recommend that our woodburning FIREPLACE hearth products be nsta ed and serviced INSTITUTE' Hby professionals who are aertilied in the U.~ by the National Fireplace Institute® (NFl)as NFl Woodburning Specialists or who are certified in Canada by r,-e.n-.~cn Wood Energy Technical ,~i,~,~.~ Training (WETT). ~.~ 30004403 7108 Rev. 4 Montpelier Medium Insert Thank you for purchasing a Vermont Castings Montpelier Medium Insert, an efficient wood stove carefully engineered to bring you the latest in wood combustion principles and modern foundry technology. This stove transforms a traditional masonry fireplace into a powerful heater. You can count on years of comfortable heating and pleasurable fire-viewing if you operate and maintain it according to the directions in this Owner's Guide. This Insert has been tested and listed by OMNI-Test Laboratories of Portland, Oregon to ANSI/UL 1482 for the United States and ULC S628 for Canada. This Insert is listed to, and in compliance with, the standards set forth by the Federal Environmental Protection Agency, 40 CFR Part 60.532(b), as stated on the permanent label attached to the stove. This manual describes the installation and operation of this Insert. This heater meets the U.S. Environmental Protec- tion Agency's emission limits for wood heaters sold after July 1, 1990. Under specific test conditions this heater has been shown to deliver heat at a rate ranging from 10,100 to 27,550 BTU/hr. For more complete details on stove performance and specifications, please refer to Page 3. The Montpelier Medium Insert is designed, tested and listed for burning wood. Do not burn other fuels. installation or service of the Montpelier Medium Insert should be performed only by a qualified installer, preferably NFl or WETT (Canada) certified. Please read entire manual before you install and use your new Insert. Failure to follow these instructions may result in property damage, bodily injury or even death. Save These Instructions for Future Reference Specifications ........................................................ 3 Installation ........................................................... 4 Operation ................................................................ 9 Maintenance ........................................................ 13 Optional Accessories ........................................... 16 Replacement Parts .............................................. 17 Warranty ............................................................. 19 The Montpelier Medium Insert is designed, tested and listed for burning wood. Do not burn other fuels. The Montpelier Medium Insert is not listed for mobile home installations. Failure to follow these instructions may result in property damage, bodily injury or even death. Proposition 65 Warning: Fuels used in gas, wood- burning or oil fired appliances, and the products of combustion of such fuels, contain chemicals known to the State of California to cause cancer, birth de- fects and other reproductive harm. California Health & Safety Code Sec. 25249.6 This stove has not been tested with an unvented gas log set. To reduce the risk of fire or injury, do not install an unvented gas log set into this fireplace. 2 30004403 Montpelier Medium Insert Montpelier Medium Insert EPA Emissions Rating ...................................... 3.0 g/hr Range of heat output*. ......... 10,100 - 27,550 BTU/hr Maximum heat output**. ...................... 50,000 BTU/hr Area heated***. ......................................... 1,500 sq. ft. Size of wood splits .................... 18"-22" (460 - 560 mm) Fuel Capacity ....................................... 30lbs. (13.5kg) Loading ................................................................ Front Flue size ..................................................... 6" (150mm) Fireplace Insert weight ....................... 335 lbs. (152 kg) Primary Air Control ............................................ Manual Glass panel ......................... High4emperature ceramic Flue exit position ..................................................... Top Blower rating ............................ 150 cfm. (115V, 60Hz) *Under specific test conditions used during EPA emis- sions standard testing. **This value can vary depending on how the unit is operated, and the type and moisture content of the fuel used. The figure shown is based on maximum fuel con- sumption obtained under laboratory conditions and with average efficiencies. ***These values are based on operation in building- code conforming homes under typical winter climate conditions in New England. If your home is of nonstan- dard construction (e.g. unusually well insulated, not in- sulated, built underground, etc.) or if you live in a more severe or more temperate climate, these figures amy not apply. Since so many variables affect performance, consult your Vermont Castings' Authorized Dealer to determine realistic expectations for your home. 263/4" (680 mm) 22V4" (564 mm) ~ 14Y, r (362 mm) > 3072" (774 mm) 283A'' (730 mm) Fig. 1 Montpelier Medium Insed dimensions. 22V,~" mm) 71/¢ (434 mm) , ' . (548 mm) 30O04403 3 Montpelier Medium Insert Installing the Montpelier Medium Insert into an existing masonry fireplace is an effective way to add an efficient heater to your home. The existing fireplace and chim- ney must meet certain requirements. The Montpelier Medium Insert is listed for installation within a properly built masonry or heat circulating, ma- sonry-type fireplace that is constructed in accordance with the requirements of recognized building codes. A heat-circulating masonry-type fireplace must conform to building code standards for masonry fireplaces, and must consist of a factory-built metal firebox with air circulation pathways that are surrounded by masonry materials. Air circulation pathways must not be blocked by the insert or surround panels. The fireplace and chimney must be clean and structur- ally sound. Have them inspected by a qualified profes- sional chimney sweep, a mason, or your Vermont Cast- ings' Authorized Dealer before the Montpelier Medium Insert is installed. Any deterioration (cracks, loose mortar or loose bricks) must be repaired. Codes may permit removal of the damper in order to make a positive vent connection between the firebox and the chimney. However, the fireplace should not be modified in any way without first checking with your lo- cci building inspector or fire marshal. Provision should be made to restore the fireplace to its original condition if the insert is removed. Do not remove bricks or mortar that may jeopardize the compliance of the fireplace with local building codes. The Montpelier Medium Insert is not listed for in- stallation in factory-built fireplaces. Chimney requirements differ for the U.S. and Canada. Specifications for each are listed below. Connect the insert to the chimney in accordance with local codes and the requirements of the listing agency as specified in this manual. Chimney height should be no less than 15' (4.5 m) above the hearth and no more than 35' (10.5 m). The chimney should extend at least 3' (914 mm) above the highest point where it passes through a roof, and at least 2' (610 mm) higher than any portion of a building within 10' (3 m). (Fig. 2) 4 0 TolO' 0 TolO' .. Point -- AC617 Fig. 2 The 2'-3'-10' rule for chimneys. DO not connect your Montpelier Medium insert to a chimney flue serving another appliance. In the U.S. (ANSI/NFPA 211, 1988), when installed in a masonry fireplace: · Aconnector must extend from the flue collar to the flue liner. If a stainless steel liner is not used, the connec- tor must extend at least four (4) feet from the flue collar of the insert.* · The cross sectional area of the flue must be less than or equal to three times the area of the flue collar. If larger, the chimney must be re-lined. · Means must be provided to prevent room air passing to the chimney cavity. · Provision must be made for removal of the insert to clean the chimney flue. · While not required in most jurisdictions in the U.S., MHSC strongly recommends that a full stainless steel chimney liner be installed for the insert to the chimney top to increase overall per- formance and to ease and reduce yeady mainte- nance. · A masonry chimney must be well-constructed and must meet minimum code requirements. The chimney flue should have a code-aoDroved liner made of masonry or pre-cast refracton¢ tiles, straight or flexible stainless steel pipe, or a poured-in-place liner. An unlined chimney must be relined professionally. · The chimney must have a nominal flue size of 6" (152 mm) diameter or 28 square inches (181 cm2) but no greater than 3 times larger or 85 square inches (548 cm2). Achimney larger than this must be re-lined. This requirement is in addition to those specified in ANSI/NFPA211. 30004403