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HomeMy WebLinkAbout34526-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~=RTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: z-33677 Date: 04/28/09 THIS CERTIFIES that the building WOOD STOVE Location of Property: 365 JASMINE LA SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) Co%unty Tax Map NO. 473889 Section 70 Block 1 Lot 6.3 subdivision Filed Map No. Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 20, 2009 pursuant to which Building PeI~nit No. 34526-Z dated MJ~RCH 24, 2009 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 INSTALLED IN AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to PAUL & LINDA ZENESKI (OWNER) of the aforesaid building. SUFFOLK COUNtrY DEPART~NT OF HEALTH APPRO~ ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DA'rF~3 N/A N/A N/A tth~r'/ed~S'Sig~ature Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD 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 t A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, topographic featureg. 2. Final Approval from Health Dept. of water supply and sowerage-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 coropleted site plan reqmrements. 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 cempleted application and consent to iuspect 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, Additioro to dwelllng $25.00, Alterations to dwelling $25.00, Swiroroing 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 Ce~ificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. New Constmcti°n: Location of Property: House No. Street Owner or Owners of Property: ?~/ ~ ~ Suffolk County Tax Map No 1000, Section "~ O Subdivision Old or Pre-exis~ing Building: (check one) Permit No. 51'~ ~2/.~'7-.- Date of Permit. Health Dept. Approval: Block Filed Map. Applicant: Underwriters Approval: Hamlet Lot ~,~__~ Lot: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~ Final Certificate: (check one) App~cant ~gnature TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ] INS~ATION [//~NAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: .P~h.A__- ×~/-~-~(h DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ] ROUGH PLBG. [ ] INSULATION [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] F. IR~E RESIS~ANT~CONSTRUCTION [ ] FIRE RESISTANT PENETRATION DATE INSPECTOR>~~~'/ FOUNDATION (1ST) FOUNDATION (2ND) ~-~' PLUMBING INSULATION PER N. Y. STATE ENERGY CODE .~L~~ 1 ~DITION~ COmNTS TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined ,.ff t-5~ ~ 20 D~ Approved 3 {°q~{ ,20df~ Disapproved a/c Expiration q /~(-{ ,2010 PERMIT NO. 07/-~ 5['~ ~' MAR 2 0 81.11ti. I~tH. 10~10F $0Ullt01~ 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 Permit Storm-Water Assessment Form Contact: Mail to: Phone: APPLICATION FOR BUILDING PERMIT 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 water~vays. 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 s[all 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. (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 /~-~ ~ ~ (_...~ ~ ~--~'~ ~L4~ (As on the tax roll or4atest 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. Location o~f. land on which proposed work will be done: House Number Street County Tax Map No. 1000 Section ~)' Block Subdivision Hamlet ~' 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 Repair Removal 4. Estimated Cost 5. If dwelling, number of dwelling units If garage, number of cars 6. 7. Addition Alteration Demolition Other Work --TVx~'4o~~/~ (Desc{~ption) J;i" ;i ~? [ '] f} ;21 ~ "(T~o be paid on filing this application) '(i l'~?"'~u~B4¢'o'fdwte~gm fits on each floor ~1 I{I lt'i - If b. sin~ss, ~omm~rdal or mixed occupa ~cy, ~ nat.m and ~nt o~'~ach t~ o[ us~. Dimensions of existing structures, if any: ~.ront . ~:?~ 2'..' . ;'.';?[ ~ Depth Height. Number of Stories Dimensions of same structure with alterations or additions: Front Depth. Height Number of Stories Rear 8. Dimensions of entire new construction: Froot 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 X/{' 13. Will lot be re-graded? YES__ NO ~XNWill excess fill be removed from premises? YES 14. Names of Owner of premises ~4-L ~X~--~4.' AddressL'~- --~tc~t_/¢-~_Phone No. Name of Architect Address Phone No Name of Contractor Address Phone No. 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 BI~ REQUIRED. b. Is this property within 300 feet cfa tidal wetland? * YES NO * iF YES, D.E.C. PERMITS MAY BE REQUIRED. NO 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 NO J~ · IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY O~-~ (,~ {/"~k- ~ ~'( being duly sworn, deposes and says that (s)he is the applicant (Name of individual siggling contract) above named, CONNIE D. BUNCH (S)He is the Notaey~ub~,cb~a~of~N~ York (Contractor, Agent, Corporate Officer, etc.) Qualified in Suffolk CounbY ' cl*'mission Fxoires AOFil 14, 20 !~ 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 this ~ o~'C~ day of {'~kO,& F~3 200 ~ Notaw Public Signature oy,~plicant LOT I OWNER STREET ~ ~ ~,~ VILLAGE DIST: SUB. LOT ~_. FRONTAGE ON WATER TIELABLE FRONTA6E ON ROAD WOODLAND DEPTH MEADOWLAND .... BULKHEAD HOUSE/LOT ~_ TOTAL 70.-1-6.3 4/07 Z X' J ~--3 ,.~, 7..~ ~Z~, f Basement ~ Floors Kit. ~xtens~on ~ ~ -- SLAB Extension (~1 ~ ~,~ ~ tO~ Ext. Walls ~ Interior Finish ~, ~, LR Exl~naion Fire Place Heat O~ ~ D~. Patio Woodstove BR Breezeway Rooms 1st Floor Garage :.~X2~ ~ ~& ~ 12~ ~OB Driveway Rooms 2nd Floor O.B, ' ~ool i Stove Details I Hearthstone Stoves Page 1 of 5 hearths n The Heart of Your Home Select Collection ALL : U MEET T~iE Rh..O :. EQUINOX WOOD Heats up to: 3,500 sq. ft. ~/~ '~ r r~ ~ ' ~'' :' ~ ' ~ Burn Time: Up to 12 hours [i~iT. }!'"': ' x, ' '- Heat Life: Up to 16 hours ~t i'rL~r~ r~- S,ze: ~20,oo0 BTUs ~,h ;UUi CEr~TIF!CATE EPA Rating: 3.0 grams per ~ OCCUPANCY Efficiency: 78% ~aximum Log Length: 25" View this stove in a ro~pROVEl) Ag DATE:~)~°v//.O_~ ~p. i/ ~ FEE:~OO, o~ ~]'r' NOTIFY 8U~LE;'h : ...., ,- -- ' ' ,~',~:NT t'tT Description z~s-~02 8 A;~i -, ,,,~ i:o~? TRE FOLLOWING The powerhouse built to warm your home - the Equinox. This woO. dg~e~wO REQUIRED designed to heat even the largest of spaces - while keeping the hig~~CC, hCRrT~. and style of our HearthStone Sele~ Collection of soapstone stoves.ROUGH- FRAMING & PLut,,B,~Gr' 3. 4. RNAL - CO,,,c, RuCT,ON MUST BE COMPLETE ,'O>~ C,O. ~[k CONSTRUCTION SMALL MEET REQUIREMENTS OF THE CODES OF NEW YORff STATE. NOT RESPONSISLE FOR Features ~Es~a~ o~ CONSmUCT~O~ 4.0 cubic foot firebox Large firebox accepts 25" logs through the front door, or through the easy-loading side door. Front and side doors provide maximum loading ease, and increased fuel efficiency. Single air-intake lever/stove control Stove operation is easy; performance more consistent. http://www.hearthstonestoves.conffwood-stoves/stove-details?product_id= 1 10/4/2008 Stove Details I Hearthstone Stoves Page 2 of 5 Easy, clean ash removal; pan can be removed while fire is burning. Unmatched fire viewing Air entering the firebox through the stove's secondary air tubes ignites the gases rising off the burning wood. The resulting light and flames provide dazzling fire viewing, even when the fire is burning at a Iow rate. Non-catalytic combustion system Clean burning, complete combustion provides more heat from less wood, greater efficiency, reduced smoke and creosote build-up. 8" reversible flue collar Flexible installation; stove can be installed as a freestanding unit, or as a hearth stove. Outside air adapter (optional) Improved efficiency in today's newer, "airtight" homes; reduces cold drafts along the floor. Rear heat shield (optional) Allows more placement options; stove can be installed closer to a wall because clearance requirements are reduced; creates a convection passageway between shield and back of stove to allow optional fan to circulate air through the house more effectively. Fan with built-in thermostat and rheostat (optional) Helps spread heat evenly throughout home; fan only operates when stove is at a significant heat level. The rheostat controls fan speed. Use of rear heat shield is required. Fan moves air up to 200 CFM. Screen (optional) Allows for open door fire viewing. Side door lock kit (optional) Use optional lock kit to reduce side hearth clearance from 16" to 3 1/8", Photos click the enlarge thumbnail http://www.hearthstonestoves.com/wood-stoves/stove-details?product_id= 1 10/'4/2008 Stove Details I Hearthstone Stoves Page 3 of 5 Specifications Specifications Heats up to 3,500 sq. ft. Burn Time Up to 12 hours Heat Life Up to 16 hours Size 120,000 BTUs EPA Rating 3.0 grams per hour Efficiency 78% Width 33 5/8" Height (includes 30 5/8" flue collar) Depth 27" Maximum Log 25" Length Clearances (With single wall pipe & no rear heat shield) Side Rear Corner Clearances (With double- wall pipe & rear heat shield) Side Rear Corner Hearth Pad 21" 21" 15l' 13 1/2" http://www.hearthstonest6ves.com/wood-stoves/stove-details?product_id= 1 10/4/2008 Stove Details I Hearthstone Stoves Page 4 of 5 Flue Diameter Flue Exit ... Flue Exit & Top or rear exit 8" Diameter flue collar Ash Pan Yes Optional Blower Yes Kit Mobile Home Yes Certified Alcove Certified Yes Actual Weight (lbs.) 689 Minimum Size (Canada) 122 cm x 105.4 cm Finishes Color Finishes Matte Black Stone Fi nishes Polished Gray Soapstone Accessories Description Blower kit, EQX DRAFT METER: WOOD STOVES Outside Air kit, EQX PAINT, SPRAY MAI-i-E BLACK Rear Heat Shield kit, EQX Side Door Lock Kit, EQX SKU 90-57502 90-99000 93-53500 90-58110 90-68000 90-70200 http://www.hearthstonestoves.com/wood_stoves/stove_details?product_id= 1 10/4/2008 Stove Details [ Hearthstone Stoves Page 5 of 5 Spark Screen kit, EQX 90-69000 Documents Schematics Downloads Equinox 8000 Manual Equinox Schematic © 2008 Hearthstone Stoves. All rights reserved. Other Areas of Interest: www.hergom.com Vermont website design~graphic design~ and web hosting provided by Vermont Design Works http://www.hearthstonestoves.comiwood-stoves/stove-details?product_id= 1 10/4/2008