HomeMy WebLinkAbout43015-Z a,�$UF�flI�C� Town of Southold 12/18/2018
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40108 Date: 12/18/2018
THIS CERTIFIES that the building WOOD STOVE
Location of Property: 625 Franklinville Rd, Laurel
SCTM#: 473889 Sec/Block/Lot: 125.-2-1.25
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
8/27/2018 pursuant to which Building Permit No. 43015 dated 9/7/2018
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 BUILDING AS APPLIED FOR
The certificate is issued to Meehan,William&Lucki, Sonya
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
rize ignature
0 0 U
,t
gufFoc�- TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
o SOUTHOLD, NY
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit#: 43015 Date: 9/7/2018
Permission is hereby granted to:
Meehan, William & Lucki, Sonya
29 Central St
Huntington, NY 11743
To: install wood stove in existing building as applied for.
At premises located at:
625 Franklinville Rd, Laurel
SCTM # 473889
Sec/Block/Lot# 125.-2-1.25
Pursuant to application dated 8/27/2018 and approved by the Building Inspector.
To expire on 3/8/2020.
Fees:
SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $200.00
CERTIFICATE OF OCCUPANCY $50.00
Total: $250.00
Buil ing nspector
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 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.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$50.00,Additions to dwelling$50.00,Alterations dwelling$50.00,
Swimming pool$50.00,Accessory building$50.00,Additions to accessory bui ding$50.00,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
Date. z 1 5� /L'A
New Construction: Old or Pre-existing Building: (check one)
Location of Property: b�3 Fri kk ih o 1
House No. Street / Hamlet
Owner or Owners of Property: ; t'+rev►. Mee PP LcAe n
Suffolk County Tax Map No 1000, Section \)S Block Lot 1
Subdivision Filed Map. Lot:
Permit No. -5 Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval: /
Request for: Temporary Certificate Final Certificate: ./ (check one)
Fee Submitted: $�0 ,00
Applicant Signature
ho�aoF souryolo ---
# # TOWN OF SOUTHOLD BUILDING DEPT.
cou765-1802
-
INSPECTION ,
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] F ING /STRAPPING [ ] FINAL
[ FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
DATE 1 INSPECTOR
r
FIELD INSPECTION}REPORT DATE COMMENTS
FOUNDATION (IST)
------------------------------------
'FOUNDATION (2ND)
P5
z
�o
�r
4
ROUGH FRAMING& y l
PLUMBING
INSULATION PER N.Y. y
STATE ENERGY CODE
l�
FINAL
ADDITIONAL COMMENTS Rc
O
z
qz-- rn
i
- d
I
d
b
y
rOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL Board of Health
SOUTHOLD, NY 11971 - - 4 sets of Building Plans '
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 Survey
Southoldtownny.gov PERMIT NO, Check
Septic Form
N.Y.S.D.E.C.••
Trustees
p� C.O.Application
Examined
201 Flood Permit
Single&Separate
I
Truss Identification Form
Storm-Water Assessment Form
Contact:
Approved 20 (9 ,
Mail to:
Disapproved a/c
V Phone:
°xpiration - ,2
Buil ' pector
APPLICATION FOR BUILDING PERMIT
Dat /�,�� , 20
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,
3hal I be kept on the premises available for inspection throughouf the w6rk.
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 inspe 4i building for necessary inspections.
L_ , , (Signature of applicant or name,if a corporation
218,
BUII.IB•LNG b, (Mailing address of applicant)
TOW1r1 OF SOU1 IR_PL_,1
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premise/ �Aj I d C4_y✓_ Mee_,,
(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(oif land on whic ropo.e 4brk will be d
jron 'n Lct,Lle,�_
House Number Street Hamlet
County Tax Map No. 1000 Section V4.3 ._00 Block 1.00 Lot I o
vuvua.auav ----�_•�t -•
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 Alteration
Repair Removal Demolition Other Work 1 W.WTSJro%je1 �Pn
(Description)
4. Estimated Cost Fee
(To be paid on filing this application)
5. If dwelling, number of dwelling units Number of dwelling units on each floor
If garage, number of cars
6. If business, commercial or mixed occupancy, specify mature and extent of each type of use.
7. Dimensions of existing structures, if any: Front Rear Depth
Height ..Number of Stories
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories'
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 premises Address _ 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:•PERMTTS MAY 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
17. If elevation at any point on property is at 10 feet or below, must provide topograpQc data on survey.
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 .Trt u�c.fr�
�� � /1�{�pr✓1 being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(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 true to the best of his knowledge and belief and that or�k wi H be
performed in the manner set forth in the application filed therewith. GEonar:Mi
Notary Pubiio®t New York
Sworn to before me this I No.01MIS090290
0?3 da of ' 20� Qualified in Nassau Count
Y Curnmission Expires May 2®,
Notary Public Signature of Applicant
Y 'NIT
1 {n.xl x
1:A'
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SURVEY FOR
CEWM iq' DER• JAM S
e-ad,ry•at.,„b.: TE
REAL,.,VE,STA�
���,V hi,,,,-� At Laurel, Town of Southold
Suffolk County, New York
,\ . _-1 r•j� 4P� - +,11 Count ,
!� y Tom Map a�ut�l 7ggp ,o 7Z5 e,a 2 1.25
B(0UN C7
U.! ARY SUF2VEY�
YAP NEPAREO DES;tT,2003
1_ i
L
peal
APPR VED AS NOTED
DATE: B.'P. RETAIN STORM WATER RUNOFF
1,@.\.' PURSUANT TO CHAPTER 236
FEE: '•V� BY: OF THE TOWN CODE.
,NOTIFY BUILDING DEPAR NT 4T-
7 65-`1'802
7-765=1802, 8 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:'-
1. FOUNDATION - TWO REQUIRED
POR POURED CONCRETE
2.'ROUGH'-_FRAMING & PLUMBING
3. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS.
COMPLY WITH ALL CODES OF
NEW YORK STATE & TOWN CODES
AS REQUIRED AND CONDITIONS OF
'-%Jml
D
SOUTH M10��
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
^
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^ `
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,
INSTALLATION AND OPERATION MANUAL
MATRIX
BE��K���
��±�� J�
||Fe
USENVIRONMENTAL PROTECTION
AGENCY PHASE UCERTIFIED WOOD
' STOVE
Safety tested according toULC S6Z7\
UL737and UL148ZStandards
byanaccredited laboratory.
This appliances is
nE
`
Stove Builder International Inc.
25O' rue deCopenhagus,St-AugusUn'deDesmauns<QuebedCanada G3A2143
Tel:(418)878'3O40 Fax:(418)878'3OO1
This manual is available for free download on the manufacturer's web site. It is a copyrighted
P document. Re-sale is strictly prohibited. The manufacturer may update this manualfrom time to
time and cannot be responsible for problems, injuries, or damages arising out of the use of
information contained in any manual obtainedfrom unauthorized sources.
READ AND KEEP THIS MANUAL FOR REFERENCE
4559Ix
Printed in Canada 12'03'2015
Matrix Installatiop and Operation Manual
PART B - INSTALLATION
6 SAFETY INFORMATION
6.1 SUMMARY OF INSTALLATION CAUTIONS AND WARNINGS
• THE INFORMATION GIVEN ON THE CERTIFICATION LABEL AFFIXED TO THE APPLIANCE
ALWAYS OVERRIDES THE INFORMATION PUBLISHED, IN ANY OTHER MEDIA (OWNER'S
MANUAL, CATALOGUES, FLYERS, MAGAZINES AND/OR WEB SITES).
• MIXING OF APPLIANCE COMPONENTS FROM DIFFERENT SOURCES OR MODIFYING
COMPONENTS MAY RESULT IN HAZARDOUS CONDTIONS. WHERE ANY SUCH CHANGES ARE
PLANNED,STOVE BUILDER INTERNATIONAL INC. SHOULD BE CONTACTED IN ADVANCE.
• ANY MODIFICATION OF THE APPLIANCE THAT HAS NOT BEEN APPROVED IN WRITING BY THE
TESTING AUTHORITY VIOLATES CSA 8365 (CANADA),AND ANSI NFPA 211 (USA).
• CONNECT THIS STOVE ONLY TO A LISTED FACTORY-BUILT CHIMNEY FOR USE WITH SOLID
FUEL OR TO A LINED MASONRY CHIMNEY CONFORMING TO NATIONAL AND LOCAL
BUILDING CODES.
• IF REQUIRED,A SUPPLY OF COMBUSTION AIR SHALL BE PROVIDED TO THE ROOM OR SPACE.
• DO NOT CONNECT TO OR USE IN CONJUNCTION WITH ANY AIR DISTRIBUTION DUCTWORK
UNLESS SPECIFICALLY APPROVED FOR SUCH,INSTALLATION.
• DO NOT CONNECT THIS UNIT TO A CHIMNEY FLUE SERVING ANOTHER APPLIANCE.
• MAY BE INSTALLED IN A MOBILE HOME.
• THIS MOBILE HOME APPROVED STOVE REQUIRES INSTALLATION OF A FRESH AIR KIT, SOLD
SEPARATELY.
WARNING: DO NOT INSTALL IN SLEEPING ROOM.
WARNING:THE STOVE MUST BE ATTACHED TO THE STRUCTURE OF THE MOBILE HOME.
CAUTION: THE STRUCTURAL INTEGRITY OF THE MOBILE HOME FLOOR, WALL, AND
CEILING/ROOF MUST BE MAINTAINED.
28
Matrix Installation and Operation Manual
6.2 REGULATIONS COVERING STOVE INSTALLATION
When installed and operated as described in these instructions, the Osburn Matrix wood stove is
suitable for use as a freestanding heater in residential installations.The Osburn Matrix wood stove
is not recommended for installation in a sleeping room of a mobile home.
In Canada, the CSA 8365 Installation Code for Solid Fuel Burning Appliances and Equipment and
the CSA C22.1 Canadian National Electrical Code are to be followed in the absence of local code
requirements. In the USA, the ANSI NFPA 211 Standard for Chimneys, Fireplaces, Vents and Solid
Fuel-Burning Appliances and the ANSI NFPA 70 National Electrical Code are to be followed in the
absence of local code requirements.
This stove must be connected to a chimney complying with the requirements for Type HT
chimneys in the Standard for Factory-Built Chimneys for Residential Type and Building Heating
Appliances, UL 103 HT and ULC S629 or to a code-approved masonry chimney with a flue liner.
29
Matrix Installation and Operation
7 CLEARANCES TO COMBUSTIBLE MATERIAL
The clearances shown in this section have been determined by 'test according to procedures set
out in safety standards ULC 5627 (Canada), UL1482 (U.S.A.) and UL737 (U.S.A.). When the stove is
installed so that its surfaces are at or beyond the minimum clearances specified, combustible
surfaces will not overheat under normal and even abnormal operating conditions.
No part of the stove or flue pipe may be located closer to combustibles than the minimum
clearance figures given.
7.1 LOCATION OF THE CERTIFICATION LABEL
Since the information given on the certification label affixed to the appliance always overrides the
information published, in any other media (owner's manual, catalogues, flyers, magazines and/or
web sites) it is important to refer to it in order to have a safe and compliant installation. In
addition, you will find information about your stove (model, serial number, etc.). You can find the
certification label on the back of the stove.
7.2 CLEARANCES TO WALLS AND CEILING
The clearances to combustible walls may be slightly different in Canada and the U.S.A. and may
also differ depending on whether you use single or double wall flue pipe. Please be sure to choose
the correct clearance for your location and type of flue pipe. See figure Clearances to combustible
materials and floor protection to match each letter to a clearance.
CLEARANCES(SINGLE WALL PIPE) CLEARANCES(DOUBLE WALL PIPE)
CANADA USA CANADA USA
A 15" (381 mm) 15" (381 mm) A 6" (152 mm) 6" (152 mm)
B 1 16" (406 mm) 16" (406 mm) B 14" (356 mm) 14" (356 mm)
C 10" (254 mm) 10" (254 mm) C 1 6" (152 mm) 6" (152 mm)
D 18%" (470 mm) 18%" (470 mm) D 9%" (241 mm) 9%" (241 mm)
E 26%" (673 mm) 26%" (673 mm) E 24%" (622 mm) 24%" (622 mm)
F 19%" (495 mm) 19%" (495 mm) F 15%2." (394 mm) 15%" (394 mm)
K 48" (1219 mm) 48" (1219 mm) K 48" (1219 mm) 48" (1219 mm)
L 72" (183 cm) 72" (183 cm) L 72" (183 cm) 72" (183 cm)
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Matrix Installation and Operation Manual
Clearances for mobile homes
MOBILE HOME CLEARANCES(DOUBLE WALL PIPE)
CANADA USA
A 10" (254 mm) 10" (254 mm)
B 17" (432 mm) 17" (432 mm)
C 8" (203 mm) 8" (203 mm)
D 13%" (343 mm) 13%" (343 mm)
E 27%" (699 mm) 27%" (699 mm)
F 17%2" (445 mm) 17%" (445 mm)
K 48" (1219 mm) 48" (1219 mm)
L 84" (213 cm) 84" (213 cm)
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Matrix,Instal lationand Operation
A � �
D GIVe�
E � H
Bi I Ho
N
I L
K
M
\ C
F
/F \\
/
\v/
Clearances to combustible materials and floor protection
32
Matrix Installation and Operation Manual
7.3 FLOOR PROTECTOR
Your stove is designed to keep the floor from overheating. It should be placed on a non
combustible surface to protect the floor of hot embers that could fall from the stove during
loading and maintenance. As shown in the table below and by the dotted area in the figure
Clearances to combustibles and floor protection, there are differences between the floor
protections in Canada and in the United States.
FLOOR PROTECTOR*
CANADA USA
G 8" (203 mm)—Note 1 N/A (Canada only)
H 8" (203 mm) N/A (Canada only)
1 18" (457 mm) 16" (406 mm)
From door opening From door opening _
i N/A(USA only) 8" (203 mm)
M 8" (203 mm) N/A (Canada only)
N N/A(USA only) Note 2
*Steel with a minimum thickness of 0.015" (0.38 mm) or ceramic tiles sealed together with grout.
No protection is required if the unit is installed on a non-combustible floor(ex.concrete).
Note 1: The floor protection at the back of the stove is limited to the stove's required clearance if
such clearance is smaller than 8 inches (203 mm).
Note 2: Only required under the horizontal section of the connector. Must exceed each side of
the connector by at least 2 inches (51 mm).
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Matrix Installationand Operation Manual
7.4 REDUCING WALL AND CEILING CLEARANCES SAFELY
It is often desirable to reduce the minimum , =
installation clearances by placing the stove
closer to walls so the installation takes up less t
floor space. You can safely reduce the minimum
clearances by permanently installing a shield
between the stove and combustible material.
The rules for safe shields can be complicated, so ;s'
read them carefully and follow them exactly. ,J .
Note that there may be minor regional
differences in clearance reduction rules so be
sure to check with your building or fire inspector
before proceeding., ,
7.4.1 SHIELD CONSTRUCTION RULES
See figure Clearances forshield construction to match each letter to a clearance.
- Adhesives used in shield construction must not ignite or lose adhesive qualities at
temperatures likely to be encountered.
- Mounting hardware which extends from the shield surface into combustibles may be used only
at the edges of the shield.
- Mounting hardware must allow full vertical ventilation.
A Minimum clearance between the appliance top and an unshielded combustible ceiling:
890 mm (35 in.)
B Shield extension above appliance: 500 mm (20 in.).
C Minimum space behind shield: 25 mm (1 in.). In Canada 21 mm (7/8 in).
D Clearance along the bottom of shield: minimum: 25 mm (1 in.) and maximum: 75 mm (3 in.).
E Minimum clearance along the top of shield at ceiling: 75 mm (3 in.).
F Mounting hardware must not be located closer than 200 mm (8 in.) from the vertical centre
line of the appliance.
G Edge clearance for ceiling shields to side and back walls: 75 mm (3 in.).
H Shield extension beyond each side of appliance: 450 mm (18 in.).
34
Matrix Installation . Operation
I
E I
I H
I
A �
B � F
F
c
E
I
C
I
A A
B
Clearances for shield construction
35
Matrix Installatian . Operation
7.4.2 TABLE OF CLEARANCE REDUCTION PERCENTAGES
Clearances may be reduced by these
percentages
Type of shield Sides a Top%
and rear / (ceiling)
Can/USA USA Can/USA USA
N min. N min.
Sheet metal, a minimum of 24 gauge
(0.61 mm) in thickness , spaced out at
least 25 mm (1 in)* by non- 67 12 po 50 18 po
combustible spacers
Ceramic tiles, or equivalent non-
combustible material, on non-
combustible board spaced out at least 50 18 po 33 24 po
25 mm (1 in)* by non-combustible
spacers
Ceramic tiles, or equivalent non-
combustible material, on non-
combustible board, with a minimum 67 12 po 50 24 po
of 24 gauge (0.61 mm) sheet metal
backing spaced out at least 25 mm
(1 in)* by non-combustible spacers
Brick, spaced out at least 25 mm ti
(1 in)* by non-combustible spacers
50 18 po N/A N/A
Brick, with a minimum of 24 gauge
(0.61 mm) sheet metal backing, 67 12 po N/A N/A
spaced out at least 25 mm (1 in) by
non-combustible spacers
*in Canada this space can be 21 mm(7/8 in)
36