HomeMy WebLinkAboutCertificate of Occupancy
CJ1Y HALL
215 Church Avenue
P. O. Box 1130
OShkOSt>54~~~_~~~8 . City of Oshkosh
ct)
OJHKOJH
Approved:
Issued:
June 27, 1995
August 25, 1995
Landmark Unlimited Partnership III
304 Ohio street
Oshkosh, WI 54901
CERTIFICATE OF OCCUPANCY
t
An Occupancy Permit is hereby granted for the interior alterations
located at 376 S. Koeller Street, Oshkosh, Wisconsin 54901 as
described in Building Permit Application number(s) 44913.
This space is to be used only as a retail space and is
located in the C-3 Commercial District.
LIMITATIONS:
Maximum Floor Loading: Undetermined/Slab on Grade
Maximum Persons and/or living units: 25 Occupants
NOTE:
A new Certificate of Occupancy shall be required prior to occupancy
should additional building(s) be erected, or should any buildings
mentioned above be altered or moved.. The use of land, or
buildings, shall not be changed until a Certificate of Occupancy is
issued for that occupancy.
CHIEF BUILDING INSPECTOR
Compliance Statement
This form is required to be submitted by the architect, engineer, or HVAC desi~ner (supervising professional)
observing construction of projects within buildings with total volumes exceeding 50,000 wbic feet and construction
of antennas, towers and bleachers (ILHR 50.10). Failure to submit this form may result in penalties as specified in ILHR
50.26 and/or local ordinances.
General Instructions: Prior to the initial occupancy of new buildings or additions and the final
occupancy of altered existing buildings, submit thiS completed and signed form to:
. The municipal building inspection office and
. DILHR, Safety and Buildings, P.O. Box 7969, Madison, WI 53707
Personal Information you provide may be used for secondary purposes [Privacy Law, s. 15.04 (1}(m)].
1. PROJECT INFORMATION: (Use the DILHR or municipal project label, or type or print the information. If label is
used, no additional entry is needed on part 1.)
Owner Information Project Information
Name Building Occupancy Chapter(s} & Use
L
A Company Name
Landmark Unlimited partnershi III
B Num er an Street
E 304 Ohio street
L City
H
E
H
E
Tenant Name (if any)
Silk & Art Galler
Building Location (number & street
376 S. Koeller Street
~City DVillage DTown of Oshkosh
County of
Winnebago
Property Identi ication Num er
6-877
Name and Registration Number of the HVAC Supervising Professional
2. PURPOSE OF THIS STATEMENT:
(Check Box A, B. Cor D to indicate purpose and complete any other applicable
boxes and information. Attach additional pages if necessary.)
o Building and HVAC ~OnIY 0 HVAC Only
o Partial Completion
~ Description of Portion Completed
A) WSt~tement of Substantial Comp.liance
To the best of my knowledge, belief, and based on on site observation, construction of the following building and/or HVAC items
apph. Ie to this project have been completed in substantial compliance with the approved plans and specifications.
o HVAC ITEMS
1. HVAC system including final test
(ILHR 64.53)
1. Structural system including submittal and erection of all
building components (trusses, precast, metal building, etc.)
2. Fire protection systems (sprinklers, alarms, smoke detectors)
designed, installed and tested (including forward flow on
back flow devices) by appropriately registered professionals
4. Shaft and stairway enclosures
3. Exits including exit and directional lights
5. Fire-resistive construction, enclosure of hazards, fire walls,
labeled doors, class of construction
6. Sanitation system (toilets, sinks, drinking facilities)
7. ILHR barrier free requirements
8. All conditions of building plan approval and applicable variances
The following items are not in compliance and must be addressed:
2. All conditions of HVAC plan approval
and applicable variances
B) 0 Statement of Noncompliance
Due to the follOWing listed violations, this project is not ready for occupancy:
C)
D) 0 Abandoned
3. SUPERVISING PROFESSIONAL SIGNATURES:
Supervising Professional for:
D~Bld9&&
~dg. ONLY ',-
o Supervising Professional Withdrawn From Project (Use A or B above to indicate project status as of this date.)
~..~ ~
Date
Date
'1. ~ ."..-
SBDB-9720 (R. 01/95)
o HVACONLY
Date
Compliance Statement
This form is required to be submitted by the architect, engineer, or HVAC desi9ner (supervising professional)
observing construction of projects within buildings with total volumes exceedmg 50,000 cubic feet and construction
of antennas, towers and bleachers (ILHR 50.10). Failure to submit this form may result in penalties as specified in
ILHR 50.26 and/or local ordinances.
General Instructions: P~io.r to th~ ir:'itial occup'ancy of new buildings,or additions and the final
occupancy of altered eXlstmg bUlldmgs, submit this completed and signed form to:
The municipal building inspection office and also to
DILHR, Safety and Buildings, P.O. Box 7969, Madison, WI 53707
Personally identifiable information may be used for other purposes.
H
E
R
E
Building Project #
L
A
B
E
L
Nameland Registration Number of the HVAC Supervisipg Professional HVAC Project # \
D. \~. EJ' {'ON\4.\-tl n~n(o r~ \ q 0
2. PURPOSE OF THIS STATEMENT: (Check Box A, B, or C to indicate purpose and camp'lete any other applicable
boxes and information. Attach additional pages If necessary.)
D Building and HVAC D Building Only . HVAC Only
D Partial Completion
Description of Portion Completed
A) . Statement of Substantial Compliance
To the best of my knowledge, belief, and based on onsite observation, construction ofthe following building and/or HVAC items applicable to
this project have been completed in substantial compliance with the approved plans and specifications.
D BUILDING ITEMS
1. Structural system including submittal and erection of all
building components (trusses, precast, metal building, etc.)
2. Fire protection systems (sprinklers, alarms, smoke detectors)
designed and installed by appropriately registered professionals
3. Exits including exit and directional lights
4. Shaft and stairway enclosures
5. Fire-resistive construction, enclosure of hazards, fire walls,
labeled doors, class of construction
6. Sanitation system (toilets, sinks, drinking facilities)
7. ILHR barrier free requirements
8. All conditions of building plan approval and applicable variances
The following items are not in compliance and must be addressed:
. HVACITEMS
1. HVAC system including final test
(ILHR 64.53)
2. All conditions of HVAC plan approval
and applicable variances
B) 0 Statement of Noncompliance
Due to the following listed violations, this project is not ready for occupancy:
C) 0 Supervising Professional Withdrawn From Project.
(Use A or B above to indicate project status as of this date.)
Date Withdrawn
. D) 0 Abandoned
3. SIGNATURES:
pervlsl
..q~
Building Supervising Professional
SBD-9720 (R. 01/94)
Date