HomeMy WebLinkAboutCertificate of Occupancy - 09/24/2003 CITY HALL
Inspection Services Div
215 Church Avenue City of Oshkosh
011 PO B
Oshkosh ox WI
54903 -1130 1130
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Oft I<O /I 1
ON THE WATER
Approved: April 30, 2003
Issued: September 24, 2003
St Mary's Catholic Church
442 Monroe St
Oshkosh, WI 54901
CERTIFICATE OF OCCUPANCY
An Occupancy Permit is hereby issued for the 2475 sf addition for elevator and
handicap accessible bathrooms located at 442 Monroe Street, Oshkosh,
Wisconsin 54901 as described in Building Permit Application number(s) 85360.
This building is to be used only as a church and is located in the
R -2 Two Family Residence District.
LIMITATIONS:
Maximum Floor Loading: Per State Approved Plan
Maximum number of persons: Per State Approved Plan
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. All conditions noted
above must be complied with in order for this certificate to be valid.
tiIPL
D''E O' OF INSPEC N SERVICES
cc: Flour Bros Construction Co
AD /km
Building Permit Work Card
Job Address 442 MONROE ST Permit Number 0085360 Create Date 4/17/01
Owner ST MARY'S CATHOLIC CHURCH Contractor FLUOR BROS CONSTRUCTION CO
Category 207 Addition Churches other Religious
Type Building O Sign O Canopy O Fence O Raze Plan A7 -22 -0401
Zoning Class of Const: Size irreg Value $274,000.00
Unfinished /Basement 0 Sq. Finished /Living 2475 Sq. Ft. Garage 0 Sq. Ft.
Ft.
Rooms 0 Bedrooms 0 Baths 0 Projection I
Stories 1 Height 0 Ft. Canopies 0 Signs 0
Foundation Poured Concrete O Floating Slab 0 Pier 0 Other
0 Concrete Block O Post 0 Treated Wood
Occupany Permit Required Flood Plain Height Permit
Park Dedication Dwelling Units 0 Structures 0
Use /Nature Church/ 2475 sf addition for elevator and handicap accessible bathrooms.
of Work
HVAC Contr Plumbing Contr
Electric Contr
Inspections:
Date 05/29/2002 Type Re Final Inspector Allyn Dannhoff approved
Date/Time requested: Notice Type: Phone Number:
Access:
Ready Datemme: Requested By:
0 Reinspect Fee 0 Fee Waived Reinspect Fee Paid
Building Permit Work Card
Job Address 442 MONROE ST Permit Number 0085360 Create Date 4/17/01
Owner ST MARY'S CATHOLIC CHURCH Contractor FLUOR BROS CONSTRUCTION CO
Category 207 Addition Churches other Religious
Type Building 0 Sign 0 Canopy 0 Fence 0 Raze Plan A7 -22 -0401
Zoning Class of Const: Size irreg Value $274,000.00
Unfinished/Basement 0 Sq. Finished /Living 2475 Sq. Ft. Garage 0 Sq. Ft.
Ft.
Rooms 0 Bedrooms 0 Baths 0 Projection
Stories 1 Height 0 Ft. Canopies 0 Signs 0
Foundation IS Poured Concrete 0 Floating Slab 0 Pier 0 Other
0 Concrete Block 0 Post O Treated Wood
Occupany Permit Required Flood Plain Height Permit
Park Dedication Dwelling Units 0 Structures 0
Use /Nature Church/ 2475 sf addition for elevator and handicap accessible bathrooms.
of Work
HVAC Contr Plumbing Contr
Electric Contr
Inspections:
Date 02/27/2002 Type Final Inspector Allyn Dannhoff not approved
NOT APPROVED SEE FCN
Date/Time requested: Notice Type: FC Phone Number:
Access:
Ready Date/Time: Requested By:
0 Reinspect Fee 0 Fee Waived Reinspect Fee Paid
Date 05/21/2002 Type Re Final Inspector Allyn Dannhoff not approved
Check code on elevator exhaust fan. All other itmes have been addressed.
Date/Time requested: Notice Type: Phone Number:
Access:
Ready Date/Time: Requested By:
0 Reinspect Fee 0 Fee Waived Reinspect Fee Paid
Electric Permit Work Card
Job Address 442 MONROE ST Permit Number 88724 Create Date 08/24/2001
Owner ST MARY'S CATHOLIC CHURCH Contractor C &S ELECTRIC INC
Category 643 Commercial- Addition /Remodels
Service New 0 Changer Temp N/A Type O Overhead Q Underground N/A J
Volts Circuits 0 Fixtures 0
Amps 0 Switches 0 Receptacles 0
Fee $180.00 Value $9,493.00
Appliances
Use /Nature Work in association with installation of an elevator for St. Marys Church.
of Work
Inspections:
Date 04 /30/2003 Type Re Final Inspector Kevin Benner approved
Date/Time requested: 04/29/2003 09:34 AM Notice Type: Phone Number:
Access:
Request from the building inspector
Ready Datemme: 04/29/2003 09:34 AM Requested by:
0 Reinspect Fee 0 Fee Wavied Reinspect Fee Paid
Electric Permit Work Card
Job Address 442 MONROE ST Permit Number 88724 Create Date 08/24/2001
Owner ST MARY'S CATHOLIC CHURCH Contractor C &S ELECTRIC INC
Category 643 Commercial- Addition /Remodels
Service 0 New 0 Change Temp f0 N/A Type 0 Overhead O Underground N/A
Volts Circuits 0 Fixtures 0
Amps 0 Switches 0 Receptacles 0
Fee $180.00 Value $9,493.00
Appliances
Use /Nature Work in association with installation of an elevator for St. Mary's Church.
of Work
Inspections:
Date 01/17/2003 Type Consultation Inspector Kevin Benner
CN
Date/Time requested: 01/14/2003 11:35 AM Notice Type: Phone Number:
Access:
Meet Steve from the E.C. on site
Ready Date/Time: 01/17/2003 09:00 AM Requested by:
O Reinspect Fee 0 Fee Wavied Reinspect Fee Paid
Date 02/04/2003 Type Re Final Inspector Kevin Benner not approved
Phone request (no address or permit given).
NO ACCESS. Called E.C. to make arrangements 2/4/03 2:49pm.
Date/Time requested: 01/30/2003 10:52 AM Notice Type: Phone Number: 920 858 -4401
Access:
Ready Date/Time: 01/30/2003 10:52 AM Requested by: C &S ELECTRIC INC -Steve
0 Reinspect Fee 0 Fee Wavied Reinspect Fee Paid
Electric Permit Work Card
Job Address 442 MONROE ST Permit Number 88724 Create Date 08/24/2001
Owner ST MARY'S CATHOLIC CHURCH Contractor C &S ELECTRIC INC
Category 643 Commercial- Addition /Remodels
Service 0 New 0 Change 0 Temp N/A Type 0 Overhead 0 Underground N/A
Volts Circuits 0 Fixtures 0
Amps 0 Switches 0 Receptacles 0
Fee $180.00 Value $9,493.00
Appliances
Use /Nature Work in association with installation of an elevator for St. Marys Church.
of Work
Inspections:
Date Type Final Inspector Kevin Benner not approved
Date/Time requested: 00:00 AM Notice Type: CC Phone Number:
Access:
Ready Date/Time: 11/04/2002 00:00 AM Requested by:
0 Reinspect Fee 0 Fee Wavied Reinspect Fee Paid
Date 01/09/2003 Type Re Final Inspector Kevin Benner not approved
Request from Tim McEnroe of Fluor Bros. Const.
Results faxed to the E.C. G.C.
Date/Time requested: 01/03/2003 08:03 AM Notice Type: CC Phone Number:
Access:
Ready Date/Time: 01/03/2003 02:00 PM Requested by: (Reinspect fee for C S Electric)
Reinspect Fee 0 Fee Wavied Reinspect Fee Paid
Electric Permit Work Card
Job Address 442 MONROE ST Permit Number 88724 Create Date 08/24/2001
Owner ST MARY'S CATHOLIC CHURCH Contractor C &S ELECTRIC INC
Category 643 Commercial- Addition /Remodels
Service 0 New O Change Temp N/A Type O Overhead O Underground N/A
Volts Circuits 0 Fixtures 0
Amps 0 Switches 0 Receptacles 0
Fee $180.00 Value $9,493.00
Appliances
Use /Nature Work in association with installation of an elevator for St. Mary's Church.
of Work
Inspections:
Date 10/23/2001 Type Rough In Inspector Kevin Benner not approved
10/19/01
NOT APPROVED SEE F\C \N
Date/Time requested: Notice Type: FC Phone Number:
Access:
Ready Date/Time: Requested by:
O Reinspect Fee O Fee Wavied Reinspect Fee Paid
Date 11/20/2001 Type Rough In Inspector Kevin Benner not approved
7:52 AM
RE- INSPECT
NOT APPROVED FAXED TO THE E.0 11/21/01
Raceways shall be secred to the building structure within 3' of a fitting every 10'
Date/Time requested: Notice Type: Phone Number:
Access:
Ready Date/Time: Requested by:
0 Reinspect Fee 0 Fee Wavied Reinspect Fee Paid
HVAC Permit Work Card
Job Address 442 MONROE ST Permit Number 86135 Create Date 05/15/2001
Owner ST MARY'S CATHOLIC CHURCH Contractor BALCO SERVICES
Category 512 Ind. Comm -Both Plan A7 -22 -0401
Fuel Gas Oil 1 Electric Solar f Solid Value $30,000.00
System New Replace Other
Li Forced Air U Radiant U Steam u NC Vent
u Electric u Hot Water I J Suppl. u Con. Bumer
Chimney Type p Chimney A 0 Chimney B 0 Direct Vent Not Applicable
Heat Loss 0 As Approved 0 Existing Not Applicable Value 0
BTU Rate 0 As Per Plan 0 Variable Other Value
Use /Nature Expand HVAC for addition.
of Work
Inspections:
Date Type Inspector
Date/Time requested: Notice Type: Phone Number:
Access:
Ready Date/Time: Requested By:
0 Reinspect Fee 0 Fee Waived Reinspect Fee Paid
:91/ (glet)
006
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HVAC Permit Work Card
Job Address 442 MONROE ST Permit Number 86135 Create Date 05/15/2001
Owner ST MARY'S CATHOLIC CHURCH Contractor BALCO SERVICES
Category 512 Ind. Comm -Both Plan A7 -22 -0401
Fuel 11 Gas I Oil 11 Electric 1 Solar 1 1 Solid Value $30,000.00
System n New 1 Replace I Q Other
1__1 Forced Air Hi Radiant u Steam I u A/C u Vent
I_] Electric U Hot Water u Suppl. u Con. Burner
Chimney Type p Chimney A 0 Chimney B 0 Direct Vent 0 Not Applicable
Heat Loss 0 As Approved 0 Existing 0 Not Applicable Value
BTU Rate ID As Per Plan Q Variable 0 Other Value
Use /Nature Expand HVAC for addition.
of Work
Inspections:
Date Type Inspector Approved
Z'?7
-.1.0 TION NOTICE FIELD INSPECTION REPORT
i rr f a_., JOB LOCATION: z
t
,77,,, CONTRACTOR:
q�el'
A( PROJECT TO BE INSPECTED:
BUILDING: HVAC: ELECTRIC: PLUMBING: EROSION CONTROL: PROPERTY MAINT.:
Footing Rough Rough Rough Tracking Setback Park.
Foundation Furnace Service Test On Silt Fence Unlicensed Veh
Rough A/C Temp Perm Underfloor Stone Access Garbage
Insulation Fireplace UG OH Sewer/Water Straw Bales Dilapidated bld's, fences,
Re -insp. Re -insp. Re -insp. Re -insp. Re -insp. etc.
Final Final Final Final Final Ext. Maint.
VA' a J CODE, INSPECTION RESULTS
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VIOLATIONS MUST RRETEIT 3S FNCNO
CONCEALMENT AND /OR OCCUPANCBE CO C
Y. W D H A AND CORRECTION W S ARE HIN COMPLETED 0 DAYS UNLESS THE OWNE OTHERWI R/ E CONTRACTOR NOTED. CALL IS OR REQUIRED RE- ISPE TO TIO SIGN S PRI DAT TO E THIS
NOTICE AND RETURN IT TO THE INSPECTION DIVISION WHEN REQUESTING A RE- INSPECTION.
COMPLIANCE DATE:
,,,,V ACTION TAKEN:
/i-o t Approved/ Insp.: ort ft on site Not Ap .roved/ Insp. Report given to Mailed/Faxed
Signed C (P -,c0-5(' •r ton Services Division ate o nspection Phone
I hereby certi o at the violations at the above address have been corrected.
�'RACTDR OWNER SIGNATURE DATE
Safety and Buildings
1340 E GREEN BAY ST STE 300
SHAWANO WI 54166
D (64 -877
o 1VF www.com TD D (state. 608) 2 64-8 7 77
i sconsin r
Department of Commerce Tommy G. Thompson, Governor
NOV 07 2004 Brenda J. Blanchard, Secretary
November 06, 2000 DEPARTMENT OF
CUST ID No.673100 O a.'. _IB ITY DE V �A /'7 "N: Bu ildin g s Structures INSPECTOR
JAMES GROFF OSHKOSH INSPECTION
HGM ARCHITECTURE 215 CHURCH AVE
805 N MAIN ST PO BOX 0976 PO BOX 1130
OSHKOSH WI 54902 OSHKOSH WI 54902-1130
RE: CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 11/01/2002 Identification Numbers
Transaction ID No. 446224
SITE Site ID No. 132982
Site ID: 132982, ST MARY PARISH Please refer to both identification numbers,
WINNEBAGO County, City of OSHKOSH; above, in all correspondence with the agency.
Fire Dept ID: 7003; 442 MONROE ST, OSHKOSH 54901
FOR:
Description: Chapter 55, Church
Object Type: Building Regulated Object ID No.: 769134
5B Masonry- Unprotected class of construction, Addition plan, 2,475 project sq ft, Unsprinklered, Occupancy
(Assembly), elevator indicated
Description: Chapter 55, Church
Object Type: HVAC System Regulated Object ID No.: 769135
Boiler indicated
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes
and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in
chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements.
The following conditions shall be met during construction or installation and prior to occupancy or use:
This review does not include approval for vertical transportation. Please coordinate your design specifications
with the vertical transportation contractor who is familiar with the Elevator code submittal requirements. That
contractor may call the Elevator Plan Reviewer at (414) 521 -5444 for submittal requirements if needed.
This review does not include approval for the installation of boilers and pressure vessels as prescribed by
COMM 41, or refrigeration systems as prescribed by COMM 45. Contact Boiler Safety at (262) 548 -8617 for
specific additional requirements.
COMM 50.12 This review does not include lighting. COMM 63.01 Prior to installation, lighting plans and
calculations shall be prepared in compliance with the code and properly signed and sealed. The plans shall be
available at the job site as requested by the Department representative or local official.
COMM 50.17(1)(a) This approval will expire 2 years after the date of this letter if the building shell is not
closed in within those 2 years. Also, this approval will expire 3 years after the date of this letter if the work
covered by this approval is not completed and the building ready for occupancy within those 3 years.
COMM 50.12 Prior to installation, one copy of the precast concrete plans ,calculations, a completed SBD -118
application form and a $100 submittal fee shall be submitted to this office. Also one copy of the plan shall be
provided at the job site.. When the total building volume exceeds 50,000 cubic feet, each set of plans shall bear
an indication of review which has been signed or initialed by the building designer of record.
COMM 50.12 Prior to installation, one copy of the wood truss plans ,calculations, a completed SBD -118
application form and a $100 submittal fee shall be submitted to this office. Also one copy of the plan shall be
provided at the job site. When the total building volume exceeds 50,000 cubic feet, each set of plans shall bear
an indication of review which has been signed or initialed by the building designer of record.
Comm 51.08(2) Provide a 2 -hour rated enclosure for boilers and water heaters.
JAMES GROFF Page 2 11/6/00
Conan 51.08(3)(b) Fire doors in hazard enclosures must be self closing. Automatic self closing doors are not
permitted.
COMM 51.15(3)(h) As the occupant load of this building exceeds 100 persons, panic hardware is required on
the exit doors, and on exit access doors serving areas with an occupant load in excess of 100 persons.
ADAAG 4.1.3(9) Provide areas of rescue assistance per COMM 69.23(3) and ADAAG 4.3.11 in the same
number as the required exits for the building. An area of rescue assistance appears to be needed at both the
upper level of stairs, and the lower (basement) level of the stairs. Verify that it is properly rated per COMM
69.23(3)a -e. ADAAG 4.3.11.2 As the capacity of this floor is greater than 200 persons, each area of rescue
assistance shall contain two 30" x 48" clear floor spaces.
ADAAG 4.3.11.4 A method of two -way communication which is both audible and visual shall be provided at
an area of rescue assistance which is hard wired back to the building's main entrance.
ADAAG 4.3.11.5 Each area of rescue shall be properly identified by a lighted sign stating "AREA OF
RESCUE ASSISTANCE." Illuminated directional signage shall be provided where required for directional
signage per COMM 51.15(5).
A copy of the approved plans, specifications and this letter shall be on -site during construction and open to
inspection by authorized representatives of the Department, which may include local inspectors. All permits
required by the state or the local municipality shall be obtained prior to commencement of
construction /installation/operation.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead.
Sincerely. DATE RECEIVED 10/27/2000
r
FEE REQUIRED 450.00
'/Lts� oLfz
FEE RECEIVED 450.00
IRENE E GERLOFF ENGINEERING CONSULTANT BALANCE DUE 0.00
Integrated Services
(715)524 -6851 M -F 7:00 AM 3:30 PM
IGERLOFF a COMMERCE.STATE.WI.US WiSMART code: 7648
cc: PETER R OCHS BUILDING INSPECTOR, (920) 929 -3167, FRIDAY, 7:45 A.M. 4:30 P.M.
REV DAVID R BAETEN ST MARYS CHURCH
Safety and Buildings
1340E GREEN BAY ST STE300
SHAWANO WI 54166
TDD (608) 264 -8777
elsconsin www•commerce.statis/sb
www.wisconsin.gov
Department of Commerce
Scott McCallum, Governor
Philip Edw. Albert, Acting Secretary
September 21, 2001
CUST ID No.673100 ATTN.: Buildings Structures Inspector
JAMES GROFF OSHKOSH INSPECTION
HGM ARCHITECTURE 215 CHURCH AVE
805 N MAIN ST PO BOX 0976 PO BOX 1130
OSHKOSH WI 54902 OSHKOSH WI 54902 -1130
COMPONENT RECEIVED Identification Numbers
Transaction ID No. 677525
SITE: Site ID No. 132982
ST MARY PARISH Please refer to both identification numbers,
442 MONROE ST above, in all correspondence *Ith,the agency.
CITY OF OSHKOSH, 54901
WINNEBAGO COUNTY; FIRE DEPT ID: 7003
FOR:
OBJECT TYPE: TRUSS, ROOF REGULATED OBJECT ID NO.: 813933
Your submission of the above component(s) plans have been received by this department and the plans and other
related documents have been filed with our records for the subject project.
The submitted materials HAVE NOT BEEN REVIEWED for compliance with all applicable administrative rules.
The department will rely on, and hold responsible, the building design professional and/or supervising professional
of record for compliance with the rules. The responsible professional should particularly insure that proper loads
and fire resistive rating have been incorporated to correspond to the building design. Particularly insure: proper dead
and live loading, including snow drift loading increases, equipment loads, proper bearing/supports, concentrated
loads etc, are properly conveyed to foundations; and that required fire ratings have been employed.
The department reserves the right to formally review the plans in the future if the department determines that such a
review is warranted, and to order corrective actions with respect to the outcome of that review.
A copy of the plan that is identical to the plan submitted for our file shall be available for inspection at the job
site. When the total building volume exceeds 50,000 cubic feet, the plan shall bear an indication of review that has
been signed or initialed by the building designer of record.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead. Please refer to Transaction ID No. referred to in the regarding line when making an inquiry
or submitting additional information.
Sincerely, 411 FEE REQUIRED 100.00
FEE RECEIVED 100.00
BALANCE DUE 0.00
ANN E PETERSON
CUSTOMER SERVICE REPRESENTATIVE INTEGRATED SERVICES Wi codeva68
(715)524 -3628 M -F 7:45 AM 4:30 PM
APETERSON @COMMERCE. STATE. WI.US
cc: PETER R OCHS BUILDING INSPECTOR, (920) 929 -3167 FRIDAY, 7:45 A.M. 4:30 P.M.
REV DAVID R BAETEN ST MARYS CHURCH
Safety and Buildings
PO BOX 7162
MADISON WI 53707 -7162
z 6 TDD (608) 264 -8777
f `a r MADISON
isconsi j
=tee t www.wisconsin.gov
Department of Commerce
o o l Scott McCallum, Governor
Brenda J. Blanchard, Secretary
June 29, 2001 F(: Pn 3 C`+
CUST ID No.673100 COMMU 1.0 LO I :1
A77N: Buildings Structures Inspector
JAMES GROFF OSHKOSH INSPECTION
HGM ARCHITECTURE 215 CHURCH AVE
805 N MAIN ST PO BOX 0976 PO BOX 1130
OSHKOSH WI 54902 OSHKOSH WI 54902 -1130
COMPONENT RECEIVED Identification Numbers
Transaction ID No. 660217
SITE: Site ID No. 132982
ST MARY PARISH Please refer to both identification numbers,
442 MONROE ST above, in all correspondence with the agency.
CITY OF OSHKOSH, 54901
WINNEBAGO COUNTY; FIRE DEPT ID: 7003
FOR:
OBJECT TYPE: PRECAST SLAB REGULATED OBJECT ID NO.: 801040
Your submission of the above component(s) plans have been received by this department and the plans and other
related documents have been filed with our records for the subject project.
The submitted materials HAVE NOT BEEN REVIEWED for compliance with all applicable administrative rules.
The department will rely on, and hold responsible, the building design professional and/or supervising professional
of record for compliance with the rules. The responsible professional should particularly insure that proper loads
and fire resistive rating have been incorporated to correspond to the building design. Particularly insure: proper dead
and live loading, including snow drift loading increases, equipment loads, proper bearing/supports, concentrated
loads etc, are properly conveyed to foundations; and that required fire ratings have been employed.
The department reserves the right to formally review the plans in the future if the department determines that such a
review is warranted, and to order corrective actions with respect to the outcome of that review.
A copy of the plan that is identical to the plan submitted for our file shall be available for inspection at the job
site. When the total building volume exceeds 50,000 cubic feet, the plan shall bear an indication of review that has
been signed or initialed by the building designer of record.
Inquiries concerning this correspondence may be made to at the telephone number listed below, or at the address
on this letterhead. Please refer to Transaction ID No. referred to in the regarding line when making an inquiry or
submitting additional information.
Sincerely, FEE REQUIRED 100.00
FEE RECEIVED 100.00
BALANCE DUE 0.00
n 2
JASO► HANSEN
PA2 TE INTEGRATED SERVICES WiSMART' 7648
(608)264 -7826 M -F 8 -430 1/2 LUNCH
JHANSEN@COMMERCE.STATE. WLUS
cc: PETER R OCHS BUILDING INSPECTOR, (920) 929 -3167 FRIDAY, 7:45 A.M. 4:30 P.M.
REV DAVID R BAETEN ST MARYS CHURCH
Date Sent: 01/24/02
Customer Id: 673100 Transaction Id: 446224
Phone: (920)231 -6950
JAMES GROFF
805 N MAIN ST
PO BOX 976
OSHKOSH WI 54903
Our records indicate that you are the supervising professional for the Regulated Object(s)
(Building,HVAC, Lighting and /or Pool) listed below. Please circle the status (A,B,C,D,E)
corresponding to the statements on the reverse side.
Complete comment lines as appropriate for each object. Return a copy to Safety Buildings
and the local municipality.
Site Id: 132982 WINNEBAGO County City of OSHKOSH
ST MARY PARISH
OSHKOSH WI 54901
442 MONROE ST
For:
Regulated Object Id: 769134 Object Type: Building ��y
Description: Chapter 55, Church i- 7T- CG�^�E's 6 e
Status AMC D E Comment:
(Circle)
.046e i w
Regulated Object Id: 769135 Object Type: HVAC System E
Description: Chapter 55, Church 7-,h w s 7 4 0 1. 5 ae. 7
Status A C D E Comment:
(Circle) i )-er-/ ca/9 G i 74 7
Supervising Professional Signature: //��/02,_, Date: f 5 d�
A. Compliance B. Non Compliance C. Withdrawn D. Abandon E. Not Done Page 1 of 1
See reverse side for instructions on completing this form
Safety Buildings Division
10541N Ranch Rd
Hayward WI 54843
sconsin
Department of Commerce
Scott McCallum, Govemor
Philip Edw. Albert, Secretary
March 21, 2002
CUST ID No. 356591
REV DAVID R BAETEN OSHKOSH INSPECTION
ST MARYS CHURCH 215 CHURCH AVE
442 MONROE ST PO BOX 1130
OSHKOSH WI 54901-0 OSHKOSH WI 54902 -1130
iderdifiadonNumbers
SITE: Transaction ID No. 446224
St Mary Parish Site ID No. 132982
442 Monroe St PIcaseireidetOtottiidentrucationimunbers.
City of Oshkosh, 54901 abovejnalltorrespoodeneeimitirthe
Winnebago County; Fire Dept ID: 7003 agency
FOR
Description: Chapter 55, Church
Object Type: Building Regulated Object ID No.: 769134
Class of Construction: 5B Masonry- Unprotected; Addition Plan; 2,475 Project Sq Ft; 2 Story Bldg; Unsprinklered;
Occupancy: Assembly
Object Type: HVAC System Regulated Object ID No.: 769135
Hot Water /Steam System
In response to our request for the compliance statement, the Supervising Professional of record, James Groff,
has indicated that this project is not in compliance. A copy of that statement is included for your review.
As noted in s. Comm 50.11, the owner is ultimately responsible for compliance with the code requirements.
Please work with your Supervising Professional to resolve the listed issue(s) in order to obtain a satisfactory
compliance statement.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the
address on this letterhead. Please refer to Transaction ID No. referred to in the regarding line when making an
inquiry or submitting additional information.
Sincerely,
ts
W ean K Dixon
Customer Service Representative
Integrated Services
(715) 634 -4870, Fax: (715) 634 -5150
7:45 am 4:30 pm Mon Fri
cc: Peter R Ochs Building Inspector, (920) 929 -3167 Friday, 7:45 a.m. 4:30 p.m.
James Groff
Date Sent: 01/24/02
Customer Id: 673100 Transaction Id: 446224 AEC!IVED
Phone: (920)231 -6950 FEB 19 2002
4APR'rr pH
JAMES GROFF
805 N MAIN ST
PO BOX 976
OSHKOSH WI 54903
Our records indicate that you are the supervising professional for the Regulated Object(s)
(Building,HVAC, Lighting and/or Pool) listed below. Please circle the status (A,B,C, ,E)
corresponding to the statements on the reverse side.
Complete comment lines as appropriate for each object. Return a copy to Safety uildings
and the local municipality.
Site Id: 132982 WINNEBAGO County City of OSHKOSH
ST MARY PARISH
OSHKOSH WI 54901
442 MONROE ST
For:
Regulated Object Id: 769134 Object Type: Building
Description: Chapter 55, Church Ae,J,ZE�%1fU 74,6 -„P et i 4 74 Cal..t k n
Status A O C D E Comment: xiC/ >rG�
(Circle) �J de
Regulated Object Id: 769135 Object Type: HVAC System
Description: Chapter 55, Church 7-Aei y4 GA m L, 7
Status A C D E Comment:
(Circle)
P/1146
Supervising Professional Signature: /jlLlk_ Date: 5 jan--..
A. Compliance B. Non Compliance C. Withdrawn D. Abandon E. Not Done Page 1 of 1
See reverse side for instructions on completing this form