HomeMy WebLinkAbout44100-Z 0'=-,
p�OFFat,tC�,� Town of Southold 9/7/2019
y P.O.Box 1179
0
53095 Main Rd
oy p't� Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40681 Date: 9/7/2019
THIS CERTIFIES that the building ALTERATION
Location of Property: 51005 Route 25, Southold
SCTM#: 473889 Sec/Block/Lot: 70.4-4
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore fined in this office dated
8/26/2019 pursuant to which Building Permit No. 44100 dated 8/27/2019
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:
"as built" gas heat conversion to existing two family dwelling as applied for.
The certificate is issued to Franke,Michael&Ors.
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 40681 9/9/2019
PLUMBERS CERTIFICATION DATED
Autho ed Signature
o�SUFFo K TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
'�y • ,� SOUTHOLD, NY
�Ol � dao
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#: 44100 Date: 8/27/2019
Permission is hereby granted to:
Franke, Michael & Ors.
PO BOX 1303
Southold, NY 11971
To: legalize "as built" gas conversion to existing two family dwelling as applied for.
At premises located at:
51005 Route 25, Southold
SCTM #473889
Sec/Block/Lot# 70.-1-4
Pursuant to application dated 8/26/2019 and approved by the Building Inspector.
To expire on 2/25/2021.
Fees:
ELECTRIC $170.00
AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $400.00
CO -ALTERATION TO DWELLING $50.00
Total: $620.00
B u i Ving ns'pe ctor
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 to dwelling$50.00,
Swimming pool$50.00,Accessory building$50.00,Additions to accessory building$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, Co%erciall$15.00
.0 a-�I
.
New Construction: Old or Pre-existing Building: V (check one)
Location ofPropert VVIR
House No. Street Hamlet
kbW&C —1 ,
Owner or Owners of Prop
Suffolk County Tax Map No 1000, Section 70 Block Lot
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted:
�j Applicant Signature
pf SO(/ry®l
Town Hall Annex ® Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 �l • �®� sean.devlin(cD-town.southold.ny.us
�C®UNT`I,�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To Michael Frank
Address: 51005 Route 25 City Southold st: NY zip- 11971
Budding Permit# 44100 Section. 70 Block 1 Lot- 4
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: AS BUILT License No:
SITE DETAILS
Office Use Only
Residential X Indoor X Basement X Service Only X
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey X Attic Garage
INVENTORY
Service 1 ph X Heat Duplec Recpt Ceding Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel 100A A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks
Disconnect Switches Twist Lock Exit Fixtures Combo SD/CO
Other Equipment 2. 12 Circuit Panels, Double Meter
Notes.
Inspector Signature: Date: September 9, 2019
S.Devlin-Cert Electrical Compliance Form As
pf SOUIyO Lf Ll f o o
# TOWN OF SOUTHOLD BUILDING DEPT.
oourm, 765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL)Sf/21//Gg�
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
FyIVAL,
DATE INSPECTOR
FIELD INSPECTION REPORT DATE COMMENTS
FOUNDATION(1ST) 0
y
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FOUNDATION(2ND) N t
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ROUGH FRAMING&
PLUMBING
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INSULATION PER N.Y. H
STATE ENERGY CODE
FINAL
ADDITIONAL COMMENTS
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-6p+ b ,00 rE c. L1,&65
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TOWN 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 n Survey
Southoldtownny.gov PERMIT NO. Check
Septic Form
N.Y.S.D.E C.
Trustees
C.O.Application
Flood Permit
Examined 20 Single&Separate
r Truss Identification Form
AUG 2 6 2019 Stone-Water Assessment Form
Contact:
Approved 20
Disapproved a/c
Phone: b3 J—7&
Expiration ,20
Building Mipt6tor
APPLICATION FOR BUILDING PERMIT
�g
Date Yr0)
(9- , 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
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 co e,a d regulations, and to admit
authorized inspectors on premises and in building for necessary inspections.
(Signature of applicant or name,if a corporation)
71
(Mailing address of applicant)
State whether applicant i ow , lessee, agent, architect, engineer, general contractor, electrician,plumber or builder
Name of owner of premises `t� tkS 17JUA&
(As on the tax roll or latest de d)
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 of land on which proposed work will be done: I�C�
5-10os—
House Number Street' Hamlet
7b
County Tax Map No.'1000 Section Block "( Lot
Subdivision 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 2�rW ,Q.�HIL
b. Intended use and occupancy
3. Nature of work(check which applicable): New Buildin ,---A—d—dit1-6q Alteration
Repair Removal Demolition Other Work �d1'lf� -,s n1 v- vcmvq
C
(Description)
4. Estimated Cost Fee
(Tobe 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 nature-and-extent of each type of use.
7. Dimensions of existing strictures, 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-A-
13.
Ox13. 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 A—
• IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE 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 lines.
17. If elevation at any point on property is at 10 feet or below,must provide topographical data on survey.
18. Afe there any covenants and restrictions with respect to this property? * YES NO
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY OF )
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 the work will be
performed in the manner set forth in the application filed therewith.
Sworn to before me this
a(ems day of 20j _
K � Y)A A� Ao4
Notary Public TRACEY L. DWYER Signature of Applicant
OTARY PUBLIC,STATE OF NEW Y RK
NO.01 DW6306900
QUALIFIED IN SUFFOLK COUNTY
COMMISSION EXPIRES JUNE 30,2_
VT1
U, $ YBUILDING DEPARTMENT- Electrical Inspector
TOWN OF SOUTHOLD
12 6 2019 Town Hall Annex - 54375 Main Road - PO Box 1179
Southold, New York 11971-0959
-,)yP' . Telephone (631) 765-1802 - FAX (631) 765-9502
roger.richertCcD_town.southold.ny.us
APPLICATION
ATION FOR ELECTRICAL INSPECTION
REQUESTED BY:- --��(;W�i 1- kL Date:
Company Name:
Name:
License No.:
Address:
Phone No.:
JOB SITE INFORMATION: (All Information Required)
Address: ('L)
Cross Street: TA-5mi (4
Phone No.: - 0-03 or, 63 -Boa-V
Bldg.Permit#: 4qi 00 email:
Fax Map District: 1000 Section: 7D Block: Lot:
BRIEF DESCRIPTION OF WORK (Plee Print Clearly) (rAekWC-,4F �5640-1/46a
oonva-,,sjmn_no_r�'-)
Circle All That Apply:
Is job ready for inspection?: �/ NO Rough Ininal
Do you need a Temp Certificate?: YES NO Issued On
Temp Information: (All information required)
Service Size 1 Ph 3 Ph Size: A # Meters Old Meter#
New Service- Fire Reconnect- Flood Reconnect- Service Reconnected - Underground - Overhead
# Underground Laterals 1 2 H Frame Pole Work done on Service? Y N
Additional Information:
PAYMENT DUE WITH APPLICATION
o
Request for Inspection FormAs111�/� X% 0
14
ELE TRICAL O�-
� i► ' >:` INSPECTION REQUIRED
""• '1';:5 .(.''•'ala. ,.,
COMPLY WITH ALL CO{ S Gr ;
APPROVED AS NO •
NEW YORK STATE & TOWN'CO�- ,,.
AS R�QUIRE®
DATE: �7 B.P.# ' ®•C•�}VDlTIONS G
FEE: BY
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''Manufactured by:
WITHOUT-" R�
MA,
OFC_ �CCUJ,PAN
Biasi S.p.A. 'ry rw,ccu oanTeo
Verona, Italy Quincy Hydronic Technology Inc.
3560 Lafayette Rd. Bldg. 2 Unit A
3` PorjBs jouth, NIH 03801
® ` 'Phoned 603-334-6400
' I Fax: 603-334-6401
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P O CFRTIFIF�
FRIIF�� � �� '?1
RIVA PI 11.q C MARI II.qFR NAANI IAI
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1 . General Information
The Riva Plus Combi is a high efficiency condensing, wall mounted gas boiler which provides
central heat. The boiler features a gas valve which modulates the energy input from 49,476
BTU/h to 116,008 BTU/h. The boiler is shipped fully assembled. All units are pressure and
combustion tested at the factory prior to shipping.
Key Features:
• Wall mountable - saving valuable floor Boiler operation recognition system -
space. should the boiler not be used for longer
• Several flue options available than 24 hours, it then performs a control-
• Electronic spark ignition led system test to ensuring the motorized
• Safety flow switch - positioned on the components within the boiler do not be-
main circuit, which monitors the flow and come inoperable due to lack of use.
protects the main heat exchanger from Gas valve modulation - the gas input
thermal shock should there be a lack of modulates based,off central heating tem-
water in the system. perature to within ± 2 OF
• Frost protection-contains an integral frost Diagnostic information system equipped'
protection system to prevent frost dam- with three LED diagnostic lights for quick
,.age which can occur in areas susceptible error assessment. _.
•td''ver cold weather conditions. t
: 2. Technical Information (M135.30CM)
GENERAL INJECTORS No. Size
Height in 31.6 Natural 14130
Width in 15.7 Propane 14 85
Depth in 13.8
Weight Ib 100.3 CENTRAL
Maximum working temp. OF 185
ELECTRICAL Temp. Regulation range* OF 100-176
Voltage V 120 Maximum pressure psi 30.0 I
Frequency Hz 60 Minimum pressure psi 4.35
Current A 1.6 Max head loss (at 4.4 GPM) ft 8.25
Power consumption W 180 *At the minimum useful output
i
RIVA PLUS COMBI USER MANUAL 7
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2. Technical Information •
ENERGY CAPACITY + •W RATE
Nominal heat input MBH 116.0 Gas Min Max
(0/2000ft) Natural ft3/h 48.7 115.1
Nominal heat input MBH 110.2
{ 2000/4500ft Propane Ib/h 2.2 5.2
I Minimum heat input MBH 49.5
i. CLEARANCE TO COMBUSTIBLES
i' Maximum useful output MBH 102.0
30/2000ft Front in 18
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Maximum useful output MBH 97.2 Back in 0
(2000/4500ft) Top in 10
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Minimum useful output MBH j 41.6 Sides in 2
Bottom in 8
GAS SUPPLY PRESSURE Flue pipe enclosed in 2
Gas Normal Min 77ax Flue pipe free air in 0
!Natural inwc 7.0 3.5 10.5 Hot water pipes in 1"
Propane inwc 11.0 ' 8.0 13.0
FLUE GAS FIGURES
GAS PRESSURE. ATBURNE Gas Min Max
GasMin Max Ignition COz 2.5% 6.3%
Na��qral inwc 1:0 4.8E2.4 Oz 16.5% 9.7%
ne inwc 2.0 10.3 5.2
DOMESTIC •
sFLUE DESIGN Maximum temperature OF 131
Minimum Venturi pressure inwc 0.64 Minimum temperature OF 95
Flue pipe diameter Maximum pressure psi 145
i 2.25/4 psi 4.35
Coaxial in 3.25/5 Minimum pressure
D.h.w.AT 25K gpm 4.5
? Twin split pipesin 3.25/3.25 D.h.w.AT 30 K gpm 3.8
Nominal heat flow rate MBH 116.0 D.h.w.AT 35 K gpm 3.2
Nominal heat flow rate MBH 110.2 D.h.w.AT 40 K gpm 2.8
(2000/4500ft)
Min Exhaust temperature °F 140
Max Exhaust temperature OF 190
�i
8 RIVA PLUS COMBI USER MANUAL