Loading...
HomeMy WebLinkAbout44584-Z �gUFF0� �D Town of Southold 10/11/2020 P.O.Box 1179 o 53095 Main Rd 4ol Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 41532 Date: 10/11/2020 THIS CERTIFIES that the building GENERATOR Location of Property: 1535 Westview Dr, Mattituck SCTM#: 473889 Sec/Block/Lot: 107.-7-10 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 1/2/2020 pursuant to which Building Permit No. 44584 dated 1/9/2020 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: accessorygenerator as applied for. The certificate is issued to Hurley III,John&Maureen of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 44584 10/5/2020 PLUMBERS CERTIFICATION DATED , Authorized Signature TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE ca, ze 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#: 44584 Date: 1/9/2020 Permission is hereby granted to: Hurley III, John & Maureen PO BOX 102 Mattituck, NY 11952 To: install a generator as applied for. At premises located at: 1535 Westview Dr, Mattituck SCTM # 473889 Sec/Block/Lot# 107.-7-10 Pursuant to application dated 1/2/2020 and approved by the Building Inspector. To expire on 7/10/2021. Fees: ACCESSORY $100.00 CO -ACCESSORY BUILDING $50.00 ELECTRIC $85.00 $235.00 uilding Inspe r 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 Apri19,1957)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,Commercial$15.00 Date. New Construction: Old or Pre-existing Building: • X (check one) Location of Property: /.53.5" W es�V/e_w LANP- , M,4 1--h'-1u c K, NF—w )1DR K 119'S-2- House No. Street Hamlet Owner or Owners of Property: J"f}CK 14Lk e I E,l Suffolk County Tax Map No 1000, Section 167 Block D 7 Lot /p Subdivision ,J ` Filed Map. Lot: Permit No. `I 'l 5 Date of Permit. Applicant: Louis 14• b.E .S�A A,� tr Health Dept,Approval: Underwriters Approval: Planning Board Approval: / Request for: Temporary Certificate Final Certificate: ✓/ (check one) Fee Submitted: $ S(� ?Applit/lignature Town Hall Annex ® Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 sean.deviinCaD-town.southold.ny.us Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: John Hurley III Address: 1535 Westview Dr city,Mattituck st: NY zip: 11952 Building Permit#. 44584 Section: 107 Block. 7 Lot. 10 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Shore Power Electrical License No: 42536ME SITE DETAILS Office Use Only Residential X Indoor X Basement Service Commerical Outdoor X 1st Floor Pool New X Renovation 2nd Floor Hot Tub Addition Surrey Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt Ceding Fixtures Bath Exhaust Fan Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors Main Panel 200A A/C Condenser Single Recpt Recessed Fixtures CO2 Detectors Sub Panel A/C Blower Range Recpt Ceding Fan Combo Smoke/CO Transfer Switch 200A UC Lights Dryer Recpt Emergency Fixtures Time Clocks Disconnect Switches 4'LED Exit Fixtures Pump Other Equipment 22kW Generac Generator w/ 100A Overcurrent Protection on Generator, 200A Whole House Transfer Switch Notes: Generator Inspector Signature: cv.- Date: October 5, 2020 p 9 S.Devlin-Cert Electrical Compliance Form.xls (�((kit Board -of a®ia Application AUTHORIZATION (Where the applicant is not the owner) owners of the property identified as SGTM# 1000- l D 7— O 7 !O in the town of �AT T 1 U. X .New York,hereby authorizes L•. O(�t.l S .0 E �AI�'t7 S to act as my agent and handle all necessary work involved with the application process for permit(s)from the Southold Town ��ld► oar steres for this property. Pm Owner's Signature Property Owner's Signature /-(A-�,t(ZEC-N N ay SWORN TO BEFORE ME THIS DAY OF IV r cm j��'— ,20 Notary Public t�t�:�1:.: oFsoury°6 "4 S-6; le'k * # TOWN OF SOUTHOLD BUILDING DEPT. °`y�nu►m ''�� 765-1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLEIG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING- [ ] FRAMING/STRAPPING [ ] FINAL - [ ] -FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE.RESISTANT PENETRATION - [ ] ELECTRICAL (ROUGH) [ ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O �c� cr REMARKS: DATE INSPECTOR FIELD INSPECTION REPORT I -DATE COMMENTS b C� FOUNDATION (IST) H -------------------------------------- FOUNDATION (2ND) DO z CIO " o H ROUGH FRAMING& PLUMBING H ' 1 • r INSULATION PER N.Y. H STATE ENERGY CODE FINAL ADDITIONAL COMMENTS WIN i bf, 61A 4- 0 � z b O 1 O z - x d _ R 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 Survey Southoldtownny.gov PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Examined 20 Single&Separate Truss Identification Form Storm-Water Assessment Form Contact: Approved 20 - Mail to:54a flm None ggC'g c,+L Disapproved a/c ' % El!ZA bAm 1_ m I®A Phone:_63l-37S Xo Z9 'x- Expiration ,20 CEglge NMidiel JAY x/93 I nspector - AJ'PLICATION FOR BUIL G PERMIT JAN - 2 2020 ,v. . Date 1,5''"r , 20-_ INSTRUCTIONS a.This application'MU T'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 code,and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. i � cru-os �- U JALV ature of applicant or name,if a corporation) 10e WE(N AJ, U1if-2, Ckm4rm2 H®wdru. lely. (Mailing address of applicant) //?3* State whether applicant is owner, lessee, agent architect, engineer, general contractor, electrician,plumber or builder Name of owner of premises_ _7ACJ< ALAA 1E� 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. 5i-2• .5'3 Other Trade's License No. 1. Location of land on which proposed work will be done: ll IS'-3S- WC5�'ViEw b ua , A -4,kcK I'VEW YORK 119?SZ House Number Street IHamlet County Tax Map No. 1000 Section 107 Block 0 -7 Lot 16 l C� Subdivision _ 107 Filed Map No. O 7 Lot /O 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 Addition Alteration Repair Removal Demolition Other Woby�10A.. (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 1 6. If business, commercial-or mixed occupancy,specify nature 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 I 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 MAYBE 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.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 A4 De- IW44X, being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the Aa A (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 thik6ilL. �� day of E' " ERIN ':WA1�SN rY yb el- ow York � Bari "I tr�ff ft�101,WA8340064 tiffi[olk,' ounty Notary Public Commission Expirea'Ap �19,2020 Si tore of Applicant Michael J.Domino,President �QF S®(®,� Town Hall Annex John M.Bredemeyer III,Vice-President ,�®� ®�® 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski 4W Telephone (631) 765-1892 Greg Williams 'c°® ® �® Fax(631) 765-6641 A-UM BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 9603A Date of Receipt of Application: November 4, 2019 Applicant: John Hurley SCTM#: 1000-107-7-10 Project Location: 1535 Westview Drive, Mattituck Date of Resolution/Issuance: December 11, 2019 Date of Expiration: December 11, 2021 Reviewed by: Glenn Goldsmith, Trustee Project Description: Install a 48"x25" generator on a 55"x35" concrete pad. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the project plan prepared by Louis DeSantis, received on November 4, 2019 and stamped approved on December 11, 2019. Special Conditions: None. Inspections: Final Inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. Michael J. Domino, President Board of Trustees �,r- allILDING DEPARTMENT-Electrical Inspector .. TOWN,OF SOUTHOLD Town Hall Annex- 54375 Main Road - PO Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX(631) 765-9502 rocrer.ricj ed,MJgM.southoId,.ny.us APPLICATION FOR ELECTRICAL INSP� EGTIO, N REQUESTED BY: hl fiche IA-9 . t). -*hM i C O Date: /2 - /S-,AO /y Company Name: .S EIFc?LP-)cA- Name: ' IA-9 'A M i Co License No.: 4"L9:3 6 N E email: Nrcke S ho owr_ez -�,2r`c, cb M Address: FRQWcr'N RoAd uq�+-2 2 Hauch—S— Alew YvxK Phone No.: JOB SITE INFORMATION: (All information Required) r Name: -TA c/< Xk/e /C Address: /5-3 -5' WEs v4ew Oaei ve r ,fC Alew o2 s Z Cross Street: Ro w ER o Ad, Phone No.: 20 9- 3,11- _ BIdg.Permit#: email:; /,e eA ,.uet `E'ax Map District: 1000 Section: /07 Block. D 7 Lot: /D BRIEF DESCRIPTION OF WORK(Please Print Clearly) &s4A1/�-koy A-P as Kw l j+E/�l ER A-fOR Circle All That Apply: Is job ready for inspection?: YES / NO Rough In Final Do you need a Temp Certificate?: YES ICED) Issued On Temp Information: (Ali information required) Service Size 1 Fah 3 Ph Size: A #Mehr$ Old Metar# 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 __— - ---- - 82-Request for InspeoUon Fonn.xis Q ��k � q, AC2 I'll 4!�2-- C) SHORE-4 OP ID:CR A�oRoW CERTIFICATE DATE(MMfDDNYYY) OF LIABILITY INSURANCE 10/24/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsemen s. PRODUCER � CONTACT Hometown insurance of Ll,Inc NAME: James Small Wetterenc PHONE 60rvi11eDr�ve Suite 400 (AIC,No •631-567-1011 arc No:631-589-4207 Bohemia,NY 11716 ADDRESS: James Small INSURERS AFFORDING COVERAGE NAIC# INSURER A:The Ohio Casualty Ins.Co. INSURED Shore Power Electrical Contracting,Inc. INSURER 8: 108 Frowein Road,#2 INSURER C: Center Moriches,NY 11934 INSURER D: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHQWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR I ADDL SUB LTR TYPE OF INSURANCE D POLICY NUMBER MMIDMMIDD LIMITS POLICY EFF POLICY EXP A X coMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE T OCCUR BKO(20)67918686 07/17/2019 07/17/2020 DAMAG TO REN ED PREMISES Ea occurrence $ $00,000 MED EXP(Any one person) $ 16,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,090 POLICY X JECTPRO- El LOC PRODUCTS-COMPIOP AGG $ 2,000;000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNEDSCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED HIRED AUTOS AUTOS ! PROPERTY DAMAGE $ Per accident $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROpRIETORIPARTNERIEXECUTIVE ' OFFICERIMEMBER EXCLUDED? N/A j E L EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ f t DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is requlred) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Southold THE EXPIRATION DATE THEREOF, NOTICE WELL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town Hall Annex Southold,NY 11971 AUTHORIZED REPRESENTATIVE AA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014101) The ACORD name and logo are registered marks of ACORD Yo YORK Workers' CERTIFICATE OF INSURANCE COVERAGE <NTEW Compensation Board DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW PART 1.To be completed by Disability and Paid Family Leave Benefits Carrier or Licensed Insurance Agent of that Carrier 1 a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured SHORE POWER ELECTRICAL CONTRACTING, INC 108 FROWEIN RD-#2 631-395-4029 CENTER MORICHES, NY 11934 Work Location of Insured(Only required if coverage is specifically limited to 1c.Federal Employer Identification Number of Insured certain locations in New York State,i.e.,wrap-up Policy) or Social Security Number 20-4999885 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Bein Listed as the Certificate Holder) Town of Southold Standard Security Life Insurance Company of New York Town Hall Annex 3b.Policy Number of Entity Listed in Box"1 a" Southold, NY 11971 79516-00 3c.Policy effective period 1/1/2018 to 10/22/2020 4. Policy provides the following benefits: Q A.Both disability and paid family leave benefits. E] B.Disability benefits only. C.Paid family leave benefits only. 5. Policy covers: 0 A.All of the employers employees eligible under the NYS Disability and Paid Family Leave Benefits Law. F] B.Only the following class or classes of employers employees: Under penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has NYS Disability and/or Paid Family Leave Benefits insurance coverage as desc' d above_ Date Signed 10/24/2019 By 0. 4,viz (Signature of insurance carrier's authoriz d representative or NYS Licensed Insurance Agent of that insurance carrier) Telephone Number (212) 355-4141 Name and Title SUPERVISOR -DBL/POLICY SERVICES IMPORTANT: If Boxes 4A and 5A are checked,and this form is signed by the insurance carriers authorized representative or NYS Licensed Insurance Agent of that carrier,this certificate is COMPLETE.Mail it directly to the certificate holder. If Box 4B,4C or 513 is checked,this certificate is NOT COMPLETE for purposes of Section 220, Subd_8 of the NYS Disability and Paid Family Leave Benefits Law. It must be mailed for completion to the Workers'Compensation Board, Plans Acceptance Unit,PO Box 5200, Binghamton, NY 13902-5200. PART 2.To be completed by the NYS Workers'Compensation Board(Only if Box 4C or 5B of Part 1 has been checked) State of New York Workers' Compensation Board According to information maintained by the NYS Workers'Compensation Board,the above-named employer has complied with the NYS Disability and Paid Family Leave Benefits Law with respect to all of his/her employees. Date Signed By, (Signature of Authorized NYS Workers'Compensation Board Employee) Telephone Number Name and Title Please Note.Only insurance carriers licensed to write NYS disability and paid family leave benefits insurance policies and NYS licensed insurance agents of those insurance carriers are authorized to issue Form DB-120.1. Insurance brokers are NOT authorized to issue this form. DB-120.1 (10-17) 1I�IIIIDIB1II201 (10 1WllII ) Allt� YORK Workers' CERTIFICATE OF S16�TE I Co B® rCrtarynsatson NYS WORKERS' COMPENSATION INSURANCE COVERAGE 1 a.Legal Name&Address of Insured(use street address only 1 b.Business Telephone Number of Insured SHORE POWER ELECTRICAL CONTRACTING, INC 631-395-4029 108 FROWEIN RD-#2 CENTER MORICHES, NY 11934 ic.NYS Unemployment Insurance Employer Registration Number of Insured Work Location of Insured(Only required if coverage is specifically limited to certain locations in New York State,i.e.,a Wrap-Up 1 d.Federal Employer Identification Number of Insured or Social Security policy) Number 20-4999885 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) HARTFORD CASUALTY INSURANCE COMPANY Town of Southold 3b.Policy Number of Entity Listed in Box"1 a" Town Hall Annex 12 WEC A135PSI Southold, NY 11971 3c.Policy effective period 07/20/2019 to 07/20/2020 3d.The Proprietor,Partners or Executive Officers are Included.(Only check box if all partners/officers included) X all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box"3"insures the business referenced above in box"1 a"for workers' compensation under the New York State Workers'Compensation Law.(To use this form,New York(NY)must be listed under Item 3A on the INFORMATION PAGE of the workers'compensation insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box,2". The insurance carrier must notify the above certificate holder and the Workers'Compensation Board within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate.(These notices may be sent by regular mail.)Otherwise,this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent,or until the policy expiration date listed in box"3c",whichever is earlier. This certificate is issued as a matter of information only and confers no rights upon the certificate holder.This certificate does not amend, extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying policy is in effect. Please Note:Upon cancellation of the workers'compensation policy indicated on this form,if the business continues to be named on a permit,license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of Workers'Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law. Under penalty of perjury,I certify that 1 am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by:_Corinne Rooney (Print name of authorized representative or licensed agent of insurance carrier) Approved by: (Signature) (Date) Title:Certificate Coordinator Telephone Number of authorized representative or licensed agent of insurance carrier: 631-567-1011 Ext 352 Please Note:Only insurance carriers and their licensed agents are authorized to issue Form C-105.2.Insurance brokers are NOT authorized to issue it. C-105.2(9-17) www.wcb.ny.gov Y `I w Ax a COsY;PLY WITH ALL CODES OF ATE: f L.P.#m_�lv�— NEW YORK S?ATE & TOWN CODES � AS REOUIRED , FE a,Y . ` SOUTHOLD T N 0-IFYU�PAi.TMENT AT 765-180`2 8l�M TO 4 + M, FOR THE SOUT LD TOWN PLANNING BOAR FO!LOWING INSPECTIONS, 1. FOUNDATION T'a�'•J riCQU{R ED SOUTH TOWNTRUSTEES FOR POURED COi,I ',RETE P�,,S.DEC 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. p ��� o ALL CONSTRUCTION SHALL MEET THE L REQUIREMENTS OF THE CODES OF N'W @ � F YORK STATE. NOT RESPONSIBLE FOR USE 11 y �IfIG �'� DESIGN OR CONSTRUCTION ERRORS • ELECTRICAL INSPEMON REQUIRED GENERAC® 1` 6120 2 ftw GUARDIAN® SERIES Residential Standby Generators Air-Cooled Gas Engine IIIIIIIIIttlttno INCLUDES: Standby Power Rating • True Power" Electrical Technology Models G007036-0, G007037-0 (Aluminum - Bisque) - 16 kW 60 Hz • Two Line LCD Multilingual Digital Model G007035-0(Aluminum -Bisque) - 16 kW 60 Hz EvolutionT"" Controller (English/Spanish/ Models G007039-0, G007038-0 (Aluminum- Bisque) -2010 60 Hz French/Portuguese) Models G007043-0, G007042-0 (Aluminum - Bisque) -22 kVV 60 Hz • Two Transfer Switch Options Available: 100 Amp, 16 Circuit Switch or 200 Amp Service Rated Smart Switch. See Page 4 for Details. = • Electronic Governor ( =� • System Status & Maintenance Interval LED Indicators - • Sound Attenuated Enclosure GENERAL' • Flexible Fuel Line Connector • Direct-To-Dirt Composite Mounting Pad trt, i • Natural Gas or LP Gas Operation • 5 Year Limited Warranty Q I • Capability to be installed within 18" (457 mm) LISTED �lV - of a building* Note,CUL certification only applies to unbundled units and units packaged with limited circuit switches Units packaged with the Smart Switch are UL certified in the USA only. 'Only if located away from doors,windows and fresh air intakes,and unless other- wise directed by local codes FEATURES O INNOVATIVE DESIGN&PROTOTYPE TESTING are key components of O SOLID-STATE,FREQUENCY COMPENSATED VOLTAGE REGULATION. This state- GENERAC'S success in"IMPROVING POWER BY DESIGN"But it doesn't of-the-art power maximizing regulation system is standard on all Generac models It stop there. Total commitment to component testing,reliability testing, provides optimized FAST RESPONSE to changing load conditions and MAXIMUM environmental testing,destruction and life testing,plus testing to applicable MOTOR STARTING CAPABILITY by electronically torque-matching the surge CSA,NEMA,EGSA,and other standards,allows you to choose GENERAC loads to the engine.Digital voltage regulation at±196. POWER SYSTEMS with the confidence that these systems will provide superior performance O SINGLE SOURCE SERVICE RESPONSE from Generac's extensive dealer network provides parts and service know-how for the entire unit,from the engine to the O TRUE POWER" ELECTRICAL TECHNOLOGY:Superior harmonics and sine wave smallest electronic component. form produce less than 5%Total Harmonic Distortion for ublity qualitypower.This allows confident operation of sensitive electronic equipment and micro-chip based appliances, O GENERAL TRANSFER SWITCHES.Long life and reliability are synonymous such as variable speed HVAC systems, with GENERAC POWER SYSTEMS One reason for this confidence is that the O TEST CRITERIA: GENERAC product line includes its own transfer systems and controls for total • PROTOTYPE TESTED v NEMA MGI-22 EVALUATION system compatibility e SYSTEM TORSIONAL TESTED v MOTOR STARTING ABILITY GENERAL 4, +rJ�-�age Mobil*�,�1* Link P R 0 M I S E �QRRP�'" 08p1B1n the BSA using damoshc and foreign parts 1 CENERAC° 16/20/22 kW features and benefits Engine •Generac(OHVI)design Maximizes engine"breathing"for increased fuel efficiency. Plateau honed cylinder walls and plasma moly rings helps the engine run cooler,reducing oil consumption resulting in longer engine life. •Quiet-Test- Greatly reduces sound output and fuel consumption during bi-weekly exercise. •"Spiny-lok"cast iron cylinder walls Rigid construction and added durability provide long engine life. -Electronic ignition/spark advance These features combine to assure smooth,quick starting every time. •Full pressure lubrication system Pressurized lubrication to all vital bearings means better performance,less maintenance and longer engine life. Now featuring up to a 2 year/200 hour oil change interval. *Low oil pressure shutdown system Shutdown protection prevents catastrophic engine damage due to low oil. •High temperature shutdown Prevents damage due to overheating. Generator •Revolving field Allows for a smaller,light weight unit that operates 25%more efficiently than a revolving armature generator -Skewed stator Produces a smooth output waveform for compatibility with electronic equipment. -Displaced phase excitation Maximizes motor starting capability -Automatic voltage regulation Regulates the output voltage to±1%prevents damaging voltage spikes. •UL 2200 listed For your safety. Transfer Switch •Fully automatic Transfers your vital electrical loads to the energized source of power. •Remote mounting Mounts near your existing distribution panel for simple,low-cost installation •NEMA 313 Can be installed inside or outside for maximum flexibility Evolution"' Controls -Auto/Manual/Off illuminated buttons Selects the operating mode and provides easy,at-a-glance status indication in any condition. -Two-line LCD multilingual display Provides homeowners easily visible logs of history,maintenance and events up to 50 occurrences. -Sealed,raised buttons Smooth,weather-resistant user interface for programming and operations -Utility voltage sensing Constantly monitors utility voltage,setpoints 65%dropout,80%pick-up,of standard voltage. •Generator voltage sensing Constantly monitors generator voltage to ensure the cleanest power delivered to the home. •Utility interrupt delay Prevents nuisance start-ups of the engine,adjustable 2-1500 seconds from the factory default setting of 5 seconds by a qualified dealer •Engine warm-up Ensures engine is ready to assume the load,setpoint approximately 5 seconds •Engine cool-down Allows engine to cool prior to shutdown,setpomt approximately 1 minute. •Programmable exerciser Operates engine to prevent oil seal drying and damage between power outages by running the generator for 5 minutes every other week.Also offers a selectable setting for weekly or monthly operation providing flexibility and potentially lower fuel costs to the owner. =Smart battery charger Delivers charge to the battery only when needed at varying rates depending on outdoor air temperature. Compatible with lead acid and AGM-style batteries. -Electronic governor Maintains constant 60 Hz frequency Unit -SAE weather protective enclosure Sound attenuated enclosures ensure quiet operation and protection against mother nature,withstanding winds up to 150 mph.Hinged key locking roof panel for security. Lift-out front for easy access to all routine maintenance items.Electrostatically applied textured epoxy paint for added durability. ®Enclosed critical grade muffler Quiet,critical grade muffler is mounted inside the unit to prevent injuries. -Small,compact,attractive Makes for an easy,eye appealing installation,as close as 18"away from a building. Installation System •1 it(305 mm)flexible fuel line connector Absorbs any generator vibration when connected to rigid pipe. •Direct-to-dirt composite mounting pad Complex lattice design prevents settling or sinking of the generator system. •Integral sediment trap Prevents particles and moisture from entering the fuel regulator and engine,prolonging engine life. GENERAL" 16/20/22 W specifications _ Generator Model G0070360,G007036-0, G007038-0,G007039-0 G007042-0,G007043-0 G007037-0(16 kW) (20 kW) (22 kW) Rated Maximum Continuous Power Capacity(LP) 16,000 Wafts* 20,000 Watts` 22,000 Watts` Rated Maximum Continuous Power Capacity(NG) 16,000 Watts* 18,000 Watts* 19,500 Watts* Rated Voltage 240 240 240 Rated Maximum Continuous Load Current—240 Volts(LP/NG) 66.6/66.6 83.3/75 91.6/81.3 Total Harmonic Distortion Less than 5% Less than 5% Less than 5% Main Line Circuit Breaker 70 Amp 100 Amp 100 Amp Phase 1 1 1 Number of Rotor Poles 2 2 2 Rated AC Frequency 60 Hz 60 Hz 60 Hz Power Factor 10 10 10 Battery Requirement(not included) 12 Volts,Group 26R 540 CCA Minimum or Group 35AGM 650 CCA Minimum Unit Weight(Ib/kg) 409/186 448/203 466/211 Dimensions(L x W x H)in/mm 48 x 25 x 29/1218 x 638 x 732 Sound output in dB(A)at 23 ft(7 m)with generator operating at normal load** 66 66 67 Sound output in dB(A)at 23 it(7 m)with generator in Quiet-Test-low-speed 58 58 58 exercise mode** Exercise duration 5 min 5 min 5 min Ergine - - Type of Engine GENERAC OHVI V-TWIN GENERAC OHVI V-TWIN GENERAL OHVI V-TWIN Number of Cylinders 2 2 2 Displacement 999 cc 999 cc 999 cc Cylinder Block Aluminum w/Cast Iron Sleeve Valve Arrangement Overhead Valve Overhead Valve Overhead Valve, Ignition System Solid-state w/Magneto Solid-state w/Magneto Solid-state w/Magneto Governor System Electronic - Electronic Electronic Compression Ratio 9 5:1 9.5.1 951 Starter 12 Vdc 12 Vdc 12 Vdc Oil Capacity Including Filter Approx 19 gV1.8 L Approx.1.9 gI/1.8 L Approx 19 gI/1.8 L Operahng rpm 3,600 3,600 3,600 Fuel Consumption Natural Gas fta/hr(ma/hr) 1/2 Load 193(5 47) 205(5 8) 184(5 21) Full Load 312(8.83) 308(8.72) 281(7.96) Liquid Propane it3/hr(gal/hr)[I/hr] 1/2 Load 69(1.9)[7.2] 81(2.23)[8 45] 78(2.16)[8.16] Full Load 116(3 19)112 071 140(3 85)[14.57] 134(3 68)[13.94] Note:Fuel pipe must be sized for full load. Required fuel pressure to generator fuel inlet at all load ranges-3 5-7"water column(7-13 mm mercury)for natural gas,10-12'water column(19-22 mm mercury)for LP gas For Btu content,multiply ft3/hr x 2500(LP)or It3/hr x 1000(NG) For Mega)oule content,multiply mV/hr x 93.15(LP)or m3/hr x 37.26(NG) Controls 2-Line Plain Text Multilingual LCD Display Simple user interface for ease of operation. Mode Buttons Auto Automatic Start on Utility failure 7 day exerciser Manual Start with starter control,unit stays on if utility fails,transfer to load takes place. Off Slops unit.Power is removed.Control and charger still operate Ready to Run/Mamtenance Messages Standard Engine Run Hours Indication Standard Programmable start delay between 2-1500 seconds Standard(programmable by dealer only) Utility Voltage Loss/Return to Utility Adjustable(Brownout Setting) From 140-171 WI 90-216 V Future Set Capable Fxerciserifxercise Set Error Warning Standard RurVAlanri/Maintenance Logs 50 Events Each Engine Start Sequence Cyclic cranking:16 sec on,7 rest(90 sec maximum duration) Starter Lack-out Starter cannot re-engage until 5 sec after engine has stopped Smart Battery Charger Standard Charger FaulVMissing AC Warning Standard Low Battery/BaRery Problem Protection and Battery Condition Indication Standard Automatic Voltage Regulation with Over and Under Voltage Protection Standard Under-Frequency/Overfoad/Stepper Overcurrent Protection Standard Safety Fused/Fuse Problem Protection Standard Automatic Low Oil Pfessure/High Oil Temperature Shutdown Standard Overcrank/Overspeed((!-)72 Hz)/rpm Sense Loss Shutdown Standard High Engine Temperature Shutdown Standard Internal Faulonco«ect Wiring Protection Standard Common External Fault Capability Standard Field Upgradable Firmware Standard "Sound levels are taken from the front of Ole generator Sound levels taken from other sides of the generator maybe higher depending on installation parameters Rating definitions-Stardby Applicable for supplying emergency power for the dumbon of the utility power outage No overload capability tis available for chis rating (All ratings m accordancewith BS5514,IS03046 avid DIN6271) 'Maiamum wattage and current are subject to and limited by such factors as fuel Bhdmegajoule content, ambient temperature,allude,engine power and condition,etc Manmum power decreases about 3 5 percent for each 1,000 feet(304 8 meters)above sea level,and also will decrease about 1 percent for each 6`C(10 IF)above 16°C(60`H CENERAC® 16/20/22 W switch options Limited Circuit Switch Model 6007036-0(16 kW) • 16 circuits. No of Poles 2 • Electrically operated,mechanically-held contacts for fast,positive connections. Current Rating(Amps) 100Voltage Rating(VAG) 120/240,10 • Rated for all classes of load,100%equipment rated,both inductive and resistive. Utility voltage Monitor(Fixed)* -Pic• 2 pole,250 VAC contactors. -Dropout 65% • 30 millisecond transfer time. Return to Utility* approx.15 sec. Exercise bi-weekly for 12 minutes* Standard • Dual coil design. UL Listed Standard Total of Pre-wired Circuits 16 • Rated for both copper and aluminum conductors No 15 A 120 V 5 • Main contacts are silver plated or silver alloy to resist welding and sticking. No 20 A 120 V 5 No.20 A 240 V 1 • NEMA 3R aluminum outdoor enclosure allows for indoor or outdoor mounting No.30 A 240 V - flexibility. No 40 A 240 V 1 No 50 A 240 V 1 • Multi listed for use with 1"standard,tandem,GFCI and AFCI breakers from Tandem Breaker Capability 8 spaces Siemens,Murray,Eaton and Square D for the most flexible and cost effective install. Circuit Breaker Protected Available RMS Symmetrical Fault Current @ 250 Volts 10,000 *Function of Evolution Controller Exercise can be set to weekly or monthly Dimensions 200 Amps 1201240,ie Open Transition Service Rated Height Width Depth H1 H2 W1 I W2 in 27.24 30.0 11.4 mm 692.0 7624 289.0 1 343.0 1800 Wire Ranges Conductor Lug Neutral Lug Ground Lug 2/0-#14 2/0-#14 2/0-#14 m� Service Rated Smart Switch Features G007037-0(16 kM/0007039-0(20 kM)/ • Includes Digital Power Management Technology standard(DPM). Model G007043-0(22 kVlq •Intelligently manages up to four air conditioner loads with no No.of Poles 2 additional hardware. Current Rating(Amps) 200 Voltage Rating(VAC) 120/240,10 • Up to four more large(240 VAC)loads can be managed when used in Utility Voltage Monitor(Fixed)* conjunction with Smart Management Modules(SMMs). -Pick-up 80% • Electrically operated,mechanically-held contacts for fast,clean -Dropout 65% connections. Return to Utility* approx.13 sec •Rated for all classes of load,10D%equipment rated,both inductive and Exercise weekly for 12 minutes' Standard resistive. UL Listed Standard Enclosure Type NEMA(UL 3R • Up to four more large(120/240 VAC)loads can be managed when used in Withstand Rating(Amps) 22,000 conjunction with 50 amp Power Management Modules(PMM**) Lug Range 250 MGM-#6 •2 pole,250 VAC contactors. *Function of Evolution Controller •Service equipment rated,dual coil design. •Rated for both aluminum and copper conductors. m • NEMA 3R aluminum outdoor enclosure allows for indoor or outdoor mounting flexibility • Main contacts are silver plated or silver alloy to resist welding and sticking. N2 Mt Dimensions 200 Amps 120/240,ie Open Transition Service Rated l Height Width Depth H1 H2 W1 I W2 in 2724 30.0 11 4 13.5 7 09 mm 69-20–T 762.4 2B9 0 1 343 0 180.0 L o —w2—I ` GENERAC - 7 16/20/22 kW v available accessories Model Product Description _ Generac's Mobile Link allows you to check the status of your generator from anywhere that you have G006463-3 Mobile Link'" access to an Internet connection from a PC or any smart device. You will even be notified via e-mail or text message when a change in the generators status occurs. Available in the U.S.only. G005819-0 26R Wet Cell Battery Every standby generator requires a battery to start the system.Generac offers the recommended 26R wet cell battery for use with all air-cooled standby product(excluding PowerPact®). G007101-0 Battery Pad Warmer The pad warmer rests under the battery.Recommended for use if the temperature regularly falls below 0°F.(Not necessary for use with AGM-style batteries). G007102-0 Oil Warmer Oil warmer slips directly over the oil filter.Recommended for use if the temperature regularly falls below 0°F. G007103-0 Breather Warmer The breather warmer is for use in extreme cold weather applications. For use with Evolution c controllers only in climates where heavy icing occurs. G005621-0 Auxiliary Transfer Switch Contact The auxiliary transfer switch contact kit allows the transfer switch to lock out a single large electrical Kit load you may not need.Not compatible with 50 amp pre-wired switches. Fascia Base Wrap Kit The fascia base wrap snaps together around the bottom of the new air cooled generators.This offers G007027-0-Bisque (Standard on 22 klM a sleek.contoured appearance as well as offering protection from rodents and insects by covering the lifting holes located in the base. If the generator enclosure is scratched or damaged,it is important to touch-up the paint to protect G005703-0-Bisque Paint Kit from future corrosion.The paint kit includes the necessary paint to properly maintain or touch-up a generator enclosure. G006485-0-16,20& Scheduled Maintenance Generac's scheduled maintenance kits provide all the hardware necessary to perform complete 22 kW enance Kit routine maintenance on a Generac automatic standby generator. Smart Management Module Smart Management Modules are used in conjunction with the Automatic Transfer Switch to G006873-0 (50 Amps) increase its power management capabilities.It provides additional power management flexibility not found in any other power management system. dimensions & UPCs Dimensions shown are approximate Refer to installation manual for exact dimensions.DO NOT USE THESE DIMENSIONS FOR INSTALLATION PURPOSES. 1215— ttzs i Ini I [4e.0 e+] l Model UPC G007035-0 696471070354 G007036-0 696471070361 7Z, om— G007037-0 1 696471070378 tziSin) G007038-0 696471070385 - I ' G007039-0 696471070392 G007040-0 696471070408 r ;, , - ,.,.,.,,,.,. , �,,,;.,; ,,�, — ; G007042-0 696471070422 _ ix„%,.'/, '•;,i .'%/i % , 4i, •.. iia ii-F•,:3i, 845f�`3t �%:_ `'y;i�%:i�%; i�`is i/i;'/�/�'S i%/'i!4•�;%�/>%C�ifS`t,.%i E25.5 In, —"`y 1232.. —/ I G007043-0 696471070439 to 51n1 LEFT SIDE VIEW FRONT VIEW GENERAC' Generac Power Systems,Inc. • S45 W29290 HWY.59, Waukesha,WI 53189 •generac.com 02016 Generac Power Systems,Inc-All rights reserved All specifications are subject to change without notice Bulletin 10000000194-B 05/18/16 SCDHS REF # R10-16-0097 SURVEY OF PROPERTY RAIN RUNOFF CONTAINMENT A T MA T TI T UCK PROP05ED HOU5E + PORCH • 3157 3157 X 1 X 0.17 536.7 GU. FT. PKOP05ED DRIVEWAY • 706 5Q.FT. TOWN OF SOUTHOLD 708 X 1 X 0.17 120.4 GU. FT. SUFFOLK COUNTY, N. Y. 657/42.2 15.6 IVF. 1000-107-07-10 PROVIDE (2) DRYWELLS 0 X b' DEEP SCALE: 1'=30' OR EQUAL JULY 26, 2010 DRYWELL CONNECT TO HOUSEJULY 8, 2016 RE WITH GUTTEK5 + LEADERS N pUBLJC WATT) _ - JULY 20, 2016 ((REVISIIONS) PROVIDE (1) DRYWELL 84 X b' DEEP NGS �'(I•IIN 50 O -___�_ G) JULY 27, 2016 (PROP. SEP 77C) OR EQUAL WITH GRATE FOR DRIVEWAY (DWE -i -____ (0WE BASE/MENT) NOVEMBER 21, 2016 (TOPOGRAPHY) (WELL 1141NOVEMBER 28, 2016 (REV4SIONS) JANUARY 3, 2017 (REVISIONS) JULY 12, 2017 (PROP.HOUSE) ® WEI-L r PROPOSED SEPTIC, SYSTEM NIO�� WUSIONE A.�R) - (4 DEDROOM5) M,CMEL C pUBLJC [11 1000 GALLON PKECA5T 5EPTIG TANK p (pyyElllNG W 156-90 x$ 8.6' 131 LEACHING &ALLEYS - 4' DEEP HpuSE 6' . ,1NG` WITH 3' SAND COLLAR 3' MIN. AI3OVE c~ , » ASPHALT CMF WELL wE / GROUND WATER N�$'42 40 E DRIVEWAY (D Kfa EXISTING 5EPTIG 5Y5TEM 76' J J'� �� nHG= 8 s REM'`"" �s N TO 6E REMOVED OR FILLED IN Ne00D RE .T 0. TO 5CDH5 5PECIFICATION5vs •ROPOSEO - EL 6 9 BI 9 , I 41.5 - -; � 18 �8 0. �` O W 4' 8.2 ► w rn - f8 Sp14ALI ,� s 7. EL sof w 1 �, I" DRIVEWAY Ao\.r1 fn n / ,.' `.,, -DW W/ORAS B�\y� �♦ /� yypOD DOCK 7-1 7 ) ' 1 •1� f,`m D EL 5.3 m 0 (RE N LG OATIN = �! 2' Z; .` -. C N �10 NOU ,a �� Z UBC Fl POCK v LG; --,,,m M .•� WATER SUPPLY WATER Ln w, `�•� P 2' I, 'r R° / 1 PROPOSFD,� —� METES ..ICfj�1,G ,n1 tlY �1'I✓ tI 7. V a a OPO t� PS a t 8 c m P VAnO y ' _?, 10 r�*1� ,,,//c � 'GW 1�4 11� IST NT) ►►►33 ��q� i i m `� � � �R )0511N F TEST HOLE DA TA �.- S '8E� I N Dov R; - McDONALD GEOSCIENCE ',7 ' ' E E_; o # R•F ASPHALT JUL Y 7, 2010 1 O T 5 ' T/►1!2.9- 5' X15 rn (0.5 S) ' DRIVEWAY EL. 17.Z EL 17.8' \ O EL- 0. ESL.'' 13'w 14 (pt1c- t DARK LOAM OL C 7 }WALLS 4 TL 13.4 1 $'40 EL i. ---- J BROWN SANDY SYLT ML L wW � N/G� Fp1,9ILY TRUST ---- 51 BROWN SILTY SAND sM S�$•42'� Z RG G MUE _LEPUB�r,C WATER) m PALE BROWN RNE SAND V N INC�DWE�NG WITH 1l1'WATER IN PALE BROWN RNE SAND SP 18,18' WA7ER IN BROWN SILTY SAND SW WA 7V? IN PALE BROWN FINE SAND SP 24' N f� ■ =MONUMENT _ (pWEI.I.iN WATER) VO 13' = PROPOSED CONTOURS �N pUBuC FLOOD ZONE FROM FIRM 36103CO481H GS "VIN 150 O*i� 10 ELEVA TIONS & CONTOURLINES ARE REFERENCED TO N.G.VD. 29. i i i AREA=15,765 SO. FT. TO TIE LINE I am familiar with the STANDARDS FOR APPROVAL SEP ''C SYSTEM DETAIL NOT TO SCALE AND CONSTRUCTION OF SUBSURFACE SEWAGE r - (ELEYA110NS ARE PROPOSED) ;'f",,,3., :. i�•���' f DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES FF EL 19.2' and will abide b the conditions set forth therein and on the Y EL 1-101 ANISNED GRADE EL 1.x0' permit to construct. INKEL I _ r wAz 12.4' 12 6"MIN. 1'MIN. ; + 2'MAX The location of wells and cesspools shown hereon are INVEL 10 , 1/4'PER FOOfTCH 11s' 6 INv. �.' C. NO. 49618 from field observations and or from data obtained from others. MINIMUM P►Tri1 11.3 INv. ®®®� �..,.,..Y MIN.4'DIA. PIPE 1/6'PER FOOT 4' ,, ANY AL 7FRA 77ON OR ADDI TION TO THIS SURVEY IS A VIOLA 77ON MINIMUM PnPIl 1000 CAL �.,. ,. ...,.., ,. 4' MINA'DIA. PIPE cog OF SEC77ON 7209OF THE NEW YORK STATE EDUCATION LAW. SEPT,`A K ml�' ,[� (3) 4 Ibet e . poples = PECON/C SURVEYORS, P.C. EXCEPT AS PER SEC77ON 7209—SUBDIVISION 2. ALL CER7TFIC.A77ONS — a+ (631) 765-5020 FAX (631) 765-1797 HEREON ARE VALID FOR THIS MAP AND COPIES 7HEREOF ONLY lF -G-ROUND-VA,;;--r Ii I WATER EL Zr SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR (HWEST DU CTED) GROUN)WATER P.0. BOX 909 WHOSE SIGNATURE APPEARS HER€O;v. T ;I I� 111��1 III „ 't►+►GIEST E�E�,ED) 1230 TRA VELER STREET SOUTHOLD, N. Y. 11971 10-174