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HomeMy WebLinkAbout45097-Z $� F ` Town of Southold 10/11/2020 P.O.Box 1179 y x 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 41523 Date: 10/11/2020 THIS CERTIFIES that the building GENERATOR Location of Property: 4297 Wells Rd,Peconic SCTM#: 473889 - Sec/Block/Lot: 86.-1-9.5 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 8/3/2020 pursuant to which Building Permit No. 45097 dated 8/11/2020 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: accessory generator as applied for. The certificate is issued to van Adelsberg,Janet of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 45097 10/1/2020 PLUMBERS CERTIFICATION DATED a Authorized Signature fFilL�-c TOWN OF SOUTHOLD gdFFO(, BUILDING DEPARTMENT y TOWN CLERK'S OFFICE 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#: 45097 Date: 8/11/2020 . Permission is hereby granted to: van Adelsberg, Janet 420 Riverside Dr Apt 513 New York, NY 10025 To: install generator as applied for. At premises located at: 4297 Wells Rd, Peconic SCTM # 473889 Sec/Block/Lot# 86.-1-9.5 Pursuant to application dated 8/4/2020 and approved by the Building Inspector. To expire on 2/10/2022. Fees: f ACCESSORY $100.00 ELECTRIC $85.00 CERTIFICATE OF OCCUPANCY $50.00 Total: $235.00 Building Spector 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, Commercial$15.00 Date. I"3_ �_ 0-0 GQ New Construction: v Old or Pre-existing Building: (check one) Location of Property: G� ���l5 VC(C)OLic House No. Street _ Hamlet Owner or Owners of Property: ��--}} Suffolk County Tax Map No 1000, Section g Block Lot `'l Subdivision Filed Map. Lot: C ' Permit No. V Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ Applicant Signature Building Department Application AUTHORIZATION (Where the Applicant is not the Owner) I,�Rtin�� S U t�1 C1� residing at q Z9 7W6�s (Print property owner's name) Wailing Address) °�1 SZ do hereby authorize �E Y (Agent) (), to apply on my behalf to the Southold Building Department. 2/1111 l er's Signature ate) I-- / (Print Owner's Name) Town Hall Annex ® Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 sean.devlin(a)-town.southold.ny.us Southold,NY 11971-0959 �' a IOU BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To. Janet van Adelsberg Address: 4297 Wells Rd city Peconic st: NY zip: 11958 Building Permit# 45097 section 86 Block 1 Lot 9.5 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Platinum East Electric License No: 34091 ME 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 Survey X Attic Generator X INVENTORY Service 1 ph X Heat Duplec Recpt Ceding Fixtures Bath Exhaust Fan Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors Main Panel 200X2 A/C Condenser Single Recpt Recessed Fixtures CO2 Detectors Sub Panel A/C Blower Range Recpt Ceiling Fan Combo Smoke/CO Transfer Switch 400A UC Lights Dryer Recpt Emergency Fixture Time Clocks Disconnect Switches 4'LED Exit Fixtures Pump Other Equipment. 60kW Cummings Generator w/400A Utility Service Disconnect Notes: Generator Inspector Signature: Date: October 1, 2020 S.Devlin-Cert Electrical Compliance Form.xls L4 5 o at r7 Ji SA-7 We Its pF SOUTv � * TOWN OF SOUTHOLD BUILDING DEPT. cou765-1802 - _ A NSPECTION FOUNDATION 1ST [ ] ROUGH PL13G. [ ] -FOUNDATION 2ND [ ] INSULATIOWCAULKING [ ] FRAMING/STRAPPING [ ] FINAL [ } :FIREPLACE-& CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ELECTRICAL (FINAL) [ ] CODE VIOLATION [/ ] PRE C/O REMARKS: e A Mjtpr n en a Lolvza�)_ !�m DATE l INSPECTOR !� FIELD INSPECTION REPORT DATE CO1kIMENTS FOUNDATION(1ST) FOUNDATION(2ND) • d'ti W i ROUGH FRAMING& i PLUMBING c `� INSULATION PER N.Y. y STATE ENERGY CODE I • i i FINAL 4-ADP� :�ONS 314hVIE�'�TTS 1/ l O Z yQ ' r C, ' W H 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 South oldtownny.gov PERMIT NO. 7 Check Septic Form NYSDEC Trustees C O Application Flood Permit Examined 20 Single&Separate Truss Identification Form Storm-Water Assessment Form Contact: Approved 20 V Mail to Disapproved a/c Phone ..1 �t xi �ioW �i Building or AUG - 3 2020 APPLICATION FOR BUILDING PERMIT Date�) 20 BUn,DrNG DEPT. INSTRUCTIONS a.This applic'atton 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 code,and regulations,and to admit authorized inspectors on premises and in building for necessary inspection (Signature o applicant or name,i Ncorporation) (Mailing addre s of applicant) State whether appliccantt rner,lessee,a ent1 a chite ,engineer,general contractor,electrician,plumber or builder Name of owner ofpremises'-� �� ®� (As on the tax roll or latest deed) If applicant is a corporation,signature of duly authorized officer (Name and talk of co orate officer) Builders License No."�\�— Plumbers License No. Electricians License No. �— F Other Trade's License No. 1. Loc tiou of land on which prop sedrk will done: a House Number Street Hamlet County Tax Map No. 1000 Section Block Lot `10 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 all b. Intended use and occupancy 3. Nature of work(check which applicable)-1w Building Addition Alteration Repair Removal Demolition Other Work QP&<-CL (Description 4. Estimated Cost Fee (To be paid on filing this application) 5. If dwelling,number of dwelling units Number of dwelling units on each floor If garage, number of cars 6. If business,commercial or mixed occupancy,specify 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 premi s?YESN`O�-{_nc� ,14.Names of Owner of premises `�k�A Lctq(.1IMS W n _ e o. 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 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.Are there any covenants and restrictions with respect to this property?*YES NO *IF YES,PROVIDE A COPY: STATE OF NEW YORK) 0 41. being duly sworn,deposes and says that(s)he is the applicant Name of individual signing contract)a ove named, ti (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 to the application filed therewith Swo to efore me this n day of /t 20� nam. C� Notary Public U J Signature of Applicant -rRACEYt.DWYER MOTARY PUBLIC,STATE OF NEW YOPK No.61 DWFi306900 ��ta Al.!FLEA TY IN SUFFOLK COON GON11v11SS10N EXPIRES JANE�� f•[ i•aa}viI 'p,sluF OL ; BUILDING DEPARTMENT-Electrical Inspector TOWN OF SOUTHOLD N Town Hall Annex- 54375 Main Road - PO Box 1179 a ^ Southold, New York 11971-0959 4, � Telephone (631) 765-1802 - FAX (631) 765-9502 rogerr@southoldtownnv.gov - seandAsoutholdtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: Company Name: r Name: License No.: email: p Address: {lam9mrl Phone No.: Cts JOB SITE INFORMATION (All Information Required) Name: Ro C ' Address: Ca C� Cross Street: a Phone No.: - Q- Bldg.Permit#: email: Tax Map District: 1000 .Section: Block: Lot:_ Qv BRIEF DESCRIPTION OF WORK (Pleasq Print Clearly) Circle All That Apply: Is job ready for inspection?: YES / NO Rough In Final Do you need a Temp Certificate?: YES r 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 Request for Inspection Fortnxls guFl`Ot/� . BUILDING DEPARTMENT-Electrical Inspector TOWN OF SOUTHOLD'- o Town Hall Annex- 54375 Main Road - PO Box 1179 w Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 jog rogerr@southoldtownny.gov - sea nd@southoldtownny.gov APP:LfOATfQN FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: Company Name: Name: License No.: Cory) Address: - - - p p Phone No.: \- b - CA- `oZ JOB SITE INFORMATION (AII Information Required), Address: Cross Street: Phone No. -`_ - Bldg.Permit#: - L�_ �7 email: Tax Map District: 100Q _Se_ctiom Block: Lot:_ Qo BRIEF DESCRIPTION OF WORK easp Print Clearly) Circle All That Apply: Is job ready for inspection?: YES / NO Rough In Final Do you need a Temp Certificate?: YES .- 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 Request for Inspection Form.xls 0 [ol 4. 5 320�9^ COoNN: oil— X DKJVeW ST UrIL �, sP �9�/ / •\ ae D.oRnvnl � ZONE epee www / yj •83e I ZONE AE 6,0 \ // R=47 �suxu m / L=1 71 NO TO 5 NOTE: POOL,POOL PATIO AND PENCE ARE NOT PART OF THIS PERMITAPPICIANON, THIS IB POR BARN-AND INTERIOR RENOVATIONS ONLY i NSO. \ DRAINAGE FOR BARN; 20'x 141-280 BF /SQL 280 x 0.17 47,6 BP REQUIF PROVIDE(1)6'DIA,x S'G'D DR) O \ / SASED ON SRVEY BY: (78.2 UCF) PRANK.e&rtm,LAND SURVEYOR RIVERH��A{�,NY 681-727-1780 DATED 9E MMBER 10,2013 FEMA INFORMATION /SG '•_ / h COMMUNITY NAME;TOWN OF •S� V SCTM NO 1000-86-1-9.5 COMMUNITY NUMBER;SCOSI AREA: 2,G229&-- MAP/PANEL NUMBER;56109 SITE PLAN SCALE: P-30-a' t r tt .a,Xy •"+,7S4y°RE'S7��tlT ' ` w ik ,'ail;.�e L ' ',•��;i���'r'.�7+.'��f is}t`�r t i,(; m _•.-.. a:+:��,M,:ti,?`ri rte,„��1.�.�"�.•.�«.—.. - ?�.• r5rxi' -Yb Y �LL.�e•'” -r�: . 4 1 .F3, ...rFl; 'r.• 'Y' i - AP ROVED AS NOTED/�, DATE: o B.P.# SCJ 7 FEE: D BY: NOTIFY,BUILDING DEPARTME AT 765.1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE ELECTRICAL, 2. ROUGH - FRAMIN,u & PLUMBING INSPECTION REQUIRED 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS, COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED AND CONDITIONS OF SOUTHOL^TOWN PLANNING BOARD SOUMD TOWN TRUSTEES m.� ..o N.Y:S.DF�- OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY Generator Set Data Sheet Model: C60 N6 Frequency: 60 Hz Fuel Type: Natural Gas/Propane kW Rating: 60 Natural Gas Standby 60 Propane Standby Emissions Level: EPA Emissions Natural gas Propane Standby Standby Fuel Consumption kW(kVA) kW(kVA) Ratings 60(75) 60(75) Load 1/4 1/2 3/4 Full 1/4 1/2 3/4 Full scfh 363.4 545.0 7295 933.8 151.4 217.0 289.3 370.2 m3/hr 10.3 15.4 20.7 26.4 4.3 6.2 82 10.5 Natural gas Propane Engine Standby rating Standby rating Engine model QSJ5.9G-G2 Configuration Cast iron, in-line 6 cylinder Aspiration Turbocharged and after-cooled Gross engine power output,kWm(bhp) 74.8(100.3) Bore,mm(in.) 102.1 (4.02) Stroke,mm(in.) 119.9(4.72) Rated speed,rpm 1800 Compression ratio 8.5:1 Lube oil capacity, L(qt) 14.2(15) Overspeed limit,rpm 2250 Fuel Supply Pressure Minimum operating pressure,kPa(in H2O) 1.5(6.0) Maximum operating pressure,kPa(in H2O) 3.2(13.0) Natural gas Propane Air Standby rating Standby rating Combustion air, m3/min(scfm) 4.2(149.1) 3.9(137.7) Maximum normal duty air cleaner restriction,kPa(in H2O) 0.4(1.5) Maximum heavy duty air cleaner restriction,kPa(in H2O) 3.7(15) Our energy working for you:' power.cummins.com ©2018 Cummins Inc I NAD-6095-EN(12118) c � Natural gas Propane Exhaust Standby rating Standby rating Exhaust flow at rated load, m3/min(cfm) 13.5(475.4) 12.4(437.8) Exhaust temperature, °C(°F) 696.3(1285.3) 683.5(1262.3) Exhaust maximum back pressure,kPa(in H2O) 7(28.1) 7(28.1) Standard Set-Mounted Radiator Coolin 1 Ambient design, °C(°F) 50(122) Fan load,kW(HP) 5.2(7) Coolant capacity(with radiator), L(US gal) 16(4.2) Cooling system air flow,m3/min(scfm) 158.6(5600) Maximum cooling air flow static restriction,kPa(in H2O) 0.12(0.5) Wei hts2 Unit dry weight kgs(lbs) 1145(2524) Unit wet weight kgs(lbs) 1184(2610) Notes: 1 For non-standard remote installations contact your local Cummins representative. 2 Weights represent a set with standard features.See outline drawing for weights of other configurations. Alternator Data Natural gas/propane Full single single phase phase output, Standard alternators table Natural gas/propane three phase table reconnectable Maximum temperature 120°C 120°C 120°C 120°C 120°C 120°C 120 °C rise above 40`�C ambient Feature code BB90-2 8986-2 B946-2 B943-2 8952-2 BB86-2 BB88-2 Alternator data sheet ADS-204 ADS-203 ADS-204 ADS-204 ADS-204 ADS-204 ADS-205 number Voltage ranges 120/240 120/240 120/208 277/480 347/600 127/220 120-480 Voltage feature code R104-2 R106-2 R098-2 R002-2 R114-2 R020-2 Varies by voltage Surge kW 59.4 61.4 61.4 61.8 60.7 61.6 Varies by voltage Motor starting Shunt 231 188 231 231 231 231 260 kVA(at 90% PMG 272 221 272 272 272 272 306 sustained voltage) Full load current amps 250 180 208 90 72 197 Varies by at Standby rating voltage Our energy working for you., power.cummins.com 02018 Cummins Inc I NAD-6095-EN(12118) Alternator Data (continued) Natural Optional alternators gas/propane Full single for improved starting single phase phase output, capability table Natural gas/propane three phase table reconnectable Maximum temperature 105°C 105°C 105°C 105°C 105 °C 105°C 105 °C rise above 40°C ambient Feature code BB91-2 BB94-2 BB93-2 BB95-2 BB92-2 BB85-2 BB87-2 Alternator data sheet ADS-205 ADS-204 ADS-204 ADS-204 ADS-203 ADS-203 ADS-207 number Voltage ranges 120/240 120/240 120/208 277/480 347/600 127/220 120-480 Voltage feature code R104-2 R106-2 R098-2 R002-2 11114-2 R020-2 Varies by voltage Surge kW 60.0 61.4 61.4 61.8 61.8 61.6 Varies by voltage Motor starting Shunt 260 231 231 231 231 231 360 kVA(at 90% PMG 306 272 272 272 272 272 423 sustained voltage) Full load current amps 250 180 208 90 72 197 Varies by at Standby rating voltage Derating Factors • Natural Gas/Propane 'A Engine power available up to 1006 m (3300 ft)at ambient temperatures up to 40 °C(104 °F). v, Standby Above these elevations derate at 4%per 305 m (1000 ft)and 2%per 10 °C above 40 °C (104 °F). Ratings Definitions ;f ' Emergency Standby Limited-Time Running Prime Power(PRP): Base Load(Continuous) _4 Power(ESP): Power(LTP): Power(COP)• Applicable for supplying Applicable for supplying Applicable for supplying Applicable for supplying power to varying electrical power to a constant power to varying electrical power continuously to a load for the duration of electrical load for limited load for unlimited hours. constant electrical load for ower interruption of a hours. Limited-Time Prime Power PRP is in unlimited hours.Continuous n,fv reliable utility source. Running Power(LTP) is in accordance with ISO 8528. Power(COP)is in Emergency Standby Power accordance with ISO 8528. Ten percent overload accordance with ISO 8528, R✓,f'+ (ESP) is in accordance with capability is available in ISO 3046,AS 2789, ^�t ISO 8528 Fuel Stop power accordance with ISO 3046, DIN 6271 and BS 5514. N ^„U in accordance with AS 2789, DIN 6271 and ISO 3046,AS 2789, BS 5514 = DIN 6271 and BS 5514 "rt. Formulas for Calculating Full Load Currents: Three phase output Single phase output � J - kW x 1000 kW x SinglePhaseFactor x 1000 Voltage x 1.73 x 0.8 Voltage sA Warning:Back feed to a utility system can cause electrocution and/or property damage. Do not connect to any building's _m electrical system except through an approved device or after building main switch is open z ter• For more information contactour local Cummins distributor or visit power.cummins.com y k+ Our energy working for you.'” ©2018 Cummins Inc All n hts reserved Cummins is a registered trademark of Cummins Inc PowerCommand,Am Sent InPower and"Our energy working for you"are trademarks of .;Sa 9 9 P N. 9Y 9 Y x` Cummins Inc Other company,product,or service names may be trademarks or service marks of others Specifications are subject to change without notice NAD-6095-EN(12/18)