HomeMy WebLinkAbout45198-Z �o�gUFFOt,��OG Town of Southold 11/24/2020
P.O.Box 1179
W 53095 Main Rd
d4,y o� Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 41640 Date: 11/24/2020
THIS CERTIFIES that the building GENERATOR
Location of Property: 1365 Park Ave,Mattituck
SCTM#: 473889 Sec/Block/Lot: 123.-2-29
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
8/31/2020 pursuant to which Building Permit No. 45198 dated 9/14/2020
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 1365 Park Avenue LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 45198 11/6/2020
PLUMBERS CERTIFICATION DATED
Authorized Signature
_ - TOWN OF SOUTHOLD
�o�gtlFFOLcoG
BUILDING DEPARTMENT
x 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#: 45198 Date: 9/14/2020
Permission is hereby granted to:
1365 Park Avenue LLC
41 Hunt Farm
Waccabuc, NY 10597
To: install a generator as applied for.
At premises located at:
1365 Park Ave, Mattituck
SCTM #473889
Sec/Block/Lot# 123.-2-29
Pursuant to application dated 8/31/2020 and approved by the Building Inspector.
To expire on 3/16/2022.
Fees:
ACCESSORY $100.00
CO-ACCESSORY BUILDING $50.00
ELECTRIC $85.00
Total: $235.00
B ilding ector
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. ? ° ,3 1
New Construction: Old or Pre-existin Buil ' g: y (check one) Spm N.
Location of Property:
House No. Street Hamlet ®f g
Owner or Owners of Property: 4..4 W AL-/tea Ao .%fro 4,
Suffolk County Tax Map No 1000, Section I Block 2 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: $ O ��
Applicanf Signature
•tel
*of SO
Town Hall Annex ® Telephone(631)765-1802
54375 Main Road 411 Fax(631)765-9502
P.O.Box 1179 sean.devlinCa�town.southold.n us
Southold,NY 11971-0959 ® �® y'
®l�c®UlilTV,��
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To* 1365 Park Avenue LLC
Address: 1365 Park Ave city,Mattituck st: NY zip: 11952
Building Permit# 45198 Section: 123 Block: 2 Lot: 29
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Escobar Electric LLC License No: 53958ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service X
Commerical Outdoor X 1st Floor Pool
New X Renovation 2nd Floor Hot Tub
Addition Survey Attic Generator X
INVENTORY
Service 1 ph X Heat Duplec Recpt Ceiling Fixtures Bath Exhaust Fan
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures CO2 Detectors
Sub Panel A/C Blower Range Recpt Ceiling Fan Combo Smoke/CO
Transfer Switch 200A UC Lights Dryer Recpt Emergency Fixtures Time Clocks
Disconnect Switches 4'LED Exit Fixtures Pump
Other Equipment, 22 kW Generac Generator w/200A Whole House Transfer Switch
Notes: Generator
Inspector Signature: i Date: November 6, 2020
S.Devlin-Cert Electrical Compliance Form As
# # TOWN OF SOUTHOL-D BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] 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
REMARKS: clfnC�M
DATE I J INSPECTOR •�
FIELD INSPECTION REPORT DATE Gd1kIlVlENTS
FOUNDATION(IST)
------------------------
ONR
FOUNDATION(2ND) � �
ROUGH FRAMING&
PLUMBING
INSULATION PER N.Y.
STATE ENERGY CODE
j
FINAL
ADDIT-10NAL QC�*Fft8- W
- l2
m
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 l Survey
Southoldtownny.gov PERMIT NO. l Check
�o%� a0 Septic Form
Elf�l .1-10sP Tr ste D.E.C.
C.O.Application
Flood Permit
Examined 20 Single&Separate
Truss Identification Form
Storm-Water Assessment Form
m Contact:
Approved 1 S 20 2o Mail to:
Disapproved a/c
\ Phone: 1� �?04� �SfJ"7
Expiration ,20 l C 1PANCY O
CIEE I� LWFL
N
Building Inspector
fT uT M91FIC TE
AUG 3 1 2020 °-- APPLICATION FOR BUILDING PERMIT OF OCCUPANCY
' Date �•JS I ' , 20�
BILI:MING DEP_'T• 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 code, and regulations, and to admit
authorized inspectors on premises and inbuil lig gg�� essary inspections.
� Ea - iV6
DATE: 5' f 1 �� B'.#A!-6-MLI,
FEE: (Signature of applicant or name,if a corporation)
, ��:�--- ��;' .�-..� ;�—e�
NOTIFY BUILDING DEPARDk4ENT AT A3b�Zflvt
765-1802 8 All l TO ti i iil FOR THE (Mailing address of applicant) l `/J� ��
FOLLOWING INSPECTIONS: < 7
State whether applicar}t i 3tn�r�ll�"s'see;U��get�f0alrhFifect, engineer, general contractor, electrician, plumber or builder
FOR POURED CONCRETE
2. ROUGH - V
MIN�z a t "VIVIN
Name of owner of preffii ULATIO 4--)V�
4. FNAL1. Cule ��'-' �' As on the tax roll or latest deed)
If applicant is a co orati P -1E _01R 1C 0.
�Fn �4 a. e du 't q��egpfficer COMPLY WITH ALL CODES OF
Pp ALL CM6 K i I�I $hiv
r i NEW YORK STATE & TOWN CODES
M-1 11RP Ar
(Name and title WMe iced SPONSIBLE FOR AS`REQUIRED DITIONS OF
Builders License No. DSI I GRsONSIRUOTION ERRORS.
Plumbers License No. SOUTHOLD HOLD TOW A
Electricians License No. _ $OUTHOL WN PLANNINGBOARD
Other Trade's License No. SO OLD TOWN TRUSTEES
1. Location of lurid oehich
proposed work will be dp9e: N.Y. DEC
�1)
House Number Street, - HamYet
County Tax Map No. 1000 Section-, /�3, ,,.,Block \ `4^ 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
b. Intended use and occupancy
3. Nature of work (check which applicable): New Building Addition Alteratio w,
Repair Removal Demolition Other Work Z,4, e:, a x� ' ':a
(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 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
* 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)
COUNTY OF d LK"
being duly sworn, deposes and says that(s)he is the applicant
(Name dEindi-vidual'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 stateineriis'contained in this -application-are-true-to the best of his knowledge and belief; and that the work will be
performed in the manher'sef forth in the application filed therewith
Sworn to before me this -•••-- _,-._
day of 20 020
CEY L. DWY_
Notary-Publi NOTARY PUBLIC,STATE OF NEW YORE Signature of Applicant
NO.01 DW63(j6900
QUALIFIED IN SUFFOLK COUNTY
COMMISSION EXPIRES JUNE 30,2_1)42
t
BUILDING 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
rogerr@southoldtownny.gov� sea nd(cD-southoldtown ny.gov
APPLICATION ELECTRICAL_ INSPECTION-,
ELECTRICIAN INFORMATION (All Information Require Dato; M-10tg7
Company Name: SC-40
7E OL8 0_ e- _- c
; nCl+
License No.: � S403 email:.4 J 4 Ms � ov g, e_
Address:
Phone No.:
JOB SITE INFORMATI N (All Information Required)
Name:
Address:,
Cross Street: CL.--% 0a
1 -4
21
Phone No.:
Bldg.Permit#: email:
Tax-Map District: 1000. Section: _Block:___ -Lot:,-
BRIEF DESCRIPTION OF WORK (mlease Print Clearly) zc QM10<«'q-1.0
Circle All That Apply:
Is job ready for inspection?- YES /(9 Rough In Final
Do you need a Temp Certificate?: (LESNO 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
J#Underground Laterals 1 2 H Frame Pole Work done on Service? Y N
Additional Information*'
PAYMENT-DUE-WITH[A PPLlCATI0N_ '___
Request for Inspection Formals
BUILDING 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
roaerr(&_sputholdtownnv aav:-- seand(&-southoldtownny,aov
a;PP:L[CAT10N FOR ELECTRICAL INSPECTIODU
ELECTRICIAN INFORMATION (All Information equired) Date:, , t .map-1t�
Company Name:
--- - - -- - - - -
- - -_-------== -_ =- 11
Name: - ,ep $ C-o#I- av aG, �d�, ��_ C t°G�TIG ncT
License No.: HIS. 3 � email:.4 4
Address:.. -_ O°7__y
Phone No.: a(o 1 �►
- -- -- - - -- - - - -- - - -----
JOB SITE INFORMAT N (AII Information Required)
i
Name: -- -_
Address: ,o.
Cross Street:
Phone No::
- -- - ---- - -Bldg.Permit#: email:
Tax Map District.--_ 100Q _-_-_ Sectiori�. Block____
BRIEF DESCRIPTION OF 1NORK ( lease Forint Clearly)
Circle All That Apply:
Is job ready for inspection?: . YES /(0 Rough In Final
Do you need a Temp Certificate?: (ZESJ NO Issued On
Temp Information: (All information required)
Service Size 1 Ph 3 Ph Size:,— #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-Informatiori ,
- -
-PAYMENT-17 WIThLAPPI.ICATION
Request for Inspection FormAs t
q11�
,� 11
PERMIT# Address:
Switches
Outlets--
GFI's
Surface
Sconces
,MH's
UC Lis
Fans Fridge HW
Exhaust Oven Dryer
Smokes DW Service
Carbon Micro Generator
Combo Cooktop Transfer
AC AH Mini
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NOTES
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00
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SURVEY FOR to
400 Ostrander Avenue,Riverhead,New York 11901
tel.631.12?.230u fox.
geng631.121.0144eri VAN BONAR05 4 HELEN BONAR05
admin® oun en Ineerin .com �x
at Mattituck, Town of Southold $�
Suffolk County, New York $�
Howard A.Young,Land Surveyor
Thomas G.Aolpert,ProfessionalEngineer TITLE SURVEY
Robert G.Tost,Architect
Douglas E.Adams,Professional Engineer $
County Tax Map DStrict 1000 Section 125 Block 02 Lot 2el
km
SURVEYOR'S CERTIFICATION FIELD SURVEY COMPLETED tA►� DEC.04,2014 6?
MAP PREPARED DEG.O5,2014 m
AE HEREBY CERTIFY TO VAN B O NA R O ,. H E L-E Mt Record of Revisions a e
BONAROS, EVERBANK, IT'S 5UR
ESSORS ANL'+/O RECORD OF REVISIONS DATE No
ASSIGNS & FIRST AMERICAN LF INSURANCE c>
COMPANY THAT THIS SURVEY AAS ARED IN ACCORDAN0E,
AITH THE CODE OF PRACTICE FOR LA URVEYS ADOPTED BY 09
00
THE NEA YORK STATE ASSOCIATION O 'PI'•.OFESSIONAL LAND
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HOWARD A YOUNG,N.Y.S. NO.4589 JOB NO.2014-0230 IOF 1 '
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PLOTTED BY:Diana Lopez PLOT DATE Dec 09, 2014- 10:57am DWG FILE: R:\2014\2014_0230\dwg\2014-0230-ts.dwg
From: Adam Escobar adam@escobarelectr'l'c.net
Subject,-, Info
Date.- Aug 30, 2020 at 11:18:18 PM
To: exteriorlandscapes@mac.com
Escobar Electric LLC
P.O Box 1578
Southampton NY 11969
Adam Escobar
License # ME-53,958
Expires 08/01/22
M: 6318711343
O: 631377 3966
E: adam@escobarelectric..net
Sent from my Whone
�) ELECTRIC
' E'SCOBAR Estimate
Date: Estimate#:
Escobar Electric LLC 8/17/2020 277
P.O.Box 1578
Rmithamntnn NY 11989
Phone# 6313773966
adam@escobarelectric.net
Name/Address: Project:
Van Bonaros 22kw Generator
1365 Park Ave
Mattituck,NY 11952
Description - Total
*Building permit if required in the town of Mattituck done by others
PAYMENTS
$6,460 DUE PRIOR TO START,TO ORDER GENERATOR AND GENPAD
$1,500 DUE TO START JOB
$1,500 DUE AFTER FINAL ELECTRICAL INSPECTION
Sales Tax - 0.00
Signature:
Total $9,460.00
Estimates are an approximation-of charges to you,and they are based on the anticipated details of the work to be done. It is possible for
unexpected complications to cause some deviation from the estimate.If additional parts or labor are required you will be contacted,
immediately.
Page'2
IW
ESCO AR Estimate
ELECTRIC Date: Estimate#:
Escobar Electric LLC 8/17/2020 277
P.O.Box 1578
Srnithamntnn_NY 11969
Phone# 6313773966
adam@escobarelectric.net
Name/Address: Project:
Van Bonaros 22kw Generator
1365 Park Ave
Mattituck,NY 11952
Description Total
22kW Generac Guardian Home Standby Generator with 200A SE Rated ATS 9,460.00
*Generac G-Force 1000 Series V-Twin Overhead Valve Industrial Engine
*Indoor/Outdoor 200 Amp Service Entrance Rated Automatic Transfer Switch
*Evolution Controller with Multilingual LCD Display
*Main Breaker Located Under Same Panel as Controller
*Natural Gas or LP Gas Operation
*All Weather Aluminum Enclosure with Improved Locking System
*Smart Battery Charger
*Bi-Weekly,Weekly,or Monthly Exercise Cycle
*Access all Electrical,Fuel,and Battery Connections Under a Single Removable Panel
*5-Year Limited Warranty
Genpad 3 Inch for Generac Generators
*A sturdy,permanent base for Generac Air Cooled Standby generators
*Contoured to look aesthetically pleasing
*Dimensions:54"L x 31"W x 3"H
LABOR
-Run 1/4" conduit from transfer switch to Generator location
-Mount transfer switch next to meter
-Wire transfer switch from meter
-Wire transfer switch from generator
-Wire generator
-Wire control wire at transfer switch and generator
-Separate all neutrals and grounds in main electrical panel
NOTES
*Trenching done by others
*Fuel source provided and connections made by others
*Electrical permit and inspections done by Escobar Electric
Total
Signature:
Page 1