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�o\og�E�l oy Town of Southold 6/4/2022 o - P.O.Box 1179 "' z 53095 Main Rd y.1j01 �ao� � Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 43118 Date: 6/4/2022 THIS CERTIFIES that the building GENERATOR Location of Property: 2280 Deep Hole Dr,Mattituck SCTM#: 473889 Sec/Block/Lot: 123.4-6 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/27/2020 pursuant to which Building Permit No. 45420 dated 11/9/2020 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: accessory generator as applied for. The certificate is issued to Dimeglio,Samuel of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 45420 9/21/2021 PLUMBERS CERTIFICATION DATED t ori e Signature 4�SU�F®ice TOWN OF SOUTHOLD BUILDING DEPARTMENT 9 TOWN CLERK'S OFFICE WPB . oma ` 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#: 45420 Date: 11/9/2020 Permission is hereby granted to: Dimeglio, Samuel 2275 Deep Hole Dr Mattituck, NY 11952 To: install generator as applied for per Trustees & DEC approvals. At premises located at: 2280 Deep Hole Dr, Mattituck SCTM # 473889 Sec/Block/Lot# 123.4-6 Pursuant to application dated 10/27/2020 and approved by the Building Inspector. To expire on 5/11/2022. Fees: ACCESSORY $100.00 ELECTRIC $85.00 \ CERTIFICATE OF OCCUPANCY $50.00 Total: $235.00 uilding Inspector OF SO�r�ol Town Hall Annex ~ Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 c Q sean.deviinCaD-town.southold.ny.us Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Samuel Dimeglio Address: 2280 Deep Hole Dr city,Mattituck st: NY zip: 11952 Building Permit#: 45420 Section: 123 Block: 4 Lot: 6 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Gen Ready License No: 2740ME SITE DETAILS Office Use Only Residential X Indoor X Basement X Generator X Commerical Outdoor X 1st Floor Pool New X Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 1 ph 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: 22kW Generac Generator w/ 200A Transfer Switch Notes: Generator Inspector Signature: r' Date: September 21, 2021 S.Devlin-Cert Electrical Compliance Form OF SOUlyolo 57 * # TOWN OF SOUTHOLD-BUILDING PT. coom, 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: clKDATE 7r INSPECTOR q SOUlyolo * TOWN OF- SOUTHOLD BUILDING DEPT. `yCoum��' 765-1802 INSPECTION [ ] FOUNDATION 1 ST [ `] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] YSULATION/CAULKING/ [ ] FRAMING /STRAPPING [ FINAL Cie JA6A 'bY [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION ( ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: DATE ��'1 �� INSPECTOR FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION(1ST) ------------------------------------ �b C FOUNDATION(2ND) O ROUGH FRAMING& PLUMEING • � r INSULATION PER N.Y. H STATE ENERGY CODE 1y i FINAL ADDITIONAL COMMENTS o z m X z x b 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 Southoldtownny.gov PERMIT NO. 4,6 Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Examined 20 6 Single&Separate Truss Identification Form Stoma-Water Assessment Form Contact: Approved ,20 Mail to: Disapproved a/c AI I Phone: Expiration 20 B ildin Inspector APPLICATION FOR BUILDING PERMIT Date ,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 BuildPermit pursuant to the Building Zone Ordinance of the Town of Southold,Suffolk County,New York,and other appli able a s,Ordinances or Regulations,for the construction of buildings,additions,or alterations or for removal or demolition J§h rein described.The applicant agrees to coRlytw' III p icable laws,ordinances,building code,housing code, d r 1 ti ns,and to admit grt'�d jn=��'pia ttre is s Wing for necessary inspections. �' l�, (Signa a of applicant or name,' a corporation) OCT 2 7 2020I P � B� �i1)pj J � �A'��� N-► �,g (Mailing address of applicant) State AO ?Ri� 1 ' ° lessee,agent,architect,engineer, enera�conac�toelect�rician lumber or builder 1 Name of owner of premises TU k \� (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. Other Trade's License No. i 1. Location o4land on whicr-gyp oposed w rk will be done: � � to Mak Q\r House—Nu er StreetFF Hamlet p CountyTax Map No. 1000 Section L� Block Lot Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intgrided use and occupancy of proposed construction: a. Existing use and occupancy le ,`40 QAA C' b. Intended use and occupancy Ywl 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal Demolition Other Work (�Q11(\PJf A�p�/ ll�RA ` (Description) 4. Estimated Cost 11 � `� Fee (To be paid on filing this application) 5. If dw tng,number of dwelling units Number of dwelling units on each floor If rage, number of cars 6. If busi ss,commercial or mixed occupancy,specify nature and extent of each type of use. 7. Dimensions of ea fisting structures,if any:Front Rear Depth Height Number of Stories Dimens' ns of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Di nsions of entire new construction:Front Rear Depth H ght 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— Q�NO OL Will excess fill be rennmo�^v,ed from premises?YES NO 14.Names of Owner of premises�Yh D\nA ��A�ddress%.t O �CQX�hone No. G�) � Name of Architect �-Address Phone No Name of Contractor Address Phone No.. Ot tJV��f Atm \n,:: 15 a.Is this propertywithin 1"feet a tid 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. 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 OF5, ' C -Eck, � being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the ��Y UA— ov— (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 an belief;a at the work will be performed in the manner set forth in the application filed therewith. Swom to before me thi _ Rosemary Fa a i L t-- day of G 20 Zy Notary Public,State N or Registration No. 4 18 olk Count NotaYy Public Commission E irf tatfl?g361 Applica Building Department Application AUTHORIZATION (Where the Applicant is not the Owner) I, Sam Dimeglio residing at 2280 Deep Hole Dr. (Print property owner's name) (Mailing Address) do hereby authorize Ed Reiff- GenReady (Agent) to apply on my behalf to the Southold Building Department. 8/13/2020 Owner'si nat e) (Date) Sam Dimeglio (Print Owner's Dame) Glenn Goldsmith,President z� S1 Town Hall Annex `� 54375 Route 25 Michael J.Domino Vice-PresidentP.O.Box 1179 John M.Bredemeyer III . Southold,New York 11971 A. Nicholas Krupski cr, "',; G Telephone(631) 765-1892 Greg Williams -6641 e0UN ° BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD September 18, 2020 Samuel J. DiMeglio, Jr. 2275 Deep Hole Drive Mattituck, NY 11952 RE: 2280 DEEP HOLE DRIVE, MATTITUCK SCTM#: 1000-123-4-6 Dear Mr. DiMeglio: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, September 16, 2020. RESOLVED that the Southold Town Board of Trustees APPROVE the Administrative Amendment to Wetland Permit#9454 for the construction/installation of a 4'x20' concrete slab for the generator/air-conditioner; and as depicted on the site plan prepared by Michael K. Wicks, Land Surveying, last dated September 17, 2019, and stamped approved on September 16, 2020. Any other activity within 100' of the wetland boundary requires a permit from this office. This is not an approval from any other agency. If you have any questions, please do not hesitate to contact this office. Sincerely, Glenn Goldsmith President, Board of Trustees GG/dd Glenn Goldsmith,President OF so Town Hall Annex A. Nicholas Krupski,Vice President �Q� ®�® 54375 Route 25 Eric SepenoskiP.O. Box 1179 Ir Southold, New York 11971 Liz Gillooly C.0 Elizabeth Peeples ® Telephone(631) 765-1892 Fax(631) 765-6641 COUNT`1,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE 1909 C Date: March 31, 2022 THIS CERTIFIES that the construction of a 1-1/2 story, 1 716sq ft single-family dwelling with leaders and gutters leading to two (2) dry wells; with garage enlarged to 16' wide associated sanitary system; as-built water side trex-type deck with `/4" spacing in lieu of thru flow decking open grate deck; existing 5'x9.2' wood staircase on West side of subject property, existing of water side trex-type staircase 7.5'x 10' to ground below, existing front platform 6'x5' with stairs 5.3'x4.6' to ground below, construction/installation of a 4'x20' concrete slab for a propane tank; construction/installation of a 4'x20' concrete slab for thegenerator/air-conditioner; approval of landscape plan for planting of 3" caliper trees and other vegetation in designated 50' wide non-disturbance buffer area; establish and perpetually maintain a 50' wide non disturbance buffer-area; with the condition that the 50' non-disturbance buffer be non-fertilized; an irrigation installed for propagation is removed after eve thing is established; a 480sq ftravel (pervious) driveway' non-fertilizer dependent grass will be planted in the upland area and staked hay bales and silt fencing will be installed prior to the commencement of construction activities and be maintained during all construction activity; At 2280 Deep Hole Drive Mattituck• Suffolk County Tax Map #1000-123-4-6 Conforms to the application for a Trustees Permit heretofore filed in this office Dated March 14, 2019 pursuant to which Trustees Wetland Permit#9454 Dated May 15, 2019 was issued and Amended on August 14, 2019 and Amended again on \ January 15, 2020 and Amended again on September 16 2020 and Amended again on February 16, 2022 and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the construction of a 1-1/2 story 1 716sq.ft. single-family dwelling with leaders and gutters leading to two (2) dry wells with garage enlarged to 16' wide; associated sanitary system; as built water side trex type deck with `/4" spacing in lieu of thru flow decking open grate deck-, existing 5'x9,2' wood staircase on West side of subject property, existing of water side trex-type staircase 7.5'x 10' to ground below, existing front platform 6'x5' with stairs 5.3'x4.6' to ground below, construction/installation of a 4'x20' concrete slab for a propane tank; construction/installation of a 4'x20' concrete slab for the generator/air-conditioner• approval of landscape plan for planting of 3" caliper trees and other vegetation in designated 50' wide non-disturbance buffer area; establish and perpetually maintain a 50' wide non-disturbance buffer area; with the condition that the 50' non-disturbance buffer be non-fertilized; any irrigation installed for propagation is removed after everything is established; a 480sg.ft gravel (pervious) driveway' non-fertilizer dependent grass will be planted in the upland area; and staked hay bales and silt fencing will be installed prior to the commencement of construction activities and be maintained during all construction activity; The certificate is issued to 3�L 1. DI EGLIO owner of the aforesaid property. Authorized Signature Aug/19/2020 1:45:37 PRA law office 6315471072 214 NSW YORK STATE-CSPARTMENT OF 12-NVI RQNMSNTAL CONSERVATION DBriaton or anvlronthanial Parmtta.Region 1 SUNY o%Qny atook,bQ Grog Hand,stony 6wak,14Y 11780 P-(691)444.03661 F t01}444-036Q wwwatae.11y.00v PERMIT MODIFICATION February 14,2020 Samuel DiMegilo 141 East Main St. Huntington, NY 11743 Re: Application#1-4738-03594/00002 DiMeglio Property:2280 Deep Hole Drive BCTM#1000-123-4.6 Dear Mr. DIMeglio: The Department of Environmental Conservation(DEC)has reviewed your request to modify the above referenced permit in accordance with the Uniform Procedures Regulations(6NYCRR Part 621). it has been determined that the proposed modifications will not substantially change the scope of the permitted actions or the existing permit conditions. Therefore,the permit is hereby modified to authorize:the addition of a propane tank slab and a generator slab as shown on the plans prepared by Michael K.Wicks Land Surveying, last revised 9/17/2019 and stamped NYSDEC approved modification on 2/1412020. This letter is a modification to the original permit and must be available at the job site whenever authorized work is in progress. All other terms and conditions remain as written in the original permit.,:, Sincerely, ov Kevin Kispert Permit Administrator cc; AM Weber Associates BMHP File pli wYoiut pappAmant ar �i111�R iI��rtYlr�nmenlal CVI1garYatlOn BUILDING DEPARTMENT-Electrical Inspector TOWN OF SOUTHOLD C2 r Town Hall Annex- 54375 Main Road - PO Box 1179 o - Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 ! Via° rocerrasoutholdtownny.gov- seand southoldtownny.aov APPLICATION FOR ELECTRICAL INSPECTION . ELECTRICIAN INFORMATION (All Information Required) Date: 1 �g-d Company Name: Name: ` - OM 01 - - License No.: E '\ email: (Q� o ; Address:. - ` OAAA Phone No.: CI) 00 JOB SITE INFORMATION (All Information Required) Name: I I d Address: Cross Street: <_f Phone No:: (� Bldg.*Permit#: t i t p�p email: 1 1 d k W l -� Tax Map.District: 1000 Section: Block:.. Lot: JBRIEF DESCRIPTION OF WORK(Please Print Clearly) Z. Circle All That Apply: Is job ready for inspection?: YES / 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.xis ` PERMIT# Address: Switches Outlets G F I's Surface Sconces H H's LIC Lts Fans , Fridge _ HW Exhaust Oven W/D Smokes DW Mini, Carbon Micro Generator- Combo . Cooktop Transfer AC . . ... =.rAH. . Hood Service Amps Have used Special.- Comments: pecial:Comments: nn ca'/p/'AZ�r HOLE' SITE 1 PLAN {� 0 sm s7alrrcE I• r..... 330 �e.es' ,OO, B°is+am'o L- 7a.oD SEP '2 1020 !' SITUATE �tr�i1 g r 0 °T[Ij nfr J AT MATTITUCK 10 J�V� LP. L p '0 °ns OWN OF SOUTHOLD •. LP. ar r,:0 UFFOLK COUNTY, N.Y. Q x 7 T H Blvd of Tr.rrr.. h I 5.0' +n75 LP, m S RVEYED: FEBRUARY 21, 2018 LUT of r6L47 (N) 4 ADD. INFO:APRIL 23. 2018 TEST HOLE IDD+ _ 10 7 °mt car HYDRO. SURVEY. SEPT. 24, 2018 AA rE I +7. 10' -1 tM0• REVISED: OCT. 17 2018 4ao�� 41rao 1 "+0ar°r Rt REVISED: SEPT. 1`/, 2019 NOT TO SCALE G aW °1Lg27 97UT O.W. ' _ COMP. MCDONALD OEOSCIENCE r .�' 3 f txi J _ -_ AIC 1M�4mR s,.c 1,,Y 3 D'�C 2/15/18 c4 i, (Y In.,eo (. /kFF'I?0'fEQ f S f=SFi - 0•EOR�N D• e @� a.m. wN-" A,:i:CONOMO`:S(]C• BROW Law a CV' +an , t�7✓J sKx srrm sr CERTIFIED T0: G 4.°�� puss ',° =+4.88' 'rlm+ROW 6Ea(Nc• - t=C?`..,.Y - ROWN RNE O U•O -fA49R 81101Y 40.10 nT- Irk (J'Lr PJM 6AND SPSAMUEL J.DIMEGUO JR. Y.�- E• 1 Ia46 JODI JACOBS 0 t� v ':•,C- °�MATE ABSTRACTS INCORPORATED TITLE!f 7-38-0150-11010 4 �r or asru6 ti 4mCHICAGO TIRE INSURANCECOMPANYw Tw«YONE AOT SPEOPLE'S UNTIED BANK NA. t✓O,, g TER NE m1`rV \ 9a2D,u( a' 4476r 8 _OryTgL Y Na, 1. PRP 0 ER'rY KNOWN AS TA%NAP/ 1000-123-04-008SaD 9P C*v- r M SSITS2.LOT D' 3.THISS RVLY WAS3PREPARED USWG A 0.408 TRI)MBIE a L49RA LIQ S3 ROBOTIC TOTAL STATION.P,�IDEE 4,PROPERTY CORNER MONUMENTS WERE NOT SET AS jo , Damse 11 PART OF THISSURVEY,♦ofRB,M 5.ELEVATIONS REFER TO NAVD 19BB DATUM. �' � 43" S.EXISTING ELEVATIONS+ E10.00 PROPOSED ELEVATIONS(+10.00) wN7A NcoON,Lxm 4.6 eE1aW suREACE o -' FLOOD MAP DATA- MAP ZONE AT, (SL f 1 L h� MAP$:36103C0482H tiJ MAP DATE.SEPT.25,2009 ,T sM NOIFDISTO r FLOOD ZONE AE(EL6)k X Rm Is i W RAO N • - IW 11 N STANDARD NOTES • • IIAC 16 4t 4 +2P7' FL'mm BY + NOMI ASna4115 UC) O L In uTu`u' y'iY Prn.4 �:•'i rw...; • c •EIAO N +152 X +2 = APPROVED BY N69.32'a2'II 04'- p%rhr i,"�: ';nxrr,•W -r n '< IM 12 axa2 zs.,4'- 4 rn B ARD OF TRUSTEES �F 44Jh' 4a"` g TOWN OF SOUTHOLD Ig� 5 AO 4 wmr'c•ronw rrR_•n<n nm :iiµrn +oust: ' rF a.41 S29.26.0, ��T DATE •:1>:•,,,�<r rrwr�;umrro r.-c•kru m" rxa DSdDED PROPEMY 1JNd %SATQry� 14+2 b20 "; v`,-)Y,:,". ru+mm mAne¢.,0.70 J/y(A74.36• A.--___. _. _-__-._� _�_-_.____-_ cr. .., ...0 .r n, ...n w.i r i rr r.sr.ry. -j 19.39r I•R nwuarsA sK..r:.rFrw rsu4 mr s oaart7e •.�4��� ,•un( 10 \ urr c.u. wr m+ r'.:n i i�"•,n nii n.;rnmm".'o n n°f.• 7oun¢wNN °o.q' sEm ruga own wv.lq. 9 (,ae 7 J +01J I" �p-Po�gr wrfU(J,TBLP ur TMr�:,D Src.Y.rcr<iuKm I -0� a• +�a ' 5r as vrPtc,�. D 19 BE a•rstl:('�•• a-7a I -016 -07e SY 41.7E rtam7 V¢+Fn moue W4,w¢.4x' 11 �0'7° •031 H . .00 y,. Gi91.7ID WA1+lt¢�19' -0A -0.79 -0.77 4!4T v -0AI _pa 40M i n -134 -,•w -1.13 _IAS _ray -031 -on . -7.21 -221 -291 _2M +212 -247 -249 -2N -247 -218 _2,B -0.77 - d1D _109 -271 -24t _243 _,17 J I 1 COVERAGE INFO: -3.14 -7'1 _2,7 -0.77 4056 _160 jr LOT AREA AREA (IN)SOFT. _�15 �� -� -Ste a2 wm_lsi -741 1�n -a28 �a.( MICR L K NICXS, P.L.S. �'S0390 UPLAND AREA(INCLUDING BUFFER) 14.308 SO.Fr. 395 -4.17 ,19 521 "� � j UPLAND AREA(EXCLUDING BUFFER) 8,844 SOFT. 3.es 1A5 Loa -2a BUFFER AREA-5,464-3.5 0 SO. DEEP HOLE C K Mrcx EL K WIcx3 wETLr4+os AREA-3,soD sa.Fr. -161 -111 -'36 -132 013 +033 I l -I.m -4.77 -4M -413 '43= X OF UPLAND COVERAGE LAND SURVEYING PROP.RESIDENCE.1,920 SQ.FT.(13.4x) ADDITIONAL INFO: -310 's'6 3m -180 -4.m� -232 -DdD -037 PROP.DECK-552 SOFT.(3.8x) 220 C.Y.OF FILL NEEDED FOR FRONT YARD -6.10 _in _737 -166 200 BELLE VIEW AVENUE, E PROP,PORCH-182 SOFT.(1.2x) -730 g 3.43 -it4 1 CENTER MORICHES, NEE YORK 11934 TOTAL=2,654 SO.FT.(18.5x) 6.81 FUMM 00o(9D -nm -2.4s -0A5 VOICE. 631.874.0156 - FAX.- 631.909.3845 ApDITIONAL INFO: Ln9n¢udck9F¢74dsnT{9!v{ng.c° PROPERTY OWNER SAM DINECUO -3,75 -131 ff RECORDS OF RICHARD C DRAKE ADDRESS OF PROJECT:2EE 280 DP HOLE DRIVE MATTRUCK,NY "060 _217 ga SCALE SURVEYED BY: DRAWN BY: SHEET., cy§ 1�=30' B.W./S.S. J.W.W. 1 OF 1 -2q 7 ® DATE(MMIDD/YYYY) AC Ro CERTIFICATE OF LIABILITY INSURANCE 04/27/2020 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(les)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 endorsement(s). PRODUCER CONTACT NAME ONFARM FAMILY CASUALTY A/CC.No Ext): aC No): 859 CONNETQUOT AVENUE ADDRESS: ISLIP TERRACE,NY 11752 INSURER(S)AFFORDING COVERAGE NAIC# 631-277-7770 INSURERA: FARM FAMILY CASUALTY INS.CO. 13803 INSURED INSURER B: STATE INSURANCE FUND 36102 - GENREADY, INC. INSURER C: SHELTER POINT 81434 128 PULASKI ROAD INSURER D: KINGS PARK NY 11754 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 124317 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 SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE INSD SWVD POLICY NUMBER POLICY MMIDDIIYYEXP Y LIMITS A X COMMERCIAL GENERAL LIABILITY 3152X1390 05/07/20 05/07/21 EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE —X OCCUR PREMISESO(Ea occu°nce) $ 100,000 MED EXP(Anyone person) $ 5 000 PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 X POLICY JECOT- 7 LOC PRODUCTS-COMP/OPAGG $ 4,000,000 OTHER: $ A AUTOMOBILE LIABILITY 3152C4335 05/07/20 05/07/21 (ECOMBINED accident)accident) LIMIT $ 1,000,000 IxANY AUTO BODILY INJURY(Per person) S ALL OWNED X SCHEDULED BODILY INJURY Per accident $ AUTOS AUTOS ( ) HIRED AUTOS X NON-OWNED PR PRT AMA $ AUTOS (Per accident) A X UMBRELLA LIAB X OCCUR 3101E1933 06/03/20 06/03/21 EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DED I X I RETENTION$$10,000 $ B WORKERS COMPENSATION ER OTH YIN CERTIFICATE AND EMPLOYERS'LIABILITY STATUTE ANY PROPRIETOR/PARTNER/EXECUTIVE❑ NIA ATTACHED E.L.EACH ACCIDENT $ (Mandatory in NH)EXCLUDED? 1046681-1 E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C NYSDBL DBL 265291 01/01/07 INDEFINITE STATUTORY DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TOWN OF SOUTHOLD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 54375 MAIN ROAD ACCORDANCE WITH THE POLICY PROVISIONS. SOUTHOLD, NY 11971 AUTHORIZED REPRESENTATIVE I ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD YORK Workers' CERTIFICATE OF INSURANCE COVERAGE STATE 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 GENREADY,INC. 631-544-0400 128 PULASKI ROAD KINGS PARK,NY 11754 1 c.Federal Employer Identification Number of Insured Work Location of Insured(Only required if coverage is specifically limited to or Social Security Number certain locations in New York State,i.e.,wrap-up Policy) 112763133 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) ShelterPoint Life Insurance Company TOWN OF SOUTHOLD 54375 MAIN RD 3b.Policy Number of Entity Listed in Box"1 a" SOUTHOLD, NY 11971 DBL265291 3c.Policy effective period 01/01/2020 to 12/31/2020 4. Policy provides the following benefits: © A.Both disability and paid family leave benefits. B.Disability benefits only. E] C.Paid family leave benefits only. 5. Policy covers: © A.All of the employer's employees eligible under the NYS Disability and Paid Family Leave Benefits Law. 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 described above. Date Signed 4/27/2020 By Val/ 4f (Signature of insurance carrier's authorized representative or NYS Licensed Insurance Agent ofthat insurance carrier) Telephone Number 516-829-8100 Name and Title Richard White, Chief Executive Officer IMPORTANT: If Boxes 4A and 5A are checked, and this form is signed by the insurance carrier's 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 5B 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. D13-120.1 (10-17) 1IIIIIPiuiiii1ii2ii0iiii1iiiiiii1i0iiii17uii�l�l�l /70NIN411- NYSI F New York State Insurance Fund 8 CORPORATE CENTER DR,3RD FLR,MELVILLE,NEW YORK 11747-3129 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE (RENEWED) mo AAAAAA 112763133 VINCENT C DALEY859 CONNETQUOTAVE M ISLIP TERRACE NY 11752 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER GENREADY INC TOWN OF SOUTHOLD 128 PULASKI ROAD 54375 MAIN ROAD KING PARK NY 11754 SOUTHHOLD NY 11971 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE 11046681-1 169355 05/20/2020 TO 05/20/2021 4/27/2020 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 1046 681-1, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW, AND, WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK, TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY. IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY,INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WEBSITE AT HTTPS://1NWW.NYSIF.COM/CERT/CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION. PRESIDENT EDWARD S REIFF VICE PRESIDENT ANDREW J REIFF OF GEN READY INC-A TWO-PERSON CORP. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STATE INSURANCE FUND DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 163381139 U-26.3 saffm county-uept--oT- Labor, Licensing & Consumer Affairs MASTER ELECTRICAL LICENSE Name EDWARD S REIFF Business Name This certifies that the GENREADY, INC. bearer is duly licensed by the County of suffolk License Number: ME-2740 Rosalie Drago issued: 05/01/1980 Commissioner Expires: 05/0112022 ACORD CERTIFICATE OF LIABILITY INSURANCE °A� THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND CONFERS NO RIGHTS UPON THE CERTIIICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELYAMBND,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 INIPORTAWT: If the certificate holder is an ADDITIONAL INSURED,the polieypes)must have ADDITIONAL INSURED provlslons or be endorsed. NSUBROGATION IS WAIVED,subject to the terns and conditions of the policy,certain p°ticiea may require an endoraentertL A statement on this certificate does not cOWbr tifi to the certificate holder In lieu of such andomeme s). PRDDUCER Kat Mstratta Nadatal bis mnw Smkemp of New York.IncEoh Pito (831)2734242 Ri. (831)273 8980 175 Oval Ofte AOeRug: IINIIIdlat<fl •OOm (8l8ttdla DISURER M ANOVERAGE O CNAIC NY 11749 Nrchenffi suRERA• MeMutual IrtBtGBnCa Co 23329 INSURED Mr.Fatreet Service Company Inc INSURER B: c dba frestaIkes ram IL Paul E.Muhs INSURER o: 201 Northwest Ortwe tNStfRER E: NY 11735.4920 NSURERF• COVERAGES CERTIFICATE NUMBER: 20-21 MASTER REVISION NUMBER: THIS iS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDASM FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE I NSURAtNCEAFFOROEO BY THE POLICIES DESCRIBED HEREIN IS SU3MCTTOALLTHE TEI MS. OMLUSION8 AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. hm rA. TYPECFINSURANCE POLICY NUMBER OCCJRRENt g COr1VERCIALGENERALLIABOM EACH3C.AIA84JADE ®OCCURC�rtbaCgUe!LblbtBlir11®Exp Rae ! 16.000 SOP1048048 051012020 05/012021 Included S iFE1t AGGR60ATELIYRPERSONAI.QADVINJURY APPL�PER GENERALAGGREMYE s 2.000.000 FOLICY PRODtrCTs-COMPIDPAGG S 2,11110.000OriFR i A1110ilOBLELKSILIff ANYIAi10 eadda i — OWNED SCHEDULED B=VNJURY(Perper>an) i ONLY AVIDS SOMYNJURY(Pereoddw) is H(RED Moi AUTOS ONLY P AUTOS ONLY $ Ur19RELLALtpB QCCJR EXCESS Like UAW OCCURRENCE HCL4204ME AGGREGATE S DED I I RETF*JMN i %M8110 is r aimtf s' YIN A ER SEX tuwW NIA E)–EACH i Ir�ss.d�aso4bn�ladder EL.DISEASE-EAEUPLOYEE S OESCR(P1tONOPOPERATtON$t:elow EJ DISEASE-POLICY LLUff i DESCRIPTIDN OF 0MA7tDNS l LOCATEDNS 1VEHICLES PAM 101,A12129e10 RoMe is Sdudt:to,may be a w*w ncon spaeo to nquhed) The Ceacate HOHar is btduded as addttkmal brained A.T.I.MA with respect to Gaon!LiabMty as requlmd by w Man contracti agreemerd per the Poky terms,cmwftm and exclusions. CERTIFICATE HOLDER CANCELLATION SHOULD ANYOF THEABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN TOM of Southold ACCORDANCE WRH THE PCL(CY PROVWX)Ms. 53095 Route 25 PO Box 1179 AUTHORMO RFYRESEN A—VA SOithold NY 11971 ®19882016 ACORD CORPORATION.AB rights reserved. ACORD 25(2016M) The ACORD name and logo are registered marks of ACORD NY S ' F 199 CHURCH STREET,NEW YORK,N.Y.10007-1100 Now York Stato Insurance Fund I nysf con) CERTIFICATE OF WORKERS' COMPENSATION INSURANCE %AAAAA 112851548 Q KEEVILY,SPERO-WHITELAW INC. 500 MAMARONECK AVENUE HARRISON NY 10528 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER MR.FAUCET SERVICE CO.,INC. TOWN OF SOUTHOLD DBA INSTALLGAS.COM 53095 ROUTE 25 201 NORTHWEST DRIVE,SUITE#1 PO BOX 1179 FARMINGDALE NY 11735 SOUTHOLD NY 11971 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE G 1149 296.4 985982 05/01/2020 TO 05!01/2021 031272020 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 1149 2984, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS COMPENSATION UNDER THE NEW YORK WORKERS COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK,EXCEPT AS INDICATED BELOW. IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY, INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE, VISIT OUR WEBSITE AT HTTPS:/AMNW.NYSIF.COWCERT/ CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THE POLICY INCLUDES A WAIVER OF SUBROGATION ENDORSEMENT UNDER WHICH NYSIF AGREES TO WAIVE ITS RIGHT OF SUBROGATION TO BRING AN ACTION AGAINST THE CERTIFICATE HOLDER TO RECOVER AMOUNTS WE PAID IN WORKERS'COMPENSATION AND/OR MEDICAL BENEFITS TO OR ON BEHALF OF AN EMPLOYEE OF OUR INSURED IN THE EVENT THAT, PRIOR TO THE DATE OF THE ACCIDENT, THE CERTIFICATE HOLDER HAS ENTERED INTO A WRITTEN CONTRACT WITH OUR INSURED THAT REQUIRES THAT SUCH RIGHT OF SUBROGATION BE WAIVED. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND.EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STATE INSURANCE FUND DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 840995735 I®®1UP00000000000804®38a5�NINE Fam WC-MT-NOPRINf VcWon 3(08129 2019)(WC Pcrtq.i 1492%41 U-263 297 f00000000Do�o+2ta�Ilaacl 0000lt49a96oY�rt�rs�so�gcatJaa�rrtgai aoom) WorkWorkers' Censation CERTIFICATE OF INSURANCE COVERAGE 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 1a.Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of Insured MR.FAUCET SERVICE COMPANY INC DBA INSTALLGAS.COM 516-752-1000 201 NORTKWEST DRIVE SUITE 1 FARMINQDALE,NY 11735 1c.Federal Employer ld rOcalion Number of Insured Work Location of Insured(oNyrerr~mceverege is 8p8cUk*#Mftd to or Social Security Number c9dah bcUbw/aM wYorkState,la.Wmpa/pPalkyj 112851548 2.Name and Address of Entity Requesting Prof of Coverage 3a.Name of nuisance Carrier (Entity Being Listed as the CertSicate Holder) Town of Southold ShetterPolmt We hretnertce company 53095 Route 25 3b.Policy Number of Entity Listed in Box•1a• P.O.Box 1179 DBL338240 Southold,NY 11971 3c,Policy elfactiva pew 04/3012019 to 04/29/2021 4. Policy provides the following bwm is ® A.Both disab8tiy and paid family!esus benefits. B.Disability benefits only. C.Paid family Ism benefits only. 5. Poky covers: ® A All of the employer's employees ellgfble under the NYS Disability and Paid Family Leavy Benefits Lawn. B.Only the 1090"class or ctassas of employer's employees: >nnder��Duythat amen agard of the insurance caller referenced a1mve that the named bUty andlor Pett Family leave tderteflts[rtsurartce coverage as described atxnre. Date Signed 4/24/2020 r By {Slgk+eluNof tmtrrarxecerrtorcaunwrhedrepket¢nmttveor NYStkerued InsureraeAgeslt of that lnsurskxe karrter) Telephone Number 51 B-&29-&100 Name and nue Richard White Chief EX 1ve cer IMPORTANT: If Boxes 4A and 5A are checked,and this form is signed by the insurance canter's authorized representative or NYS Licensed Insurance Agent of that carrier,this certificate Is COMPLETE Mad it directly to the certificate holder. 9 Box 4B,4C or 513 Is checked.this certifirate 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 Rood,Plans Acceptance Unit,PO Box 5200,Binghamton,NY 13902-5200. PART 2.To be completed by the NYS Workers'Contpematlon Board(only if Box 4c or ss of Part 1 has been dmdod) State of New York Workers'Compensation Board According to Information maintained by the MIS Workers'Compensation Board,the above-named employer has compiled with the NYS Disability and Pak!Fea fly Leave Benefits Law with respect to all of his/her employees. Date Signed By (SWUM of Authorized NYS Workers'eompenaWn Board Employee) Telephorte Number Name and Tips Phww Note:OnfY hwumnce carriers/&:erased to We NYS dsablifiy andpold far*{save benefits Inskaance poMa and NYS Reamed insurance agents ofthose Insurarm carrtsra are almadzed to issue Form D13-420.f.&wumnee brokers are NOTouthoNsed tb issue dda roman. 13113-120.11(10-1-n fQI1Q[�QIIfl1mQ(fII�QI®a� �QII1313-120.1 (10-17) �� a'" 'Z—;6-'11-"f 0- R ogg gpg _0 M ................. 1. J--!A" V 15., ff® County Department ofLabor, Licensing & Consumer Affairs VETERANS MEMORIAL HIGHWAY HAUPPAUGENEW YORK 11788, ria DATE ISSUED: No. 10/08/2002 MP-32128 -Ro didi. SUFFOLK COUNTY 'p- Master Plumber License �gog1:f This is to certify that Gerard J Aaron doing business as Mr Faucet Service Cornpany Inc DBA JV hin having given satisfactory evidence of competency, is hereby licensed as MASTER PLUMBER accordance with and subject to the provisions of applicable laws, rules and regulations of the County of Suffolk, State of zb New York. NOT VALID WITHOUT Additional Businesses DEPARTMENTAL SEAL Installgas.com 1--� n R6,I-! AND A CURRENT NT R& CONSUMER AFFAIRS 1 {iJ,�J Suffolk County Dept.of ID CARD INNZ'1� Labor,Licensing&consumer Affairs "R MASTER PLUMBING NName GERARD J AARON Rosalie Drago B u Sin a S S N,a I Ni` Commissioner This certifies.rtifies that the Mr Faucet Service company Inc DBA bearer is duly licensed —f1lr by the county of suffolk License Number:MP-32128 Rosalie Draq0 Issued: 10/08/2002 re� h Cornmiss;oni)( Expires: 1010112022 ,N M 'n, Mr. Faucet Service Co., Inc. InstallGas.com 201 Northwest Dr. Farmingdale, NY 11735 Sam Dimeglio 2280 deep hole dr. mattituck ny 11952 Qai Me-pJ' u APPP VED AS NOTED DATE: B.P.# FEE:A,, d BY: NOTIFY BUILDING DEPARTMENT AT 765-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST ELECTRICAL BE COMPLETE FOR C.O. INSPECTION REQUIRED 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 N J HOLD TOWN PLANNING BOARD SOUTHOLD TOWN TRUSTEES N,Y,S.DEC OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY r A GENERAC° GUARDIAN° SERIES _ 2��22�24 kW Residential Standby Generators Air-Cooled Gas Engine OEM_ INCLUDES: Standby Power Rating G007038-1,G007039-1,G007038-3,G007039-3(Aluminum-Bisque)-20 kW 60 Hz • True Power'" Electrical Technology G007042-2,G007043-2,G007042-3,G007043-3(Aluminum-Bisque)-22 kW 60 Hz G007209-0,G007210-0(Aluminum-Bisque)-24 kW 60 Hz • Two-line multilingual digital LCD Evolution'" controller (Eng I i sh/Span i sh/French/Portuguese) • 200 amp service rated transfer switch available :' '�.�'� • Electronic governor Q' I • Standard Wi-Fi°connectivityY *tm • System status&maintenance interval LED indicators • Sound attenuated enclosure • Flexible fuel line connector • Natural gas or LP gas operation ``GENER`AC; • 5 Year limited warranty • Listed and labeled by the Southwest Research Institute allowing Installation as close as 18 in(457 mm)to a structure. *Must be located away from doors,windows,and fresh air intakes and in accordance with local codes. or CSlus https:llassets.swri.org/librarylDirectoryOfListedProductsl ONus QU'Constructionlndustry/973 DoC204_13204-01-01_Rev9.pdf LISTED Note:CEfL or CUL certification only applies to unbundled units and units packaged with limited circuit switches.Units packaged with the Smart Switch are ETL or UL certified in the USA only. FEATURES O INNOVATIVE ENGINE DESIGN &RIGOROUS TESTING are at the heart of Gen- O SOLID-STATE, FREQUENCY COMPENSATED VOLTAGE REGULATION: This erac's success in providing the most reliable generators possible. Generac's G- state-of-the-art power maximizing regulation system is standard on all Generac mod- Force engine lineup offers added peace of mind and reliability for when it's needed els.It provides optimized FAST RESPONSE to changing load conditions and MAX[-' the most.The G-Force series engines are purpose built and designed to handle the MUM MOTOR STARTING CAPABILITY by electronically torque-matching the surge rigors of extended run times in high temperatures and extreme operating conditions. loads to the engine.Digital voltage regulation at±1%. O TRUE POWER-ELECTRICAL TECHNOLOGY:Superior harmonics and sine wave O SINGLE SOURCE SERVICE RESPONSE from Generac's extensive dealer network form produce less than 5%Total Harmonic Distortion for utility quality power.This provides parts and service know-how for the entire unit,from the engine to the small- allows confident operation of sensitive electronic equipment and micro-chip based est electronic component. appliances,such as variable speed HVAC systems. O TEST CRITERIA: O GENERAC TRANSFER SWITCHES: Long life and reliability are synonymous with ✓ PROTOTYPE TESTED ✓ NEMA M131-22 EVALUATION GENERAC POWER SYSTEMS.One reason for this confidence is that the GENERAC ✓ SYSTEM TORSIONAL TESTED ✓ MOTOR STARTING ABILITY product line is offered with its awn transfer systems and controls for total system compatibility. O MOBILE LINK@ CONNECTIVITY:FREE with select Guardian Series Home standby O PWRVIEW- TRANSFER SWITCH: The Generac PWRview Automatic Transfer generators, Mobile Link Wi-Fi allows users to monitor generator status from any- Switch integrates the PWRview energy monitor to provide real-time energy con- where in the world using a smartphone,tablet,or PC.Easily access information such sumption data that can help lower a home's electricity bill. Using a convenient as the current operating status and maintenance alerts. Users can connect an mobile app,homeowners can access energy usage and alert information while under account to an authorized service dealer for fast,friendly,and proactive service.With utility power or generator power.The PWRview energy monitor is a simple to use and Mobile Link,users are taken care of before the next power outage. low cost tool which helps save money over the life of the generator.Included with model G007210-0. "' GENERAC GENERAC' PROMISE ® :YO• � a 'M PWRim r GENERAL® 20/22/24 kW Features and Benefits Engine • Generac G-Force design Maximizes engine"breathing"for increased fuel efficiency.Plateau honed cylinder walls and plasma moly rings help the engine run cooler,reducing oil consumption and resulting in longer engine life. • "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 fora 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 Regulating output voltage to±1%prevents damaging voltage spikes. • UL 2200 listed For your safety. Transfer Switch (if applicable) • Fully automatic Transfers vital electrical loads to the energized source of power. • NEMA 313 Can be installed inside or outside for maximum flexibility. • Integrated load management technology Capability to manage additional loads for efficient power management. • Remote mounting Mounts near an existing distribution panel for simple,low-cost installation. PWRview Transfer Switch (if applicable) • PWRview energy monitor Energy usage at-a-glance. • Ability to view real-time energy consumption data Better understand the home's energy profile. • PWRview mobile app Access daily energy intelligence and insights. Evolution'"' Controls • AUTO/MANUAL/OFF illuminated buttons Selects the operating mode and provides easy,at-a-glance status indication in any condition. • Two-line multilingual LCD 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 verify 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 Verifies engine is ready to assume the load,setpoint approximately 5 seconds. • Engine cool-down Allows engine to cool prior to shutdown,setpoint approximately 1 minute. • Programmable exercise 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. • Main line circuit breaker Protects generator from overload. • Electronic governor Maintains constant 60 Hz frequency. GENERAC® 20/22/24 kW Features and Benefits Unit _ • SAE weather protective enclosure Sound attenuated enclosures ensure quiet operation and protection against mother nature,withstanding winds up to 150 mph(241 km/h).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 in(457 mm)away from a structure. Installation System • 14 in(35.6 cm)flexible fuel line connector Listed ANSI Z21.75/CSA 6.27 outdoor appliance connector for the required connection to the gas supply piping. • Integral sediment trap Meets IFGC and NFPA 54 installation requirements. Connectivity(Wi-Fi equipped models only) • Ability to view generator status Monitor generator with a smartphone,tablet, or computer at any time via the Mobile Link application for complete peace of mind. • Ability to view generator Exercise/Run and Total Hours Review the generator's complete protection profile for exercise hours and total hours. • Ability to view generator maintenance information Provides maintenance information for the specific model generator when scheduled maintenance is due. • Monthly report with previous month's activity Detailed monthly reports provide historical generator information. • Ability to view generator battery information Built in battery diagnostics displaying current state of the battery. • Weather information Provides detailed local ambient weather conditions for generator location. GENERAC® 20/22/24 kW Specifications Generator Model G007038-1 G007042-2 G007038-3 G007042-3 G007209-0 G007039-1 G007043-2 G007039-3 G007043-3 G007210-0 (20 kW) (22 kW) (20 kW) (22 kW) (24 kW) Rated maximum continuous power capacity(LP) 20,000 Watts' 22,000 Watts' 20,000 Watts' 21,000 Watts' 24,000 Watts' Rated maximum continuous power capacity(NG) 18,000 Watts' 19,500 Watts' 18,000 Watts' 19,500 Watts" 21,000 Watts' Rated voltage 240 _ Rated maximum continuous load current-240 volts(LP/NG) 83.3/75.0 91.7/81.3 81.3 83.3/75.0 91.7/81.3 100/87.5 ' Total Harmonic Distortion Less than 5% Main line circuit breaker 90 amp 100 amp 90 amp 100 amp 100 amp Phase 1 Number of rotor poles 2 Rated AC frequency 60 Hz Power factor 1.0 Battery requirement(not Included) 12 Volts,Group 26R 540_CCA minimum or Group 35AGM 650 CCA_minimum ---- ---- ------- - -- - - - - --- - Unit weight(Ib/kg) 448/203 466/211 436/198 445/202 455/206 Dimensions(L x W x H)in/cm 48 x 25x.29%121. 9 x 63.5 x 73.7 Sound output in dB(A)at 23 ft(7 m)with generator operating at normal load" 67 67 67 67 67 Sound output in dM(A)at 23It(7 m)-with generator in Quiet-Test'"low-speed exercise mode" 55 57_ 55 57 57 Exercise duration 5 min Engine Engine type GENERAC G-Force 1000 Series Number of cylinders_ 2 Displacement 999 cc Cylinder block Aluminum w/cast iron sleeve Valve arrangement Overhead valve Ignilion system - Solid-slate w/magneto Governor system Electronic Compression ratio 9.5:1 - - -- — ---- -- -- -- ---- --- - ------ - - -------- - - ------ ----- - -- --------------- ----- Starter 12 VDC Oil capac[ly including litter - Approx_1.9 gt/1.8 L Operating rpm 3,600 Fuel consumption - - - - Natural gas ftl/hr(m3/hr) 1/2 Load 204(5.78) 228(6.46) 164(4.64) 203(5.75) Full Load 301(8.52) 327(9.26) 287(8.13) 306(8.66) Liquid propane ft3/hr(gal/hr)Mr] 1/2 Load 87(2.37)[8.99] 92(2.53)[9.57] 86(2.36)[8.95] 92(2.53)[9.57] Full Load 130(3.56)[13.48] 142(3.90)[14.77] 136(3.74)[14.15] 142(3.90)[14.77] _ Note:Fuel pipe must be sized for full load.Required fuel pressure to generator fuel inlet at all load ranges-3.5-7 in water column(0.87-1.74 kPa)for NG,10-12 in water column(2.49-2.99 kPa)for LP gas.For BTU content,multiply ft3/hr x 2500(LP)or ft3/hr x 1000(NG).For Megajoule content,multiply m3/hr x 93.15(LP)or m3/hr x 37.26(NG). Controls Two-line plain text multilingual LCD Simple user interface for ease of operation. Mode buttons:AUTO Automatic start on utility failure.Weekly,Bi-weekly,or Monthly selectable exerciser. MANUAL Start with starter control,unit stays on.If utility fails,transfer to load takes place. OFF Stops unit.Power is removed,Control and charger still operate. Ready to Run/Maintenance 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 V/190-216V Future Set Capable Exerciser/Exercise Set Error warning Standard RurVAlarm/Maintenance logs 50 events each Engine start sequence Cyclic cranking:16 sec on,7 rest(90 sec maximum duration). Starter lock-out Starter cannot re-engage until 5 sec after engine has stopped. Smart Battery Charger Standard Charger Fault/Missing AC warning Standard Low Battery/Battery Problem Protection and Battery Condition indication Standard Automatic Voltage Regulation with Over and Under Voltage Protection Standard Under-Frequency/Overload/Stepper Overcurrent Protection Standard Safety Fused/Fuse Problem Protection Standard Automatic Low Oil Pressure/High Oil Temperature Shutdown Standard Overciank/Overspeed(@ 72 Hz)/rpm Sense Loss Shutdown Standard High Engine Temperature Shutdown Standard Internal Faull/Incorrect Wiring protection Standard Common external fault capability Standard Field upgradable firmware Standard "Sound levels are taken from the front of the generator.Sound levels taken from other sides of the generator may be higher depending on installation parameters.Rating definitions-Standby:Applicable for supplying emergency power for the duration of the utility power outage.No overload capability is available for this rating.(All ratings in accordance with BS5514,IS03046 and DIN6271).'Maximum kilovolt amps and current are subject to and limited by such factors as fuel BTU/megajoule content,ambient temperature,altitude,engine power and condition,etc.Maximum power decreases approximately 3.5%for each 1,000 ft(304.8 m)above sea level;and also will decrease approximately 1%for each 10°F(6°C)above 60°F(16°C). GENERAC® 20/22/24 kW Switch Options Service Rated Automatic Transfer Switch Features Madel G007039-1,0007039-3(20 kW) • Intelligently manages up to four air conditioner loads with no additional hardware. __ . .___ -_ _. G007043.2,G007043-3(22 kW) _ _ Ido;'otpoles 2 I • Up to eight additional large(240 VAC)loads can be managed when used in conjunction Current rating(amps) 200 with Smart Management Modules(SMMs). Voltage rating,(VAC) T20%240;f9_ • Electrically operated,mechanically-held contacts for fast,clean connections. Utility voltage monitor(fixed)* • Rated for all classes of load,100%equipment rated,both inductive and resistive. -Pick-up 80% -Dropout 65/0 • 2-pole,250 VAC contactors. RgturnTtoiUtllUy__ Approx.13"sec.g • Service equipment rated,dual coil design. Exercises bi-weekly for 5 minutes' _ Standard • Rated for both aluminum and copper conductors. `EfL W _ Standard 0_ 1 Enclosure type NEMA/UL 311 • Main contacts are silver plated or silver alloy to resist welding and sticking. ClydulUbreaker protected '"� . 22;000; • NEMA/UL 313 aluminum outdoor enclosure allows for indoor or outdoor mounting flexibility. Lug range 250 MCM-#6 *Function of Evolution controller Dimensions Exercise can be set to weekly,bi-weekly,or monthly wr 200 Amps 120/240,1a Open Transition Service Rated Height Width Depth H1 H2 W1 W2 in 26.8 30.1 10.5 13.5 6.9 cm 67.95 76.43 26.67 34.18 17.5 m "' Wire Ranges Conductor Lug Neutral Lug Ground Lug 250 MCM-#6 350 MCM-#6 2/0-#14 , DEPTH I-W2 PWRview Automatic Transfer Switch Features Model G007210.0(24 kW) • Integrated PWRview monitor provides real-time energy usage data through PWRview app. o. 01 poles!_ -'! ? • _ Current rating(amps) 200 • Intelligently manages up to four air conditioner loads with no additional hardware. Voltage rarating(VAC), • Up to eight additional large(240 VAC)loads can be managed when used in conjunction -Utility voltage monitor(fixed)` with Smart Management Modules(SMMs). -Pick-up 80% -Dropout 65% • Electrically operated,mechanically-held contacts for fast,clean connections. _Rdium to Ufllfty` r _ Approx:l3sox • Rated for all classes of load,100%equipment rated,both inductive and resistive. Exercises bi-weekly for 5 minutes` _ _ Standard • 2-pole,250 VAC contactors. EiL:or t1L_IisteG ,�_ - __ _^. Standard' • Service equipment rated,dual coil design. Enclosure type _ - NEMA 3R — ,Circuitbrea_keFprotedtetl� 22;000 • Rated for both aluminum and copper conductors. Lug range 250 MCM-#6 • Main contacts are silver plated or silver alloy to resist welding and sticking. *Function of Evolution controller • NEMA 313 aluminum outdoor enclosure allows for indoor or outdoor mounting flexibility. Exercise can be set to weekly,bi-weekly,or monthly wi • Heavy duty Generac Contactor is an ETL recognized device. Dimensions 200 Amps 120/240,1e Open Transition Service Rated Height Width H2 H' H1 H2 W1 W2 Depth in 26.8 30.1 10.5 13.5 6.9 cm 67.95 76.43 26.67 34.18 17.5 Wire Ranges DEPTH I—W2-I Conductor Lug Neutral Lug Ground Lug 250 MCM-#6 350 MCM-#6 1 2/0-#14 GENERAL® 20/22/24 kW Available Accessories ;Model# Noduct Description ;13005819-0 126R Wet Cell Battery 'Every standby generator requires a battery to start the system.Generac offers the recommended 26R wet cell battery for fuse with all air-cooled standby product(excluding PowerPact°). G007101 0 :Battery Pad Warmer (Pad warmer rests under the battery.Recommended for use if temperature regularly falls below 0°F(-18°C).(Not nec-' Pessary for use with AGM-style batteries). I ;13007102-0 — Oil Warmer ,Oil warmer slips directly over the oil filter.Recommended for use if temperature regularly falls below 0 ' 13007103-1 �;Br tae her Warmer iBreather warmer is for use in extreme cold weather applications.For use with Evolution controllers only in climates where i jheavy icing occurs. IG005621-0 _{Auxiliary Transfer Switch iThe auxiliary transfer switch contact kit allows the transfer switch to lock out a single large electrical load that may not be ;Contact Kit jneeded.Not compatible with 50 amp pre-wired switches. - — G –1 007027-0-Bisque (Fascia Base Wrap Kit T--he-fascia— base wrap snaps together around the bottom of the new air-cooled generators.This offers a sleek,contoured i It(Standard on 22 kW) jappearance as well as offering protection from rodents and insects by covering the lifting holes located in the base. 13005703 0-Bisque ;Touch-Up Paint Kit :If the generator enclosure is scratched or damaged,it is important to touch up the paint to protect from future corrosion. The touch-up paint kit includes the necessary paint to correctly maintain or touch up a generator enclosure. IG006485-0 :Scheduled Maintenance Kit IGenerac's scheduled maintenance kit provides all the items necessary to perform complete routine maintenance on a' ! lGenerac automatic standby generator(oil not included). G007 005-0 i GWi-Fi LP Tank Fuel Level ,The Wi-Fi enabled LP tank fuel level monitor provides constant monitoring of the connected LP fuel tank.Monitoring the Monitor LP tank's fuel level is an important step in verifying the generator is ready to run during an unexpected power failure.Sta-I Itus alerts are available through a free application to notify users when the LP tank is in need of a refill. IG007000-0(50 amp)(Smart Management Module 1Smart Management Modules(SMM)are used to optimize the performance of a standby generator.It manages large el 1G007006-0 ! Itrical loads upon startup and sheds them to aid in recovery when overloaded.In many cases,using SMM's can reduce I j(1 00 amp) the overall size and cost of the system. 13007169 0 4G LTE 1Mobile Link Cellular jThe Mobile Link family of Cellular Accessories allow users to monitor generator status from anywhere in the world,using G007170-0-Wi-FU 1Accessories 1a smart phone,tablet,or PC.Easily access information such as the current operating status and maintenance alerts.Us- Ethernet !ers can connect an account with an authorized service dealer for fast,friendly,and proactive service.With Mobile Link, ,users are taken care of before the next power outage. 13007220-0-Bisque 1Base Plug Kit rBase plugs snap into the lifting holes on the base of air-cooled home standby generators.This offers a sleek,contoured jappearance,as well as offers protection from rodents and insects by covering the lifting holes located in the base.Kit I ,contains four plugs,sufficient for use on a single air-cooled home standby generator_ Dimensions & PCs Model UPC 637.6 mm 1218 mm G007038-1 696471074185 [25.1 I°, r48.0 m, G007038-3 696471074185 O G007039-1 696471074192 G007039-3 696471074192 G007042-2 696471074208 727.2 mm [28.6 in] G007042-3 696471074208 G007043-2 696471074215 G007043-3 696471074215 0 0 0 0 G007209-0 696471071511 — G007210-0 696471078220 648 mm 148.mm [25.6 in] [48.6 Int LEFT SIDE VIEW FRONT VIEW Dimensions shown are approximate.See installation manual for exact dimensions.DO NOT USE THESE DIMENSIONS FOR INSTALLATION PURPOSES. GE N G RAC Generac Power Systems,Inc. o S45 W29290 HWY.-59,Waukesha,WI 53189 o generac.com 02020 Generac Power Systems,Inc.All rights reserved.All specifications are subject to change without notice. Part No.A0000937814 Rev.A 07/15/2020