Loading...
HomeMy WebLinkAbout48265-Z S�ffbL � Town of Southold 12/20/2022 i; P.O.Box 1179 " = 53095 Main Rd � a�oSouthold,New York 11971 CERTIFICATE OF OCCUPANCY - No: 43700 Date: 12/20/2022 THIS CERTIFIES that the building GENERATOR Location of Property: 11255 Sound Ave,Mattituck SCTM#: 473889 Sec/Block/Lot: 141.-3-6.3 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 8/3/2022 pursuant to which Building Permit No. 48265 dated 9/7/2022 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 stand-by generator as applied for.Maintain 36 inch clearance from shrubs. The certificate is issued to Christina,John of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 48265 9/29/2022 PLUMBERS CERTIFICATION DATED th rizel Aignature �QSFaic TOWN OF SOUTHOLD BUILDING DEPARTMENT 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#: 48265 Date: 9/7/2022 Permission is hereby granted to: Christina, John PO BOX 1492 Mattituck, NY 11952 To: Install accessory stand-by generator at existing single family dwelling as applied for. At premises located at: 11255 Sound Ave, Mattituck SCTM #473889 Sec/Block/Lot# 141.-3-6.3 Pursuant to application dated 8/8/2022 and approved by the Building Inspector. 1 To expire on 3/8/2024. Fees: ACCESSORY $100.00 ELECTRIC $85.00 CO-RESIDENTIAL $50.00 Total: $235.00 Building Inspector /4p p. Town Hall Annex a _ f Telephone(631)765-1802 54375 Main Road 's P.O.Box 1179 e sean.devlin(e'i_town.southold.ny.us Southold,NY 11971-0959 "ill3 "''S u BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: John Christina Address: 11255 Sound Ave city:Mattituck st: NY zip: 11952 Building Permit#:` 48265 Section: 141 Block: 3 Lot: 6.3 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE contractor: DBA: Universal Electrical Services License No: 54018ME SITE DETAILS Office Use Only Residential X Indoor X Basement Service Commerical Outdoor X 1 st 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 Transformer UC Lights Dryer Recpt Emergency Fixtures Time Clocks Disconnect Switches 4'LED Exit Fixtures Pump Other Equipment: 20kW Briggs & Stratton Generator w/ 200A Transfer Switch Notes: Generator Inspector Signature: Date: September 29, 2022 S.Devlin-Cert Electrical Compliance Form - # TOWN OF SOUTHOLD BUILDING DEPT. c 631-765-1802 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 [ ] RENTAL REMARKS: OK DATE 2 2 INSPECTOR SOUlyolo * * TOWN OF SOUTHOLD BUILDING DEPT. `ycourm0 631-765-1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ INSULATION/CAULKING [ ] FRAMING /STRAPPING [ FINAIGMAW [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ]' RENTAL REMARKS: , mwr 44V DATE INSPECTOR nationalgrid This document MUST be completed and signed by the Installer prior to your natural gas service being turned on by National Grid.We appreciate your cooperation. CUSTOMER OWNED GAS PIPING INSPECTION CERTIFICATE The undersigned installation contractor herby represents and warrants that all gas piping and related appliances, appurtenances and equipment installed at the premises described herein have been installed in accordance with all applicable codes, regulations and standards in effect as of the date of this Certificate including, but not limited to,the Fuel Gas Code of New York State,the National Fuel'Gas Code,the National Grid Blue Book and the original equipment manufacturer's specifications, guidelines and installation instructions. The undersigned installation contractor further represents and warrants that all gas piping installed at the premises described herein has been subjected to and passed the pressure test requirements as outlined in the Fuel Gas Code of New York State and National Grid Specifications and Requirements for Gas Installations as written in the Blue'Book.The installation contractor MUST include a historical sketch of the underground piping location as required per the Blue Book,Section 8.4 with this Certificate. The undersigned installation contractor acknowledges that National Grid is relying upon the installation contractor's representation and warranties, as well as the accuracy of the information contained in this Certificate,as a condition to turning on the natural gas services at the premises described herein. Customer Name_ o Av C, tlR 1 S I �✓it �`'r`'2` f (�� (Please print) Service Location 11 d L D S D v N 4 V r' AA ��l I v e 1C Al II 6 � / (Street-City) 3 L Daytime Phone y'3 35- Evening Phone Cell Phoned Contractor Name W �,J /l^s VV S �� (Please print) (Authorized Signature) (;,l �% .. \ ;� 0 Jam, t Business Location 7 Z5 , ,, (Street-City) C/ /�, Daytime Phone 3/_ ��Vf, 2 5 3 Cell Phone L= 31 'Atld�Z"`'3 License# ' -/'� ��� County: .2"Suffolk ❑ Nassau The installation contractor MUST check and complete the following information for all underground gas piping that has been installed at the subject premises in accordance with this Certificate.Please include the name of the pipe manufacturer, lot number of the pipe installed and the size of the pipe installed. , i Installed Pipe Size /yY Pipe Installed at Minimum Depth of 18"? j� Yes ❑ No Plast c: Pipe Manufacturer Lot Number SDR Mechanical Fittings Used? 21�e ❑No Plastic Fusions? ❑ Yes. 8 No #Made Tracer Wire Installed? L-A-1ps ❑No Metallic Caution Tape? 0-Yes ❑ No Non-Metallic Caution Tape? [ Yes ❑No Pressure Test @ ,f- p.s.i. Duration Time / �� (Hrs/Min) Historical Sketch Provided? Rd Yes ❑ No (Refer to Blue Book Appendix D, Section 5.0) Local Municipality/Town Pressure Test Certificate Provided? ❑ Yes ❑No Plumbing Permit# Coated Steel:Anode(s)-Number/Weight Cadweld ❑ Yes ❑ No Equipment/Appliances 1 stalled: Generator Z Yes ❑No Pool Heater ❑Yes ❑ No House Heat JYes [:] No Barbecues ❑Yes ❑No Water Heater ❑Yes ❑ No Meter Header ❑Yes ❑ No Other(Specify) NATIONAL GRID USE ONLY Technician/Responder Meter Number (Employee Name/Number) Turned On Grid# ❑ Residential ❑ Non-Residential (Date) NG0326(2.10) `4. oil 4 , ESPASSING' - NJ '�� � ✓ ., of �'c'T'" ,,ryr� :;. /� ;l !�''?---z}.. •� /�'«� I4 s.. �f-.• z` �.Y�- .,rte "\\ ff �• � fid•''"�� �\ a s �� ,. .� �, w� � '.�,� �•X18 t a � of r��i � - ' c ♦.,,�.� YRa .��•;y� sI •.a ,j and am- 44 ol Av it a - �..*.":.� IGmo, • � i alw - _ •1 , +4 r r rh M i . r � q ''JJ P 4,4 �f. ~ ., •`�' � (ice/eJF7 AW Ilk,IV , ^L` • a _ -� ` 4,•. �' ^ y i� � �.. tom{ TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone(631) 765-1802 Fax(631) 765-9502 ht!ps://ww-w.southoldtownny.gov Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only PERMIT NO. atO Building Inspector: s must Ap�icati6n`s'and for' AUG 0 3 2022 '%i Odl e a1ccep 're iii�' int is notAe owh6r;,-an Aop it. BUILDING DEPT n f rift. 'ige�if ipletddl.� or`.`j� a TMV OF SOUTHOLD, 7 k7, Date: wniq�j f;0, "RTY Name:John Christina SCTM#1000-141-3 -6.3 Project Address:11255 Sound Avenue Mattituck NY 11952 ............ ...................... ............................ ........ ......................................... Phone#:516-924-3635Email:christinaroofing@ Mailing Address:11255 Sound Avenue MattituckNY 11952 .............................. .............. CONT CTPERSv. Name:Sean CINeill Mailing Address:PO Box 64 Jamesport NY 11947 Phone#:631-722-3595 Email:oneilloutdoorpower hotmail.corn .............. .......... @ ......... k§!GNPIKO FEsslp"LA, Name: .............. .......... .............. Mailing Address: .Phone ........... Email: N f TRACT MATO Name: Mailing Address: Phone#: Email: -T) ONSTRUC ON, EINewStructure ElAddition ElAlteration F_]Repair ElDemolition Estimated Cost of Project: [i]Other Generator $10,500.00 Will the lot be re-graded? E]Yes ®No Will excess fill be removed from premises? E]Yes ®No - -_ ,°PROPERTY INF.ORMATtON " Existing prope use of rty: Intended use oproperty: f ._._ _ ....._.. .- resi..d. n_t.al- M.-_m._.._.._ .. .__..._. m.µ_..__.-._.-..residenta.l._. . Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? ❑Yes ®No IF YES, PROVIDE A COPY. ,hick Bok-After Reading :Th,e'Psnrrierjcontractcrjdesign i"fessianal is respansiblefor all dralnage.aad storm water issues astp�avided Chapter 7.36 ofthe;f6iri Code APPLfCATiOAi 1S HEREBY IVIAIDE to the Building Department for the issuanceaf a Building Permit pursuar►tto the BuildingZone_ :c.o-I ;; r .. , Ordinance;aftheTownofSeuthald,5uffofik Dun NewYarkaniiotheia Ii0bleUws,Ordinancesor;Re ulatitins`fortheconstructionof;bu,0dIn s tY,.. PP. , , addltiags;alCerations or far removaPor demglitlon as herein described The applicant agrees to.camplp with alf applicable taws,ardidanses;buAdiilg.c'0 es p`` housipg,codeand,iegulatignsand to admit authorised ins ectois anpremises eagd.:in bt ilding(si`for necessary,inspections.PFalse statements made:herein are x pualsiiable as atlas A.i»isclemean(r piirsuantto Section 21p.4S of the Naw;York State Reriat law Application Submitted By(print name):Sean O'Neill BAuthorized Agent ❑Owner Signature of Applicant: Date: 8/3/2022 STATE OF NEW YORK) SS: COUNTY OF Suffolk ) Sean O'Neill being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)he is the Agent (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/her knowledge and belief, and that the work will be performed in the manner set forth in the application file therewith. Sworn before me this day of_ 20 Notary Public PROPERTY OWNER AUTHORIZATION (Where the applicant is not the owner) ,, John Christina residing at 11255 Old Sound Avenue Mattituck NY 11952 Sean O'Neill do hereby authorize to apply on my behalf to the Town of Southold Building Department for approval as described herein. C)tl - 8/3/2022 Owner's Signature Date John Christina Print Owner's Name 2 ' •I BUILDING DEPARTMENT-Electrical Inspector TOWN OF SOUTHOLD Town Hall Annex- 54375 Main Road - PO Box 1179 Southold, New York 11971-0959 .fir ply; Telephone (631) 765-1802 - FAX (631) 765-9502 rogerr(a-southoldtownnygov— seand(cb-southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: Company Name: j� Electrician's Name: b License No.: ME-�p I_Elec. email: Elec. Phone NoS%, a p y ❑I request an ail copy of Certificat f Compliance Elec. Address.: /S' aace, 7 (off, �-. JOB SITE INFORMATION (All information Required) •:_ Name: Address: QLu a T777 ziiL Cross Street: ! Phone No.: Bldg.Permit#: email: Tax Map District: 1000 Section: Block: Lot: BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): `ri =� �'�> :� ': ' 'SgtSare Fo"otage: Circle All That Apply: Is job ready for inspection?: ❑ YES❑ NO ❑Rough In ❑ Final Do you need a Temp Certificate?: ❑ YES❑NO Issued On Temp Information: (All information required) Service Size❑1 Ph❑3 Ph Size: A # Meters Old Meter# ❑New Service❑Fire Reconnect❑Flood Reconnect❑Service Reconnect❑Underground❑Overhead # Underground Laterals M 1 F12 H Frame Pole Work done on Service? Y N Additional Information: PAYMENT DUE WITH APPLICATION �"-s�,���"1 UNIVELE-02 BEGEL1 t 144_.URD" DATE(MM/DDIYYYY) �;.,. CERTIFICATE OF LIABILITY INSURANCE 8/20/2021 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 have ADDITIONAL INSURED provisions or 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 Ellen Goldman(egoldman@butwin.com) Nathan Butwin Company,Inc. PHONE FAX 60 Cutter Mill Rd.Ste.414 (a/c,No,Ext):(516)466-4200 AIC,No):(516)466-4213 Great Neck,NY 11021 ADE-MAIL DRE ,info@butwin.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Utica First Insurance Co. 15326 INSURED INSURER B: Universal Electrical Services LLC INSURER C: 151 First Avenue INSURER D: Massapequa Park,NY 1.1762 INSURER E: INSURERF: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD, INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR' TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD MM/DD MMIDD A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1'000,000 'CLAIMS-MADE FX]OCCUR ART605787807 8/20/2021 6/20/2022 DAMAGE (Ea occurrence) $ RENTED 50,000 PREMISES _ MED EXP(Anyone person $ 1'000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- JECT F�LOC PRODUCTS-CO MP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY C e a_.d."tSINGLE LIMIT $ ANY AUTO BODILY INJURY Perperson) . $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ AUTOS ONLY AUTO 0 LY PROPERDAMAGE $ $ UMBRELLA LIAR HOCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STAT TE E ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE.$ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT' $ 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 Southold Building Department THE EXPIRATION DATE THEREOF, NOTICE WILL SE DELIVERED IN 54375 Main Road ACCORDANCE WITH THE POLICY PROVISIONS. Southold,NY 11971 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NYSIF 1 New York state Insurance Fund 8 CORPORATE CENTER DR,2ND FLR,MELVILLE,NEW YORK 11747-3166 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE im- MASSAPEQUA "A^^^^ 471592478 UNIVERSAL ELECTRICAL SERVICES,LLC 151 FIRST AVENUE [oil PARK NY 11762 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER 1 UNIVERSAL ELECTRICAL SERVICES, LLC SOUTHOLD BUILDING DEPARTMENT 151 FIRST AVENUE 54375 MAIN ROAD MASSAPEQUA PARK NY 11762 SOUTHOLD NY 11971 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE H2449 563-2 792334 07/16/2021 TO 07/16/2022 8/20/2021 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2449 563-2, 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://WWW.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 THE SOLE PROPRIETOR,PARTNERS AND/OR MEMBERS OF A LIMITED LIABILITY COMPANY. 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:656275677 U-26.3 w " Suffolk County.Dept.of Labor,Licensing Consumer:Affairs k u MASTER ELECTRICAL UCENSt Name: ANTHONY.J SEMONELLA Business Nair® 7hiS cetlifiesaFiaLlfie, UNIVERSAL ELECTRICAL SERVICES LLC bearer is'r1u1Y licensed 4.y the. verity of suffolk License Number:ME-54018 Rosalie Dr000 Issued: 0812812014 Coriiiniss+oner Expires: 08101/2022 I Ids.1F 1 \ iaE:JR!d�P. F'�cH�=N SIT- PLAIT OF FR.OP ERT-, 5!TUATED.AT ftp, (�l1fSi iii WtTtF'-� �y Nlf)/r � 7(�vJJ pF SPl1THOLD r _ aC r,L?=r?LD D.r21GNARD5 SUFFaLV C-OUNTY.Kf .:.' N£„90'1^• - I•(AR.10?IE L.RIGHt,i�S c,G,'•',M [ ) 10b07 0S-Q.1�.Fi^TO.J-369fi 5 A% PU�LIG r1AA BA5EG ON ORIfaINA,L r-RVEY BY, -r,-75 Hl.. INGE5N0 LANG 5UFvEYOR P.O. 50X.I?51 RIVERH'_AD,N'f IND) \ T=L, (531)1.21-26`10 \� Fbx: (631)1l1-1171 - DATED. ,,UC�.IS' 10,Mclb 1 GONS. .O ,URF!'F.05NEA. y s- HLOt:K (PJSLIG WA.TCR1 5ARA5P Y� Itz PROi,0s=D - 1 t e.YI�TING DARN TO DE 1 1 R�5ti7�1Gr 1?EMaYE7(NO EX15T1NG 5AV41TARY 5Y5TEM) , '1 S� PRO?a D 6EPTIG SYS EM, 1000 6AL.5LFTIG TANK.wi 1-10'DIA.x 10'DEEP L,P, 5T{p tit .+ `y..ti V, ` f-WTIJFE 50515 EXPA.N51ON 10 5l 1 IO \tl. `\ X LP 0 �i ,�5 T��\���• fid? ON 1/Ib J�� a'15,0& r��pR i , 1, zp�ib O zP a? 60 00 !00 S1i ll!✓]!-1L.r.C'li1zE'T r µ'1l-.�U . EY T. RI 11....d....R P.E. DE1•d�.E - y F:_^•, 80Y. E�34, rr1 .T i I7iJ:�l�, r Y 5HOREHAM, NEW YORK TEL.! 65i.P 21,3 %0 FAX: 6__3I.E21.i2P.7 I j QF,SU=FOLk: TOl•dN OF �O11TI1nL�l JJ{ HP 'Photosmart 2610xi, 'Log for Personal . Printer/Faz%Copier/Scanner Nov 16 2006 5:30PM Last Transaction Date Time Type Identification Duration Panes Result Nov 16 5:29PM Fax Sent 16317271727 1:39 2 OK t Resident' "Service AgreementLong Island 1 1 Emaihform: I" land'rowth®national rideom Mail form to National Grid-:116601M ren wood;NY`11717 Affn`c Custoriier Connections 2nd Floor 'tYourCa"Ifcanfor`gas;servtce:: i iri`"`you,estaf;lish'a cu`sfomerxaccountwith'.National.Grid .. t. Pp. - ce' ..__.�._.,..-.,. �_::rt•%tet.. s.. ......'_.,;a:,„. .-.�........-... .... _...... ..,,....r..._.....-_ `PLEASEtNOLE Your'application:willaie'delayed:'if'you=do notfiIF.out,theform,in:ifs entirety:` :.._.. Ii'..,.4...>.;.�.-_..:....',:.:.''<:.. ..: _..-.-.,ter_.. _.,-.r.,-.Ur,e.,✓..._ .. ..._._..........='�.:r... ......----....._`._..._._ ._ _.. _y....v�.:, CUSTOMER INFORMATION PLUMBER/61UILDER INFORMATION Legal Name: John R.Christina Company Name: Rescon Inc. Preferred Name: Contact Name: William Meyer *C'".ustd merr!.; � 793800449 6525 Sound Ave. '. ,ID,�;IDAddress: Service Address: 11255 Old Sound Ave. City,State,Zip: Riverhead N.Y 11901 City,State,Zip: Mattituck,N.Y. 11952 Phone: 631 445-2937 Phone: 516 924-3635 mgtsvhc@gmail.com Email: christinaroofing@aol.com Email: Mailing Address: P.O.Box 1492 Type(select one): ❑New construction(survey required) City, State,Zip: Mattituck,N.Y. 11952 ❑Reconnection(previously had gas) ®Existing house no gas PLEASE NOTE:your customer ID is a required field for the ❑Additional meter only ❑Check service line capacity/meter upgrade application.To establish a customer ID please call 1-800-930-5003 ❑New construction common trench with other utilities and provide this number on your application. Type of Road: A Public El Private Trenching by National Grid: ®Yes El No Site Information(required to fill out) "'NY Public Service'Commission''reguI iti6ns:require;that,conversioris;- :,f' ,Surrounding Area:a to gas heat4`cbrnp y,Wth'. followin'g,effidiency'standar 'ds:', . `. .. „'.a`; _, :,;;J:-::..;: _ .. .,:_:." r..: t•Please provide distance from street to meter location 83' 'Plea'se'cfieck•.that fou have:comphed :'- ■Please circle meter box location below and provide measurements from ❑■ Roof/ceiling has at least 6 inches of insulation with an R value of front and/or rear corner of home. 19 or greater (d�d�� ® @soLai Im Left Side U0I.42wuo}uI 0 awnsaa Q BM*.qR1e W7 ©The dwelling has storm windows,or thermal windows with 55' multiple glazing (enter distance in ft. ff=R OF BUILDING T jene' d IS M =Meter location WI, �s a r uo4gn ssalau�M] aye Pup Residence Type � h� � h��� �� § � dna ��� '��u®��� d uolInq [uol,gew�lo�U�f 4 _ploa"pUe...o. d 'spa l�-IM uo uun p Cross Street Must enter'dlstano,., Cross Straetl K Single family or ❑ Multifamily No. of Meters Req'd. r a ' M 1--an•,feet-from'meter to:`;, M pa iges La :sn;e;$ Meter Size Requested(for equipment currently being installed)* '' .,corner;o.liglldingi,; '•FRONT OF HOUSE 11�32Jb0 (enter distance in ft. to E]Heat E]Water heat ElRange/dryer/other on above line) ��� M❑ 0 E �oauu vel 13 00 1 M 1.5M 3Mgn— N ❑Heat ❑Water heat ❑Ran e/d er/other• on above line) on above line) g rY 4 MN �$ � w4 Q pup U0 MI-j -4013 55aJd S PUP *Please note:This inf i�us 1 li t��l 1111tu� ids ssadauuA i 'uaad '91t➢,p Iu��2s"FI� D If new equipment will loe instal ed m th future, I ase ca (A standard residential meter requires an obstruction-free walls ace 1 ) to have your gas rate changed when additional appliances are installed. ■Please identify location of all known private und4#WMMc4"s,4xMV Gas Equipment buried oil tanks,cesspools,wiring and sprinkler lines. Yes M No Appliance E/N BTU's Appliance E/WWU"B 4t8S Is there a cesspool located on the property? ❑Yes❑N wqm Vow Heat N Water Htg.170,000 Description of Meter Location/Additional Comments: 0o Ing hying Examples of acceptable meter descriptions: 000 Fir Generator N 260, ■Left side of house- 1�cWif�FM�"d4�!�# .Rtll)'s�t1t'PPt�f>tit qg%"&� �S j4 i Rjbf t LSO fmrrra PBS16M sit .avid at Grill Light Pool Htr. Garage Htr. ■Below electric meters ■Back of house ■�bfil i Does any gas equipmei i i,"&"&t 8WKq inml�dWWd &tx � V,41A 'fiJUL&W All require elevated pressure?O Yes®No Your signature acknowledges that you have read and agree t all the Terms and Conditions on a e,2 of this a reement.Keys 4 'ati � iNY (National Grid)agrees to install gas service to the above locati s that I may cancel this We gas service line and main.I hereby authorize NationallIMMto11FAFIM99W0,140ine to the address noted above. -WLATL : i*JRKMIL9 National Grid is NOT RESPONSIBLE j'AW Ir Vale property (see#4 of"Terms an & 71 A'trr r &)• r i`: fel±.10=14"weeks:af the; ro•e s;locat­dron a state,or county.;road t`ean;add an:'add'i"`"'4-6 w `t•''.{he• The erifire:projecf.cantakeapproxima y:_•..,.: p._.p,! .,.,.,... ..,..,.:,..: :., ,, t.. .. . .:; ;ulCI: tf; t. 3imeline:Please plan'aceoidingly.Please:do;not have,your;existing equlpment.removed,Unti,l yoyr;4 s line--has,been, r,.. Date... l®1 a a /Appl'icant:�Sigtiature c, I �7.Rei«...'t;:,=':,v::!_'_��..:i:.:<ti:l // Licensed Pl_umEer'S'ign'afure:' _ Date: U` (Pa.1 of 2 LI) EE5302 LI(4/22) F APPROVED AS NOTEO occup-p*llj�,Gly OR DATE:—O�B.P.# �a USE S UNLN , I� UL �` FEE c�.7 (�Y: �J�, � V it C3.�'PITPC1`'�1 Fc NOTIFY BUILDING DEPARTMENT AT _ , ' 631-765-1802 8AM TO 4PM FOR THE G'�� �' 'lifG' 11 �� FOLLOWING INSPECTIONS: 1. FOUNDATION-TWO REQUIRED FOR POURED CONCRETE 2. ROUGH-FRAMING&PLUMBING 3. INSULATION 4. FINAL-CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRU=ON SHALL MEET THE GOMI�'JL`l WITH ALL 0, 1�S I REMjIREMENTSOFTHECODESOFNEW °� � YORK STATE & TO ISI CODES YORK STATE NOT RESPONSIBLE FOR AS REQUIRED AND CONDITIONS OF DESIGN OR CONSTRUCTON ERRORS SOUTHOLD TOWN zBA SOUTHOLD TOWN PLANNING BOARD - - SOUTHOLD TOWN TRUSTEES ��--- _ N.Y S.DEC RETAIN STORM WATER RUNOFF PURSUANT TO CHAPTER 236 OF THE TOWN CODE. t Standby - ® • BRIH'.vGS&STRATf�ill .n - 1r x The Smart Choice ` : ' Introducing our dealer exclusive line, r " Available at your local Briggs&Stratton ' Dealer with these great'features.w.; Parts'•Labor•Travel'' >' Limited ;C ' i US _- Warran tY' UL LISTED 1 New Upgraded Control System Charging System' • New AVR optimizes generator performance with tighter voltage control Independent battery charger g • LCD display that displays multi-line text and graphics Optimizes battery life with a 3-stage battery charger(bulk, • Default exercise cycle setting of 16 seconds absorption,and float stage) • Low speed exercise available to save fuel and reduce noise Corrosion Resistant Enclosure& Base • Monitors cold temperatures to avoid moisture buildup in engine oil • Cleaner power with improved frequency regulation Made with automotive grade galvanneal steel or aluminum to resist rust Designed for Easy Installation& Maintenance Powder-coated paint for years of protection against chips and abrasions • Approved for installation as close as 18"to a buildingz Certified to withstand hurricane-force winds up to 175mph5 • Hinged lid with removable side panels for better service access to the engine and alternator Briggs&Stratton"Full Synthetic Generator Oil • Controller,battery charger,and AVR can be replaced separately — • Cold weather kit included Shields the engine from low temperature sludge buildup and high temperature deposits • External on/off switch located on back of enclosure • Reduces engine wear,scoring and abrasion Commercial Vanguard"Engine Compatible with Symphony"II Power • Easy conversion between natural gas(NG)and liquid propane vapor Management System (LPV)during installation • Advanced debris management keeping engine clean and cool for Customizable to your home's needs enhanced durability and performance • Automatically balances the power of your home's electrical load • Dynamically balanced crankshaft minimized engine noise and vibration including high wattage items like air conditioning units and electric ovens • Compatible transfer switches and modules sold separately lk Gen tor Set Aatfng Liquid Propane Vapor Natural Gas Limited Warranty' Model Enclosure Voltage Phase' Hz Circuit LPV kW LPV Amps NG kW' NG Amps Parts,Labor,Travel Type Breaker Amps _ 040587 Steel 120/240 1 60 100 20 83.3 18 75.5 6 Year 040589 Aluminum 120/240 1 60 100 20 83.3 18 75.5 6 Year 040609 Aluminum 120/240 1 60 100 20 83.3 18 75.5 10 Year 'This generator is certified in accordance with UL(Underwriters Laboratories)2200(stationary engine generator assemblies)and CSA(Canadian Standards Association)standard C22.2 No.100-14(motors and generators). The installation manual contains specific instructions related to generator placement in addition to NFPA 37,including the requirement that carbon monoxide detectors be installed and maintained in your home. 'Single phase units are rated at 1.0 power factor and three phase units are rated at 0.8 power factor, 'See operator's manual or BRIGGSandSTRATTON.com for complete warranty details. 'Up to 175 mph,when installed in accordance with the installation manual. 1 BRIGGSsSTRATrGN 20M' Fortress"Standby Generator Lubrication i i ,". Engine Brand Vanguard Oil Capacity(L/qt) 2.3/2,46 Engine Speed(RPM) 3600 Low Pressure Switch Included Engine Fuel Liquid Propane Vapor(LPV)or Lubrication System Full Pressure Natural Gas(NG) Engine Cylinder Configuration OHV Oil: Briggs&Stratton 5W30 Full Synthetic Number of Cylinders 2 Low Oil Pressure Sensor Yes Displacement(L/Cl) 0.993/60.60 Alternator Spens a a y "m Compression Ratio 9,7:1 Manufacturer Briggs&Stratton Governor Type Electronic Type Self-Excited,4-Lead Frequency Regulation +/-0.3 Hz(0,5%) Voltage Regulator Automatic Valves OHV with Hardened Seats Insulation Class F Ignition System Fixed Timing Magnetron® Peak Motor Starting kVA 41 Starter Motor Rating Voltage 12 Volt !es Battery Required 12 Volt,Group BCI 26 or 51, 540 CCA Minimum Generator Sensing Single phase voltage monitoring High Temperature Switch Included LCD Display Displays multi-line text and graphics Dura-Bore Cast Iron Included Fault Display Provides up to 39 detailed fault codes Cylinder Sleeve Exercise Cycle Six exercise length options Default:Start and run for 16 seconds; Abort exercise below 40°F(internal temperature) operations ) n. •R=: ��� -..,».,_.__.._m__H_..-.a.--,—.- a .._.. _�______ __.,._. .ems �,_ .-._.........w_..�._,r,-.„,-b.,.�-. .,.,..._.�...._... -- _ „„.....„ 'FuelConsump#fan Sour flatingAt7 Meters .° Full Load 1/2 Load No Load Low Idle Mode 64 dBA4 BTU/hr NO-260,000 NO-187,000 NO-99,000 No Load 67 dBA^ LPV-337,500 LPV-207,500 LPV-100,000 ft'/hr NG-260 NG-187 NG-99 LPV-135 LPV-83 LPV-40 M3 NO NG-7.36 NG-5.30 NG-2.80 LPV-3.82 LPV-2.35 LPV-1.13 g/hr LPV-3.65 LPV-2.24 LPV-1.08 i Parts-Labor-Travel Unlike some other standby generator manufacturers, our warranty covers parts, Limited labor AND travel for the full length of the warranty with no start-up costs! Warranty' 'This generator is certified in accordance with UL(Underwriters Laboratories)2200(stationary engine generator assemblies)and CSA(Canadian Standards Association)standard C22.2 No,100-14(motors and generators), !Fuel consumption rates are estimated based on normal operating conditions at yz load.Generator operation may be greatly affected by elevation and the cycling operation of multiple electrical appliances-fuel flow rates mayvary depending on these factors. 'See operator's manual or BRIGGSandSTRATTON.com for complete warranty details. 4 Lowest no-load measurement per ISO 3744.Sound level measurement at other locations around generator may be different depending upon installation configuration. 2 ' t BRIOCiB&9iRA1Tf1N° 20kW' Fortress'"Standby Generator Qp8Yi3ti O1I6'' �'r8ltl�ICat�E1q� -. " Engine Warm Up(sec) 20 seconds after all settable delays CARB Compliant* Engine Cool Down(min) 5 FCC Part 15 Class B/CAN ICES-003(B) Response Time(sec) Immediate after engine warm up NFPA37Compliant I Weight and Dimensions € cUL Listed to CSA 22.2 No.100-14 Assembled Weight(lbs/kg) Steel-489/222 UL2200 Listed Aluminum-440/200 Overall Dimensions(in/mm) 50.5 x 33.8 x 30.6/1283 x 859 x 777 EPA Certified Fuel System Packaged Weight(Ibs/kg) Steel-634/288 Complies with NFPA 37 4.1.4.1.2 Aluminum-580/263 Packaged Dimensions(in/mm) 68,1 x 41 x 39.9/1730 x 1041 x 1013 AVG(�0)1D AlcessscirNa ;;a " Galvanneal Steel or Aluminum Maintenance Kit 6036 Enclosure Material with Corrosion Resistant Paint , E-Stop Kit 6491 Available'Fran°steKSwitches , ..;...,. :�2._. Power Management ..,.......,,._._ ...__.... ......�._...._......... ...,,..... 71052,71053 071100 100 Amp Low Voltage Module Power Management 071150 150 Amp High Voltage Module 71051 Generator Status LED Kit 6535 071200 200 Amp Battery Warmer 6578 071071 Symphony'11 100 Amp InfoHub Universal 6574 071070 Symphony'11 150 Amp 071068 Symphony'11 200 Amp 071057 Symphony'It Dual 200 Amp 50.5 in(1283 mm) 33.8 in(859 mm) . -"('_vim=.•�"-'"------'— 30.0 in (777 mm) 48.1 in(1222 mm) 29.6 in(752 mm) 'CARB does not regulate emergency standby generators outputting less than 50 HP.Only the EPA standards apply. 'This generator is certified in accordance with UL(Underwriters Laboratories)2200(stationary engine generator assemblies)and CSA(Canadian Standards Association)standard C22.2 No,100-14(motors and generators). 3 RiocsssTaariol� 20kW' Fortress""Standby Generator 1 ;- wx off . 'This generator is certified in accordance with UL(Underwriters Laboratories)2200(stationary engine generator assemblies)and CSA(Canadian Standards Association)standard C22.2 No.100-14(motors and generators). BRIGGS 6 STRATTON CORPORATION its specifications i Stratton has a policy of without prior product improvement and reserves the right to modify POST OFFICE BOX 702 BRIGGS&STRA N its specifications at any time and without prior notice. Notfor Prime Power or use where standby systems are legally required,for serious life safety MILWAUKEE,WI 53201 USA or health hazards,or where lack of power hampers rescue of fire-fighting operations. BS1155-9/19 Copyright©2019.All rights reserved. YOU.POWEREOF.