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HomeMy WebLinkAbout48702-Z s� ��S�EFOI�cot� Town of Southold 3/4/2023 P.O.Box 1179 y 53095 Main Rd oy o�Fr Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 43 874 Date: 3/4/2023 THIS CERTIFIES that the building GENERATOR Location of Property: 830 Sunset Dr,Mattituck SCTM#: 473889 Sec/Block/Lot: 106.-8-37 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 11/14/2022 pursuant to which Building Permit No. 48702 dated 1/6/2023 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: accessoU generator as applied for. The certificate is issued to Macros, Steven&Michelle of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 48702 2/24/2023 PLUMBERS CERTIFICATION DATED Au o z d Signature SufFo t TOWN OF SOUTHOLD BUILDING DEPARTMENT y x TOWN CLERK'S OFFICE "oy • � : SOUTHOLD, NY dip Lail 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#: 48702 Date: 1/6/2023 Permission is hereby granted to: Macros, Steven 830 Sunset Dr Mattituck, NY 11952 To: install generator as applied for. At premises located at: 830 Sunset Dr, Mattituck SCTM # 473889 Sec/Block/Lot# 106.-8-37 Pursuant to application dated 11/14/2022 and approved by the Building Inspector. To expire on 7/7/2024. Fees: ACCESSORY $100.00 ELECTRIC $85.00 CERTIFICATE OF OCCUPANCY $50.00 Total: $235.00 uilding Inspector pF SOUj�QI 0 Town Hall Annex Telephone(631)765-1802 54375 Main Road P.O.Box 1179 sean.devlin(a-town.Southold.ny.us • O Southold,NY 11971-0959 �Q BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Steven Macros Address: 830 Sunset Dr city,Mattittuck st: NY zip: 11952 Building Permit* 48702 Section: 106 Block: 8 Lot: 37 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: Electrician: Neal Coleman Electric License No: SITE DETAILS Office Use Only Residential X Indoor X Basement Service Commerical Outdoor X 1st Floor Pool New X Renovation 2nd Floor Hot Tub Addition Survey X Attic Generator X INVENTORY Service 1 ph 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 Strobe Heat Detectors Disconnect Switches 4'LED Exit Fixtures Sump Pump Other Equipment: 20kW Kohler Generator w/200A Whole House Transfer Switch Notes: Generator Inspector Signature: r Date: February 24, 2023 S. Devlin-Cert Electrical Compliance Form * # TOWN OF SOUTHOLD BUILDING DEPT. courm,��'' 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: Cis A �- 64n lZkm DATE INSPECTOR laso TOWN OF SOUTHOLD BUILDING DEPT. °ycoum, 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] SULATION/CAULKING [ ] FRAMING /STRAPPING [VI FINAL&Aao�ru� [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL RE RKS: DATE ?i INSPECTOR Il.�ll:i''���I:I II IIII I�IIIIII'I�I SII L.� F 098346894 .eea I _ x!914-V-- ,.•FOCUS RXR-SD FORM 2S CL200 240V 3W 6OHz TA=30 Kh 71 ow or..<.waao 9p834689p4 p LONG ISLANDS POWER AUTHORITY ,w� IH UI IIIIIIII I'II 11111 rpm -�,� Canalis+Gyr S Y 1 This Building is equipped with an Interconnected Electric Power Production Source II I I 1 Source Type: Standby Generator Solar Photo Voltaic—Other: Disconnect is Located: Interim Basement. Garage:_ Exderior:� i I Front Rear:_ LH Side:_ RH Side._ Other Location: -Call Your Installer for SerWces- ,� Suffolk Bureau of Electrical inspectors Inc- "-"'SufTolkiDei.com Per NFPA 70%20M Mlde 705 10 d, 1 1 i This Building Is equipped with an Interconnected Electric Power . t Production Source t ; Source Type: Standby Generator: 1 vl� Solar Photo Voltaic: Other: Disconnect is Located: Interior: Basement: Garage: Exterior: Front: Rear: LH Side: RH Side: —"' — Other Location: -Call Your Installer for Services- ` f �- Suffolk Bureau of Electrical Inspectors "W.Suffolkbei.com Inc. Per NFPA 70 / 2008/Article 705.10 i r � I�� YJ1�'Q �i0a13 _ Y � • - �i�wi�C � �1�.il� . ` � J i� 4 �•H 1 ' 1 � I I I'w C3 1 1 1 i i SUITMLE FOR USE At Q0 SERVICE EOUNIMENT- JA L N g `\p NORMAL SOURCE ONLY. L `0 \/ 1 AN ADDIT>UNAL 5 OISCONNECT MUST BE N READILY AVAILABLE FOR C - - THE AI TFRNATE SOURCE n 1 1 UNLESS THE ALTERNATE � SOURCE IS AN { ACCEBSIBLE GENERATOR ► N ANO CAN BE READILY j SMJT DOWN S p T R A M N q Y , E S R' E EM R Nl LV EpUIPN' GROW t � 'CH E ,WA,rA OR STAN68 11 SE ON M OR I+O D FOR -E oweadc M.u'V NYrIM 1 r utlt flE.'._n' ~tEllt T �apyi� .fart >rBp To �ti 1 1 I t� e\ � y w `des. t ♦ ^r /�.' ..•+.��- �£ ���. ;. : . ,�� Nom"' �'-_1:'k� .7✓, 1� ',�. �'m !\� .� •4 Zlie ����•i�1 t t •,r, �/�..r�k. ..•fir�j+.r 1M.%�.��� � � •.+ _ ell Ov fol IwA- !� �dP •/i �,^ ' -..tj� r �"��. ,k�,t1� I. IA(., /►::�1�. • ..ate 1 � �],1 ` "/'c A/ •N ,. ��� 'i .�.�,+��.: w. ♦eye .�, , �'� ��• ��, � lipT 'wV ■II' � a r �8�. I L�11v/ _1�® Ka, nd z '9 �-wk- i U'ALIFAENTq- SOURCES L'ENTRETIEN T OE FAIRE , EPARATIONS e„ II �1 i .. If � \s ..0 SUITABLE FOR USE AS SERVICE EQUIPMENT- fNORMAL SOURCE ONLY 1 ADDITIONAL DISCONNECT M"T BE I` READILY AVAILABLE FOR C THE ALTERNATE SOURCE, N UNLESS THE ALTERNATE SOURCE IS AN ACCESSIBLE GENERATOR AND CAN BE READILY ► N SHUTDOWN. S p T R A M � . N A L )� r I EOUIPh' ITCH EOUIPMENTid ,100A OR STAND BY SE ON OR MOT � J a FIELD INSPECTION REPORT I DATE COMMENTS b FOUNDATION (1ST) ids H -------------------------------------- FOUNDATION (2ND) z � o H \ ROUGH FRAMING& PLUMBING � v ,1 r INSULATION PER N. Y. STATE ENERGY CODE T FINAL ADDITIONAL COMMENTS b3 2 Z �m ;o S J H O z H x d b H ao�guFFatr�oGy 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 htips://www.southoldtownny.gov Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only " IL 2 Pow iy i aro; �- PERMIT N0. O` Building Inspector: 0i 1� Applications and forms must_tie filled out in their:entiretV..i gcomplete'„ applications Will not be`accepted Where the.Applicant is not'the owner,an 'Owner's Authorization form`(Page t)shall`be completed:-: Date: ,.OWNER(S OF. ;ROPERTY:.:, Nam e�l.e� ._.._OInG�_...._.. ._ .. -I. . . _ SCTM#1000- Project Address: \� 4 I1 Phone#• Z 2 Ema ._ .�_y�_._ _il: 3.l _ Mailing Address: 8-Sz - CONTACT PERSON: .; Name: Mailing Address: .(..5 Phone#: 5.I -` l�- '_.S-`I_I - EmaiL� - 0� �� -�c1 - - -.-.. DESIGN-PROFESSIONAL.INFORMATION:" Name: Mailing Address: Phone#: Email: .CONTRACT ,.R_ INFORMATION: - Name: Mailing Address: Phone#: E il: I ;..: DESCRIPTION OF.PROPOSED..0 ,N TRUCTION: .-.:-:-. :.... . .... ...._. ..... -:.,.:.- :,-_ .... ..:.."-.,..: ....-......,. .,, -:. : -:- •..._.: ...... ❑N Stru re ❑Ad ition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: Other $ 3X-0.6- FW 777 ill the lot be re-graded? ❑Yes KkAo Will excess fill be removed from premises? ❑Yes No 1 PRO •:,; PERTY'INFORMAT.ION: : Existing use of property: Intended use of propertyLsldim ' Zone or use district in which premises is situated: Are there any covenants d restrictions with respect to this property? ❑Yes o IF YES, PROVIDE A COPY. check Box After Reading: The ownercontractor/,design professional is responsible for all drainage s and storm water issueas provided by.''.;: `Chapter;236,of the'-Town Code;APPLICATION,IS HEREBY MADE to.the Building Department for the issuance,&&Bullding Permit pursuant to the Building Zone':. Ordinance of the Town of Southold,Suffoik,County,New York and other applicable Laws;Ordinance's or Regulations,for the construction of buildings; additions;,aiterations or for removal or demolition as herein described..Th6`applicant agrees to comply with all applicable laws,ordinances;building code,.- .housirig code and eeguiations and to admit authorized inspectors on premises and in building(s).for necessary inspections False statements,made herein are punishable as. class A:misdenieanor pursuant to,Section 210.45 of the New York State Penat Law.', Application Submitted B (print name): ❑Authorized Agent G/Owner Signature of Applicant: Date. lilt J ,,-02-Z - CONNIE D:-BUNCH Notary Public,State of New York STATE OF NEW YORK) No. 01 BU6185050 Qualified in Suffolk County COUNTY OF SS: Commission Expires April 14,20�k4 ) being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)he is the (Contractor,Agent,Corporate Officer,etc.) of said owner or owners,and is duly authorized to perform or have performed the said work and to make and file this application;that all 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 m.�er this Il-kday of DV--4" ,20o� -4) Notary Public PROPERTY OWNER AUTHORIZATION (Where the applicant is not the owner) I, residing at do hereby authorize to apply on my behalf to the Town of Southold Building Department for approval as described herein. Owner's Signature Date Print Owner's Name 2 OS� QjlrCG BUILDING DEPARTMENT- Electrical Inspector .� 0 Gym TOWN OF SOUTHOLD 9 N z Town Hall Annex - 54375 Main Road - PO Box 1179 Southold, New York 11971-0959 y per Telephone (631) 765-1802 - FAX (631) 765-9502 rogerrc@-southoldtownny.gov — seand(aD-southoldtownny.gov r APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: I I 23 Company Name: Electrician's Name: License No.: Elec. email: Elec. Phone No: ❑I request an email copy of Certificate of Compliance Elec. Address.: JOB SITE INFORMATION (All Information Required) Name: Address: Cross Street: Phone No.: Bldg.Permit#: email: Tax Map District: 1000 Section: Block: Lot: BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Square Footage: 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 12 H Frame Pole Work done on Service? Y N Additional Information: PAYMENT DUE WITH APPLICATION /,� 3 n Z �� UI~I=oitr BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD ' Town Hall Annex - 54375 Main Road - PO Box 1179 Southold, New York 11971-0959 *4 Telephone (631) 765-1802 - FAX (631) 765-9502 ' rogerr(aD-southoldtownny.gov — seand(a-southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: I 3 I 2.3 Company Name: Electrician's Name: License No.: Elec. email: Elec. Phone No: ❑I request an email copy of Certificate of Compliance Elec. Address.: JOB SITE INFORMATION (All Information Required) Name: V e, Mace- S Address: 3 o C Cross Street: Phone No.: Bldg.Permit#: �;.-7&1 email: Tax Map District: 1000 Section: Block: Lot: BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Square Footage: 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 LateralsF-] 2 0 H Frame Pole Work done on Service? Y N Additional Information: PAYMENT DUE WITH APPLICATION �A ��5,. 3 Ye "mob 0 oa cooits 0) N /" h♦ All, O C. Ll �'i� , y N ,uN �• Lo �r�E' 01 r0 `V' p Vy� 0 •I.y U� O + N •� J\Vv H � \ O A RO o ,� p �w � 1 r P n � n ~ a H c(p -4 ` 1� w A .14 1► . W r C \ Z U') hof 5� 18182 N \� tic. �2 1°3130 v+Pti ok \j KD r b to O L 28 ' NIDpO N \ `� \ e '001 19 9.86 � •N 11 W � c co CI'- �= �1 °3130'VJ• A�gp S.'67 gcrgOflon . \ R NOi E' •=MONUMENT S•UB D/V/S/ON MAP F/L£D/N THE OF [;F-ME CL ERX OFSUFFOLK couNrrcw APR.9, /970 AS FILE NO. 5448. REVISIONS YOU NG & YOU Pte OF NFw LIME 8,/978 400 OSTRANDER AVENUE, RIVER Ab 11 IO ALDEN W. YOUNG p�HOWARR YIO NG PROFESSIONAL ENGINEER AND `Z` 1RV(X t LAND SURVEYOR. N.Y.S. LIC. NO. 12845 NQ. 5e 3 SURVEY FOR: (� THISUNAUTHORIZEDSVEYALTERATION OR ADDITION TO R. D. HOUSTON S SONS,/NC. THIS SURVEY 19 A VIOLATION OF SECTION ' LAw9 OF THE NEW YORK STATE EDUCATION LOTNO. DOF ,,SUNSET KNOLLS, S �� 458'9 COPIES OF 71119 SURVEY MAP NOT BEARINGL�MD SUR�E�°� THE LAND SURVEYOR'S INKED SEAL. OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. AT MATT/TUCK GUARANTEED TO: OI, EES INDICATED HEREON SHALL RUN SOf1TNOL D SAV/NGS BANK ONLYLY TO SECUR/TY T/TLE B GUARANTY CO. TO THE PERSON FOR WHOM THE TOWN OF SOUTHOLD :iUHVfY 19 PREPARED,AND ON 1113 BEHALF TO THE TITLE COMPANY.GOVERNMENTAL AUENCY AND LENOINU INST11U11ON LISTED IICII EON,AND TO THE ASSIGNEES OF THE SUFFOLK CO., N.Y. BY ,ENDING INSTITUTION. GUARANTEES ARE NOT igAN.yFE1OR S TO ADDITIONAL SCALE: 11'r AO' DATE: Y/S /975 NO. 75•—270 INSTITUTIONS OR 9UBSEOUE'NT OWNERS. .1. NEALCOL-01 CFRITZ ACORN® CERTIFICATE OF LIABILITY INSURANCE FDATE(MM/DD/YYYI� �� 11/15/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must 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 NA ERCT Cassandra Fritz Lupton&Luce,Inc. p PHONE FAX 226 Howell Ave (AIc,No,Ext):(631)727-4114 245 A/c,No):(631)727-7138 Riverhead,NY 11901 EODRLESs:Cassandra@luptonandluce.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Ohio Security Insurance 24082 INSURED INSURER B:The Ohio Casualty Insurance Company 24074 Neal Coleman Electric Inc;Jashre LLC INSURER C: P.O.Box 619 INSURER D: Manorville,NY 11949 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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 LT ISD M/DD MWO A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1'000'000 CLAIMS-MADE �OCCUR X BKS58925160 10/17/2022 10/17/2023 DAAI E 1 RENTED $15,000 PRMGESS Ea occurrence $ MED EXP An one person) $ 15'000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY[X]jER,?T F__]LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY ca aBadeD SINGLE LIMIT $ ANY AUTO BODILY INJURY(Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS p BODILY INJURY(Per accident $ AUTOS ONLY AUTOS O�Y PROPERTY AMAGE Per accadent $ B UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 X1 EXCESS LIAB CLAIMS-MADE ES057681596 10/17/2022 10/17/2023 AGGREGATE $ 5'000'000 DED RETENTION$ $ PER OTH- WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y/N STA UTE ER ANY P�R�OPRIETOERR/PARTNER/EXECUTIVE ❑ NIA E.L EACH ACCIDENT $ Mandato En NH EXCLUDED? ( ry ) E.L DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attachedIf more space is required) Certificate holder is included as additional insured per provisions of attached endorsement#1CG8810 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Steve Macros THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 830 Sunset Dr Mattituck,NY 11962 AUTHORIZED REPRESENTATIVE r _ ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD A�® CERTIFICATE OF LIABILITY INSURANCE DATE(MNUDD/YYY1) 11/17/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT. If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must 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 Jessica Garcia NAME: Newtek Insurance Agency,LLC A/C No Ext): (866)380-7007 FAX No): (866)648-0916 1981 Marcus Avenue E-MAILIgarcia@newtekone.com ADDRESS: Suite 130 INSURERS)AFFORDING COVERAGE NAIC 9 Lake Success NY 11042 INSURER A: Hartford Fire Insurance Co. 19682 INSURED INSURER B: Neal Coleman Electric Inc. INSURER C: PO BOX 519 INSURER D: INSURER E Manorville NY 11949 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2161022792 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 CONTRACTOR 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 WVD POLICY NUMBER ADDLSUBR POLICYEFFPOLICY EXP uMrrs COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO CLAIMS-MADE FlOCCUR PREMISES Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY 0 PRO JECT F—]LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANYAUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED I RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY STATUTE ER Y!N 1,000,000 ANY PROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ A OFFICERIMEMBEREXCLUDED? N!A 12WECAKOANO 01/15/2021 01/15/2022 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1.000,000 If yes,describe under 1,000,000 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 THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Steve Macros ACCORDANCE WITH THE POLICY PROVISIONS. 830 Sunset Drive AUTHORIZED REPRESENTATIVE Mattituck NY 11952 Cyt'p s ©1988-��/2015"ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD �a APPR VED AS NOTED DATE: B.P.# FEE- BY: NOTIFY BUILDING DEPARTMENT AT 765=1802 8 AM TO 4 PM FOR THE ELECTRICAL FOLLOWING INSPECTIONS: INSPECTION �������® 1. FOUNDATION.- TWO REQUIRED FOR POURED CONCRETE .2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED AND CONDITIONS OF iiOt'r,—16'VIVIN dNNING BOARD S0I ITWG 9 T9WPJ'TDI ISTEES NYS PES )CCU'PANCY OR JSE-l$`�U'NL4'WFU4 WITHOUT �CE,RTIFICA OF"-OCCUPANCY v� KOHLER. Models: 20RCA(L) Multi-Fuel LPG/Natural Gas 09001 Standard Features • 4 KOHLER. • RDC2 Controller NATIONALLY REGISTERED O One digital controller manages both the generator set and transfer switch functions (with optional Model RXT). o Electronic speed control responds quickly to varying _"`. • '; demand. r o OnCue@ Plus Generator Management System for remote monitoring is included with the generator. • Kohler Command PRO Engine Features L o Kohler Command PRO@ OHV engine with hydraulic valve lifters for reliable performance without routine valve adjustment or lengthy break-in requirements. . Designed for Easy Installation {�!iiElt o Sturdy aluminum base can be mounted on gravel or a concrete mounting pad. o Fuel and electrical connections through the enclosure wall The"Kohler® Advantage eliminate the need for stub-ups through the base. o Customer connection terminal block located near the • High Quality Power controller allows easy access for field wiring. Kohler home generators provide advanced voltage and o Designed for outdoor installation only. frequency regulation along with ultra-low levels of • Certifications harmonic distortion for excellent generator power quality to o Meets emission regulations for U.S. Environmental protect your valuable electronics. Protection Agency(EPA) with both natural gas and LPG. • Extraordinary Reliability o UL 2200/cUL listed (60 Hz model). Kohler is known for extraordinary reliability and o CSA certification available (60 Hz model). performance and backs that up with a premium 5-year or o Accepted by the Massachusetts Board of Registration of 2000 hour limited warranty. Plumbers and Gas Fitters. • Powerful Performance o Meets 181 mph wind rating. Exclusive Powe§boost'" technology provides excellent a Approved for stationary standby applications in locations starting power. served by a reliable utility source. • Aluminum Enclosure • 20RCAL models packaged with a Model RXT automatic o Attractive aluminum enclosure allows installation as transfer switch are available. See page 4 and the Model close as 18 inches from your home or small business. RXT ATS specification sheet. o Enclosure panels can be removed without tools to allow easy access for maintenance and service. • Warranty o 5-year/2000 hour limited warranty for on-grid (standby) applications in locations served by a reliable utility source. Generator Ratings Standby Ratings Line Circuit Natural Gas LPG Breaker Alternator Voltage Phase Hz kW/kVA Amps kW/kVA Amps Amps Poles 2F7 120/240 1 60 18/18 75 20/20 83 100 2 120/208 3 60 17/21 58 17/21 58 70 3 2137 120/240 3 60 17/21 51 17/21 51 60 3 277/480 3 60 17/21 26 17/21 26 30 3 Note: The line circuit breaker is automatically selected based on the generator set model and voltage configuration. RATINGS:Standby ratings apply to installations served by a reliable utility source.All single-phase units are rated at 1.0 power factor.The standby rating is applicable to variable loads with an average load factor of 80%for the duration of the power outage. No overload capacity is specified at this rating. Ratings are in accordance with ISO-3046/1,BS5514.AS2789,and DIN 6271.GENERAL GUIDELINES FOR DERATING:ALTITUDE:Derate 4%per 305 m(1000 ft.)elevation above 153 m(500 ft.).TEMPERATURE:Derate 2Y per 5.5°C(10°F)temperature increase above 16°C(60°F). Availability is subject to change without notice.The generator set manufacturer reserves the right to change the design or specifications without notice and without any obligation or liability whatsoever. Contact your local Kohler Co.generator distributor for availability. § Check the appliance manufacturer's specifications for actual power requirements. Consult a Kohler©Power Systems professional to calculate your exact residential power system requirements. t Meets NFPA guidelines for 1a inch clearance to combustible materials. Check state and local codes for minimum distance required from a structure. G4-272 (20RCA) 5/21d , w Alternator Specifications Alternator Specifications Alternator Features Specifications Alternator a Compliance with NEMA, IEEE, and ANSI st2tidards for Manufacturer Kohler temperature rise. Type 2-Pole,Rotating Field o Self-ventilated and dripproof construction. ; Leads,quantity 2F7 4 • Windings are vacuum-impregnated with F,poxy varnish for 2G7 12 dependability and long life. �. Voltage regulator Digital • Superior voltage waveform and minimum harmonic Insulation: NEMA MG1-1.66 distortion from skewed alternator construction. Material Class H • Digital voltage regulator with t1.0 no-load to full-load Temperature rise 130°C Standby RMS regulation. Bearing:quantity,type 1,Sealed a Rotating-field alternator with static,exciter for excellent Coupling Direct load response. . Amortisseur windings Full • Total harmonic distortion (THD)from no'load to full load with Voltage regulation,no-load to full-load RMS ±1.0% a linear load is less than 5%. One-step load acceptance 100%of Rating Peak motor starting kVA: (35%dip for voltages below) 240 V,1 ph 2F7(4 lead) 41 (60 Hz) 240 or 480 V,3 ph 2G7(12 lead) 69(60 Hz) Application Data Engine Exhaust Engine Specifications Exhaust System Manufacturer Kohler Exhaust temperature exiting the Engine:model,type CH1000 4-Cycle enclosure at rated kW,dry, °C(°F) 260(500) Cylinder arrangement V-2 Lubrication Displacement,cm3(cu.in.) 999(61) Bore and stroke,mm(in.) 90 x 78.5(3.54 x 3.1) Lubricating System Compression ratio 8.8:i Type Full Pressure Main bearings:quantity,type 2,Heavy-Duty Sleeve Oil capacity(with filter),L(qt.)§ 1.9(2.0) Bearings Oil filter:quantity,type§ 1,Cartridge Rated RPM Oil cooler Integral 60 Hz 3600 § Kohler recommends the use of Kohler Genuine oil and filters. Max.engine power at rated rpm,kW(HP) LPG,60 Hz 23.0(30.9) Fuel Pipe Size Natural gas,60 Hz 20.2(27.1) Cylinder head material Aluminum Minimum Gas Pipe Size Recommendation,in.NPT Valve material Steel/Stellite( Pipe Length, Natural Gas LPG Piston type and material Aluminum Alloy m(ft.) 281,000 Btu/hr. 340,000 Btu/hr. 8 (25) 1 3/4 Crankshaft material Heat Treated,Ductile Iron Governor:type Electronic 15 (50) 1 1 Frequency regulation,no load to full load Isochronous 30 (100) 1 1/4 1 Frequency regulation,steady state ±0.5% 46 (150) 1 1/4 1 1/4 Air cleaner type Dry 61 (200) 11/4 11/4 Engine Electrical Engine Electrical System Ignition system Electronic, Capacitive Discharge Starter motor rated voltage(DC) 12 Battery(purchased separately): Ground Negative Volts(DC) 12 Battery quantity 1 Recommended cold cranking amps: (CCA)rating for-18°C(0°F) 500 Group size 51 G4-272 (20RCA) 5/21d rt Fuel kequirements RDC2 Controller Features, Continued Fuel System • LED indicators for utility power and generator set source Fuel types Natural Gas or LPG availability and ATS position (Model RXT transfer switch Fuel supply inlet 1/2 NPT required) Fuel supply pressure,kPa(in.H2O): • LCD display: Natural gas 0.9-2.7(3.5-11) o Two lines x 16 characters per line LP 1.7-2.7(7-11) o Backlit display with adjustable contrast for excellent Fuel Composition Limits* Nat.Gas LPG visibility in all lighting conditions Methane,%by volume(minimum) 90 min. - • Scrolling system status display: Ethane,%by volume(maximum) 4.0 max. - o Generator set status Propane,%by volume 1.0 max. 85 min. o Voltage and frequency Propene,%by volume(maximum) 0.1 max. 5.0 max. o Engine temperature C4 and higher,%by volume 0.3 max. 2.5 max. o Oil pressure Sulfur,ppm mass(maximum) 25 max. o Battery voltage Lower heating value, o Engine runtime hours MJ/m3(Btu/ft ), (minimum) 33.2(890) 84.2(2260) • Date and time displays * Contact your local distributor for suitability and rating derates based • Smart engine cooldown senses engine temperature on fuel compositions outside these limits. • Digital isochronous governor maintains steady-state speed at all loads Operation Requirements • Digital voltage regulation: ±1.0% RMS no-load to full-load Fuel Consumption,m3/hr.(cfh)@ 60Hz • Automatic start with programmed cranking cycle %Load Natural Gas LPG e Programmable exerciser can be set to start automatically on 100 8.0 (281) 3.9 (136) any future day and time,and run every week or every two 75 6.9 (243) 3.1 (109) weeks 50 4.6 (161) 2.3 (82) • Exercise modes: 25 3.6 (127) 1.7 (59) o Unloaded weekly exercise with complete system Exercise 2.0 (71) 1.0 (35) diagnostics Nominal fuel rating: Natural gas: 37 MJ/m3(1000 Btu/ft.3) c Unloaded full-speed exercise LPG: 93 MJ/m3(2500 Btu/ft.3) o Loaded full-speed exercise (Model RXT ATS required) LPG conversion factors: 8.58 ft.3=1 Ib. • Front-access mini USB connector for SiteTech- or USB 0.535 m3=1 kg Utility connection 36.39 ft.3 =1 gal. • Integral Ethernet connector for Kohler@ OnCue@ Plus Generator Set Sound Data • Built-in 2.5 amp battery charger a Remote two-wire start/stop capability for optional connection Model 20RCA 8 point logarithmic average sound levels are of a Model RDT transfer switch 66 dB(A) during weekly engine exercise and 70 dB(A) during • Diagnostic messages: Displays diagnostic messages for the full-speed generator diagnostics and normal operation.* engine, generator, Model RXT transfer switch, programmable All sound levels are measured at 7 meters with no load. interface module (PIM),and load management device. • Maintenance reminders * Lowest of 8 points measured around the generator. Sound levels at System settings: other points around generator may vary depending on installation y parameters. . o System voltage,frequency, and phase RDC2 Controller o Voltage adjustment o Measurement system, English or metric • ATS status (Model RXT ATS required): F o Source availability Voltage: 240V . o ATS position (normal/utility or emergency/generator) Freq: 60.0 Hz o Source voltage and frequency 0 0 0 • ATS control (Model RXT ATS required): tea 0 0 o Source voltage and frequency settings o Engine start time delay o-F=6 o Transfer time delays o Voltage calibration The RDC2 controller provides integrated control for the o Fixed pickup and dropout settings generator set, Kohler Model RXT transfer switch, • Programmable Interface Module(PIM) status displays: programmable interface module(PIM), and load shed kit. o Input status (active/inactive) o Output status (active/inactive) RDC2 Controller Features e Load control menus: • Membrane keypad: o Load status o OFF,AUTO, and RUN pushbuttons o Test function o Select and arrow buttons for access to system configuration and adjustment menus • LED indicators for OFF,AUTO,and RUN modes G4-272 (20RCA) 5/21d Y MOHLER, Phone 9 CO.,Kohler,Wisconsin 9-164 USA Phone 920-457-4441,Fax 920-459-1646 For the nearest sales and service outlet in the US and Canada,phone 1-800-544-2444 KOHLERPower.com Generator Set Standard Features Automatic Transfer Switches and Accessories • Battery cables ❑ Model RDT ATS • EPA certified fuel system ❑ Model RXT ATS • Aluminum sound enclosure ❑ Model RXT ATS with combined interface/load • Critical silencer management board ❑ Load shed kit for RXT or RDT • Field-connection terminal block C] Power relay modules (use up to 4 relay modules for • Fuel solenoid valve and secondary regulator each load management device) • Line circuit breaker ❑ Other Kohler®ATS • Multi-fuel system, LPG/natural gas,field-convertible 20RCAL Model Packages • Oil drain extension with shutoff valve ' ❑ 20RCAL with 100 amp RXT with 16-space load center and • OnCuelb Plus Generator Management System NEMA 1 steel enclosure for indoor installation • Premium 5-year limited warranty ❑ 20RCAL with 200 amp service entrance-rated Model RXT • RDC2 generator set/ATS controller with combined interface/load management board and • Rodent-resistant construction corrosion-resistant NEMA 3R aluminum enclosure • Sound-deadening,flame-retardant foam per UL 94, Warranty class HF-1 ❑ 5-Year Comprehensive Limited Warranty Available Options Ll1,0-Year Comprehensive Limited Warranty Approvals and Listings ❑ CSA approval Concrete Mounting Pads ❑ Concrete mounting pad,3 in.thick ❑ Concrete mounting pad,4 in.thick (recommended for storm-prone areas) Electrical Accessories ❑ Battery ❑ Battery heater, 120VAC ❑ Battery heater, 240VAC ❑ Cold weather package, 120VAC Generator Set Dimensions and Weights ❑ Cold weather package, 240VAC ❑ Emergency stop kit Generator Set Size,L x W x H: 1193 x 666 x 817 mm ❑ PowerSync®Automatic Paralleling Module(APM) (47 x 26.2 x 32.2 in.) (single phase only; parallel two 20kW residential generator Shipping Weights: sets with the RDC2 controller) 20RCA Generator Set: 252 kg(555 Ib.) Programmable interface module PIM 20RCAL with 100 A RXT ATS w/LC 277 kg(611 lbs.) ❑ g (PIM) 20RCAL with 200 A RXT SE ATS: 272 kg(600 Ib.) (provides 2 digital inputs and 6 relay outputs) L Fuel System Accessories ❑ Flexible fuel line(included on OS models) ❑ Carburetor heater, 120 VAC ❑ Carburetor heater,240 VAC EMMM Carburetor heater is recommended for reliable starting H at temperatures below 0°C(32°F) �® Literature ❑ General maintenance literature kit ❑ Overhaul literature kit W ❑ PIOdUC110n literature kit NOTE: Dimensions are provided for reference only and should not be used for planning installation.Contact your local distributor for more detailed information. Maintenance DISTRIBUTED BY: ❑ Maintenance kit(includes air filter, oil,oil filter, and spark plugs) ©2018 Kohler Co. All rights reserved. G4-272 (20RCA) 5/21d