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HomeMy WebLinkAbout50351-Z TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE ' `5r 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#: 50351 Date: 2/16/2024 Permission is hereby granted to: Mea her....D.e.c.la..nm.........- 750 Blue Marlin Dr _._ Southold ... ......_____....... _ ---..._ . NY 11971 To: Install an accessory generator to a single-family dwelling as applied for per manufacturers specifications. Must maintain minimum setbacks of 10 feet. At premises located at: 750 Blue Marlin Dr. Greenport m SCTM #473889... ........ ...........................��.—_. m WW�............................................................................... Sec/Block/Lot# 57.-1-29 Pursuant to application dated 024 and approved by the Building Inspector. To expire on a... 8/17/2025. Fees: ACCESSORY $125.00 CERTIFICATE OF OCCUPANCY $100.00 ELECTRIC $100.00 ----------------- Total: $325.00 Building Inspector TOWN OF SOUTHOLD-BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 �n Telephone 631 765-1802 Fax 631 765-9502 htt -// ww.sol�tlioldIgM � .. Dov' ce � A P � ) J Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only gg E C E WE ?� JA PERMIT NO." „ S I Building Inspector P)u ,JAN 1 9 2024 Applications and forms must be filled out in their entirety.Incomplete applications will not be accepted. Where the Applicant is not the owner,an Owners Authorization form(Page 2)shall be completed. Date: 'Q44-21 OWNER(S)OF PROPERTY: Name: ' , �., v� me SCTM#1000- _ �--r- _ Project Address: -75`0 ?-L I AJ P112-, LJ 1 , Phone#: 16 7Z3 Email: Ae e j14Q I,, Ir wa I , ev&t Mailing Address: 4AK f- ,5 PXX.FC!T- CONTACT PERSON: Name: Mailing Address: 7() H A e L,-J Phone#: l & 4 Email: (JL°L144t4 V-V ® Ototc ► �A--- DESIGN PROFESSIONAL INFORMATION: Name. kCA6 i4W At 1 (.A Mailing Address: -7G0 - , v r Phone#: ! Email: der- dl�v it ® CONTRACTOR INFORMATION: Name: '� D to(C- b W �� � ��if Mailing Address: fo 50 Ct>'T<-Ho Phone#: (Q�j -73 L� S V DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: then AJS-%A vtiJ 41k' Will the lot be re-graded? ❑YesNo Will excess fill be removed from premises? ❑Yes 300 1 PROPERTY INFORMATION Existing use of property-4 mow. Intended use of property. I" , Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to „, t this property? ❑Yes; No IF YES, PROVIDE A COPY. Ch ck Box the Town Code. API PUPATION IS er SEB rector design professional Is responsible for all drainage and storm water Issues as provided by Reading: I Ch,pte to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold,Suffolk,County,New York and other applicable Laws,Ordinances or Regulations,for the construction of buildings, additions,alterations or for removal or demolition as herein described.The applicant agrees to comply with all applicable laws,ordinances,building code, housing code and regulations and to admit authorized inspectors on premises and in building(s)for necessary inspections.False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the New York State Penal Law. Application Submitted By(print name): JLO�^4A&S C-,�14 � ❑Authorized Agent OGwner Signature of Applicant: Date: //7/ STATE OF NEW YORK) S: COUNTY OF cc—(O-sa a R s "` being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)he is the -� n (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 . I day of V GL vl U oc / 20 Notary Public Rebecca A. Lucak Notary Public, State of New York PROPERTY OWNER AUTHORIZATION Reg. No. 01 LU6386882 (Where the applicant is not the owner) Qualified in Suffolk County - Commission Expires 02/04/2027 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 n � d u✓,cr,M fft BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD Town Hall Annex- 54375 Main Road - PO Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 amesh southoldtownn ov sea nd southoldtownn .aov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: 1/19/24 Company Name: Peconic Power Systems Electrician's Name: Robert Stanevich License No.: ME-45056 Elec. email: Peconicpowersys@gmail.com Elec. Phone No: 516-819-7191 ❑I request an email copy of Certificate of Compliance Elec. Address.: PO BOX 512 Cutchogue NY 11935 JOB SITE INFORMATION (All Information Required) Name: Declan & laura Meagher Address: 750 Blue Marlin Dr, Southold Cross Street: Dolphin Phone No.: 516-761-7343 BIdg.Permit#:- 50 1 email:decmarr@gmail.com Tax Map District: 1000 Section: S7 Block: I Lot: a BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): New 24KW Generac generator with 200 amp transfer switch __Square Footage:_ Circle All That Apply: Is job ready for inspection?: YES NO ❑Rough In Final Do you need a Temp Certificate?: 0 YES I`/ 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 1 n2 H Frame Pole Work done on Service? Y N Additional Information: PAYMENT DUE WITH APPLICATION DATE(MM/DD/YYYY) ACCOR" CERTIFICATE OF LIABILITY INSURANCE 06/1512023 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). CT PRODUCER CONT NAME. Josh Mitchell „d_ .._. —, Freedom Coverage Corp PHONE1-31)709-2777 FAX m(At9.Nac),._ m .m . 80 Orville Dr Suite 100 E-MAIL Josh Freedo Covera eNY com RPR ._ ro ,_e m. � �mnwm�... NAIC# Bohemia, NY 11716 .....mm.... INSURER 3)A„FFORDING COVERAGE...�... .............................._� INSURER,A: MldVal 117dEnl1tY(.9Q,Illparly_.__. INSURED INSURER B Tile j artfprd.,�f1S,CioIY1�1a11�...u.w....--.. --. 29424 R C _........m� - mmm.._. _. ..... Peconic Power Systems LLC wsuRE ... _....... 315 Commerce Rd INSURER D: ..,_. ...... m�. ... .m. . Cutchogue, NY 11935 INSURER E m INSURER F: COVERAGES CERTIFICATE NUMBER: 00000166-206682 REVISION NUMBER: 18 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. ..�.----------- wmw....N__............ .. .. LIMITS __ ...... INSR� TYPE OF INSURANCE m POLICY NUMBER POt IC f EFF WOl IITIXF” TR M MM0qy1YY A COMMERCIAL GENERAL LIABILITY1,000,000.. CLAIMS-MADE ❑X occuR GLP1092481 05/28/2023 05/2812024 Y� �� ��mmm m�m Q0 000 MED EXP(Anp one person) $ rJ o00..... .... ........-. 6K PEP �...N INJURY $ 1 Oyogogi RSONAL&ADV GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE mmmmm $ 1_10001000 POLICY J LOC a ...L m.. ... _COMP/OP AGG $ 2 000 000 m PRODUCTS COMP OTHER. AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person)m^ $ J BODILY INJURY(Per ) _w OWNED f SCHEDULED � $ AUTOS ONLY _"AUTOS HIRED I NON-OWNED PROPERTY DAMAGEacc"dent $ _m AUTOS ONLY j AUTOS ONLY UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ -_ ...... a-.... ...._... _- DED RETENTION$WORKERS COMPENSATION $ g 12WECAT7UBP os/ozlzoz2 09/o212oz3 XGA �E t °R" m, mmm AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YCH ACCI "/AEADENT $ 1,000,000 OFFICEE L DISEASE R/MEMBER EXCLUDED? � (Mandatory In NH) - EA_ EMPLOYEE $ 1,000,000..m If es,descntie under D SCRIPVON OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) As pertains to insureds operations CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Southold Building Department THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town Hall Annex 54375 Main Road ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 1179 Southold, NY 11971 AUTHORIZED REPRESENTATIVE JCM ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Printed by JCM on 06/15/2023 at 11:23AM Z N r Ln All � rrio 21 (14 15 o M"00,9 "0 CnR' � m z r' � cn r C co Do - Ti -4 o EA me Nly ryl 30 ca 17- En t3 30 7i L,4 LA 9.09 NA Ln y 14,0 oc WJ � a o m '30 �� to Ci 1.9 lzi cf) v -�-To ti „ 000 � ry, .� `Zg•`l o Q) � � � rn � � 0 v � � b O 9P� O