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HomeMy WebLinkAbout51440-Z p 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#: 51440 Date: 12/05/2024 Permission is hereby granted to: Carl E Juul-Nielsen 95 Hunters Dr Muttontown, NY 11791 To: install generator as applied for. Premises Located at: 1125 W Cove Rd, Cutchogue, NY 11935 SCTM# 111.-3-14 Pursuant to application dated 10/11/2024 and approved by the Building Inspector. To expire on 12/05/2026. Contractors: Required Inspections: Fees: GENERATOR $125.00 ELECTRIC -Residential $100.00 CO Accessory $100.00 Total S325.00 wilding Inspector M '1 TOWN OF SOUTHOLD—BUILDING DEPARTMENT *� Town Hall Annex 54375 Main Road P. O.Box 1179 Southold,NY 11971-0959 f Telephone(631) 765-1802 Fax(631) 765-9502 htt :/1 ww. outli2ldtowti� . oy qq Date Received BUILDINGAPPLICATION FOR For Office Use Onlyy iii r ti9 , PERMIT NO. .. - Building Inspector; 4r � Applications and forms must be filled out in their entirety.Incomplete applications will not be accepted. Where the Applicant is not the owner,an Owner's Authorization form(Page 2)shall be completed. Date:10/11/2024 OWNER(S)OF PROPERTY: Name:Carl & Patty JUuI-Nelson scrM#s000- Project Address:1125 West Cove Rd , Cutchogue, NY 11935 Phone#: S'f y10 Email:qnpc@optonline.net Mailing Address: 44 CONTACT PERSON: Name: Mailing Address: Phone#: Email DESIGN PROFESSIONAL INFORMATION: Name: Mailing Address: Phone#: Email: CONTRACTOR INFORMATION: Name:Peconic Power Systems Mailing Address:PO Box 512 Cutchogue NY 11935 Phone#:631-734-5026 Email:Peconicpowersys@gmail.com DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: 20t er 26KW Generac Generator 16,000 Will the lot be re-graded? ❑Yes IN No Will excess fill be removed from premises? ❑Yes N No 1 PROPERTY INFORMATION Existinguse ofproperty: ��f Intended use of property: w r f Zone or use district in which premises is situatedV Are there any covenants and restrictions with respect to this property? ❑Yes El No IF YES, PROVIDE A COPY. ❑ 'iChei'III( Box Af teiii, Reading: The owner/contractor/design professional is responsible for all drainage and storm water issues as provided by Chapter 236 of the Town Code, APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold,Suffolk,County,New York and other applicable Laws,Ordinances or Regulations,for the construction of buildings, additions,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(pri name}: 'ur wy s � uthorized Agent ❑Owner Signature of Applicant: Date: J0 /a STATE OF NEW YORK) SS: COUNTY OF IT ) r r� &;�/ 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 an::file this application;that all statements contained in this application are true to the best,,of hi /her knowledge and belief;and that the work will be performed in the manner set forth in the application file t rlerewith " Swo n before me this �day y of � 2 _ ::�t-47 Z :��VRMA Public/ LAMB Notary Public,State of New York W)IIR 10 P E l) (Y OWNER AUTHORIZ IIO11 #01 LA6179883 (Where the applicant is not the owner) OUalified In Suffolk County Term Expires December 31.20-2- residing at P 9 do hereby authorize mm_ ��mC a _� � � _IT•m• _•Wto apply on my be if o h T n Southold Building Department for approval as described her(An. 0' ner's Signature ate 1 ) d� Print Owner's Name 2 4' tttf# BUILDING DEPARTMENT- Electrical Inspector „ TOWN OF SOUTHOLD ' Town Hall Annex- 54375 Main Road - PO Box 1179 Southold, New York 11971-0959 P ( ) ( ) Tele hone 631 765-1802 - FAX 631 765-9502 H. amesh southoldtownn . ov - seand(@southoldtgWgDy.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: 10/11/24 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 ❑1 request an email copy of Certificate of Compliance Elec. Address.: Po Box 512 Cutchogue NY 11935 JOB SITE INFORMATION (All Information Required) Name: Carl & Patty Juul-Nelson Address: 1125 West Cove Rd, Cutchogue Cross Street: Vanston Phone No.: 516-286-8410 BIdg.Permit#: email:gnpc@optonline.net Tax Map District: 1000 Section: Block: Lot: BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): New 26KW Generac generator with 200 amp service rated transfer switch S uare Footage. Circle All That Apply: Is job ready for inspection?: El YES FV NO E]Rough In Final Do you need a Temp Certificate?: YES NO Issued On Temp Information: (Ail information required) Service SizeLJ1 Ph 3 Ph Size: A # Meters Old Meter# []New Service[]Fire Reconnect[]Flood Reconnect[]Service Reconnect❑Underground❑Overhead ' #Underground Laterals 1 2 H Frame Pole Work done on Service? Y FIN Additional Information: PAYMENT DUE WITH APPLICATION iiii�REFCERTIFICATE OF LIABILITY INSU NCE DA'�`� ' '1120 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 ADOiTIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the Polley, nt certain policies may require an endorseme A statement on this certificate does not confer ri'' hts to the certill holder In lieu of such endorsement . PRODUCER Freedom Coverage Corp 80 Orville Dr Suite 100 LIoI1 reedomCoversSeNY,com_ Bohemia, NY 11716 K41C eastaRERA; 1 1 i Co INsuRED INSURER B Peconic Power Systems LLC INSURI R D 315 Commerce Rd INSUREFtD: H In Cutchogue, NY 11935 INSURER E INSU F: COVERAGES CERTIFICATE NUMBER: 00000166-206"2 REVISION NUMBER;; 65 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 CLAIM'S. LIM TYPE OF INSURANCEAVUL POLICY NUM LIMITS A COMMERCIAL GENERAL LIABILITY GLP1092481 0512 112024 05/28/2025 EACH OCCURRENCE I0'00 000 X E TO RMTED CLAIMS-MADE �OCCUR IMI rnm] _ wS 100,000 MED EXP(Any cna tson) $ 5 000' PERSONAL.B ADY INJURY �'S 1 Agog GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 5 2.000.000 PRO- Loc PRODUCTS®COMMOP AGG E 2,000,000 POLICYlil JECT El R S B LIABILITY UMInl I s 11000,000 AUTOMOBILE LIABIr 32.2324-04 05/28/2024 05/28/2025 BODILY INJURY(Per person) $ X ANY AUTO OWNED SCHEDULED DAMAGE PROPERTY S AUTOHIRED ONLY AUTTOS BODILY INJURY(Per accident) S AUTOS ON LY AUTOS ONLY $ C UMBRELLA I LAB 4 OCCUR N9CX577151 05128/2024 05/28/2025 EACH OCCURRENCE S 3 000 tM00 EXCESS LIAB CLAMS MADE AGGREGATE S 31000,000 • DED C X I RM-noN S 100100S D '��RPSLo � 12 WEC AT7UBP 0910=024 09102/2025 X ANY PROF#4ETDFi/PAITN'EIEXECNJIIWE Y❑ N f A E.L.EACH ACCIDENT $ 1II �I OFFICERIMEMSER EXCLUDED? E.L.CHSEAASE=EA EMPLOYE S 1 000,000 +(Mandry In NH)) D SCRIPTI r ERATIONS bow E.L.DISEASE-POLICY LIMIT $ 1 000 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Addltlonal Remrks a 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 AUTHORIZEo REPRESENTATIVE Southold, NY 11971 i/i(,f. UM ©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 09/11/2024 at 09:07AM SURVEY OF S LOT 2 REVISED SUBDIVISION rr PROPERTY OF ALONZO JERSEY m s BEING PLOT No. 282 OF NASSAU CLUB PROPERTIES, Inc, 10 +'0 f ev, a'tc"f� FILE No. 763 FILED APRIL 28. 1930 "a Ip SITUATE ° NASSAU POINT TOWN OF SOUTHOLD 90.0 , .a SUFFOLK COUNTY, NEW YORK �" ; S.C. TAX No. 1000-111-03-14 " * ' SCALE 1"=20' 'Wit, OCTOBE1t $2 2007 JANUARYRI23"29g68LOCAATE FOUNDATTION AREA= 27,906 9q. 71. 0.641 M NOTES: I. ELEVATIONS ARE REFERENCED TO AN ASSUMED DATUM EXISTING ELEVATIONS ARE SHOWN THUS:s5m CERTIPIED TO: FIDELITY NATIONAL TITLE INSURANCE COMPANY OF NEW YORK CARL JUUL—NIELSEN PATRICIA CADAVID + 7 ®ry �� a " q 0 Do � 3 !I/ ^ l 00' 3J .„ Nathan Taft Corwin III Land Surveyor TRI,A.M._Abi,YNr_A»pp.- cnrWefwi i.9ow PHONE(A31)727-2090 1.(631)777-1727 7:.0 4d"AnN1T!1qA tlW7 OFR=LOOAIFD a WAM A00FEM 322 RGAIME AM" P0.Ae 193, w"7g. pgyy d9d G%9. MWI*Ml N.Y k 11001 M-t w.N T.,9 11901—am