HomeMy WebLinkAbout51117-Z o�g�FFOIK Gr 9/23/2024
c Town of Southold
a ?e P.O.Box 1179
0
53095 Main Rd
�y4j�1 �ao� Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 45571 Date: 9/23/2024
THIS CERTIFIES that the building GENERATOR
Location of Property: 1140 Park Ave,Mattituck
SCTM#: 473889 Sec/Block/Lot: 123.-8-1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
7/11/2024 pursuant to which Building Permit No. 51117 dated 8/22/2024
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:
"as built"accessorygenerator as applied for.
The certificate is issued to Stork,Ryan
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 51117 9/9/2024
PLUMBERS CERTIFICATION DATED
Au oriz Signature
o�S�Fai�.co TOWN OF SOUTHOLD
BUILDING DEPARTMENT
y 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#: 51117 Date: 8/22/2024
Permission is hereby granted to:
Stork, Ryan
275 W 10th St Apt 5B
New York, NY 10014
To: legalize "as built" generator as applied for.
At premises located at:
1140 Park Ave, Mattituck
SCTM #473889
Sec/Block/Lot# 123.-8-1
Pursuant to application dated 7/11/2024 and approved by the Building Inspector.
To expire on 2/21/2026.
Fees:
AS BUILT-ACCESSORY $250.00
ELECTRIC 1$200.00
CERTIFICATE OF OCCUPANCY $100.00
Total: $550.00
Building Inspector
oF So�ryo
,moo �o
Town Hall Annex Telephone(631)765-1802
54375 Main Road
P.O.Box 1179 G Q
Southold,NY 11971-0959 �Oly� 0 a� sean.deviinl'cD-town.southold.ny.us
OUNT`I,
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: Ryan Stork
Address: 1140 Park Ave city:Mattituck st: NY zip: 11952
Building Permit#: 51117 section: 123 Block: 8 Lot: 1
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: Electrician: Wildwood Electric License No: 4836ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service
Commerical Outdoor X 1st Floor - Pool
New Renovation 2nd Floor Hot Tub
Addition Survey X 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 CO 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 11 Sump Pump
Other Equipment: 20kW Cummins Generator w/200A Transfer Switch. Only Backs Up One Panel
Notes: AS BUILT NO VISUAL DEFECTS " Generator
Inspector Signature: Date: September 9, 2024
S.Devlin-Cert Electrical Compliance Form Copy
OF SOUTyOlo ! l / 7 I I Lq V <P�K A
# TOWN OF SOUTHOLD' BUILDING DEPT.
co 631-765-1802
INSPECTION
[ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG.
[ .] FOUNDATION 2ND' [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) LECTRICAL (FINAL)
[ ] CODE VIOLATION: [ ] PRE C/O [ . ] RENTAL
REMARKS: "55g
DATE INSPECTOR
OF SOUIyO
* # TOWN O.FSOUTHOLD BUILDING DEPT. .
631-765-1802
INSPECTION
[ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH-PLBG.
[ ] FOUNDATION 2ND [ ] SULATIOWCAULKING
[ ] FRAMING /STRAPPING [ FINAL -�e
[ ] FIREPLACE & CHIMNEY [: ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ( ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O [ ]. RENTAL
REMARKS: R 5- Ail#
e-
a ltt, el 22 = 0
DATE -/ ' 9 a INSPECTOR.
FIELD INSPECTION REPORT I DATE COMMENTS r n
�d
FOUNDATION (IST) y
--------------------------------------
cl
FOUNDATION (2ND)
z
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ROUGH FRAMING& ; y
PLUMBING
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INSULATION PER N.Y.
STATE ENERGY CODE v
04—
iiu0-4
IV
FINAL
ADDITIONAL COMMENTS (A
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��S�FFOIq�oG, TOWN OF SOUTHOLD—BUILDING DEPARTMENT
y`x. Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
w a�
Wp Zki Telephone (631) 765-1802 Fax (631) 765-9502 https://www.southoldtoLNM.Rov
Date Received
APPLICATION FOR BUILDING PERMIT c�
For Office Use Only , V
PERMIT NO. � Building Inspector: J J U f_ 1 1 2024
Applications and forms'must be filled-out.inLtheir entirety. Incomplete BUILDING DE .
applications will,-not be accepted. Where the Applicant is not the owner,an TOWN X S® HOg
Owner's'Autlioriiation form,(Page-2).sha"H be completed.
Date:7/11/24
OWNER(S)OF PROPER--ft
Name:Ryan Stork SCTM#1000-123-8-1 .
Project Address: 1140 Park Avenue, Mattituck
Phone#:631 684 9293 1 Email:admin@permitguy.org
Mailing Address:PO Box 1445, Westhampton Beach, NY 11978
CONTACT PERSON:
Name:Steve Caputo
Mailing Address:PO Box 1445, Westhampton Beach, NY 11978
Phone#:631-684-9293 Email:admin@permitguy.org
DESIGN,PROFESSIONAL INFORMATION:
Name:WORK DONE
Mailing Address:
Phone#: Email:
CONTRACTOR"I N FORMATI ON:
Name:WORK DONE
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ®Alteration ❑Repair ❑Demolition Estimated Cost of Project:
,r .
❑Other $N/A
Will the lot be re-graded? ❑Yes BNo Will excess fill be removed from premises? I9Yes ®No
1
PROPERTY]N FORMATION.
Existing use of property: �� �� Intended use of property: �� S 1z j
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? Eyes EWNo IF YES, PROVIDE A COPY.
f VCheck Box After Reading: The owner/contractor/design.professional is responsible for all drainage and storm water.issues.as provided by
Chapter236 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 applicantagrees to comply with all applicable iaws,ordinances,�building code,
housing code and regulations and to admit authorized inspectors on preinises.and in building(i)for,nece.ssary inspection's:False statemients made herein are.
punishable as a Class'A misdemeanor.pursuant to Section 210A5 of'the New York State Penal Law.
Application Submitted By(print name): a6k CAAf +C> [99�horized Agent ❑Owner
Signature of Applicant: 1 Date:
STATE OF NEW YORK)
COUNTY OF
V(_ C )0 being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing c ntract)above named,
(S)he is the A—U4, k
62 (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 Kay of A,
ILI
20J-A
otary Public
ENOTARY
E CLAIRE ORMOND
IC,STATE OF NEW YORK
PROPERTY OWNER AUTHORIZATION 10R6435937
In Suffolk Countyy(Where the applicant is not the owner) on Expires 07/05/2026
Ryan Stork residing at 1140 Park Avenue
Mattituck do hereby authorize Steve Caputo to apply on
my behalf to the o n Southold Building Department for approval as described herein.
'Z Z �c,
0 ner' Sign ture ate
r aj—DtL
Ant Owner's Name
2
Board of Zoning Appeals Application
AUTHORIZATION
(Where the Applicant is not the Owner)
I, c r, SIVA— residing at 1140 Pc,-� Av.
(Print
t"property owner's name) (Mailing Address)
M���yc - do hereby authorize 4i�Te vt- Cws
(Agent)
to apply forywlaftse(s'fon my behalf from the
Southold als.
&NWVer's ignature)
D�
((Print Owner's Name)
AGENT/REPRESENTATIVE
TRANSACTIONAL DISCLOSURE FORM
The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The purpose
of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever
action is necessary to avoid same.
YOUR NAME: V
(Last name,first name,middle initial,unlesoyou are applying in the name of someone else or other entity,such as a
company.If so,indicate the other person's or company's name.)
TYPE OF APPLICATION: (Check all that apply)
Tag grievance Building Permit
Variance Trustee Permit
Change of Zone Coastal Erosion
Approval of Plat Mooring
Other(activity) Planning
Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer
or employee of the Town of Southold?"Relationship"includes by blood,marriage,or business interest."Business
interest"means a business,including a partnership,in which the town officer or employee has even a partial
ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the
shares.
YES NO
If you answered"YES",complete the balance of this form and date and sign where indicated.
Name of person employed by the Town of Southold
Title or position of that person
Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.
Either check the appropriate line A)through D)and/or describe in the space provided.
The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply)
A)the owner of greater that 5%of the shares of the corporate stock of the applicant(when the applicant is a
corporation)
B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation)
C)an officer,director,partner,or employee of the applicant;or
D)the actual applicant
DESCRIPTION OF RELATIONSHIP
Submitted this y o ,20
Signature
Print Name,Mgt
VPU l
APPLICANT/OWNER
TRANSACTIONAL DISCLOSURE FORM
The Town of Southold's Code of Ethics prohibits conflicts of interest on the hart of town officers and employees.The purpose
of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever
action is necessary to avoid same. �r
YOUR NAME•• yC.�N �` k-
(Last name, name,middle initial,unless you are applying in the name of someone else or other entity,such as a
company.If so,indicate the other person's or company's name.)
TYPE OF APPLICATION: (Check all that apply)
Tax grievance Building Permit
Variance Trustee Permit
Change of Zone Coastal Erosion
Approval of Plat Mooring
Other(activity) Planning
Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer
or employee of the Town of Southold?"Relationship"includes by blood,marriage,or business interest."Business
interest"means a business,including a partnership,in which the town officer or employee has even a partial
ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the
shares.
YES NO x
If you answered"YES",complete the balance of this form and date and sign where indicated.
Name of person employed by the Town of Southold
Title or position of that person
Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.
Either check the appropriate line A)through D)and/or describe in the space provided.
The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply)
A)the owner of greater that 5%of the shares of the corporate stock of the applicant(when the applicant is a
corporation)
B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation)
C)an officer,director,partner,or employee of the applicant;or
D)the actual applicant
DESCRIPTION OF RELATIONSHIP
7
Submitted this day of 204
Signature /l
Print Name Ol"lC
' SUFFO(� BUILDING DEPARTMENT- Electrical Inspector
0�0 CMG TOWN OF SOUTHOLD
Town Hall Annex - 54375 Main Road - PO Box 1179
`- Southold, New York 11971-0959
y p� Telephone (631) 765-1802 - FAX (631) 765-9502
La mesh(p southoldtownny.gov - seand(cr-southoldtownny.gov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All information Required) Date: -26-� Z`l
Company Name: I LDWeoD CLE IFaIC aoc..
Electrician's Name: "� ��sSm►-a�'�+��
License No.: (•E Elec. email: (q ►; w11_1>wto0'beLEG C41s 1
Elec. Phone No: 63i_23b--22 I i E T request an email copy of Certificate of Compliance
Elec. Address.: `_-0o O, 0 313 "Roc_ '?o;m'T 1I 78
JOB SITE INFORMATION (All Information Required)
Name: &tJ STor.Y,
Address: I yO 'FAO* 805
Cross Street:
Phone.No.:
Bldg.Permit#: J1C&W9y4 gam//1 7 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?: Er YES ❑ NO ❑Rough In ❑ Final
Do you need a Temp Certificate?: ❑ YES F��rNO 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 2 H Frame Pole Work done on Service? Y N
Additional Information:
PAYMENT DUE WITH APPLICATION
�S�F���� BUILDING DEPARTMENT- Electrical Inspector
N �Gy� 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
La mesh CoDsoutholdtownny qov seand(a-southoldtownny.gov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date:
Company Name: 41 LDWOOD EL CTaIe c-
Electrician's Name: TKWH. Jgs5ApsT ..-
License No.: ► y.;6 _ M£ Elec. email: �� �; WiLDvtco�El.tG a cOf-
Elec. Phone No: 6.3/_23b-22I 1 [YrI request an email copy of Certificate of Compliance
Elec. Address.: 7:0, O, 'a 313 �RocK -o;"a 11778
JOB SITE INFORMATION (All Information Required)
Name: 1Z &N 5-Fec-y,
Address: t I LJO ►?Aa-K Avg
Cross Street:
Phone No.:
Bldg.Permit #: j 1 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?: Ef YES ❑ NO [—]Rough In ❑ Final
Do you need a Temp Certificate?: ❑ YES F:�rNO 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 F 1 2 H Frame Pole Work done on Service? Y N
Additional Information:
PAYMENT DUE WITH APPLICATION
N SURVEY OF PROPERTY
A V E N U E AT MATTITUCK
p A R K TOWN OF SOUTHOLD
"SOU T H ROAD" SUFFOLK COUNTY, N.Y.
1000-123-06-01
UTILITY SCALK 1--40'
POLE APRIL 9, 1998
254.50'
N86'57'00'E AUG. 14, 2014
Fr.s's MARCH 22, 2017 (CERTIFICATIONS)
CHAINUNR Nce 1J'W FE JANUARY 18, 2018 (PROPOSED GARAGE)
9'W
Z WOOD GArf 1. FEB. 5, 2018 (GARAGE STAKES)
o MARCH 9, 2018 (FOUNDATION LOCATION)
MAY 17, 2024 (FINAL SURVEY)
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CER77FIED TO: 84.5 11.e'
abtERED
ABSTRACTS, INCORPORATED EPED `
MIST AMERICAN 777LE INSURANCE r6wA,4'Y DECK
RYAN STORK l �ie 1
s � ZONE X
LOT NUMBERS REFER TO 'MAP OF \
MARRATOOKA PARK'FILED IN THE M-5 I.O W Top or BANK
SUhr C" GYXINIY GYEXK J'Q`FIGL ..ON NOV. 1, 1905 AS MAP Na 450 _ ~'a
FLOOD ZONE!ME
__ 2 o
FL. o —GA2E 12 FLOOD ZOW LAVE
O.4Y
EL 587 36'S1'W LwE ALoNO SEA WALL • 167.89 IL ry.N.ww.ALow srA PAL l
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EL B ALAYG N.H.WN AS OEIERNINfD BY Slli'FDLK
ENVRDNMENrx CDNSULTING. INC.ON,AA.Y 10,'D'4.
GREAT PECONIC BA Y -�--
MONUMENT
— it If
ELEVA77ONS d CONTOURS ARE REFERENCED TO N.G V D 29
FLOOD ZONE FROM FIRM MAP NUMBER J610JCO482H b q>♦tPf
ANY ALTERATION OR ADIN77ON TO THIS SURVEY IS A KOLA77ON
OF SECTION 720QOF`THE NEW YORK STATE EDUCA7ION LAW. N.Y.S• LIC. NO. 49618
EXCEPT AS PER SEC77ON 7209—WMWSI V 2 ALL CER7IFICATIONs p�� PECON/ S P.C.YORS,
HEREON ARE VAUD FOR THIS MAP AND COPIES THEREOFNL ONLY IF AREA 137,087 SO. Fr. (6J1) 765— 20 FAX P.C. 765-1797
SAND MAP OR LYWIES BEAR THE IMPRESSED SEAL OF THE SURVEY(M
*HOSE 9&VATURE APPEARS HEREON. TO 77£ LINE
909
SOUTr�GLoN.Y.A S1971 T 98-151
a �
P.M. CONDITION REPORT
r Date:0522/2024
608 Johnson Ave,Suite 6 Job#:32271
Bohemia,NY 11716 Tech:Andre LeGette
Ph:631-567-2700 Fax:631-563-4473
powerprog enerators.com
NAME: Stork,Jennifer
ADDRESS: 3500 Marratooka Road MAKE: GUM0-206ML
Mattituck,NY 11952 ODEL U BER.
EC SEA R1ALaNUMBER:F18Q3697S3
Check Radiator Core For obstruction: Not Applicable
APPROVED-AS-NOTED
Check Antifreeze Protection: Not Applicable
Check Coolant Level and Add as Needed: Not Applicable
FEE BY:
Test Coolant Inhibitors and Add as Needed: Not Applicable NOTIFY BUILDING DEPARTMENT AT
631-765-1802 8AM TO 4PM FOR THE
Check Condition of Radiator Cap and Seal: Not Applicable FOLLOWING INSPECTIONS:
1. FOUNDATION-TWO 0l7-1—)!
Check for Coolant Leaks: Not Applicable
FOR POURED:-,uk.'t',I4.
2. ROUGH-FRAMING t;
Check Belts and Adjust Belt Tension as Needed: Not Applicable & INSULATION
4. FINAL-CONSTRUCTION MUST
Check Water Connections: Not Applicable BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET TH
Tighten Hose Clamps as Needed: Not Applicable REQUIREMENTS OF THE CODES OF NE
VVI
YORK STATE. NOT RESPONSIBLE FOP
Check jacket Water Heaters: Not Applicable DESIGN OR CONSTRUCTON ERRORS
OMP-LY4M-ALL-CODS 0
Check Oil Level in Governor: Not Applicable NEW YORK STATE&TOWN CODES
C-
AS REQUIRED-AND- NDff--I-N- OF
Check Brushes and Slip Rings: Completed SOMOLVrOWN ZBA
Drain Water From Fuel Filter and Day Tank: Not Applicable SOUTHO TOWN PLANNING OARD
�etewN�Rasf
Lubricate Rear Bearing of Generator. Not Applicable N.Y ,DEC�•��1 li IITu
Drain Water in Exhaust Moisture Traps: Not Applicable •`�•`�••� u I HOLD HPC
HD
Check Air Cleaner Indicator: Not Applicable
Check Turbocharger: Not Applicable
O)CC-FRANC-Y=OR
Adjust Governor Control for Optimum Performance and Frequency: Not Applicable
- S- E-IS--UNLAWFUL
Check Remote Fan Motors,Thermostats,Circulation Pumps and Solenoid Completed WITHOUT CERTI FICA
T.
Valves:
Check Day Tank Pumps and Alarms: Not Applicable
- F OCCUPANCI(
ELECTRICAL
INSPECTION REQUIRED
Test Specific Gravity of Batteries: Not Applicable
C�gck Battery Voltage: Completed
Check Electrolyte Level and Add Water as Needed: Not Applicable
Check Flexible Fuel Lines: Completed
Check Fuel Level In Main Tank LP 60
Check for Leaks in Complete Fuel System: Completed
Check Battery Charger: Completed
Check Battery Connections,Tighten and Clean: Completed
Check Flexible Exhaust Couplings: Completed
Check Air Cleaner Seal: Completed
Check and Tighten Loose Electrical Terminals: Completed
Check for Loose Relays: Completed
Lubricate Governor Linkage: Completed
Check Vibration Mounts: Completed
Check Insulation on Generator Leads: Completed
Check for Dirt or Oil Buildup on Generator: Completed
Check for Oil Leaks: Completed
Check and Clean Crankcase Vent/Breather: Completed
Walk Around Inspection of Complete Installation: Completed
Run Generator Until Normal Operating Temperature is Reached: Completed
Check for Abnormal Vibration: Completed
Check Cranking Termination: Completed
Check Engine Instruments: Completed
Check for Abnormal Noise: Completed
Check for Abnormal Exhaust Characteristics: Completed
Check Exhaust for Abnormal Discharge: Completed
Check Inlet and Discharge Louvers: Completed
Check for Excessive Crankcase Blow by: Completed
Adjust Voltage for Proper Output: Completed
Re-check for Oil,Water and Exhaust Leaks With The Engine Running: Completed
Epp Engine and Check Shutdown: Completed
Place all Switches in Proper Operation Mode: Completed
Complete Overview of System: Completed
Provide Full Report and Provide any Recommendations: Completed
Change Lube Oil and Filters: Replaced
Check Lube Oil Level: Replaced
Check Air Cleaner Elements: Replaced
Perform Oil Analysis: Not Applicable
Change Fuel Filters: Not Applicable
Check and Clean Primary Fuel Filter: Not Applicable
Remove Valve Covers,Check Valve Clearance as Needed: Not Due at this Service Visit
Check Rocker Arms for Wear and Lubrication as Needed: Not Due at this Service Visit
Replace Valve Cover Gaskets as Needed: Not Due at this Service visit
Perform Gas Engine Tune up: Completed
Legally Dispose of all Materials: Completed
Check Operation of Automatic Transfer Switch: Completed
Run Hours 167.5
Labor Hours 1.25
Travel Hours 2
Accepted By: