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HomeMy WebLinkAbout51543-Z 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#: 51543 Date: 01/13/2025 Permission is hereby granted to: Port of Egypt Enterprs 62300 Route 25 Southold, NY 11971 To: install NFPA 13 fire sprinkler system to an existing commercial building as applied for with flood permit. Premises Located at: 62300 Route 25, Southold, NY 11971 SCTM# 56.-6-6.1 Pursuant to application dated 11/20/2024 and approved by the Building Inspector. To expire on 01/13/2027. Contractors: Required Inspections: Fees: Fire sprinkler-Commercial $300.00 Flood Permit $150.00 CO Commercial $100.00 Total $550.00 Building ector� 5 ��. Fttt :, 4 TOWN OF SOUTHOLD—FIRE MARSHAL Town Hall Annex 54375 Main Road P. O. Box 1179 Southold, NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502ttl' :�lrtattltoldltartn, . aar' FIRE PROTECTION SYSTEM PERMIT Date Received: APPLICATION r � I � 1 �Pr Office Use Only6 t PERMIT NO. Building Inspector., ector., r r, a r Ari 1 Has a building permit been obtained for this project? ❑Yes ❑No If yes, building permit# Date: Z�- „r,;, 01111�'/7 rill / "%r r f�%/i//���/ 9y%r,-.,/' „J��i%i�/„ Project Address: 2ajCo n SCTM# 1000- GC.CC) _00 .O C¢ty: �b -� t(#�d� dip`. �n ��/�rirr,�,`��'✓1 ��,�-/ �/��� iiY„%//.,,,!r, 4n,r,,; r.:4-.r ,/r 2r� ,G,r ,,r/,.,L//,,,,{,�,,,�G,r/fir„/Air%��r/� /�r�'r. Name: �1c1 r rC0-44 Mailing Address: I tZ Phone Email:im1l�b�rGv� Preferred contact method(select one): (Phone ❑Email r /r h r - # /G// r r 1 / r rU• r r /r b Name: l � h Contractor License#: LA ' Mailing Address. t >1 E #: r ma :Phone 1i 1 1 W l(t nn•(dyl / r.., //,;"r, //��lr/llr�,Jl rr.r �///lri/r/ �, r, ri � Jr o,.E, r,,,,, i„ J. Ji /A r ✓ ,r;; / i� / �o,C//r ��,��,,.'�. Occupancy Description. ❑Assembly [Business ❑ Education ❑ Factory/Industrial ❑ Institutional ❑Mercantile ❑Residential ❑ Storage Description of Work: irkr1L SAOrfix lNiAk ... m V New System El Existing System Modification Sprinkler/Standpipe/Water Supply Fire Alarm r CO Detection Systems Other Fire Protection Systems (Check all that apply), (Check all that apply) (Check all that apply) INFPA 13,13D or 13R System ❑Manual ❑Automatic ❑ Smoke Control ❑Standpipe ❑ Fire Pump ❑Protected Premises (local) ❑ Wet or. Dry Chemical/Clean ❑Supervising station Agent Number of sprinkler heads: 551 ❑Central Station ❑ Kitchen hood/exhaust ❑ Other Floor Area(sq. ft.): (W 1 /'r(/ l/,i,r✓,e / .i r., .,i /i ir;/ r/1'it r;,r,r ,,rP ,,.:. /rii /.. / ,','/"%r/ /'ii / ! /H. l/ / ;/ ,. /; / H / rl. rw "r // rLer„ r,, hc, ,rrr, rmru_�m/rr/it ti, /rlr/ l au � Yl lw r //o %/rrrr. / r it /i.✓/111��d r..�,� .ryG. /r r,ll,..i/.r,� NI 1,. ,,, ,N .Y >I � 1� � I`"/ f t�I•I�I;I�;.� �"i� I� ,1 ,/J ,� ;f../� I, V'a r�o N ����� I f J /7 I c u�;.,, r ,r r1N r+ ,rrrr., ,%/noDi�.�r//,Jr nyr7u ltievitir ✓r r/ iva�.o:.,/r„/� /rr: ,,,,r��:,, r/,,,,,r '„/G�/iG ��o�LOi/i/-,/ lilr/r„16ia�o,c i'nyr a,��u'L�rH�,Jr r .G���wrz. Application Submitted By(print name): Authorized Agent ClOwnr P Y( PP.. )Con an tfa hcable. �_._ ...� .�,...�. � ....,.� ��... e_�.� -.-- —._._m......,, �_.....�___._.._....... .�� ..___ Applicant Signature: ' Date IRE PRO°ITECTI S" STEM PERMIT APPLICATION SUBMITAL INSTRUCTIONS Submit application only after reviewing the requirements for the specific permit for which you are applying(click the applicable link below). • FIRE ALARM/CARBON MONOXIDE DETECTION SYSTEM SUBMITTAL GUIDELINES • FIRE;SPRINKLER SYSTEM SUBMITTAL GUIDELINES • FIXF0 FIRE SUPPRESSION,HOOD& E XHAUST SYSTEMS SUBNMITTAL GUIDEI.<INES FEES A$300 permit fee is required for a non-residential permit. A$100 Certificate of Occupancy fee is required if the project is not part of an existing open building permit. All checks should be made payable to the Town of Southold. Permits,once issued,shall at all times be kept on the premises designated thereon with a copy of approved drawings and all related documentation required to obtain said permit.Installations subject to final testing,inspection and approval.Arrangements for testing/inspection shall be trade by contacting the Town of Southold Building Department(631)765-1802. / ;1'!/ / r t/, / ///;!l// //ag r/ / /y/ Amount Paid: Check No.: FM: Permit No.: Date: Exp, Date. 2 CERTIFICATE OF LIABILITY INSURANCE CATE(MMIDD/YYYYl liilit ✓l 11/07/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Samantha Alicea 670 Old Willets Path _NAME:___ 31 360 8800 c Nab 63 360 ..� Prof.Risk Planners, Inc. 1 8875 PHONE � � �FAx � ) Ad�r�.Ext) .._ — ...... Suite A A A , m.__...... al[rea@pmdskplan.com.................... ...._........m,_._... .._.,,..................... _ Hauppauge NY 11788- — YN$UR Cm 9 Alf f F f?tNGp I V.F,RAP� � �I4A, ._.. WRERA:National Liability&Fire Ins.Co. 20052 P p, INSURED I , �.Cham lain Specialty Ins Co 16834 _„ ....._ Mill Brook Fire Protection Corp. _�� �.Endurance American Specialty Insurance Company 41718� 23329 112 Parkway Drive South UB� S�S.�pMerchants Mutual Ins Co y _______�y_ ]1*NY 11788- p ty Insurance Co SlriusPoint Specialty -- ---- J Hauppauge20 Standard Security Life 69078 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. ._._ U _ m _ .._ INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXPITR LIMITS CSSE-CGL-0000637-03 6/27/2024 6127/2025 � f RENTE Lr�) 100 000 RAL OCCUR X ANE5071896 24 11/14/2024 11/14/2025 PACH OCC° ,000 G ;..Xm..��COMMERCIAL E�X�wealTY x X � 1 000..� X Contractual Liabilit 10 000 MEIaEXP...lAnyoln"arson)--$---- X Professional Liabili 1,000 000 _PERSQNAL&ADV INJURY EPi L AGGREGATE JECT APPLIES PER: —GENERAL.. QO TS COMP{qP AGG $ 2,000,000 LIMIT2,000,0 POLICY LOC PR ,000 0 OTHER Professional Each Occ/Agg $ 2,000,000 D AUTOMOBILE LIABILITY X X CAP1072692-- 1/18/2024 1/18/2025 COMBINED SINGLE LIMIT $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ ...XALL OWNED SCHEDULED .. W.X_ 'BODILY INJURY(P _ AUTOS AUTOS Per accident) $ X NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS X,. AUTOS QPseaceldsnty _._..__ $ B X UMBRELLA LIAR XLCLAIMS-MADE R X X CSSE-CEL-0000638-03 6/27/2024 6/27/2025 EACH OC. _U.RRENGE, 2,000 000 2,000,000 C Excess aria X X ELD30000706806 6/27/2024 6127/2025 _ACGR_EGq_T� _, � m, OCC/AGGREGATE 3,000,000 A WORKERS COMPENSATION X V9WC517173 /28/2024 4/28/2025 X PER OTH AND EMPLOYERS'LIABILITY -%T.AIUIF �_ '� '-- ANY PROPRIETOR/PARTNER/EXECUTIVE Y N E.L EACH._ACCIDENT �,,,,,,,,," 1,000,000 'OFFICER/MEMBEREXCLUDED? NIA -" (Mandatory in NH) E.L DISEASE-EA EMPLOYEE. $ ,OOO IF yes,describe under --."-- -_—__- __. ._. lI I E,.L DISEASE-POLICY LIMIT .. ... 1 OOO,OOO E UMBRELLA LIABILITY X X ARCUSXC174882024 6/27/2024 6/27/2025 OCC/AGG LIMIT 2,000,000 F DISABILITY R88027-001 - 1/01/2024 12/31/2024 STATUTORY LIMITS DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) Additional InsUfod:Town of Southold Coverage provided as required by written,signed,executed contract,per the terms,conditions and exclusions of the policies listed above. I CERTIFICATE HOLDER CANCELLATION Al 060141 SHOULD ANY OF THE ABOVE.DESCRIBED POLICIES BE CANCELLED BEFORE Town of Southold THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 54375 Route 25 ACCORDANCE WITH THE POLICY PROVISIONS. P.O.Box 1179 Southold NY 11971- AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD jr It Labor,Licensing eOnSUYEFQ�a1CS RESTRICTED PLUMBING' /�j��� i r lro ✓r ii r r ,Name JOSEPH DALY Business Name Millbrook Fire Protection Corpl�r� /'!' �/�y "hisrrEiiie^�Slhw��t"t1£� bearer is dti,9yr licensed License Number RP-61376 Issued: 0611012019 Expires: Q610'tf2025 (.'.4rT1rnISSlOr1@r 4060 Sunrise Highway Oakdale NY 11769-0901 (631)563-0201 Fax(631)563-9794 4/9/2024 Re: Results of Fire Flow Test Location:as noted As requested, below please find the results of fire flow test. This test was performed during period of low water demand. Such a test, usually,does not reflect the fire flow available under the conditions found in a high-water demand period. We have reviewed the past peak demand information that is available for this area. Historically,the static pressure in this area has been as low as 66 psi. You should adjust the flow test to reflect the lower static pressure prior to using it for any design work, such as a sprinkler system. You may need to adjust the flow as well. Always remember to account for any difference in the ground elevation between the test location and your design site location as well. Any flow test, including one with a peak demand adjustment, only reflects the conditions at the time of the test and may not accurately reflect what fire flow or static pressure will be available in the future. It could be a higher or lower value. The fire flow or the static pressure available at any specific time will depend on system demand and the availability of water supply infrastructure. If you have any questions, please contact the undersigned at(631)563-0239. It is the closest test. Very truly yours, Brendan Warner, P.E. Director of Construction Maintenance �� jl,% �a r�� �������J✓✓�r �'//`irF l//�ri/���%r%ii%/%1�iir//i� //�°/9p�/r�// SOUTHOLD ,. ,.i, ( .il: /%//r //,/r/(�;, ,AG,,. � r/ r �� r, ,,,,,,, ,, ,,,�C%✓r,ri, i,c„m,,, r,r {:r;,0 r„i,:, r r,:: r r„ %r f r c e r:, r ,,::r� _. �, rr,.;/,////;f„ r : I% r��..,/�/fi/ „rf„,r, I, r/r rr,r/ 1 I � ,:,; ,(,.. // ,/,u/ „%,✓U /i / r/ /r/r r r r//,r/r//J.:rr %ii r i f r �// ✓ „r r�r,,,u,,,/r//,...rralrrarG U,,,,,,vG.v /,�,.,��r�,, ,vim .,rrp ,i�.�OUrr 6,.>„//i//�„a,�,r lo„�.,,.//ii.�%�e„�i�ii i,r,rLeorl���,./iar%l,ria r,//✓,.a�Oi4i,/'I/Gc,,.. r,rv.,,,r/�/�,./i,t 820109008 OLD ROAD 1ST HYD E/O MAIN ROAD 21—R /s! 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