Loading...
HomeMy WebLinkAbout49223-Z �o�a°F SOpriyo`o Town of Southold * * P.O. Box 1179 io 53095 Main Rd rouNn�' Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 45748 Date: 11/09/2024 THIS CERTIFIES that the building GENERATOR Location of Property: 1225 Arrowhead Ln Peconic,NY 11958 Sec/Block/Lot: 98.-3-8 Conforms substantially to the Application for Building Permit heretofore, filed in this office dated: 03/31/2023 Pursuant to which Building Permit No. 49223 and dated: 05/10/2023 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: accessory generator as applied for(maintain clearances to combustibles as required by code). The certificate is issued to: Maria Ott Of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL: ELECTRICAL CERTIFICATE: 49223 11/06/2024 PLUMBERS CERTIFICATION: A tho 'zed Signature SOF TOWN OF SOUTHOLD BUILDING DEPARTMENT y�.C* TOWN CLERK'S OFFICE ui r 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#: 49223 Date: 5/10/2023 Permission is hereby granted to: Ott, Maria 301 W 57th St Apt 52A New York, NY 100193181 To: install generator as applied for. At premises located at: 1225 Arrowhead Ln, Peconic SCTM #473889 Sec/Block/Lot# 98.-3-8 Pursuant to application dated 3/31/2023 and approved by the Building Inspector. To expire on 11/8/2024. Fees: ACCESSORY $100.00 ELECTRIC $85.00 CERTIFICATE OF OCCUPANCY $50.00 Total: $235.00 Building Inspector pF SO�jyolo Town Hall Annex Telephone(631)765-1802 54375 Main Road P.O.Box 1179 G Q Southold,NY 11971-0959 • �o Jamesh southoldtownny.goV �yCou�m,N ' BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Maria Ott Address: 1225 Arrowhead Lane city:Peconic st: New York zip: 11958 Building Permit#: 49223 Section: 98 Block: 3 Lot: 8 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: Laurel Lighting INC. Electrician: Frank Fenoy License No: 4718-ME 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 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 200a 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: 1 22kw generator with 100amp breaker Notes: GENERATOR Inspector Signature: Date: October 7, 2024 1225 arrowhead In %OF SO(/lh�� # TOWN OF SOUTFIOLD BUILDING DEPT. cou 631-765-1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I ULATION/CAULKING [ ] FRAMING /STRAPPING [ FINAL 6PMAR�n� [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: DATE INSPECTOR OF SOUIyOIo 3 `�Irr 1 QW kt zJ — # # T i F SOU & BUILDING DEPT. 631-765-1802 INSPECTION . [ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] .FINAL [ ] FIREPLACE &CHIMNEY j ] FIRE SAFETY INSPECTION { ] -FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH)- [ J ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: 0�flerrocfor tj�A DATE �J O I o��l INSPECTOR L4.tu OF SOUIyOIo # # TOWN" OF SOUTHOW BUILDING DEPT.' coo 631-765-1802 INSPECTION [ ] FOUNDATION.1 ST/ REBAR [" ] ROUGH PLBG. [ ]' FOU.NDATION 2ND' . [_ ] I SULATION/.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: CDC - Ma,t -[z.,o'n C)ea,e�ce_5 -�o adX4,bQ51�16le-5 �.s DATE (o o? INSPECTOR FIELD INSPECTION REPORT I DATE COMMENTS b FOUNDATION (IST) - ------------------------------------ DO FOUNDATION (2ND) z c N i ROUGH FRAMING& PLUMBING W 1 r r� INSULATION PER N.Y. STATE ENERGY CODE •l�• or_ 2 .0. a rL a c .eaf2-"Ce �u5 des Gres t ik4 bq Cole. FINAL ADDITIONAL COMMENTS _ 3 c P �1� ic- o �3-0? in ¢ Z 9 r� x b �z H x e H ,yXYYz„;� urtFocx 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 https://www.southoldtowntiy.gov Received APPLICATION FOR BUILDING PERMIT o 'or Office Use OnlyD-ID i PERMIT NO. Building Inspector: J AUG 2 9 2024 F AppllcatC�hs an 'forms iriitst be filled out rn their entirety-Incomplete £ BLTII.,DING I)EPT, applications wdl not be accepted H Where the ApliGcant is not the owner,an T®V xDF SQ�aOI gwner's Authorization farm(Page�)sh�N be co�pJet�d��� F � �.; _ 4 Date:8/9/2024 Name:ANDRES MESZAROS SCTM#1000-098.00-03.00-..8.000 Project Address:1225 ARROWHEAD LANE PECONIC NY Phone#:646-575-3506 Email:ONEILLOUTDOORPOWER@HOTMAIL,COM Mailing Address: WEST 57TH STREET�APT 52 NEW YORK NY 10019 ONTACTPERSON >`f Name:SEAN ONEILL Mailing Address:PO BOX 64 JAMESPORT NY 1.1947 Phone#:631-722-3595 Email:ONEILLOUTDOORPOWER@HOTMAIL.COM ©EStGM PROFESSIONAL tNFORMATIONA' . . � , Name:' Mailing Address: Phone#: Email: CONTRACTOR INFORMITION. TA �.. t Name: Mailing Address. Phone#: Email: �, .� DESCRIPTION Ot=PROPOSED �CONSTRUCTIQi11 � ' > -. f ' Pa z El New Structure ❑Addition ElAlteration ❑Repair ❑Demolition Estimated Cost of Project: ❑' Other GENERATOR $14000.00 Will the lot be re-graded? ❑Yes MNo Will excess fill be removed from premises? ❑Yes. MNo .A k PROPERTYINFORMATIONR .. .,.. .M t yip Existing use of property:RESIDENTIAL Intended use of property:RESIDENTIAL Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? Dyes RNo IF YES, PROVIDE A COPY. Chick Box After Readlhg r The owner/contractor/design professional is respons►ble for all drainage and storm water issues`as provided by .ChaEpte�236of the iown Code APPEICATioN IS HEREBY MADE to the Budding Department,for the►ssuance;afa i ilding Permit parsuaiit to the Budding Zone Ordnance of the Town pf Sauthold�Suffolk,County,New York and}other'appl►cabte la4vs,Ordttlaoces or Regu� #►ans for the cdnstruct►on f buildings, additions alteratloris or for rmovhl or demolition as herein described The ap{rlicant agrees to comply wi#h all applicable housing co oslFaawsesardineanecenss,mbuidldeinhgeded egulat►onvandtoad nitauthor►zed►nspec m creeidnea, re { aasaClamsdeeanrA- uan#to Section�1.0 4 wYonshab ofhNkSrtate Penal a1N , Application Submitted B SEAN ONEILL pp y(print name): ®Authorized Agent ❑Owner Signature of Applicant: Date: CONNIE D.BUNCH STATE OF NEW YORK) Notary Publlc,.State of New York SS: No.01BU6185050 COUNTY OF SUFFOLK ) Qualified in Suffolk County c, Commission Expires April 14,2 SEAN ONEILL being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)he is the AGENT r (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 7 /ay of )q(/( 20 Notary Public PROPERTY OWNER AUTHORIZATION (Where the applicant is not the owner) ANDRES MESZAROS residing at 1225 ARROWHEAD LANE I, PECONIC NY do hereby authorize SEAN ONEILL to apply on my eha to the Town of Southold Building Department for approval as describe herei . 912-L Owner's Signature Date ANDRES MESZAROS Print Owner's Name 2 "$l1fFQ(,q �o TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 1 1 971-0959 oho aot,, Telephone(631) 765-1802 Fax (631) 765-9502 littt)s://www.soutlioldtownny.gov Date Received APPLICATI N FOR BUILDING PERMIT F. Office Use Only PERMIT N0. B '[ding Inspector: r Applications and forms must be filled out in heir entirety.Incomplete MAR 3 1 9023 applications will not be accepted. Where the plicant is not the owner,an F_ Owner's Authorization form(Page 2)shall be c pleted. BUILDING DEFT. TOWN OFSOUTHOLD Date: O3 31 Z 3 OWNER(S)OF PR PERTY: f Name:Maria Cecilia Ott SC-r/M#1000- Project Address:1225 Arrowhead Lane, Peco kc,✓KY 11958 Phone#:917-991-3259 4,mail:Cecilia.Ott@gmail.com Mailing Address:301 West 57th St, Apt 52A,/NY, ky 10019 CONTACT PERSON: Name:Andres Meszaros Mailing Address:301 West 57th St, apt 52A, NY, NY 10019 Phone#:646-575-3506 Email:Andr�s.Meszaros@gmail.com DESIGN PROFESSIONAL INFORMATION: Name:Mark K. Schwartz, AIX- Architect, PLLC Mailing Address:P.O. Box 9,33, Cutchogue, New York 11935 Phone#:(631) 734-4185f Email:mksarchitecto ptonIine.net CONTRACTOR INFORMA�T(ON: Name:AMS Property Renovations Mailing Address: 1/549 Main Rd, Rivehead, NY 11901 Phone#:631-2176-3334 Email:amsremodelingcontractors@ ail.com DESCRIPTION?F PROPOSED CONSTRUCTION JXNew Structure ❑Addition ❑Alteration []Repair ❑Demolition Estimated Cost of Project. (Other I C Ng Tg= $ Will the lot be re-graded? ❑Yes No Will excess fill be removed from premises?XYes ❑No 1 PROPERTY INFORMATION Existing use of property: (tq&Lfr6�, Q S Intended use of property: Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? ❑Yesk�No IF YES, PROVIDE A COPY. Check Box After 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(print name): H Ar2V 4W iOr2 Authorized Agent ❑Owner Signature of Applicant: Date: ^ �I 3) 23 CONNIE D.BUNC Public,State of STATE OF NEW YORK) Notary No.01 U6185050w York SS: Qualified in Suffolk il Commission xplresANr IiO 14,2�Q COA NTY OF Q .0 ) � C �' � _being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above nam d, (S)he is the ( ractor,Agent,Corporate Officer,etc.) of said owner or owners,and is duly autho ized 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 /h, 29 Y Notary Public PROPERTY OWNER AUTHORIZATION (Where the applicant is not the owner) Maria Cecilia Ott residing at 301 West 57th St, Apt 52A, NY, NY 10019 I, Mark K. Schwartz, AIA-Architect, PLLC do hereby authorize to apply on my behalf to the Town of Southold Building Department for approval as described herein. 14al"/.Zy/ 2oZ 3 Owner's S nature Date Maria Cecilia Ott Print Owner's Name 2 Fat/( BUILDING DEPARTMENT-Electrical Inspector y TOWN OF SOUTHOLD o Town Hall Annex- 54375 Main Road - PO Box 1179 CM, Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 rogerr@southoldtownny.gov - seandpsoutholdtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (Ali Information Required) Date: 05.15.2023 Company Name. odern Electric East Inc. Electrician's Name: RobertRough, 2LIN License No.: ME-34283 email:bobhough918@yahoo.com Elec. Phone No: 516=90 - 0✓ I reques it copy of Certificate of Compliance Elec. Address.: Box 321, Mattituck, NY 11952 JOB SITE INFORMATION (All Information Required) Name: Maria Cecilia Ott Address: 1225 Arrowhead Ln., Peconic, NY 11958 Cross Street: Indian Neck Ln Phone No.: 646-575-3506 Bldg.Permit#: 4,?a a 3 email: andres.meszaros@gmail.com Tax Map District: 1000 Section:98 Block: 3 Lot: 8 BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Square Footage: I <500 Circle All That Apply: Is job ready for inspection?: F1 YES[,(] NO n 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# 0 New Service®Fire ReconnectF�Flood Reconnect[]Service Reconnect FlUnderground DOverhead # Underground Laterals 1 2 H Frame Pole Work done on Service? Y N Additional Information: PAYMENT DUE WITH APPLICATION 6P *f g9v2� PERMIT H Address: Switches Outlets G FI's Surface Sconces H H's UC Lts Fans Fridge Exhaust Oven W/D Smokes DW Mini Carbon Micro Generator -ombo Cooktop ;•Transfer 4C AH Hood Service Amps Have Usec )pecial: :omments BUILDING DEPARTMENT-Electrical Inspector 0� qG TOWN OF SOUTHOLD y, z Town Hall Annex- 54375 Main Road - PO Box 1179 '* Southold, New York 11971-0959 oyo apt Telephone (631) 765-1802 - FAX (631) 765-9502 1 ' rogerr@southoldtownny.gov- seanda-southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFOR (Ail Information Required) e: 05.15.2023 Company Name: Modem Electric Eas Electrician's Name: Robert Hough License No.: ME-34283 Elec. email:bobhoug 8@yahoo.com Elec. Phone No: 5 - 03-7149 [ I request an email copy""f ertificate of Compliance Elec. Address.: PO Box 321, Mattituck, NY 11952 JOB SITE INFORMATION (All Information Required) Name: Maria Cecilia Ott Address: 1225 Arrowhead Ln., Peconic, NY 11958 Cross Street: Indian Neck Ln Phone No.: 646-575-3506 Bldg.Permit#: email: andres.meszaros@gmail.com Tax Map District: 1000 Section:98 Block: 3 Lot:8 BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Square Footage: T,500 Circle All That Apply: Is job ready for inspection?: ❑ YES❑✓ NO 7 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 1 2 M H Frame Pole Work done on Service? Y MN Additional Information: PAYMENT DUE WITH APPLICATION ` �I�l 5 , OSUFFot BUILDING DEPARTMENT—Electrical Inspector TOWN OF SOUTHOLD c Town Hall Annex- 54375 Main Road - PO Box 1179 2 Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 ' of jamesh(aDsoutholdtownny.gov — seand(j�southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: 8/9/24 Company Name: LAUREL LIGHTING INC & FRANK FENOY Electrician's Name: FRANK FENOY License No.: 4718-ME Elec. email: KFCELECTRIC@ ao/ .,OM Elec. Phone No: 631-457-3363 E I request an email copy of Certificate of Compliance Elec. Address.: 1977 MAIN ROAD LAUREL NY JOB SITE INFORMATION (All Information Required) Name: Andres Meszaros OTT Address: 1225 Arrowhead Lane Peconic NY 11958 Cross Street: Indian Neck Lane Phone No.: 646-575-3506 Bldg.Permit#: email: oneilloutdoorpower@hotmail.com Tax Map District: 1000 Section: 098 ' Block: 03 Lot: 008 BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): installation of briggs&stratton 22kw generator Square Footage: Circle All That Apply: Is job ready for inspection?: YES []NO ❑Rough In Final Do you need a Temp Certificate?: ❑ YES a 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 R2 H Frame Pole Work done on Service? M Y ON Additional Information: PAYMENT DUE WITH APPLICATION PERMIT# Address: Switches Outlets GFI's Surface Sconces H H's UC Lts Fridge HW POOL Panel Fans Mini Fr. WAD Pump Exhaust Oven Sump Heater Trnsfmr Smokes DW Gen6rator Salt Gen. Water Bond Carbon Micro GrbDis Lights Heat Pucks ERV . HOT TUB/SPA Inst Hot DeHum Transfer Disc Combo Cooktop IVlinisplit Blower AC AH Hood Blower Service Amps gODWHavep� Used IN Sub Amps Have Used Comments rLS IQo fP 1 , r Aca® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 08/09/2024 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 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 Pamela Moss NAME: Roy H Reeve Agency,Inc. a/c No Ext: (631)298-4700 ,C,No): (631)298-3850 PO Box 54 ADDAIL RESS: pmOSS@royreeve.com 13400 Main Road INSURER(S)AFFORDING COVERAGE NAIC# Mattituck NY 11952 INSURERA: Merchants Preferred Ins Cc 12901 INSURED INSURER B: Laurel Lighting Inc&Frank Fenoy INSURER C: 1977 Main Rd INSURER D INSURER E: Laurel NY 11948 INSURERF: COVERAGES CERTIFICATE NUMBER: CL2412620416 REVISION NUMBER: THIS IS TO CERTIFY THATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 AUUL1bUt5K POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICYNUMBER MMIDD MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ 5,000 A CTRIO10377 01/30/2024 01/30/2025 PERSONAL&ADVINJURY $ 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ❑JEC LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANYAUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED P $ NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N I STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? N/A E.L.EACH ACCIDENT $ (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe 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 Town of Southold ACCORDANCE WITH THE POLICY PROVISIONS. 53095 Rt.25 PO BOX 1179 AUTHORIZED REPRESENTATIVE Southold NY 11971 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD N Y S ' F New York State Insurance Fund PO Box 66699,Albany,NY 12206 I nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE 6� 2 AAAAAA 202207186 ROY H REEVE AGENCY INC 13400 MAIN RD PO BOX 54 MATTITUCK NY 11952 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER LAUREL LIGHTING INC TOWN OF SOUTHOLD 1977 MAIN ROAD 53095 RT.25 LAUREL NY 11948 PO BOX 1179 SOUTHOLD NY 11971 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE 11282 068-4 21960 09/21/2023 TO 09/21/2024 8/9/2024 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 1282 068-4, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW, AND, WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK, TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY. IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY,INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WEBSITE AT HTTPS://WWW.NYSIF.COM/CERT/CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION. FRANK FENOY(PRES) OF ONE PERSON CORP LAUREL LIGHTING INC THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STAT SUR NCE FUND DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER:531706178 U-26.3 06-0 -E007 09:5� 50UTHOLD-BUILDING DEPT 16317659502 CA lea N. ��•py'50�E. 93.9' /9/Y• Jk is Lol- zi ' I I Z 0g6G PIf• ���r�^� 84ro9'50' � ter. (, o _ CAMPFIRE ' i Too. DA w c. obApY \ CdM1AAPEAA71 ILAND MLE P C W!ANGE> ( Gam[[.YkM C7R /r CORP 11 ' i SUMEY 1 OF LOT � . "MAID OFAAWOWWAD COVE" � ANECAMP�no I TO WN OF S011 HOLD SUFFOLK COUNTY, N.Y. � . Sca/mi 1"=40' Apra 10, 1997 AREA a 23)011 It �a �� --gT�� '�4;;•, Fra fit• JIM? �nOr rC AIR S. LIC NO. 4961 B r IV can nar,ao enr HE mei•,u rr} +,�p'ANr Ntt r Ik'30 "` STWE'T auQra ° .a�r��r 'u° • saurnoLa, N. . usfl . 97- 1ST' N v,. a �/� A,�* PIDIWERPROTECT Standby Generators A M E D M 3 N 1 a ::; & T 1 RESIDENTIAL � � �°� Standby Generators � � w SPECIFICATIONS . r Brand Briggs&Stratton ......... ,.�z c e .........................................................................................................._ ... ...... .................................................... a \F .. ..._. i 5�9 yes Ram!e - PowerProtect' ilVipdei Namel a PPDX22 - - r - — ------ —.-- —----- --_-._._._._�._...------ Power,Standby(i P/NG)(kyV) 22/22 - Ratotl ACYoltaae(Volts)' 120/240 ted Fr®quency(Hz)' # 60 1 j Generator Breakar(Amps} 100 ......................._.__._______..._.._.. ........_.....__..__._ ......... Operating Ambient Temperature(C/ Fj -28 to 40/-20 to 104 Rated Ampora�ge,Stand�iy(LP/NG) ���` � I (Amps)' 91,7/91J K .X xz6 .............................. ......................... ................................. ............ ...................... ........................... I Rated POW®r Factor, 1.0 _ ............................ ...................................... g y " 16 sec(default) 20 mins I Pro rammabieF�caroeseC cio �J En ilneBrand/Manufacturer guard g Van e-..{.S,.f..L t "P 4 ky. R ........................_......................Y. ................... ModeiType ' M61......... ... .................._..... ....................... ....................................................... ................................ ..................... ._........................................................................................ .................................. ..............._...............................I Aspiretton Naturally Aspirated ............................... .............................. ................................... ..................._ ........ ....................................................................._ .......... . ....... .... .... Speetl(Ri�IN) I 3600 61/993 ( Oitplacem ent(cr/ccXs .s t ___._.._...-- Coh ression Ratro P r - 9.7:1 GouernorType a SAE 11444 Class B Frequency Regulation —� --- Bodo&Stroke�(in/mm} s 3.37 x 3.41/85.5 x 86.5 I Cylinder Biock 1 Aluminum w Cast Iron Sleeve -................. ______ ._____...._.__._... ...................... ..._.............-____._.____._....--....._.._.__.. ....._.._.._......_.._ ._. _. —-------__...._._.._..___ Ya)ve`Arrangement ,..1 OHV r ; PPDX22 POWERPROTECT C Standby Generators RESIDENTIAL STANDBY GENERATORS SPECIFICATIONS Engine Engine C bndei Coilfiggratian V Y ................. ............................. .. ......................... ..................... .............._............ ............................... ................... ................ NumberotCylinders s { 2 ...... ............................... __..... ........... ._................. __... .......... ...... ..................... ..... ... ................ .... ._... .................... _ _................. ... ... _......... . ----------....._. StaHType r 43 Automatic,Starter Motor .. --_._....................__._........ ............._.............._ .._._..........._...._......._ ............--........................_.............._......._...._..._...................._........ .......__.................................._.........._.............. ---- - Air Filter type m Dry I LtVW OIIPressureSwtch ' Yes e3 Y _--_...__......................_..............._.__.........._ _..... Engine Oil Heater Available as an Accessory — .. _..._._.................._ _. — Rated Temperature(F/ C) 77,125 Sound Rating Law idle Mud®Soun!dB 64 € Normal Operet(! g SaundtlB(A)' # 68 Lubrication System TYpm Full Pressure ! g a � k�O1lGepalaty(ozlL) � � <�� _................................- ............. ----............ ..................... _.. .... . .. ......................................... .......................................................................... . ........ . 78/2.31 p ............................... OII Fliter quantlt / a �Q Y TyP ) 1/Cartridge ................... .................................................. (( OII Brannd `. Schaeffer............... ... ....................... ....................._........................................ .... .............................................. ................................................................ ......... .. .............._.._....... ...................._.... Racommegded011 « a 5W30 Full Synthetic �. Electrical System IgnitlonSygtem Variable Timing .--....... .............._...._....._:....................._....__._............................... Battery quantity,,. � � �� � 1 .. .............._...._........ Battery Voltage(VbG) 12 ................. ............... .. Battery GCA ................ ............. {Amps) 540 ' a _ .......................... Battery BCI Group Size r E . .. . _....._.. 26 or 51 ............... _ ... .................. _...... . Sfarfer Mioter Voltage{VDC) 12 Fuel System NG/LPV i Fqo)SupP Y t Line tnt®t E xs�4 3/4"NPT i Reeommen ed Fuel,„.Lower Heating Value NG:34.3/904 Minimum{NJJIm'/BTUift') LPV:87.1/2338 ------------------------------------------------------ --- --—-------------------------------... Fuel Supply Pressures(mbarllnH�O) �.,... LPV:28 34/11-14 Fuel Consumption No Loan,NG(BTUihr} 107,000 Wo Load i�G.(ttg/hr) ° 107 < a Hai16 Load NG(BTU/hr) 194,000 PPDX22 POWERPROTECT Standby Generators RESIDENTIAL STANDBY GENERATORS SPECIFICATIONS & T Fuel Consumption €Half Loadr(f Q(ft'/hr} a - 194 rs ....................................................................................... .................... ........_..............................................._........_..........._..........................---........................................................__........_..... .........._._....__ PyR Load,RICa(BTUfhrj 281,000 � a E yI _.............._.........................._._............ ......................_........__._................. ......................__-...................... ............_........_..................._................._. .._......._........._.... Ful(Load,N6(ft�Jhrj 281 ....................._..... ......... ........._............... ... ._................_. ... ............. N6 LOatlr LP(BTtf/hrj,R _................. _......... .........._..._..__..........__.............. . 80 K, y 10 00 _........... .................... ................... ......................._ .... ..............................._................................. 43 .... .. ..............._..... ..._................_ ............................ __....... ....... No Load.LP(gal/hr} ..... ..... ............. 1.2 ........ . 1 ......................... ..................... d 1� ......................... ........ .............. ................. ............. ......... ............. .. . Nalf Load,LP(BTU/hr} 217,000 87 k. Half Load,LP(gal/hrj 2.4 Full Loadr LP(BTQJhr} ' a 368,000 Full Loadr C P(fN/fir} 147 I Full Load,LP(gal/hr? 4.1 Alternator Specifications AlternatorType 1 Synchronous,Self-Excited,Rotating Field a ? } ...... ................................................... .................... ...................... ............. ................... ................. .................... ........ Alternator Manufacturer` B&S Iv ..... .................... ................. _...................................._._.......... .........................................................._.................._.......................................... RatedFre uenc Hx' °< q� Y( � 60 .................. ...................1................._.......... fnsulatwn Rating(Clssj k H .......................................... ..........._....................................._.....................................................................__......................._._..........................._.........._............................_............ ................... I Designed temperature Rlse(Cj 125 _.............................. .........................._..._............................................................................ ...... ........................... 6eanng{Quantity/Typ®} ,� 1 Sealed S ................. ................... .................................. .............................. ........................... .. -? Number of Poles 2 �•- ... ..................................................................... ... . ... ..__..... .................._.. ... ................._.... Voltage Regulator Brushed/Electronic ........................................................... _............._......._.............. _........._._........ ..........._...................................... I Motor Starting Capabtlity(kVA} 45 ' ......................_.... _......._................................_._.... ......__............. v ............._.—._. ..........._.__...... .....—....._ ..._ ..........._....._... ........-'_._._..._........ Total Harmgnic Distprtion Controls Instrumentation Controller 9 GC-1032 —_...._.....—..__...... .___.—..-----------._._.__._..._.___-.._.___...... ___._.._._........_i Charger Stand Alone k Starting d --- AMF or 2-wire _--- .._.._ .._._ . . � mh -- ---------- -..-------"--"----"---- _._._----- ----- -— G LED Displayfwlth FauitCode Indications ? s ______-___---- _ -------"-- ----------------.. ........ -------- Yes..._..--- Re _..- alTimeC(ock g Yes -------- _- -____—_—___ _.__-_—,_—.-__-_.._.._..__ .___. _________. ___.._—________—_.__-..__.._..__—_ ____—_______ ___________ Engine HourCounteY A, Yes �. �EngineFfuntlmeSeheduler _ ', Yes r - M. P,PDX22 P* CWERPROTECT Standby Generators RESIDENTIAL STANDBY GENERATORS SPECIFICATIONS - I &S A Controls Instrumentation Low OIl Pressure Shutdown Yes 9 p ...Yes I Hi`h Tem eratrire Sillutdowri' a'' Other Features .-g Battery Raek and Cables Yes n .................. Fuel SolenbI Mire Yes f .. ... .................... ..................... 1 .............................................. ................ ; Integral Yi'ratlon�sblation Yes ............. ............... Oil Draln Exiens�on es Y ._._..............._._..__.._ __._-_ _._._....... ..... ___... . .......... !_. _, Operationand!InstailatloelNanual(s) Yes ( .-. _—.__..__ ..._.___.____..__ ._ __.._ .._.._.__—._.._. _------___........ _. .----___........... II Enclosure Aluminum__.___...._.._ _ Ertciesure Wind Speed Rating[mph} 186 Accessories i {•.: fl a g. tk• Nle(ntenance Kit 9 6872 :. ............... ............. ................. ................. ....................... ....................................................... ouwarmer >, 6840 �_ ..................._........... ................ ......................... ............................ ........ ..............6845................ .. ........ ............................................. ..................... ...........1 Fuei Ire ulatorEVvorltrer ... ................ ............... E eprotector `� � , ....................................... .... ......... sur ' 9 6631 4 ` ............ .................. ................................ ........................ .. ........................................... ....... ........................... ........ InfoHub"Unlversai Cellular 6574 Limited Warranty4 warranty Generator,D6lhest�c&Canada tpP!is J Labor J Travel} Years j Warranty Enclosure,Surface Rust and 1 !Go�rvslon(Parts]Lgber I Travelj� ltoarsa�� Warranty;Enclosure RustThroush(parts/ aborlTravelj .•YEaars L 3 warranty)Non Emergency{parts/Labor! Tvavei Years , 10yr1000 hr f.. Certifications UL� Yes - ..... ....................... . ....................... . ........................................................... ......... ....... ....................................................__. _......_....._......... ........ __..............__................................. Yes i d _.......................... ................. ...._...... .. ..-..............._........._........................................................................_.........__................ _................. FCC£ b Yes i ............................_........-..............................................................._.........................__..................._._..........._............... ............................__............................._.............................................. .. I iYlassachusetisplumber andGasfitters ! Yes E NFPA37' ' 4 18"Installation Clearance from Houses PPDX22 POWERPROTECT Standby Generators RESIDENTIAL STANDBY GENERATORS SPECIFICATIONS & We,!Ph1ts,&Dimensions Ass�mbledDlmens�ons{LengtiiXWifihX i i#elgbt){In!ram) 46.5 X 26.8 X 28.4/1181 x 681 x 721 j ............. ........................ ......................... ........... Aesembied Weight(Ibs/Cgj 465/210 i ................__ ................................ ...................................................._........._ ....................... PdGkagEd Dimen$Iet►8(I�ltrng#h X Widtlw X " 48.8 x 30,5 x 50.5/1240 x 775 x 1283 HQight)(IR/ram) I m� ................ .................. ............................................................. ................................................................... Packaged Weight(!bS J kg) r 540/245 wm q...................... ........................................................................................... ...................... ..............__..................................................._............................................................................. .............. ...............� s € OutUne and Pad layout t)raw�ng� E 80104089 t_... _., r ...M .....:a ._ ......__...................... .. . ..........._._.._ . . . . . .. _ ......_ ..._........._._...........-_... _....._._..........................._..._................._..._........._....................................._.....................................___..................._............................_ __ ..............: _ i iil � i is i 26.4 in (721 ram) l i H it 46.5 in(1181 mm) 26.8 in(681 mm) -� CULUS LISTED 'This generator is rated in accordance with UL(Underwriters Laboratories)2200(stationary engine generator assemblies)and CSA(Canadian Standards 'Association)standard C22•2 No.100-14(motor and generators). Per ISO 3744.Sound level measurement at other locations around generator may differ depending on installation,based on lowest microphone at 7m. Normal operation based on average household usage. Fuel consumption rates are estimated based on normal operating conditions.Generator operation may be greatly affected by elevation and the cycling operation of multiple electrical appliances—fuel flow rates may vary depending on these factors. 'See operator's manual or BRIGGSandSTRATTON.corri for complete.warranty details. 'Listing and labeling to NFPA 37 per Southwest Research Institute. Briggs&Stratton has a policy of continuous product improvement and reserves the right to modify BRIGGS&STRATTON its specifications at any time and without prior notice. POST OFFICE BOX 702 This standby generator is not for Prime Power applications. MILWAUKEE,WI 53201 USA Published 2023.Please visit BRIGGSandSTRATTON.com for the latest information. BS1454-9/23 Copyright©2023 Briggs&Stratton.All rights reserved.