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HomeMy WebLinkAbout51864-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#: 51864 Date: 04/22/2025 Permission is hereby granted to: Noah Levine 360 Central Park W Apt 12E New York, NY 10025 To: legalize "as built" EV charger as applied for. Premises Located at: 4790 Blue Horizon Bluffs, Peconic, NY 11958 SCTM#74.-1-35.56 Pursuant to application dated 03/17/2025 and approved by the Building Inspector. To expire on 04/22/2027. Contractors: Required Inspections: Fees: As Built EV Charger $250.00 ELECTRIC -Residential $200.00 CO-RESIDENTIAL $100.00 Total S550.00 wilding Inspector r�r TOWN OF SOUTHOLD —BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. ®. Box 1179 Southold. NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 l:r:i. � . Date Received For Office Use Only � . PERMIT NO. Building Inspectorr�..... fin.% pw Applications and forms must be filled out in them 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: OWNER(S)OF PROPERTY: Name Go =CTM # 1000- �'? 00 -Q ( . OU -U Project Address:4-7 L) g 1 L -C, Igtjv %ZW f, J I k S fz-( rani G 1J Phone#: �D 3 1- a -7 04 1 Email: ���✓7a�1-�-� °' a��� .CO #I Mailing Address: &4,-' / CONTACT PERSON- Name: L®r-rdl.11 n<_., 3 a `P Mailing Address: -7 4'o S Odd a v?,) M!A-++1 Phone#: (0 3 1 3 9 2 1-7 0 LI I Email: DESIGN PROFESSIONAL INFORMATION. Name: Mailing Address: Phone#: Email; CONTRACTOR INFORMATION: Name: 211')6n4- S ✓l,- LC Mailing Address:. 4 q f r @ vc I\[`®d i I 5 Phone#: I . 159 g .'� Z) f Email: �� ,� cS com DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: '150ther I t 1-0- s 1 1 e)s -a.-a �Will the lot be re-graded? ❑YesANo Wi II e ss fill be removed p from remr es. El Y s ncJ Gh&4,-V- a��S -urt 1 PROPERTY INFORMATION Existing use of property: ej.4= Intended use of property: Zone or use district`n which premises is situated: Are there any covenants and restrictions with respect to this property? ❑Yes'fMNo 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(pri, t r ame):y rr��► A U � I��f�J authorized Agent El owner Signature of Applicant: ,� � Date: STATE OF NEW YORK) SS: COUNTY 041k'olFs Jk- Lre-A4 n2_• +a 4 jQt^-;fP-- being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)he is the can't1��-G' �✓ (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 7day of I ' l CL I'�-V� , 20 ZS" No'ta P Nic LOUIS J ROMEO Notary Public,State of New York No.01 R06314813 PROPERTY OWNER AUTHORIZATION Qualified in Suffolk County' Commission Expires November 17,20,96 (Where the applicant is not the owner) I„ Jbalei �' residing at cDP �.�✓r7�-L ", `" , U q�� do hereby authorize -6Uj e.�" " to apply on my behalf to the Town of Southold Building Department for approval as described herein. /"aj 3 Owner's Signature Date Print Owner's Name 2 k° f BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD Town Hall Annex - 54375 Main Road - PO Sox 1179 Southold, New York 1 1 971-0959 � `. Telephone (631) 765-1802 - FAX (631) 765-9502 sear,d asoutholdtoa rq' v APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: 1_ Company Name.- E 1 -m4-ui+ �• Electricians Name: License No.: - � � � ���6 Elec. email: P��''�� � Elec. Phone No: �:5 '?q. -2 9 9,3 CAI' request an email copy of Certificate of Compliance Elec. Address.: `1 "1 _S� -� 4 V ���# a��. I 5 �2- JOB SITE INFORMATION (All Information Required) Name.- Address- o I t�0,�1" � Cross Street: q Phone No.: 5! 5 Z/ 0 5 9 Bld Permit#: Pp_(- �o � � S G g- V email: Tax Map District: 1000 Section.(°'q an Block. p t. & Lot: 3 �.. r BRIEF ESCRIPTION OF WORK,�✓ INCLUDE SQUARE FOOTAG E (Please Print Clearly) I� I'ns-1-�.-�,1 o`� ,bo �lo►�-o&_S ;r� f►�trn4, o� �k '. +'o I f j �' Square Footage: Circle All T Apply Is job ready for inspection?: El YES NO Rough In Final Do you need a Temp Certificate?: 11 YES® NO Issued On Temp Information: (All information required) Service Size1 Phi Ph Size: A # Meters Old Meter# New ServiceQ Fire Reconnect[]Flood Reconnect®Service Reconnect❑Underground®Overhead Underground Laterals 1 2 H Frame Pole Work done on Service? 11 Y N Additional Information: 6xS0$4- CA-r- C err w� a►�c1 J0�--HnJabntla►-oCs PAYMENT DUE ITI APPLIC TION 14 p--NO*N*- New York State insurance Fund PC Bcx 66699,Albany:NY 122C6 I nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE (RENEWED) ^A^A^^ 823336604 ROBERT S FEDE INSURANCE AGENCY ' 23 GREEN ST STE 102 HUNTINGTON NY 11743 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER ELEMENT ENERGY LLC TOWN OF SOUTHOLD DBA ELEMENT ENERGY SYSTEMS 54375 MAIN ROAD 7470 SOUND AVENUE SOUTHOLD NY 11971 MA T TiTUCK NY 11952 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE 12449 444-5 962287 07/13/2024 TO 07/13/2025 7/11/2024 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2449 444-5, 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 A"I'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 THE SOLE PROPRIETOR, PARTNERS AND/OR MEMBERS OF A LIMITED LIABILITY COMPANY. THE POLICY INCLUDES A WAIVER OF SUBROGATION ENDORSEMENT UNDER WHICH NYSIF AGREES TO WAIVE ITS RIGHT OF SUBROGATION TO BRING AN ACTION AGAINST THE CERTIFICATE HOLDER TO RECOVER AMOUNTS WE PAID IN WORKERS'COMPENSATION AND/OR MEDICAL BENEFITS TO OR ON BEHALF OF AN EMPLOYEE OF OUR INSURED IN THE EVENT THAT, PRIOR TO THE DATE OF THE ACCIDENT, THE CERTIFICATE HOLDER HAS ENTERED INTO A WRITTEN CONTRACT WITH OUR INSURED THAT REQUIRES THAT SUCH RIGHT OF SUBROGATION BE WAIVED. 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 STILT S4 71*1 NCE FUND DiR�CTOR,INSURA+;CE FUN_r�UNCERINR!TING Zoho Si n Document ID: A7 8FFA•7HLGKCDHJ7T36MN23MBZZON C3AOP3TZZY1IH04YNZY LEGEND DESIGN B DRAFTING BY: ELEMENT ENERGY LLC o EXISTING UTILITY METER MAIN SERVICE PANEL REVIEW BY J.M.NABCEP CERTIFIEC ® NEW PV SUB—PANELS PROPERTY LINE 051 1 1 2-1 29 N/CE DISCONNECT ` �� REVISIONS COMBINER GND ELECTRODE O —V DESCRI PiION DATE REV MPV MODULE ` / o GI ...W ,4 ORIGINAL I 19 2024 RACKING RAIL Yf+ REVISION 03 07 2025 A vWw..... 0 ATTACHMENT POINT ^OoD Q �(.JO ..,„... .W...._._...._,�,.,.,._ .......STANDING SEAM Oo o O PROOF PITCH ANGLE 'L rL�� ��C eSUNRUN METER MAIN HOUSE ®VENT 0PLUMBING VENT �rrrrnnom ®SKY LIGHT CONTRACTOR NCHIMNEY ELEMENT ENERGY, LLC, COMPOSITE SHINGLES GOOD CONDITION 7470 SOUND AVE POTENTIAL SHADING ISSUES MATTITLICK, NY 1 1952 TRIM/REMOVE AS NECESSARY' LICENSE # 6746 I -t11 &UnLITY METER LICENSE # 52689-ME ®MAIN ELECTRICAL PANEL ©PV AC DISCONNECT �rrr� IN PV INVERTER "SUB ELECTRICAL PANEL �Vr�" �. " PATHWAY 36'ACCESS PATHWAYS MAIN MACE E! ` ✓" ✓ IN BASEMENT 340 . 18' ACCESS PATHWAYS / Ott THE CONCRETE EXTERIOR WALL PROJECT NAME DETACHED GARAGE LL_ tL D J c lL o[L] Ln Lu0 - p fV — � D/ >-- LLJ O Z Iz = U J W Lu J Z L1] m 0 Lu OZO � SHEET NAME SITE PLAN DRAWING SCALE I/3 2" = I '-OIL CONSTRUCTION NOTES 1 .) ALL EQUIPMENT SHALL BE INSTALLED IN ACCORDANCE WITH THE SHEET NUMBER MANUFACTURER'S INSTALLATION INSTRUCTIONS. 2.) ALL OUTDOOR EQUIPMENT SHALL BE RAINTIGHT WITH MINIMUM NEMA 3R RATING. PV—2 3.) ALL LOCATIONS ARE APPROXIMATE AND REQUIRE FIELD VERIFICATION. 4.) THE LOCATION OF BATTERY ENERGY STORAGE UNIT 15 COMPLIANT WITH R327.4 OF 2020 RESIDENTIAL CODE OF NEW YORK STATE TAX MA 1 000-074.00-0 1 .00-035.05G \W 6 ss 6K. ��` Ford Charge Station Pro The Ford Charge Station Pro provides level charging capability at home •Designed specifically for your Ford EV,and works with all J1772 plugs (EV industry standard) •Backed by Ford Motor Company 3-year limited warranty' •The Ford Charge Station Pro provides up to 80 amps to maximize your home charging speed for your Ford electric vehiclez •Adjustable power levels to accommodate a range of circuit breakers s (20-100 Amps)in situations where power may be limited,to enable compatibility with almost any home electrical systems " •Fully charges your all-electric F-150 Lightning Extended Range s- $`b vehicle overnight4 Works with the F-150 Lightning and the Home Integration System to provide Intelligent Backup Power to your home during an outage; Ford's recommended installer is Sunrun. Details Specification •Connector uses industry standard/universal SAE J1772 Output Power Max Weight connector.Compatible with all electric vehicles on Max 80AA9.2kW4 23.6 lbs. the market today(that are compliant with SAE 11772), Input Voltage Weatherproof including Testa with a commonly used adaptor 240 VAC NEMA 4 rated for -Up to 19.2 kW(240 VAC at 80 Amps)output Input Freq outdoor installation •Bluetooth and WI-Fi capability(5.0 GHz and 60Hz Warranty 2.4 GHz 802.11 b/g/n) Output cord Length Limited 3yr' •Dynamic color LED lights show power,bi-directional 25 ft. power status,vehicle connected status and Dimensions charging status 322 mm x 595 mm Installation x 176 mm(WxHxD) •Capable of both indoor and outdoor installation In the box (NEMA 4 rated) •Capable of post-mounting •Ford Charge Station Pro,including removable •Capable of installation with the Home Integration outer cover System and other home energy management solutions •25 ft.cord and charge coupler •Cord length is 25 ft. •Wall-mounting bracket -Integrated ergonomic coupler dock for storage •Mounting template(cardboard) to keep debris and dust out of the plug •User and installation manual •Integrated cable management system to keep charge •Installation hardware(some installer-specific cord organized and off the ground conduit hardware not included) -Ergonomically designed handle with grip •Impact-resistant replaceable faceplate" •Flexible wiring options to feed power into unit from rear or either side •Security lock has two screws that prevent the wallbox from being removed without completely disassembling 'See your dealerfor Umited-warranty details.2Ford electric vehicles Include entire unit the F 150 lightning.Mustang Mach-e,E-Transit,and Ford Plug-in Electric Vehicles.Home charging refers to AC charging(https://www.energygov/eere/ electricvehicles/charging-home).'13ased on Internal Ford testing.'Usable amperage Is 80%of home breaker amperage.Amps x Volts=Watts.'Charging times vary based on household circuit amperage. 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