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34266-Z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPAI~CY No: Z-33615 Date: 03/24/09 THIS tU~K'~IFIES that the building GENERATOR Location of Property: 895 SUTTON PL GREENPORT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 33 Block 5 Lot 3 'Subdivision Filed Map No. __ Lot No. -- conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 14, 2008 purs,,m-t to which Building Permit No. 34266-Z dated OCTOBER 31, 2008 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 GENERATOR AS APPLIED FOR. The certificate is issued to A D D INC of the aforesaid building. (OWNER) SuFfOLK COUNTY DEPART~T OF ~ALTH A~PROVAL N/A ~.R,JrKiCALCERTIFICAT~NO. 4020540 12/31/08 PL~Ei~S C~KTIFICATION DA'r~ N/A ~t~ r~lz~i~ature Rev. 1/81 This applic TOWN OF SOUTHOLD ~)~~L.~ BUILDINGTowN765_1802DEPARTMENTHALL BLDG. I)~ICATIO' ~ FOR CERTIFICATE OF OCCUPANCY s0um0t ~tion must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of t% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A ProPerlY completed application and ennsent to iuspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy- $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. -II- ,9 ? New Coustmction: Old or Pre-existing Building: ~' (check one) House No. Street Hff~n'~et Suffolk County Tax Map No 1000, Section Subdivision Permit No. 3~//a~x ~ 6 7_. Date of Permit./~ - Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ 0~, ~0 Block ~'~ Icot ~,~ Filed Map. Lot: Underwriters Appm~l: Final Certificate: (c~ one) Xpplic.~ni Si~n.ature ...L FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 34266 Z Date OCTOBER 31, 2008 Permission is hereby 9ranted to: AID TO DEVELOPMENTALLY DISABLE 901 EAST MAIN STREET RIVERHE~iD,NY 11901 for : INSTALLATION OF A GENERATOR AS APPLIED FOR at premises located at 895 SUTTON PL GREENPORT County Tax Map No. 473889 Section 033 Block 0005 Lot No. 003 pursuant to application dated OCTOBER 14, 2008 and approved by the Building Inspector to ex/Dire on APRIL/~,201~ < \ Fee $ 200.00 ORIGINAL Rev. 5/8/02 BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU Of ELECTRICITY 40 FULTON STREET - NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by GERARD f. D'ANDRAIA 341 2ND AVE BAYPORT, NY 11705 * ADD, INC 901 MAIN ST RIVERHEAD, NY 11901 Located at 895 SUT]'ON PLACE GREENPORT, NY 11952 Application Number: 4020540 Certificate Number: 4020540 Section: Block: Lot: Building Permit: * BDC: ns11 Described as a Commercial occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Basement, Outside, A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed herein, was conducted in accordance with the requirements of the applicable code and/or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other authority having jurisdiction, and found to be in compliance therewith on the31st Day of December, 2008. Name QTY Ratg Rating Circuits Typ~ Alarm and emergency equipment Generator permanent installation Tmnsfer Switch Miscellaneous installation of permanent generator and transfer switch 1 0 030kw 1 0 070a I of I sea! This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. FOUNDATION (1ST) FOUNDATION (2ND) © _ PLLrM~ING STATE ENERGY CODE '\ ADDITIONAL COiVI2VIENTS ~- N -..~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined ,20___ Approved ,20__ Disapproved a/c Expiration 20 __ OCCUPANC USE IS!" WIT'" BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planning Board approval Survey_ Check Septic Form N.Y.S.D.E.C. Trustees Flood Permit tf~ ...... ~ Storm-Water Assessment Form ~ ~ ~ ~ ~' [~ ~'Contact: APPLICATION FOR BUILDING ~ .... Date 0¢~ & ,20 Og INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining promises or public streets or areas, and waterways. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a permit s-hgll be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an addition six months. Thereafter, a new permit shall be required. 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, or 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 for necessary inspections. -.go,~dd ,e,~,~ ~r,~,,,~,~ve h,'ra,,J'cr. ,q-, 3.3. (signaturd of a~plicant or name, ifa co~oration) (Ma~ihg address of a~plicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises If appl' t is a c, gqxn~iq~ignaturrq of duly authorized officer (Name and title of corporate officer) .Doqojct ~i03 ~ t~Xe( ' Builders License No. Plumbers License No. Electricians License No. _._ Other Trade's License No. 1 Locationofl donwhich~'' ...... ~[(llJ~.~. ' · aB _ proposed~fll be done: gq5 6 o-k/ oo House Number Street County Tax Map No. 1000 Section ~.~ Block 5 Subdivision Filed Map No. 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost Fee Addition Alteration Other Work ~e~coJmr a,.cP ca or~rai~.,, '(Description) 5. If dwelling, number of dwelling units ..~ 0 ff~ Number of dwelling units on each floor If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature an&extent of each type of use. 7. Dimensions of existing structures, if any: Front ~0 b. ~ ' Rear ~'~e, ~'/t Depth ~, Height Z ~ %', c>" Number of Stories o ~ ~ (To be paid on filing this application) ia Dimensions of same structure with alterations or additions: Front Depth Height Number of Stories Rear Height 9. Sizeoflot: Front ~0, (') 10. Date of Purchase Itl] lb] ~ot>d 11. Zone or use district in which premises are situated 8. Dimensions of entire new construction: Front Rear Depth Number of Stories Rear }DOt-&'' Depth I ~t2~1-,..~11/~bI~'~-Oll Name of Former Owner omo_ [. oJ'kins, 5 r. 12. Does proposed construction violate any zoning law, ordinance or regulation? YES__ NO__ 13. Will lot be re-graded? YES NO v/ Will excess fill be removed fi-om premises? YES__ 14. Names of Owner of premises Name of Architect Name of Contractor / NO Address .... , [LiV~t~Wd, ~Phone No. to31- o-q- O Address Phone No Address Phone No. 15 a. Is this property within 100 feet cfa tidal wetland or a freshwater wetland? *YES __NO * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet cfa tidal wetland? * YES __ NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. 18. Are there any covenants and restrictions with respect to this property? * YES__ NO s/ · IF YES, PROVIDE A COPY. HOLLY A. GURNICK STATE OF NEW YORK) Notary Public, State of New York No. 01GU6018502 SS: Qualified in SuffolR County OF,.,~tftc0t. K ) Commission Expires Jan. 11, 20 COUNTY (Name of individual signing contract) above named, (S)Heis the ~ (Contractor, Agent, Corporate Officer, etc.) being duly sworn, deposes and says that (s)he is the applicant 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 tree to the best of hi~ knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Swom to before me this dayof O0.~. 20OD ~/ Notary Public Signature of Applicant PROPOSAL PAC Contracting P.O. Box 5 Riverhead, N.Y. 11901 631-334-3955 Date 7/25/08 Presented to: Aid To The Developmentally Disabled Address: 901 East Main St Riverhead N.Y. 11901 Job Location: 895 Sutton place Scope of Work Proposed: Supply, and install 16kw Guardian generator with 100-amp automatic transfer switch. Refeed existing panel box. Provide LP gas hook up to customer supplied propane tank. Install 12-voltbattery forgenemtor. Perform initial nm of wiring, and gas lines. At the customers request the generator is to be located approx 70' away bom penetration to house. Total price. ....................... $12,750.00 The total price includes a fee for IVYS underwriters certificate of $550.00. ~ooAO' SURVEY OF LOT 38 M4POF ~0~ O~ S.C. ~ ~o. ~-~-~-03 ~Y 21. ~ f S 7~'$7'