Loading...
HomeMy WebLinkAbout34803-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPA/qCY NO: Z-34140 Date: 12/17/09 THIS CERTIFIES that the building SOLAR PANELS Location of Property: 1980 HENRY'S LA PECONIC (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 74 Block 2 Lot 2 Subdivision Filed Map No. __ LOt No. -- conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 15, 2009 pursuant to which Building Permit No. 34803-Z dated JTrNE 19, 2009 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 SOLAR PANELS ON AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOHN MLOT of the aforesaid building. ( OWNER ) SUFFOLK COUiTFYDEPARTMENT OF HEALTH APPROVAL ELE~-,-KICAL CERTIFICATE NO. FL[~RS CERTIFICATION DA'£~D N/A N/A N/A ~Aut~orize~ Signature Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUI This application must be filled in by typewriter or ink and submitted to the Buildin DEC Department '8~11 O[l~l$ollow~ng TOWN OF SOUTHOLD 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 1% 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. 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and consent to inspect 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 New Construction: Location of Property: Old or Pre-existing Building: (check one) House No. Street Hamlet Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Subdivision Permit No. ~ Date of Permit. Health Dept. Approval: Block Lot Filed Map. Lot: Applicant: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: G Ap~h~ Signait~rer'- + SUFFOLK BUREAU ~,~ E LECTRICAz INSPEC 10RS.~nc 40 Nottingham Drive, Middle Island, NY 11953 Telephone: 631 495 8136 · Fax: 631 980 6455 · E-Mail: SBEIGS@gmail.com CERTIFICATE OF ELECTRICAL COMPLIANCE Applicant: Rough In Inspection Date: Application No.: LIPA Solar App No.:. Suffolk County Tax Map No.: GO SOLAR Znc. September 18~2009 11159 09-4045-SP Certificate No.: Final Tnspection Date: Building Permit No.: 11159 September 18,2009 This Certificate of Electrical Compliance is limited to the inspection and compliance of electrical equipment and/or work described below, installed by the applicant named above, located at the premise of and not after the final inspection date above: Owner: lohn Mlot Site Location: Mlot, 1980 Henrys Lane, Peconic, NY 11958 Owner's Address (if different): [] Residential [] Indoor [] Basement L~ Service [] Shed [] Commercial [] Outdoor [] First Floor [] Pool [] Hottub [] New L~ Renovation [] Second Floor [] Attic [] Garage [] Addition [] Survey Other: Photo Voltaic System Single Phase HID Fixtures Smoke Three Phase Main Panel CO Detect Pumps Sub Panel Time Clock Transformer INVENTORY Heat Duplex Recpt Ceiling Fixture Hot Water GFCl Recpt Wall Fixture AC Cond Single Recpt Recessed Fixture AC Blower Range Recpt Flourescent Appliances Dryer Recpt Emergency Switches Twist Lock Exit Fixtures Heat Pump Electhc Heat Pool Luminaire Other Equipment: 36 SunPower 230 watt modules = 8,280 watts and 1 SunPower Fronius inverter 8000 watts, The electrical work and/or equipment described above were inspected and appear to be in compliance with local, state and national electrical code requirements and this office. :,, Applicant: GO SOLAR Inc. Inspected By: Gene Surdi Signature:. License No.: 35972-ME Date Of Certificate: Sep 18,2009 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. 34803 Z Date JUNE 19, 2009 Permission is hereby granted to: JOHN MLOT PO BOX 373 PECONIC,NY 11958 for : INSTALLATION OF SOLAR PANELS TO AN EXISTING DWELLING AS APPLIED FOR at premises located at 1980 HENRY'S LA PECONIC County Tax Map No. 473889 Section 074 Block 0002 Lot No. 002 pursuant to application dated JUNE 15, 2009 and approved by the Building Inspector to expire on DECEMBER 19, 2010. Fee $ 200.00 Autho~rized Signature Rev. 5/8/02 ORIGINAL TOWN OF SOUTHOLD BUILDING DEPT. __ ~ 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS/ULATION [ ] FRAMING / STRAPPING [~I~NAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: DATE //~//~/'~/~ ~ INSPECTOR 272 Main Road Riverhead, NY 11901 Phone (631) 727-22~ F~x (631) 779-3344 Email info(a~ gosolar.corn Website: www.gosolar.com November 5, 2009 Town of Southold Building Department 54375 Route 25 PO Box 1179 Southold, NY 11971 BLDG. DEPT. TOWN OF SOUTHOLD Re: Building Permit # 348037 for solar modules - John Mlot of 1980 Henrys Lane, Peconic, NY 11958 To Whom It May Concern: This is to certify that Go Solar, Inc. has installed John Mlot's 8,280 watt solar electdc system to New York State building codes and to the manufacturer's specifications.. If you have further questions, please don't hesitate to contact either me at the above address and phone number. Thanks! Sinceref~,~ _ Gary Minnick (~/'" ~ President, Go Solar, Inc. Sworn to me this Day of '~?.,(~.g,e..t., "Improving Our Planet One Roof At A Time" F/ELD INSPECTION REPORT I DATE [ COMMENTS FOUNDATION (2ND) . ROUGH F~G & PL~G ~S~A~ON PER N. Y. STATE E~RGY CODE /, , , ~DITION~ COUNTS .' TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ' SOUTHOt~D, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined Approved Disapproved a/c PERMIT NO. 5(0°03 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 Storm-Water Assessment Form Contact: Mail to: Phone: Expiration /_~/~, 20  Building Inspector ~ d~J~Th~l'"" I I~N~TpRUe~t[7oNr Sin ~nk andla '/~ ~ ,20 II ~ etel filled ~. This apl~ig~ y ' y yp ' ' ' submitted to the Building Inspector with 4 sets of ~ plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or c. The work covered by th/s 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 shall 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 regmlations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant or name, ifa corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 35q7, - 1. Location of land on which proposed work will be done: House Number Street ~ Hamlet County Tax Map No. 1000 Section ')-'/'/ Block e2_ Lot o2, Subdivision Filed Map No. Lot · ' n State existing use and occupancy of premises and intended use and occupancy of proposed constmct~o :, a. Existing use and occupancy t~£5 ! r) ~ ~9 L_ b. Intended use and occupancy .~ ~ t~ 3. Nature of work (check which applicable): New Building. Repair Removal Demolition 4. Estimated Cost $ ~':]' ~ o 5. If dwelling, number of dwelling units If garage, number of cars Addition Alteration Other Work (Description) Fee ~t90.d-~ (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if any: Front Rear Depth Height. Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Height Number of Stories Rear Depth 9. Size of lot: Front Rear .Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated ~ ! f)~-'JxFTD 12. Does proposed construction violate any zoning law, ordinance or regulation? YES __ NO 13. Will lot be re-graded? YES NO k~ill excess fill be removed from premises? YES NO 14. Names of Owner of premises Address Phone No. Name of Architect Address Phone No Name of Contractor (r~ $ot.a~e, t~(-~. Address ~, PhoneNo. bs7/-2,,7,~-~,~.25l tT~v ~-~ ~P~-~% Nv/ 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE RE~QUIRED. b. Is this property within 300 feet of a 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 ~ · IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF ) ~ ~o..x-~x ~-~ <'Lo~¢ ~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the (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 knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this 1~ day of, ~v~t~ 200~ g~o~ ~ o/ve61~q~57 Signature of Applicant - r w i/ TOWN OF $OUTHOLD PROPERTY RECORD CARD z_ OWNER STRE~ / ~''S"O WLL~GE DIST. SUB. FORMER OWNER':~'-~tr~'~ J 1~'~/'~ N E ~C%....~ ~d~ta~H -,~~ s W ~PEOF BUILDING RES, ~/~ S~S:. VL, FARM CO~. CB, MICS. Mkt. Value ~ND IMP, TOT~ DATE RE~RKS AGE BUILDING CONDITION/ ~ / / NEW NORMAL BELOW ABOVE FARM Acre Value Per Value Acre Tillable FRONTAGE ON WATER W~lond FRONTAGE ON ROAD Meodowl~d DEPTH House Plot BULKH~D _ ,Total~ ~ ~ ~ DOCK Extension Extension Extension Porch Breezeway Garage Total COLOR Foundation [Bosement ~Ext. Walls Fire Piece Type Roof Recreation Room Do mer Bath :loors Interior Finish ~eot Rooms 1st Floor Rooms 2nd Floor Driveway Dinette K. BR. FI~. B COLOR Extension New York State Insurance Fund ~Yorkers ' Compensation & Disabili~ BeneJ~tts Specialists Since 1914 8 CORPORATE CENTER DR, 3RD FLR, MELVILLE, NEW YORK 11747-3129 Phone: (631) 756-4300 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE GO SOLAR INC 272 MAIN RD RIVERHEAD NY 11901 POLICYHOLDER GO SOLARINC 272 MAIN RD RIVERHEAD NY 11901 CERTIFICATE HOLDER TOWN OF SOUTHOLD BUILDING DEPARMENT TOWN HALL SOUTHOLD NY 11971 POLICY NUMBER I 1346 970-5 CERTIFICATE NUMBER PERIOD COVERED BY THIS CERTIFICATE DATE 579480 02/09/2009 TO 02/09/2010 5/27/2009 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 1346 970-5 UNTIL 02/09/2010, 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 SAID POLICY IS CANCELLED, OR CHANGED PRIOR TO 02/09/2010 IN SUCH MANNER AS TO AFFECT THIS CERTIFICATE, 10 DAYS WRITTEN NOTICE OF SUCH CANCELLATION WILL BE GIVEN TO THE CERTIFICATE HOLDER ABOVE. NOTICE BY REGULAR MAIL SO ADDRESSED SHALL BE SUFFICIENT COMPLIANCE WITH THIS PROVISION. THE NEW YORK STATE INSURANCE FUND DOES NOT ASSUME ANY LIABILITY IN THE EVENT OF FAILURE TO GIVE SUCH NOTICE. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYANDCONFERS 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 STATE INSURANCE FUNC DIRECTOR,INSURANCE FUND UNDERWRITING This certificate can be validated on our web site at https://www, nysif, com/certJcertval.asp or by calling (888) 875-5790 VALIDATION NUMBER: 76580459 AC°Rb* CERTIFICATE OF LIABILITY INSURANCE I ~ODUC.R THIS CERTIFICATE IS ISSUED AS A MATI'ER OF INFORMATION LoVulloAssociates, lnc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 6450 Transit Road HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Depew, NY 14043 INSURERS AFFORDING COVERAGE NAIC # ~NSURED Go Solar, Inc. *NSURER A: BCOTTSDALE INBU RANCB COMPANy 4'1297 cio Gary Minnick INSURERS. $COTTSDALE INBU RAN CE COMPANY 4'1297 272 Main Road INS[JEER C; Riverhead, NY 1190'1 INSURER D: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTW~r HSTANDING 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 TH E POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. A 2 OTHER Properly CPS0934428 10/20/2008 '10120/2009 Business Personal 90,000 Deductible '1,000 CERTIFICATE HOLDER CANCELLATION TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 1'1971 AUTHORIZED REPRESENTATIVE ACORD 25 (2009/01) © f988.2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD For more Information contact: Walter P Geoghan Agency Inc at 631-472-5000. GENERAL NOTES ' 12 /.¥._~~______~//~ mean roof height 2eft pitch 61/4 in on12 in 1. CONTRACTOR SHALL CHECK AND VERIFy ALL CONDITIONS AT THE 11, THE OWNER SHALL SELECT ALL FINISH MATERIALS AND COLORS roof rafter 2x6 HIMSELF WlTH THE IN'rENTOFTHESEPLANSANDMAKEWORK REMAINTHEPROPERTYOFTHEENGINEERWHETHERTHEPROJECTJ~ ~' rafter spacing 16 inch on center A~ROVI~ .A~ ,,0, ED AGREE WITH SAME FOR WHICH THEY ARE MADE IS EXECUTED OR NOT. THEY ARE ceiling joist 2x8 2. CONTRACTOR OR OWNER SHALL OBTAIN ALL REQUIRE[3 APPROVALS. NOT TO BE USED ON ANY OTHER PROJECTS OR EXTENSIONS TO E DFT. I ~.~ PERMITS. CERTiFICATESOFOCCUpANCY. INSPECTION THISPROJECTEXCEPTBYAGREEMENTINWRITINGANDWITH ~ joist spacing 16 inch on center ~.TS: ._ WHICH DISAGREES WiTH THAT AS IN~I~TED ~ TH~SE P~NS' C~E~O"' ~PLE~ ~' ~C' A~A~ F~ THE ~R~SES ~ ~tS ~OJECT AND~ collar tie spacing eve~ third rafter FABRICATED~OINSTALLEDASpER~TESTAISC TEM~ARY~AFFOLD~.STAIRS. ETC.AS~LLASpER~NT~STR~T~ NT.S P ROHGH - FRAMING ~ pLUMEtNG ALL ELECTRICALWORK SHALL BE BOARDOF FIRE UNDERWRITERS I~. C~CTOR S~LC~TEALL~SES 0RW~W[TH THE REQUIREDPARTIES. ~L ALU CONS' CERTIFICATIONOFTHESE ,~NS. 19 ~N~CT~TOREM~ALLDES~SCR~DBYTHISWORKFROMTHESITEANDOI~OSEOF CODES OF NE. ~ , _. REQUIREMENTS OF TH~; 20DES OF NEW FI~INGORPATCHINGREQUIREOTOCOMPLE~THEWORKORTO 20.ATTHEC~I~OF~RK,~ES~EISTOSECL~REDOF~DEBRIS~DEXCE~ YORK STATE. NCT RESPONSIBLE FOR MAKEI~SPARTSFITT~E~ERPR~ERLY ~TER~S. THEFACEi~ISmBELEFTBR~MCL~NANDWOR[ISTOBECOMPLET~TO DESIGN OR ~CTION ERRORS. FROM AR~Y CERTIFICATIONOF - NAILING & CONNECTIONS .... ~'~ '.~ . ' . INVERTEr NVERTER SERVICE PANEL , I ..... CERTI TYPICAL RISER DIAGRAM , OFOCCL ANCY ~ ' UNDERWRrTE~; CERTIFICATE S~oun~ ~a~ TO my best belief and knowledge, the work in this document is accurate, conforms with the governing codes applicable at the time of submission, conforms with reasonable standards .~v~s,on 3 ~PICAL CONNEXION D~AIL ~ ALL ROOF PENE~T~ON5 ARE TO BE SEALED of practice, with the view to the safeguarding of life, health, prope~ and public welfare. PV PANEL W/TH SI~FLEX OR E~UIVALENT SEA~NT Rev,s,on 1 as per ASCE7, Method 1: ~ (fig 6-2) 1.36 I (table 6-1) 1 Pnet= A Kzt IpnetCO (eq 6-2) Ka(~c 6.5.7) 1 Pnet3O (fig 6-3) -25.9 ~ PO ~ox 1~8. SAW/LLE. NY CLIMATIC AND GEO~PHIC Wind Live Icad point Fastener fastener ~ /" ~ ~...~,~ DESt~N CRITERIA Catego~ Speed, 3 pnet30 pullout spacing Jo~ ~0~ sec gust, 3erASCE Icad, lb ~pe along mph 7, psf ~e~o H~rgs I~, P~co~ic~ ~ 5/16" did PROPOSED 50~R ENERGY C 120 36 492 screw, 32 ~ENE~L NO~5, ROOF 5E~ON, DATA, DETAI~ AND SPECS 3-112" ,~, 0 40'- 4" ROOF LAYOUT THIS CERTIFIES THAT THE ROOF LOAD HAS BEEN CHECKED FOR WIND, SNOW, LIVE AND DEAD LOADS BASED ON ASCE7-05 AND 2007 NYS BUILDING CODE. THE ROOF STRUCTURE IS ADEQUATE TO SUPPORT THE PROPOSED LOADS PRODUCT: QTY: LENGTH: WIDTH: WATTS: PV Panel SunPower 230 36 61.39 in 31.42 in 8280 Revisio~ 5 Revision 4 Revision 3 Revision 2 Revision I PO 8ox ~44g, SAYVILLE, NY ~.~-752- Tgi: 6~--qgg-O000 FaX: O3~--~,g2.-$2.3& Em~[l: ~i~g~l JoAn ~lot · egO H~r~s I~, P~co~ic, NY ~eS~ PROPOSED SOLAR ENERGY INSTALLATION ENERAL NOTES, ROOF SEC~3ON, DATA, DETAILS AND SPECS o~/o,t./o~ AS NOTED 2.