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
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.