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HomeMy WebLinkAbout35867-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~RTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUP~dgCY NO: Z-34800 Date: 01/14/11 T~IS c~TIFIES that the building SOLAR PANELS Location of Property: 4175 NEW SUFFOLK AVE (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 115 Block 4 subdivision Filed Map No. Lot No. MATTITUCK (HAMLET) Lot 34.1 conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 15, 2010 pursuant to which Building Permit No. 35867-Z dated SEPTEMBER 16, 2010 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 GROUND MOUNTED SOLAR ELECTRIC SYSTEM AS APPLIED FOR. The certificate is issued to EDWARD S & BONNIE G ADAMS (OWNER) of the aforesaid building. SUFFOLK COUN77~DEPA~TOFHEALT~APPRO~-AL N/A ELEC'~RICAL CERTIFICATE NO. 35867 11/22/10 PLUMBERS ~KTIFICATION DA-,-.~.u N/A Rev. 1/81 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. 35867 Z Date SEPTEMBER 16, 2010 Permission is hereby granted to: EDWARD S ADAMS BOX 622 MATTITUCK, NY 11952 for : INSTALLATION OF GROLrND MOUNTED SOLAR ELECTRIC SYSTEM AS APPLIED FOR at premises located at 4175 NEW SUFFOLK AVE MATTITUCK County Tax Map No. 473889 Section 115 Block 0004 Lot No. 034.001 pursuant to application dated SEPTEMBER 15, 2010 and approved by the Building Inspector to expire on MARCH 16, 2012. Fee $ 100.00 Authorized Signature ORIGINAL Rev. 5/8/02 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application 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 °f Property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. ' 2. Finsl Approval from Hcalth 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 Pl.anning Board Approval of completed site plan requirements. B; Fo~ existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: I. Accu~'ate survey 0f pr0perty 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. Ifa 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 $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00, Swimming PO01 $50.00, Accessory building $50.00, Additions to accessory building $50.00, 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 lql~w 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 lO00, Section Subdivision Health Dept. Approval: Planning Board Approval: Filed Map. Dateofperrait. ~;.fr lq "~ ' · , ~./CApplicant: / Underwriters Approval: Lot Lot: Request for: Temporary Certificate Fee Submitted: $ Final Certificate: . (check one) Town Hall Atmcx 5~375 Main Road P.t). Box 1179 Simlhold, NY 11971419.59 Teleiihllne (631) 765-1802 Fax (631) 765-!)502 ro.qer.richert~,town.southold.ny.us BI IILI)ING 1)EPARTMIqNT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION ssued To: B & E Adams Address: 4175 New Suffolk Ave City: Mattituck St: NY Zip: 11952 3uilding Permit #: 35867 Section: 1 1 5 Block: 4 Lot: 34.1 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE 3ontractor: DBA: Eastern Energy Systems LicenseNo: 47657-me SITE DETAILS Office Use Only Residential ~ Indoor ~ Basement ~ Service Only ~ Commedcal Outdoor 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 3 ph Hot Water GFCI Recpt Main Panel A/C Condenser Single Recpt Sub Panel A/C Blower Range Recpt Transformer Appliances Dryer Recpt Disconnect Switches Twist Lock Other Equipment: Ceiling Fixtures [~ HID Fixtures Wall Fixtures I I Smoke Detectors Recessed Fixtures[~ CO Detectors Fluorescent Fixture [~ Pumps Emergency Fixtures~.._J Time Clocks Exit Fixtures [~ TVSS photovoltaic system, to include, 36 solar panels, 1-SB3000 inverter, 1-SB6000 inverter, 2-D/C disconnects, 1-NC disconnect Notes: Inspector Signature: Date: Nov 22 2010 81-Cart Electrical Compliance Form TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] iNSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] RRE RESISTANT CONSTRUCTION [ ] FIRE RESISTAI~I' PENETRATION [ ] ELECTRICAL (ROUGH) .~'~ ELECTRICAL (FINAL) REMARKS: DATE ~/__~_~__ INSPECTOR~~~-~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRA~qNG [ ]FIREPLACE & CHIMNEY [ ] ~'~'r~ RE.ARKS: [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION ] fiRE RESlST4NT I~IETRATION DATE _ INSPECTOR__~-~ ~ FOUNDATION (1ST) FOUNDATION (2ND) PLUMBING ~D~0N~ CO~S TOWN OF SOUTHO~LD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY ! 1971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork.net Examined ~/~ ,20 /g~} Approved ',/~,4/, 20 ~ Expiration ~//~,. 20/~: PERMIT No. 3 T 'b 7 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 NYSDEC Trustees Flood Permit Storm-Water Assessment Form Contact: Mail to: Phone: / L~.4E/~.~~'~ Building Inspector APPLICATION FOR BUILDING PERMIT Date 7 INSTRUCTIONS .20/o 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 premises 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 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 Cefft ficate 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. lfno 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. (Signature of a~pllcant o?name, if a-co'rporation) (Mail(ng edd~:c~ of app'[ican() State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ~__~,,-~ ~,~ ~e~,nn~q (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed~ork will be done: q/7ff A/e~, ~o.~Mk Age. House Number Street County Tax Ma No. 1000 Section I~ ~":~, OO Block Subdivision ~0~{~. Hamlet 04, OO Lo, Filed Map No. ~' Lot 2. State existing use and occupancy ofprellfises and intended a. Existing use and occupancy ~,,,.e; ;~']t,,n · ~. b. Intended use and occupancy /~t'$ ;tt[~,v~ · ~, 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost .~ ~.O ~ Fee 5. If dwelling, number of dwelling units p If garage, number of cars 10. II. 12. 13. use and occupancy of proposed construction: Addition Alteration Other Work ~-,,,~,nd J~oo-.,~.,.] (Description) (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. D' ' f ./xt~i.ts~ac6~tu~ s .fan Font ~O,'~-- ' 7. ,menslonso exls lngs rucue,i y: r Reartr---"~ t'~.,,.~-,l I Depth Height. | ~ t Number of Stories ! Dimensions of same structure with alterations or additions: Front ~ .~)._1 Rear Depth '~-/~, ~ ~ Height ! ~ t Number of Stories I Y"~"- 8. Dimensions of entire new construction: Front Rear _Depth Height Number of Stories S zeof,ot:rro.t Iqo' {qo, 7' 7 ODt( ) Rear . Depth DateofPurchase ~['7{ ~1~ NameofFormerOwner A'I~('~ Zone or use district in which premises are situated ~' 4~) 'I~ Does proposed construction violate any zoning law, (~r~inance or re~ul'f~ftion? YES NO ~ Will lot be re-graded? YES NO ~ Will excess fill be removed from premises? YES NO ~q aamm: So; fAOr~h~.~;c? f P re m is e s~Addrels~ [~ pPhho°nn~ , Address Name of Contractor~]h.~ddress ~one No. 15 a. Is this prope~y within 100 feet of a 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 of a tidal wetland? * YES NO .X * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to properly lines. ~.~lf elevation at any point on property is at I 0 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 ) CONNIE D. 8UNCt~ Notary Public. Stete of New Yor~ No. 01BU6185050 Qua fled n Suffolk County Commission Expires April 14 20 being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the t~t~Jf (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 tree 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, 6 aayof /Dr6ct:/t.c.~"J-_ 20/o Notary ~blic ~--"gigna'tum o~Appllcant ' Town of Southold ;~ Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: S.C.T,M. #: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A I STO..W. .R, A.D E.OS,O. CO'T.O- Disb'ict ClOCk CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW Y~RK. [ - SCOPE OF WORK - PROPOSE~D CONSTRUCTION ITEM# / WORKASSESSMEh~ Ye~ No a. What is the Total Ama of the Project Parcels? (thclude Total Ama of all Parcels located within i Will this Project Retain All Stetro-Water Run-Off the Scope of Work for Proposed Construction) ~t'"~3 ~ Ganemted by a Two (2") Inch Rainfall on alta? b. What is the Total Ama of Land Cleadng (S.F./~) ('this Item will Include all mn-off created by site ~.~.~ and/or Ground Disturbance for the proposed clearing and/or construction asflvffias as wall as all -- construction activity? ©,fil~ Site Improvements and the permanent creation of impervfous su~.) ts~.,~,,i 2 Does the Site Plan and/or Survey Show All Proposed PROVIDE B]~' PROJ-EC'T DESCZd~i'tON {thova.~m~ Drainage Structures Indlcatthg Size & Location? This Item shall include all Proposed Grade Changes and -- ~-~.~ ~ t')4~'.~ ~-C'Co,~ ~Co,~._,~-~ fqqo~_,~-~,~ Slopes Cantrolllng Surface Water FIow. ~3~ d'~v~ov~ ~'~3o.~',n ,% , and ssdiment control Practices that will he used to (~ ~ conln31 site erosion and storm water discharges. This item must be maintained throughout the Entire Construction Period. ~.,- ;.~ ~,J c~-A. H;~A- 4 Will this Project Requim any Land Filling, Gmdingor ~,~'~t~'~r t~([ ~ r~o ~'~;O,~/~ ,.~,.O,.~ ~t ExcevaUon where there is a change to the Natural E~isting Grade Involving mom than 200 Cubic Yards ~ 0 of Matedal within any Parcel? 5 Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five ThousandL~ (5,000 S.F.) Square Feet of Ground Surface? 6 Is them a Natural Water Course Running through the Site? Is this Project within the Trustees jurisdictionL~ General DEC SWPPp Requlremente = or within One Hundred (t00'} feet of a Wetland or Submiesle~ ~ a SWpPP is required for alt Conslmcfion acflviltes involving soil Beach? dlstuthanc~ of one (!) or more acres; including disturbances of less then o~e acre that 7 Will there be Sile preparation on Existing Grade Slopes ~ are pert of e !ar#er common plan that wifi uifimately disturb o~e or mom acme of ised; whish Exceed Fifteen (15) feet of Verticel Rise to I ir~cluding Consauciton activities involving ~ disturbances of less than one (1) acre where Otqe Hundred (1 Off) of Horizontal D/st a.n. ce? [~J the DEC hes detom~foed that a SPDES permit is required for stun~ water discharges, . SWPPp'~ Shall meet the Mtulmum Requlmmeofs o! the SPDES General Penwit 8 Will Driveways, Parking Areas or other Impervious let st~m~ Wa~ Dlechanges frm~ Conslmclton ~6~lty. Permit N~. GP-~t~-~t.) Surfaces be Sloped to Direct Storm-Water Run-Off r~ 1. The swpPP shalt ha prepared ~ to the submittal of the NOI. The NOI shall pe into and/or in the direction of a Town right-of-way? submitted tu the Deperlment prier to the comme~ement of ce~.slmcllen activity, ~. Th~ SWPPP shall desc~ae the erosion a~d sediment control pmcaces a~d wham 9 Will this Project Require the Placement of Material, required, pest-construct;on stu~m water management prac~;~es that wifi he used and/or Removal of Vegetatton and/or the Coastmstic~ of any consthnded to reduce the pera~mis in ~tunn water dis~arpe~ and to assure item Within the Town PJght-of-Way or Road Shoulder . Identify potonital ~rces of polluiton whleh may reasonably he expected to alfect the q ueltty of sthfT~ water dlscharge~. NOTE; If Any Ans*w~ to Que~tfm3s On® through Nlme le/~nswe~.ed web a Che¢k yaK~ 3. All SWPPPs that require the post-constmcUon storm water management practice In a Box and the ¢onst~uctlen site disturbance is bel~veen 5,000 $,F. & ~ Acm In ama, c~=mponent shall he p~pered by a qualified Design Protosskmal Licensed in New York a Storm-Water, Grading, Drainage & Erosion Control Plan le Requhed by the Term of that is knowledgeable in the principles end p~ o! Storm Water Management. aouthold and Must ha Submitted for Rel~ew P~lo~ to Issuance ~ AI~ B~Jitdthg NO-~: AChe~Mark(~) and/orAn~werfo~eecbQuesUonaRequi~dloraC~Ap~) STA3~. OF N[W COUNter OF ........................................... SS Thatl, '"~' '~'~0"'~" % ~[~.--~. being duly swom, de sssalIdsa that .......... . · ................... make and file this application; that ail statements contained in this application are t~ue to the best of his knowledge and belief; and that thc work wiJJ be perfol3ned in the manner set forth hi thc application fi]ed herewith, Sworn to before me this; .............................. ~ .............. d,~, of...~c~.~.~. ................... ~.Z.~. .~'~ ................ · .... ........ -' r.~ ~;~;i; ........................... FORM - 06/10 11-10-10;14:28 ; 4665200 ; ¢ 1/ ILO. Oox 1179 $oudlold, NYJ1971-0959 Tclephonc (6~4 t) ro er ' - -~:a (6,t0 ~ -ncnerc(mtown.southord.nv .~ BUILDING DEPARTMENT TOWN OF $OLrTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: ~,ompany Name: Name: License No.: Address: Phone No.: JOBSITE INFORMATION: *Name: *Address: *Cross Street: *Phone No.: Permit No.: Tax Map District: (*Indicates required information) qrT$ ~[~ guFF~K AVE.; ~A~u~k, N~ ttq~g 1000 Se~ion: *BRIEF DESCRIPTION OF WORK (Please Print Cleady) Block: Lot: oF (Please Circle All That Apply) *Is job ready for inspection: *Do you need a Temp Certificate: Temp Information (If needed) *,Service Size: ~ 3Phase 100 *New Service: ~ Underground Additional Information: i~/NO {~/NO Rough In Final 150 200 300 350 400 Other Number of Meters Change of Service Overhead PAYMENT DUE WITH APPLICATION 82-Request for Inspection Form Town Hall Annex 54375 Main Road P.O. Box 1179 Southold. NY 11971 0959 Telephone (631) 765 1802 Fax (631) 765-9502 BUILDING DEPARTMENT TOWN OF ISOUTItOLD January 11,2011 Edward & Bonnie Adams 4175 New Suffolk Avenue Mattituck, NY 11952 TO WHOM IT MAY CONCERN: The Following Items Are Needed To Complete Your Certificate of Occupancy .~ l Application of Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. A fee of $50.00. Final Health Department approval. __ Plumbers Solder Certificate. (All permits involving plumbing after 4/1/84) __ Trustees Certificate of Compliance. (Town Trustees #765-1892) __ Final Planning Board approval. __ Final Fire Inspection from Fire Marshal. __ Final Inspection from the Building Dept. __ Final Landmark Preservation approval. Building Permit:: 35867-Z solar panels sURVEYED FOR:- ~-~¢J~ ~ ._-~. LOCATED AT /~A7"'7'/~-~'c~ , TOWN OF ~0~'7'~'/0/~ LOT SCALE 1" -- ~)' SUFFOLK CO. TAX MAP DATA:- DIST. /¢::~OO , SEC. OFFSETS FROM STRUCTURES TO RELATIVE BOUNDRY LINES, ON SURVEY, ARE FOR A SPECIfiC USE ONLY, AND SHOULD NOT BE USED FOR CONSTRUCTION OF FENCES OR OTHER STRUCTURES. , CO. CLK. NO. SUFFOLK COUNTY N.Y. FILED ,LE NO. / DRAWN BY~_~ WILLIAM R. SIMMONS JR. P/O BOX 377 JAMESPORT, L.I., N.Y. 11947 PAGE ~ GRID ...J..-~"~' JOSEPH SCHMITT En ineers Consulting Joseph Schmitt, Consulting Engineers 12 VWlie Way Stony Brook, NY 11790 Phone 631-689-7270 Fax: 63%751-7047 www.schm~en ineedn . m e-mail: jscepe~scflmittengineefing.com September 8, 2010 Town of Southold Building Department Town Hall Annex Building 54375 Route 25, P.O. Box 1179 Southold NY 11971 Bonnie & Eddie Adams 4175 New Suffolk Ave. Mattituck, NY 11952 SEP 1 5 2o 0 BLDG· DEPT. TOWN OF SOUTHOLD Dear Sir/Madam: I have reviewed the UNIRAC Free Standing PV Mounting Frame and their calculations based on the following: I. The ASCE7- Code for wind and snow loads using 20 psf ground snow loads and 130mph wind loads in Exposure "D". II. "Manual of Steel Construction: Load Resistance Factor Design," 3~d Ed, American Institute of Steel Construction, Chicago, IL, 2001. III. "Aluminum Design Manual: Specifications and Guidelines for Aluminum Structures":, The Aluminum Association, Washington D.C., 2000. IV. Mechanical Properties of UNIRAC extruded rails and related cora~ats.h~ed on data obtained from UNIRAC. IAPFRO EDAS NOTED In our opinion the UNIRAC Free Standing PV Mounting Frame e~s-~ 2010BulldlngCodeofNew'~e~ :',i .!,a ~ OR .F~5 /~, BY_. ~C..~ _ , N' ~FY BUILDNG DEPART -- ! 7 ~ ~ , MENT AT Szncerely, USE IS ~,..LtlIT! !.-*'";! V;' .~,Pp"',,""t-lr-'"~,-~, a'~"~ LLi'I"¢Nr INSPECTION.g "- · ' '"': UCTION & ELECTRICAL /// ~ REQUIRED ~ ;,' is' SE COMPLETE FOR C O ' LL CON: TRUCTION SHALL MEET THE ~ REQUIREMENTS OF THE CODES OF NEW YORK STATE NOT RESPONSIBLE FOR DESIGN OR PURSUANT TO CHAPTER 236 15/16" 5' 3/4" 9/16' r 3 1/~' Eastern Energy Systems Date: 08/04/2010 Revision: A Location: 4175 New Suffolk Ave Mattituck, NY 11952 Customer: Eddie and Bonnie Adams View: Right Side Eastern Energy Systems Date: 08/04/2010 Revision: A Location: 4175 New Suffolk Ave Mattituck, NY 11952 Customer: Eddie and Bonnie Adams View: Rear Side