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Town of Southold Annex P.O. Box 1179 54375 Main Road Southold, New York 11971 CERTIFICATE OF OCCUPANCY 12/18/2012 No: 36088 Date: 12/18/2012 THIS CERTIFIES that the building OTHER Location of Property: 54075 Route 25, Southold, SCTM #: 473889 Sec/Block/Lot: 61.-2-7.3 Subdivision: Filed Map No. conforms substantially to the Application for Building Permit heretofore Lot No. filed in this officed dated 10/16/2012 pursuant to which Building Permit No. 37597 dated 10/25/2012 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: furnace and hot water heater as applied for. The certificate is issued to Southold ProfOffices LLC (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 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 #: 37597 Permission is hereby granted to: Southold Prof Offices LLC 128 Vanderbilt Ave Manhasset, NY 11030 Date: 10/25/2012 To: replace an existing furnace and hot water heater as applied for At premises located at: 54075 Route 25, Southold SCTM # 473889 Sec/Block/Lot # 61.-2-7.3 Pursuant to application dated To expire on 4126/2014. Fees: 10116/2012 and approved by the Building Inspector. NEW COMMERCIAL, ALTERATION OR ADDITIONS CO ~ BUSINESSES Total: $250.00 $50.00 $300.00 u~ ~ng Inspector Form No. 6 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF occUPANcy This application must bo filled in by typewriter or ink and submitted to the Building Department with the following: For new building or new use: 1. Final sm'roy of property with acCUrate'location of all buildings, property lines, streets, and unusual natura} or topographic featur6s. 2. Final Approval from Health Dcpt. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical ins. tallation from Board 0fFire Underwriters. 4. aw.om stat~a~nt from ptumbor c~nifying that the solder used in system contains less than 2/10 of 1% lead.. 5. Conmaexoiat building, industsial building, multiple residences and similar buildings and installations, a cortifieate 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, stleets, building and. unusual naturai or topographic features. 2. A properly e. gmpleted application and con~ent 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. Certificaie of Occupancy - New dwelling $50.00, Additions to dwelling $50.00, Alterations to dwelling $50:00, Swimming pool $50.00, Accessory building $50.00, Additions to accessory building $50.00, Businesses $50.00,. 2. Ceytificate 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. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: ~ Filed Map. Date of Permit. /0 ~_~? ~ t 7.- Applicant: Underwdtel~ Approval: Final Certificate: (check one) Subdivision New Construction: Old or Pre-existing Building: ~ / (check one) House No. .. , · Strut ./ , . Suffolk County T~ Map No ' 000, S~tion ~/, ' Bi~% ~ ~~, TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH P?~B~. [ ]FOUNDATION 2ND [ ] INS~TION [ ]FRAMING/STRAPPING [~I:INAL [ ] FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONSTRUCTION [ ] ELECTRICAL (ROUGH) REMARKS: [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (FINAL) DATE INSPECTOR f TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoatholdTown.NorthFork.net PERMITNO. 7 BUll.DING PERMIT APPLICATION CItECKLIST Do you have or need the following, before applying? Bosrd of Health 4 sets of Building Plans Planning Board approval Survey. Check Septic Foma N¥SDEC. Flood Permil Mail to: OCT 1 b 2012 BLl}6 DEPt T0'¢¢~' OF SOUIHOLD APPLICATION FOR BI.lit,DING PERMIT INSTRUCTIONS a This application MUST be completely filled in by typewriter or i'~ ink and submined to the Building Inspector with 4 sets ofplat~, accurale plot plan to scale Fee according to schedule b. Plot plan showing location of lot and o f buildings on premises, relationship m adjoining premises or public streets or ;treas, and waterways c The work covered by this application may net be commenced belbre issuance of Building permit. d. Upon apploval 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 threu~'chom tho work e. No building shall be occupied or used in whole or in part lbr any purpose what so ever unlil the Building Inspector issues a Certificate of Occupancy. £ Every building pem~it shall expire if the work authorized has not coh'~menced w/thin 12 months after the date of issuance or has nol been completed wilhin t8 months flora secl~ date. If po zothng 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 q IS HEREBY MADE to the Building Depatlment for the issuarme ora Building Permit pursuant to the ,fthe Tovm of Sonthold. Suffolk Counly, New York, and other applicable Laws, Ordinances or additions, o herein descfibefl The and to admit · a and in buildin[ State whether applicant is owner, lessee, agent, architect, engineer, general contractol r or builder on the ro, o/', tcsl aeed i f ~pfi.~ant i;s a cor.~,,~.ati~?n, signature of dub. ~thorized officer t // //// / ,.-..-- ,_...- . Builders License No. Pluml~rs Licen~ No. '2~ Electricians License No~" Other Trade's License No. ~r~ c~ g~_ ~_~' I. Locatlon of lane on whlch peoposed work ,viii be dpnc;/7 /~ tlouse ~ umoer btrect t~,~l'?Map~o. 1000 Section fliP/. Block ':~ Lot '"7, ~' /! Subdivision Filed Map No. Lot 2. State existing use and oe. cupancy o£j~c)~.~mjlsp a~d~d~ ~ and~a~ o~p~oposed conslmction: a. Existing use ~d occup~cy ~~_ 3. Nature of work (check which applicable): New Building Additioa AIt~mtion Repair~ Removal Demolition Other Work ~r~/~ ~~ (To be paid on filing this appli~tion) 5.Iflfdwelling' numb~ of~tSgarage, numbers ~~fdwelling units on each fl~r ~ ~ 6. lfbus~ess, com~;}~orm~xed~cup~cy, s~c,~namreandextentofeachtypeoruse~~__ ¢ ' F t ~ ~ar~''''' ~~ 7. Dimensions ofexisting structures, ifany: rea y~' ~l~pth Height. Number of Stories ~. w,t, Depth ~ ,/ Height / V // Numb~ori~ Height ~ /~ N~bYr of~todes ~ 9. Size of lot: From Rear ~pth_ 10. Date of Purchase Name of Former Owner l I. Zone or use district in which premises a,e situated ~ 2 )ocs proposed constrt c on v o a c any zoning law ordinance or regulatlon?'YES__.~_. 13. Will lot be re-graded? YES {~ Will excess fill be removed fromm premisgs~° YES. NO,.,. '4. Names o f Owner o f premis:2t~/.~ ~:>/~~~~ ~._ 15 a. Is thls property wlthin i 00 feet of a tidal wetland or a freshwater wetland? *YES -//~/ ~' - * [F YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUI~,'/?TD.~'''>--- ~ / ~ ~'~ b. is this property within 300 Feet ora 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. lfeievation at any point on property is at 10 feet or below, must provide topographical dam on survey. 18. Are there m~y covenants and restrictions with rcspec: to this property? * YES · IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUN"I'Y OF /--O/$ ~__ being duly sworn, deposes and says thal (s)he i$ the applicant (Name ofindividu~ si~ing ~tmct) above n~ed, (S)Hc is t~_ O~Mg~ (Contractor, Agc~t, Co~a~c O~ccr, crc ) of said o~cr or o~ers. ~d is duly authorized m ~rform or have per fo~ed the said work ~d Io make ~d file ~ application; fl~at afi Aatements coat,ned in this ~plication ~e ~e to ~ b~l of his ~owiedge md ~lie f; and ~at the wo~ will be perf~ in the m~er set rouh m the application filed therewith. N0a~Public, S~td of New York Ouallfl~ in Na~u ~un~ R~, No. 01M~795921 _ Tow~ Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 Telephone (631) 765-1802 ro,qer.r chert~-~,~own sout~ol~d ny us BUILDING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: CompanyName: Name: Date: - /O License No.: Address: Phone No.: JOBSITE INFORMA.TION: (*Indicates required information) ,,'7 - *Address: ~./Z'~ 7 g-- -'~z¢~-'~ ~ / ~ ~ /~-~//f 7/' *Cross Street: ~e~,"~3 ~ ' ' / *Phone No.: ~.~/- ~/- ~ / ~ ~ Permit No.: ~ ~ ~ Tax Map District: 1000 Section: /~/. Block: ~ Lot: /~S ~ ~ PdntClearly) /] r,] , (Please Circle All That Apply) *Is job ready for inspection: *Do you need a Temp Certificate: Temp Information (If needed] *Service Size: 1 Phase *New Service: Re-connect Additional Information: 0 YES/~--~ Rough In Final 3Phase 100 150 200 300 350 400 Other Underground Number of Meters Change of Service Overhead 82-Request for Inspection Form Town Hall Annex 54375 Main Road P.O. Box I 179 Southold~ NY 11971-0959 Telephone (631) 765 1802 Fax (63 I) 765-9502 BUILDING DEPARTMENT TOWN OF' SOUTHOLD December 7, 2012 Southold Prof Offices, LLC 128 Vanderbilt Ave Manhasset, NY 11030 Re: 54075 Route 25, Southold TO WHOM IT MAY CONCERN: The Following Items Are Needed To Complete Your Certificate of Occupancy: __ Application for Certificate of Occupancy. (Enclosed) ~//' Electrical Underwriters Certificate. (contact yogr electrician) __ AfeeofS50.00. __ Final Health Department Approval. __ Plumbers Solder Certificate. (All permits involving plumbing after 4/1184) __ Trustees Certificate of Compliance. (Town Trustees # 765-1892) __ Final Planning Board Approval. (Planning # 765-1938) __ Final Fire Inspection from Fire Marshall. __ Final Landmark Preservation approval. __ Final inspection by Building Dept BUILDING PERMIT: 37597 - Furnace and Hot Water Heater APPROVE~D AS NOTED 765-1802 8 AM TO 4 PM FOR THE FOLLOVVING INSPECTIONS: 1 FOUNDATION- TWO REQUIRED FOR POURED CONCRETE 2. ROUGH- FRAMING, PLUMBING, STRAPPING, ELECTRICAL & CAULKING 3 INSULATION 4 FINAL-CONSTRUCTION & ELECTRICAL MUST BE COMPLETE FOR CO. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. ELECTRICAL INSPECTION REQUIRED ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY PLUMBER CERTIFICA TIOI~ ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPAI',IC Y SOLDER USED IN WA TEF~ SUPPLY SYSTEM CANNOT EXCEED 2/10 OF 1% LEAD. PLUMBING ALL PLUMBING WASTE & WATER LINES NEED TESTING BEFORE COVERING , TP. ANE TUC1 D120-SU B-1B TAG: 24-1/2" 23-1/4" 5/8" 28-1/2" Upflow/Horizontal Condensing Gas Furnace Single Stage TUC1 D120A9601A 2" DIAMETER FLUE CONNECT 7/8" DIA. HOLES ELECTRICAL., CONNECTION 1-1/2" DIA. HOLE -- GAS CONNECTION 2-15/16" 7/8" DIA. K.O. ELECTRICAL (ALTERNATE) 7/8" DIA. K.O. SUPPLY (ALTERNATE) 3/4" 1-1~2" DIA. K.O. GAS CONNECTION (ALTERNATE) CONDENSATE DRAIN - Alternate 24-1/32" 1-7/8" X 7/8" SLOT K.O. CONDENSATE DRAIN (FOR HORIZONTAL) FURNACE AIRFLOW (CFM) VS. EXTERNAL STATIC PRESSURE (INS. w.g.', MODEL SPEEDTAP 0.10 0.20 0.30 0.40 0.50 0.60 0.70 0.80 0.90 TUClD120A9601A 4- HIGH-Black 2454 2406 2358 2310 2261 2184 2106 2017 1928 3- MED.-HIGH-Blue 2105 2092 2078 2045 2012 1950 1887 1826 1765 2 - MED.-LOW-Yellow 1747 1742 1736 1720 1703 1677 1651 1593 1535 1 - LOW- Red 1448 1447 1449 1440 1430 1400 1369 1325 1280 © 2011 Trane CFM VS. TEMPERATURE RISE MODEL TUCl D120A9601A Cubic Feet Per Minute (CFM) 1600 1700 18001190012000 210012200 63595653504846 07/11 General Data TYPE Upflow/Horizontal RATINGS ~ Input BTUH 120,000 Capacity BTUH (ICS) ® 113,000 AFUE 92.1 Temp. rise (Min.-Max.) °E 40 - 70 BLOWER DRIVE DIRECT Diameter-Width (In.) 11 x 10 No. Used 1 Speeds (No.) 4 CFM vs. in. w.g. See Fan Performance Motor HP 3/4 R.RM. 1100 Volts/Ph/Hz 115/1/60 COMBUSTION FAN ~ Type Centrifugal Drive - No. Speeds Direct - 1 Motor HP - RPM 1/20- 3450 Volts/Ph/Hz 115/1/60 EL. Amps 0.71 FILTER -- Furnished? No Type Recommended High Velocity Hi VeL(No.-Size-Thk.) 1 - 24 x 25 - lin. Central Furnace heating designs are certified to ANSI Z21.47 / CSA 2.3. VENT COLLAR -- Size (In.) HEAT EXCHANGER Type-Fired -Unfired Gau[le (Fired) 3 Round Alum. Steel 2O ORIFICES -- Main Nat. Gas. Qty. -- Drill Size L.R Gas Qty. -- Drill Size 6--45 6 -- 56 GAS VALVE PILOT SAFETY DEVICE Type BURNERS --Type Number POWER CONN.--V/PIVHz ~ Ampacity (In Amps) Max. Overcurrent Protection (amps) PIPE CONN. SIZE (IN,) DIMENSIONS Crated (In.) Uncrate~ (In.I WEIGHT Shipping (Lbs.)/NBt (Lbs) Redundant - Sin,qle Staqe Hot Sur/ace I~nition Multiport Inshot 6 115/1/60 13.9 HxWxD 3/4 x 26-1/2 x 30-1/2 40 x 24-1/2 x 28 205 / 193 Ratings shown are lot elevations up to 2000 feet. For elevations above 2C00 feet; Ratings should be reduced al the ra~e of 4% for each 1000 feet above sea level. Based on U.S. Government Standard Tests. The above wiring specifications are in accordance with National Electrical Code; however, installations mus~ comply with local codes. Mechanical Specifications NATURALGAS MODELS--Central heat- ing furnace designs are certified to ANSI Z2.1.47 / CSA 2.3 for both natural aRd LP. gas. Limit setting and rating data were established and approved under standard rating conditions using American National Standards Institute standards. SAFE OPERATION --The Integrated System Control has solid state devices, which continuously monitor for presence of flame, when the system is in the heat- ing mode of operation. Slow opening, dual solenoid combination gas valve and regulator provide extra safety and quieter operation. QUICK HEATING-- Durable, cycle tested, heavy gauge aluminized steel heat ex- changer and stainless steel secondary heat exchanger quickly transfer over 90% of the heat to provide warm conditioned air to the structure. Low energy power vent blower, to increase efficiency and provide a positive discharge of gas fumes to the outside. BURNERS -- Multi-port, in-shot burners will give years of quiet and efficient service. All models can be converted to L.P. gas without changing burners. INTEGRATED SYSTEM CONTROL-- Exclusively designed operational program provides total control of furnace limit sen- sors, blowers, gas valve, flame control and includes self diagnostics for ease of service. The built-in, selectable "Cooling Fan Off" feature provides time-delay capability like a BAY24X045 Time-Delay Kit for cooling operation. Also contains connection points for E.A.C./humidifier. AIR DELIVERY --The multispeed, direct- drive blower motor, with sufficient airflow range for most heating and cooling require- ments, will switch from heating to cooling speeds on demand from room thermostat. The blower door safety switch will prevent or terminate furnace operation when the blower door is removed. (Fan relay and 35VA control transformer is standard). STYLING -- Heavy gauge steel and "wraparound" cabinet construction is used in the cabinet with baked-on enamel finish for strength and beauty. The heat ex- changer section of the cabinet iscompletely lined with foil-faced fiberglass insulation. This results in quiet and efficient operation due to the excellent acoustical and insulat- ing qualities of fiberglass. FEATURES AND GENERAL OPERA- TION--These High Efficiency, Direct Vent, Condensing Gas Furnaces employ s Hot Surface Ignition system, which eliminates the waste of a constantly burning pilot. They are convertibre for HORIZONTAL use by rotating the unit to its left side. The integrated system control lights the main burners upon a demand for heat from the room thermostat. Complete front service access. a. Low energy power venter. b. Vent proving differential switch. Technical Literature - Printed in U.S.A. 6200 Troup Highway Tyler, TX 75707 c T us MA~ .... ' ............. Pau~ A. C'~initi & Shirley C~initi & Irwin R. Kaplan & Ceil Kaplan /