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HomeMy WebLinkAbout39174-Z Town of Southold Annex 9/29/2014 o� P.O.Box 1179 � z f 54375 Main Road Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 37178 Date: 9/29/2014 THIS CERTIFIES that the building EXHAUST HOOD AND/OR FIRE SUPRESSION SYSTEM Location of Property: 170 Love Ln, Mattituck, SCTM#: 473889 Sec/Block/Lot: 140.-3-42.4 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore Sled in this officed dated 8/26/2014 pursuant to which Building Permit No. 39174 dated 9/11/2014 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: Fire Supression System in an existing commercial building_. The certificate is issued to Persevera Holdings LLC (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Authorized Signature x ' TOWN OF SOUTHOLD � x * BUILDING DEPARTMENT TOWN CLERK'S OFFICE 'a • { 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#: 39174 Date: 9/11/2014 Permission is hereby granted to: Persevera Holdings LLC 332 Bleecker St F48 New York, NY 10014 To: install a Fire Supression System in an existing commercial building ®fi At premises located at: 170 Love Ln, Mattituck SCTM #473889 Sec/Block/Lot# 140.-3-42.4 Pursuant to application dated 8/26/2014 and approved by the Building Inspector. To expire on 3/12/2016. Fees: COMMERCIAL ADDITION/ALTERATION $250.00 CO -COMMERCIAL $50.00 Total: $300.00 `f Building Inspector 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 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. 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 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$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. 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. New Construction: Old or Pre-existing Building: (check one) Location of Property: House No. Street Hamlet Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Block Lot Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (chec one) Fee Submitted: $ Applicant Signa ure i OF SOUlyO \`</ `6 7 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLUMBING [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ FINAL [ ] FIREPLACE A CHIMNEY FIRE AFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [r 11 FI ESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REI)MARKS:-LL L�� i--I)�_-04- DATE _2Sr INSPECTOR r FIELD INSPEqXON REPORT DATE COMMENTS EOUNDArtION(IST) J rrrrrMrwnr7rwrrrrrrrrrrrwrr _ R FOUNDATION(2ND) x . ROUGH FI AAMC& y PLUMBING c, TNSUL•ATION PER N.Y. �- H STATE ENERGY CODE n . Y FINAL ADDITIONAL,d6 S c r . 1 O TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD,NY 11971 4 sets of Building Plans TEL:(631)765-1802 Planning Board approval FAX:(631)765-9502 Survey SoutholdTown.Norffork.net PERMIT NO. 7 _ Check Septic Form j N.Y.S.D.E.C. Trustees C.O.Application i f Flood Permit Examined / 20 Single&Separate Stoma-Water Assessment Form / Contact: Approved ,20 Mail to: niPhone:Building Inspector APPLICATION FOR BUILDING PERMIT Date ��( ,20�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 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 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. (Signature of applican or name,if a corporation) g o n4e� 49W 5401'Q I) (Marling address of icwt) State whether applicant is owner,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder Iq Name of owner of premises `e r S'e4-y`'C 0 l VLC,S (As on the tax rol r latest dee If applicant is a corporation,signature of duly authorized officer FI R E I N q P E CTI ON ' (Name and title of corporate officer) R ECS V!R E D B E FORE..--� i--, Builders License No. OPENING Plumbers License No. F L' _B' Electricians License No. NOTIFY BUILDING EPARTMENT AT Other Trade's License No. 765-1802 8 AM TO 4 PM FOR THE 1. Location FOLLOWING INSPECTIONS: of land on which proposed work will be done: � UNDATION-TWO REQUIRED House Number Street Hamlet CRETE 2. RO G F ING,PLUMBING, County Tax Map No. 1000 Section �YD Block J Lot FT I ECTRICAL & Cr•')LKHNG 4 ^LE E FOR C.O. ALL CONSTRUCTION SHALL MEET THE PEOOPFnIFNTS OF THE CODES OF NEW 3I; ;E. N01'iiESPONSIBLE FOR w DESIGN OR CONSTRUCTION ERRORS Subdivision Filed Map No. Lot 2. State existing use and occupancy of pregijses apd tended 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 Addition Alteration Repair Removal Demolition Other Work rn / 0 o (Descri tion) 4. Estimated Cost Fee (To be paid on filing this application) 5. If dwelling,number of dwelling units Number of dwelling units on each floor If garage, number of cars 6. If business,commercial or mixed occupancy,specify nature and extent of each type of use. A 7. 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 Rear Depth Height Number of Stories 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 12.Does proposed construction violate any zoning law,ordinance or regulation?YES_NO 13.Will lot be re-graded?YES_NO Will 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 Q r,,2e Address W rVWJPhone No. — 0 15 a.Is this property within 100 feet of a tidal wetland or a freshwate 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 *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 LA Lk- _being duly sworn,deposes and says that(s)he is the applicant (Name of r ii signing contract)above named, (S)He is the qm�4c (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. Swom to before me thi day of 20 Notary Public it VICKI TOTH Notary Public`0619State of New York No.010696 Qualified in Suffolk Countpp J Commission Roires July?8 1 - 7 TOWN OF SOUTHOLD ROPERTY RECORD CARD /Vo , - YA A 1*4 D STREET VILLAGE ®IST. ' SUB. LOT tt ,€ FORMER OWNER M,< " . c,0141 4 E ACR. J t, ? 13 + 1 t yQ / S W TYPE OF BUILDING ' SFAS. VL- FARM comm. / B. MICS. Mkt. Value2vz RES. ✓ LAND IMP. TOTAL DATE REMARKS f 'G� ` + � -t ; ° tl j , '„? //a 3 r, v ,rsr��1�; ) docs Al 3 QQ c V17 - "A F3 . Ca b4 v ??,°/..w.sl.' a , / % c. r¢,s 3 3 I t -IJ&b&-"<9C>!54 , 33 (n z I- + 7 24-# 9 I 1... 11 -2>t7y( J4ru-) u r^ '0rNz) c'�+ flz) � 17 Q� • Q - , � I o�` �rus �rdxl towel 2 1 b Iv� 3521? -y-e-v la us gP-'233IS o -L_ l 21A1 - ot�rauit�n�n 1-70 eve 176vl” Tillable fRONT Gf ON WATER Woodland FRONTAGE ON ROAD Meoclawkind DEPTH House Pim BULKHEAD z1 12,131p1 '.-j 76 LW c-ft t 1J Total A _ ,two r SN I NEI IR r w ` 10. ■■Ii■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■s■■■r�■■■■■■■■■■■■■■■■■■■■■■ Basement Interior Finish Rooms 1st Floor R f Recreation _• • R•• # , y •• • •• IF.r Yl I --11611OP ID:KL '4oRv. , CERTIFICATE OF LIABILITY INSURANCE X081 ` ,4„ 2014 TANS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO MGM UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: N the eertlNeats hokNr le an ADDITIONAL INSURED,the policy(in)must be endorsed. 9 SUBROGATION W WANED,subject to the terms and conditlons of the Policy,c tain policies may n luire an endoro n ent. A statet on this cerNNeats does not Nonfor rWft to the certiticats holder in Neu of such s. PRODUCER Phone:631-58841CONTACT Hometown Insurance of U,Inc Weber ,�sncy Fax:631-588-01 N, 6 OrviNeA Drive Suits 400 BotwRIK NY q1716 Diane Setter WWI .ANDER-1 AFNrorwING cxArERAoe NANc N< INSURED Suffolk Fire,Inc.DRA I CURE R A:Arch Insurance Co. ArMerson Fire Equipment Inc. 9 O'Neil Avenue I • Bay Shore,NY 11706 INSURER 0: INSURER E: COVERAGES CERTIFICATE FABER: REVISION NUAABER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING 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 THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN N MAY HAVE BEEN REDUCED BY PAID CLAIMS. III=- RUM 11UMIt TYPE OF INSURANCE POLICY Pw NUMBER LRBTa GENERAL LIABILITY EACH OCCURRENCE $ 1,000, A X COMMERCIAL GENERAL LIABILITY MFPK06312109 04PA 2014 OVW"15 CLAMAB-mDE OCCURt 00,004 MED EXP tkn ons pw•on) $ 5,004 X BLANKET ADDL INSO PERSONAL s AM 94JURY $ 1,000 00 ML001900 0806 GENERAL AGGREGATE $ 21000 GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG S 2,000r X POLICY PRO- LOC t AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ; ANY AUTO (En accident BODILY INJURY(Par person) $ ALL OWNED AUTOS BODILY WARY(Per modderk) S SCHEDULED AUTOS PROPERTY DAMAGE _ HIRED AUTOS (per aocidwd) NON-OWMED AUTOS i S UMBRELLA LIRE OCCUR EACH OCCURRENCE i EXCESS LAM CLAIMS-MADE AGGREGATE i DEDUCTIBLE $ RETENTION i WORUERB COMPENSATION WIC STATU- TH AND EMPLOYERS'LIABI ITY Y I N ANY PROPMETORIPARTNERIEXECUTIVE N/A E.L.EACH ACCIDENT WMi OFFICEEMBER EXCLUDED? M �in E.L.DISEASE-EA EMPLOYE S S UrMwwmERA IONS below E.L.DISEASE-POLICY LINT t DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ANaeh ACORD 101,AdMonM Reawks 8dwdPMe,I om"we 4 Proof of Insurance CERTIFICATE HOLDER CANCELLATION TOW O14 SHOULD ANY OF THE ABOVE DESCRIBM POLICIES BE CANCELLED BEFORE Town of Southold THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVER® IN 54375 Route 25 ACCORDANCE WITH THE POLICY PROVISIONS. P.O.Box 1169 AUTHOP&M REPRESENTATIVE Southold,NY 11871 / _ 0111�9a8-2009 ACORD CORPORATION. AN right ro"mod. ACORD 25(2009109) The ACORD name and logo are regiebr*d marks of ACORD New York State Insurance Fund Workers'Compensation&Disability Benefits Specialists Since 1914 8 CORPORATE CENTER DR,3RD FLR,MELVILLE,NEW YORK 11747-3129 Phone:(631)7564300 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ^^^^"A 112195449 SUFFOLK FIRE INC T/A ANDERSON FIRE EQUIPMENT CO 9 ONEIL AVE BAY SHORE NY 11706 POLICYHOLDER CERTIFICATE HOLDER SUFFOLK FIRE INC T/A TOWN OF SOUTHOLD ANDERSON FIRE EQUIPMENT CO 54375 ROUTE 25 9 ONEIL AVE PO BOX 1169 BAY SHORE NY 11706 – --- SOUTHOLD NY 11971 j POLICY NUMBER CERTIFICATE NUMBER PERIOD COVERED BY THIS CERTIFICATE--jDATE 1723 238-2 — 107699 �_ 10/29/2013 TO 10/29/20154/21/2014 l THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 723 238-2 UNTIL 10/29/2015, 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. IF SAID POLICY IS CANCELLED,OR CHANGED PRIOR TO 10/29/2015 IN SUCH MANNER AS TO AFFECT THIS CERTIFICATE, 30 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. THIS POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION. PATRICK TURRO(PRESIDENT)OF A ONE PERSON CORPORATION THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS 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 FUND DIRECTOR,INSURANCE FUND UNDERWRITING This certificate can be validated on our web site at https://www.nysif.com/cert/certval.asp or by calling(888)875-5790 VALIDATION NUMBER: 372084864 U-26.3 STATE OF NEW, YORK WORKERT COMPENSATION BOARD CERTIFICATE OF INSURANCE COVERAGE UNDER THE NYS DISABILITY BENEFITS LAW PART I. To be completed Disability Benefits Carrier or Lkensed Insurance Agent of that Carrier Ia. Legal Nam and Address of Insured(Use street address wily) lb. Business Telephone Ntunber of Irmuvd SUFFOLK FIRE INC (631) 665-6862 dba ANDERSON FIRE EQUIPTMENT lc.NYS Unemployment Insivalxe Einployer Registration 9 ONEI LL AVE Number of Insured BAY SHORE, NY 11706 Id.Federal Euiployer Identification Ntunber of Insured or Social Sec uity Nutuber 113-26-8460 2. Name and Address of the Entity Requesting Proof of 3a.Natne of Insurance Carrier Coverage(Entity Being Listed as the Certificate Holder) NEW YORK STATE INSURANCE FUND Town of Southold 54375 Route 25 3b.Policy Number of entity listed in box"la": PO Box 1169 DBL 5853 65 - 1 Southold, NY 11971 3c.Policy effective period: 10/02/2013 to 10/02/2014 4.Policy covers: a. ® All of the employer's enlplo}gees eligible tutder the New York-Disability Benefits Law b. 0 Only the following class or classes of the employer's tnwkyees: Under penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance carrier referenced abotc and that the reamed inured has NYS Disability Benefits insurance coverage as described above. Date Sighed 04/21/2014 By, �' �"r Joseph J. Masi (Sigratun of mann n=ca rd@es authorized npraaartativa of AM Ucarsed i rstaa rna Aprd of ttv t irsuno m rvii ar) TelephowNiunber (866) 697-4332 Title Director of Disability Benefits Insurance DIPORTA M, If lox"4a"is checked,aid this fount is siltaed by the iisunwce carTwes audio ized nepresenwre or Ott"S Licensed Instaaace Agent of ekai cattier.this ceniticate is CObePLETE. %fait it direaly to due certificate bolder. 1f box'4b-is checked.dais cettificaee is NOT COIMIPLETE for putposes of Section 22o.Sakid.S of eke Disability Benefits Law. It inose be hailed for coutpletioi to the Workers Compensation Board.DB Plans Accepuice Untie.20 Park Sates.Al wwy.New fork 12207. PART 2.To be complewd by NYS Worterilongwnsat on&mrd(Only If box"4b" art 1 his-Nm— ) State Of New York Workers'Compensation Board According to mformatiar maintained by the NYS Workers'Compensation Board,the above-named employer has complied witb the NYS Disability Benefits Law with respect to all of his-lier employees. Date Signed By (Sipaatttre ofN'Y$Worker'Conipeasittion Hoard Employee) Telephone Ntunber Title Please Note:Only insinuce carriers licensed to write NYS disability benefits instua we policies and NYS licensed insurance agents of those insurance carriers are authorized to issue Fonn DB-124.1. Insurance brokers are NOT authorized to issue this farm. DB-120.1(546) Certificate Number 258585 SUFFOLK COUNTY DEPARTMENT OF FIRE, RESCUE AND EMERGENCY SERVICES PORTABLE FIRE EXTINGUISHER AND AUTOMATIC FIRE EXTINGUISHING SYSTEMS LICENSING BOARD CERTIFICATE OF REGISTRATION REGISTRATION #: 113 EFFECTIVE DATE: 01/31/13 EXPIRATION DATE: 1/31/15 ISSUED TO: NAME: Suffolk Fire, Inc. dba Anderson Fire Equipment ADDRESS: 9 O'Neil Avenue Bay Shore, NY 117,06 ENDORSEMENTS: Portable Fire Extinguishers High Pressure Hydrostatic Testing DryWeet Chemical Extinguishing Systems This Certificate of Registration Does Not Exclusively Recommend the Bearer C rISSIO�NER CHIEF FIRE RSHAL BADGER Certificate of Completion This is to certify that Paul Turro An employee of Anderson Fire Equipment, Bay Shore, NY, USA an AUTHORIZED BADGER DISTRIBUTOR has successfully completed a certification training session covering design, installation, operation and maintenance and has demonstrated a practical knowledge of following Badger systems/products: Industry Guard Dry Chemical Fire Suppression System Credit: , Issue Date: 04/02/2014 Expiration Date: 04/01/2017 Chris M. Hopwood,Technical Training Manager Certificate No: 52912 This certificate is nontransferable. Certificate is only valid as long as the above named company employs the certified individual. Acceptance of this certificate implies agreement to abide by the terms of distributor agreement by the above named company and individual. Any violation or alteration of this certificate will result in the immediate voiding of this certificate. �d x M*w b M to hModtp so*11 -1•-tr' Y okn mdm x FK RAIM WWI-2 His I NEW WCHEN Iwo*WAS _t Nae shod) _a . 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X RG 6 GAL. SEAL TIGHTS (TYP.) Piping Material BLACK SCH 40 Max. Rise 12' "x Y" TEE Supply Pipe Size 3/4" Branch Pipe Size 1 2" DROPS 3/8" 14"x12" DUCT 14'x12 DUCT Gas Valve Type: MECH Size 2" Manufacturer ASCO VENT PLUG 14' HOOD DP AD DP AD Detector Temperature Rating: 360' & 450' t Hood Size: 14'_ Duct Size: (2) 14"X12" CONTROL 360' 16a — — — 360' — 450' 50' 360' EQUIPMENT QTY SURFACE TIP#/OTY NOZZLE LOCATIONS HEAD ADP — — — — — — — ADP TYPE AREA HEIGHTS J _ DUCT 2 14"X12" ADP 4 0"-6" 0"-6" IN OPENING PLENUM 1 14 FT. ADP 2 0"-6" FROM END OF PLENUM TILT SKILLET 1 48"x24" F 2 27.5"-46" MID POINT OF HAZARD AIM CTR. 6.0 I I I I I 6 BURNER RANGE 1 36"x27" R 2 20"-42" CENTER GAL. ♦ ♦ ♦ RAD. GRILL 1 36"x24" GRW 2 24"-48" 45' TO 90' F F R R GRW GRW F R � I FRYER 1 14"x23" F 1 27.5"-45" 45' TO 90' —FRYER CANDY STOVE 1 18"x18" R 1 20"-42" CENTER GUARDS PULL 6" o — STATION Of Q 36CD X "x27" 36"x24" � m .MIN. TO EDGE RANGE GUARD - RG 6.0 GALLON - MAX. FLOW POINTS = 18 2" GAS 48"x24" L- d OF HOOD ON 6 BURNER RADIANT Of CANDY POINTS USED = 17 VALVE TILT SKILLET BOTH SIDES RANGE GRILL N STOVE TOTAL PIPE VOLUME NOT TO EXCEED 400 CUBIC INCHES L — — MAX. PIPE LENGHT 75 FT. RG-6.0 GAL. CYLINDER,: #60-120005-001 R NOZZLE #87-120014-001 DISCHARGE ADPT. KIT #83-844908-000 LINK HOUSING #804548 VENT PLUG #9196984 MANUAL RELEASE #8875572 A FIRE EXTINGUISHER SHELF BRACKET #100013 360' LINK #WK-282664-000 WITH A MINIMUM RATING CONTROL HEAD (UCH) #B120099 450' LINK #WK-282663-000 FRONT VIEW OF CLASS K MUST BE DUAL SPOT #919723 2" GAS VALVE #8120075 SCALE:%$"-1'-0" INSTALLED WITHIN THE ADP NOZZLE #87-120011-001 VICINITY OF THE F NOZZLE #87-120012-001 COOKING AREA. GRW NOZZLE #87-120013-001 SUM STAMP NOTES: Anderson Fire x Fryers to have High Limit Control to shut off fuel at 425'. 9 O'Neil Ave., Bay Shore, N.Y. 11706 x Detectors shall be located over every piece of equipment. x The System installed as per manufacturers specs and the AHJ. Tel: 631-435-1002 x The System has been installed as per UL300. x The following functions to operate upon system discharge: Contact: Patrick Turro * Supply air Damper closes * Gas fuel shuts off in kitchen S ENC(yE * Exhaust furl remains on * Electric fuel shut off under hood * All systems to activate simultaneously in some hazard area. PEGASUS ENGINEERING * Fire Alarm shall activate if one is installed in building. x Manual Pull is located a maximum 20 ft. from hood and 4 ft. = 6 Nodworny Lone, Stony Brook, N.Y. 11790-2100 from floor. PLANNING A BETTER WORLD x All fuel sources are GAS unless otherwise noted. 631-751-6600 WWW.PEGASUS.ENG.PRO UNAUTHORIZED ALTERATION OF, OR THE ADDITION SEAk JOB SITE: TO PLANS OR DOCUMENTS BEARING THE SEAL ',S) OF A LICENSED PROFESSIONAL ENGINEER IS A VIOLATION OF SECTION 7209, SUBDIVISION 2 OF Lombardi's Market THE NEW YORK STATE EDUCATION IAW. v r ^ I s ANY ALTERATION TO THIS DOCUMENT MUST BE DONE BY A PERSON ACTING UNDER THE DIRECT ,2 � I 170 Love Lane, Mattituck,N.Y. 11952 SUPERVISION OF A LICENSED PROFESSIONAL IN ACCORDANCE WITH THE STATE EDUCATION LAW. COPIES OF THIS DOCUMENT NOT MARKED WITH '�•.�- ._T(1- AN ORIGINAL OF THE PROFESSIONAL ENGINEERS -- INKED OR EMBOSSED SEAL SHALL NOT BE '--� DATE: SCALE: DWG BY: DWG N0: CONSIDERED TO 15F VALID TRUE COPIES. — 08/21/14 AS SHOWN A.X.C. 1 System Design 3-4.4 14 in. a 14 in. (986 mm a 356 mm) Deep Fat Fryer Table 3-5. F Nozzle Coverage Area Items Parameters Maximum Hazard Area 14 in.x 14 in. (356 mm x 356 mm) Maximum Appliance Area(with drip board) 14 in.x 24-1/2 in. (356 mm x 622 mm) Nozzle Aim Midpoint of hazard area Nozzle Location(from top of appliance at an angle of 45°or more 27-1/2 in. (686 mm)Min. from the horizontal) 45 in. 0143 mm)Max. AN F NOZZLE MAY BE LOCATED ANYWHERE WITHIN THE GRID AN F NOZZLE MAYBE LOCATED ANYWHERE 45 In.(1143 mm) WITHIN THE GRID MAX DIAGONAL FROM AIM POINT i i 45 In.((1114 mm) 45 In.(1143 mm) MAX 4 R NOZZLE LOCATION ^E 45°OR MORE FROM HORIZONTAL It ` MIDPOINT OF 27-1/2 in. HAZARD AREA (699 mm)MIN AIM POINT: MIDPOINT OF HAZARD AREA 14 in.(356 mm) MAX 24-1/2 in. HAZARD AREA (622 mm)MAX DRIP BOARD DRIP BOARD 14 in.(356 mm)E 24-112 in.(622 mm)MAX. �-- 14 in.(358 mm)MAX ---► APPLIANCE AREA FRONT VIEW SIDE VIEW Figure 3-5. 14 in. x 14 in. (356 nun x 356 nun)Deep Fat Fryer P/N 60-9127100-000 3-9 April 2009 System Design 3-4.9 Four Burner Ranges Table 3-13. R Nozzle Coverage Area—Four Burner Range Items Parameters Maximum Hazard Area 28 in.x 28 in. (711 mm x 711 mm) Nozzle Aim Midpoint of Hazard Area Nozzle Location—Anywhere within the area of a circle 20 in. (508 mm)Min. generated by a 9 in. (229 mm)radius about the midpoint 42 in. (1067 mm)Max. Note: Shape of burner not important. 18 in.(457 mm)DIA. I I 42 In.(1067 mm)MAX. I (FROM TOP OF RANGE) I I A'R'NOZZLE MAY BE LOCATED ANYWHERE WITHIN THE SHADED AREA I I 20 In.(508 mm)MIN. _ AIM POINT:MIDPOINT OF (FROM TOP OF HAZARD AREA RANGE) 28 in.(711 mm) 14 In.(356 mm)MAX. MAX.HAZARD BURNER CENTERLINE AREA LENGTH i TO CENTERLINE 14 in.(356 mm)MAX. BURNER CENTERLINE TO CENTERLINE 28 in.(711 mm)MAX. HAZARD AREA WIDTH Figure 3-10. R Nozzle Coverage for a 4-Burner Range P/N 60-9127100-000 3-15 April 2009 System Design 3-4.10 Two Burner Ranges Table 3-14. R Nozzle Coverage Area—Two Burner Range Items Parameters Maximum Hazard Length 28 in. (711 mm) Nozzle Aim Midpoint of hazard area Nozzle Location-Anywhere within the area of a circle 20 in. (508 mm)Min. generated by a 9 in. (229 mm)radius about the midpoint 42 in. (1067 mm)Max. Note: Shape of burner not important. I 18 In.(457 mm)DIA. I — 42 in.(1067 mm)MAX. I (FROM TOP OF RANGE) I A'R'NOZZLE MAY BE I LOCATED ANYWHERE WITHIN I THE SHADED AREA i 1 I I I 20 In.(508 mm)MIN. AIM POINT:MIDPOINT OF (FROM TOP ; HAZARD AREA OF RANGE) 28 In.(711 mm)MAX.AREA 14 in. 356 mm MAX.BURNER HAZARDLENGTH CENTERLINE TO CENTERLINE Figure 3-11. R Nozzle Coverage for a 2-Burner Range April 2009 3-16 P/N 60-9127100-000 System Design 3-4.11 Single Burner Range Table 3-15. R Nozzle Coverage Area—Single Burner Range Items Parameters Nozzle Aim 7 in. (178 mm)from center of burner Nozzle Location—Anywhere within the area of a circle 20 in. (508 mm)Min. generated by a 9 in. (229 mm)radius about the aim 42 in. (1067 mm)Max. point. Note: Shape of burner not important. 18 in.(457 mm)DIA. 42 in.(1067 mm)MAX. (FROM TOP OF RANGE) i A'R'NOZZLE MAY BE LOCATED ANYWHERE WITHIN THE SHADED AREA 20 In.(508 mm)MIN. — AIM POINT (FROM TOP OF RANGE) 7 in.(178 mm)FROM BURNER CENTERLINE TO AIM POINT CENTERLINE Figure 3-12. R Nozzle Coverage for a 1-Burner Range P/N 60-9127100-000 3-17 April 2009 System Design 3-4.15 Gas Radiant/Electric Charbroiler Table 3-21. GRW Nozzle Coverage Area Items Parameters Maximum Cooking Surface 21 in.x 24 in. (533 mm to 610 mm) Nozzle Aim Midpoint of the hazard area above cooking surface Nozzle Location(located at an angle of 450 or more from 24 in. (610 mm)Min. the horizontal) 48 in.(1219 mm)Max. A GRW NOZZLE MAY BE LOCATED ANYWHERE WITHIN THE GRID 48 in.(1219 mm) DIAGONAL FROM MAX AIM POINT 481n.(1219 mm) 48 In.(1219 mm) MAX. A GRW NOZZLE MAYBE LOCATED ANYWHERE WITHIN THE GRID t i i i 24 in.(610 mm) AIM POINT:MIDPOINT MAX OF HAZARD AREA NOZZLE LOCATION FFA 45'OR MORE FROM q 1 HORIZONTAL E ` N 21 In.(533 mm) AIM POINT: MIDPOINT OF MAX. HAZARD AREA I(/ RADIANT LAYER GAS FLAME 21 in.(533 mm)MAX. �-- -- 24 in.(610 mm) APPLIANCE AREA MAX. SIDE VIEW FRONT VIEW Figure 3-17. Gas Radiant/Electric Charbroiler April 2009 3-22 PM 60-9127100-000 System Design 3-4.22 Tilt SkilletS (Braising Pans) Table 3-28. F Nozzle Coverage Area Items Parameters Maximum Hazard Area 24 in.x 24 in. (610 mm x 610 mm) Nozzle Aim Midpoint of hazard area and placed so it does not Interfere with appliance operation Nozzle Location—At the front perimeter line of the 27-1/2 in. (699 mm)Min. appliance 46 1n. (1168 mm)Max. Note:Appliance cover cannot interfere with distribution of agent from the nozzle. F NOZZLE COVER MUST NOT INTERFERE WITH EDGE OF / 1 DISCHARGE PATTERN � / I i j I � I i � / I � / I � I i � / I � I � / 1 � 1/• I ' 1 CENTERLINE OF HAZARD ZONE THE NOZZLE IS TO BE PLACED TOWARD THE FRONT OF THE APPLIANCE TO MINIMIZE THE POTENTIAL FOR THE SKILLET OR BRAISING PAN COVER TO INTERFERE WITH THE NOZZLE DISCHARGE. Figure 3-24. Tilt Skillet(Braising Pan) P/N 60-9127100-000 3-29 April 2009 System Design 3-6 VENTILATION 3-6.1 Plenums Table 3-29. Plenum Protection Items Parameters ADP Nozzle No Filter 1 10 ft.x 4 ft. (3 m x 1.2 m)Max. 1 -located at one end of the plenum W"Filter 10 ft.x 4 ft. (3 m x 1.2 m) 1 -located at one end of the plenum 20 ft.x 4 ft. (6 m x 1.2 m) 2-located at end of plenum pointing inwards Single Bank Filter 10 ft.x 4 ft. (3 m x 1.2 m) 1 -located at one end of the plenum 20 ft.x 4 ft. (6 m x 1.2 m) 2-located at end of plenum pointing inwards 1 When no filters are present,the nozzle protecting the plenum is used to discharge the wet chemical on the under- side of the hood.In this case, the hood may not exceed a length of 10 ft. (3 m)or a width of 4 ft. (1.2 m). Plenums larger than 10 ft. (3.0 m)x 4 ft. (1.2 m)may be protected by adding additional ADP nozzles for each additional 10 ft. (3.0 m)of plenum length and each additional 4ft. (1.2 m) of plenum width. Nozzles may be installed pointing in the same direction, and/or at the ends of the plenum pointing toward each other (see Figure 3-28).Each nozzle will provide coverage for a maximum of 10 ft. (3 m) of plenum length and 4 ft. (1.2 m) of plenum width. ADP nozzles must be centrally located in the plenum with their discharge directed along the length of the plenum and located in relation to the filters as shown in Figure 3-28.Refer to Figure 3-28 for filter height. P/N 60-9127100-000 3-33 April 2009 System Design 3-6.1.1.2 Ducts 50 to 100 inches in Perimeter Two ADP nozzles, P/N 87-120011-001, pointing in the same direction are required for protection of ducts with perimeters greater than 50 inches and less than or equal to 100 inches. Ducts can be of unlimited length (refer to Figure 3-30). For other option of ducts up to 75 perimeter inches (See Figure 3-32). Note: All Range Guard systems are listed by UL and ULC for use with the exhaust fan either on or off when the system is discharged. DUCT HOOD If X X '/4X'/2X- /4,♦X /2' %d Y2d MAX.DIAMETER 31.83 in.(809 mm) X NOZZLES TO BE ALONG ONE 25 in.(635 mm) CENTERLINE AT THE 114 POINTS. MAX.SIDE' , ♦ F ♦ ♦ NOZZLES TO BE 0-6 in.(0-152 mm) Y UP FROM ENTRANCE OF VERTICAL DUCT MAX.DIAGONAL 11.78 in.(300 mm) MAX.DIAGONAL n'P(2)ADP NOZZLES 11.78 In.(300 mm) SQUARE RECTANGULAR ROUND Tc ADP NOZZLE 0 to 6 in. L to 152 mm) 1 . DUCT ENTRANCE Pc OF VERTICAL DUCT � i - - - - Tc OF HORIZONTAL DUCT � 2-4 In.(51 mm-102 mm) ADP NOZZLEi L�� AIM POINT NOZZLE TIP TO DUCT HIP VERTICAL/HORIZONTAL DUCT Figure 3-30. Duct Protection Using Two ADP Nozzles, P/N 87-120011-001 April 2009 3-36 P/N 60-9127100-000 AES MANUFACTURER: SEAL TIGHTS (TYP.) RANGE GUARD: _ISG 1.25 GAL. _RG 2.5 GAL. _RG 4 GAL. X RG 6 GAL. Piping Material BLACK SCH 40 Max. Rise 12' "x Y" TEE 14"x12" DUCT 14"x12' DUCT 2Supply Pipe Size 3 4" Branch Pipe Size 1 " DROPS 3/8" Gas Valve Type: _MECH Size 2" Manufacturer ASCO VENT PLUG 14' HOOD ADPADP ADPADP Detector Temperature Rating: 360' & 450' 1 ( ) T � Hood Size: 14' Duct Size: 2 14"X12" „ CONTROL 360' 360' 360' 450' 50' 360' EQUIPMENT SURFACE NOZZLE I HEAD — — — — — - — — — — — — — — — — � -j QTY. TIP#�OTY. LOCATIONS ADP ADP TYPE AREA HEIGHTS DUCT 2 14"X 12" ADP 4 0"-6" 0"-6" IN OPENING I I I PLENUM 1 14 FT. ADP 2 0"-6" FROM END OF PLENUM RG I I I I I TILT SKILLET 1 48"x24" F 2 27.5"-46" MID POINT OF HAZARD AIM CTR. 6.0 6 BURNER RANGE 1 36"x27" R 2 20"-42" CENTER I GAL. F F R R GRW GRW F R RAD. GRILL 1 36"x24" GRW 2 1 24"-48" 45' TO 90' FRYER 1 14"x23" F 1 27.5"-45" 45' TO 90' — FRYER CANDY STOVE 1 18"x18" R 1 20"-42" CENTER , I GUARDS PULL 6" - — STATION C.0 C) w I Q 36"x27" m MIN. TO EDGE 2" GAS 48'x24" 36'x24' 18'x 18' RANGE GUARD - RG 6.0 GALLON - MAX. FLOW POINTS = 18 M OF HOOD ON 6 BURNER RADIANT - iz CANDY POINTS USED = 17 VALVE TILT SKILLET RANGE BOTH SIDES L — GRILL N STOVE TOTAL PIPE VOLUME NOT TO EXCEED 400 CUBIC INCHES — MAX. PIPE LENGHT 75 FT. RG-6.0 GAL. CYLINDER #60-120005-001 R NOZZLE #87-120014-001 DISCHARGE ADPT. KIT #83-844908-000 LINK HOUSING #804548 VENT PLUG #9196984 MANUAL RELEASE #B875572 A FIRE EXTINGUISHER SHELF BRACKET #100013 360' LINK #WK-282664-000 WITH A MINIMUM RATING CONTROL HEAD (UCH) #8120099 450' LINK #WK-282663-000 FRONT VIEW OF CLASS K MUST BE DUAL SPDT #919723 2" GAS VALVE #B120075 SCALE:Y8"=1'-0" INSTALLED WITHIN THE ADP NOZZLE #87-120011-001 VICINITY OF THE F NOZZLE #87-120012-001 COOKING AREA. GRW NOZZLE #87-120013-001 SUM STAMP NOTES: Anderson Fire x Fryers to have High Limit Control to shut off fuel at 425'. 9 O'Neil Ave., Bay Shore, N.Y. 11706 x Detectors sholl be located over every piece of equipment. x The System installed as per manufacturers specs and the AHJ. Tel: 631-435-1002 x The System has been installed as per UL300. x The following functions to operate upon system discharge: Contact: Patrick Turro * Supply air damper closes * Gas fuel shuts off in kitchen * Exhaust fan remains on * Electric fuel shut off under hood Q oP s ENCIN Eeprc * All systems to activate simultaneously in same hazard area. PEGASUS ENGINEERING * Fire Alarm shall activate if one is installed in building. x Manual Pull is located a maximum 20 ft. from hood and 4 ft. y 6 Nodworny Lone, Stony Brook, N.Y. 11790-2100 from floor. PLANNING A BETTER WORLD x All fuel sources are GAS unless otherwise noted. # - � � 631-751-6600 WWW.PEGASUS.ENG.PRO SEAL UNAUTHORIZED ALTERATION OF, OR THE ADDITION B SITE: TO PLANS OR DOCUMENTS BEARING THE SEAL OFA LICENSED PROFESSIONAL ENGINEER ISA ' Gefi ' _r, , VIOLATION OF SECTIONSUBDIVISION 2 OF - i'�.s Lombardi's Market THE NEW YORK SFATE EDUCATION LAW. ANY ALTERATION TO THIS DOCUMENT MUST BE DONE BY A PERSON ACTING UNDER THE DIRECT 170 Love Lane, Mattituck, N.Y. 11952 SUPERVISION OF A LICENSED PROFESSIONAL ACCORDANCE WITPr THE STATE EDUCATION LAW. �����,� O"(i'��•'� � r' 'I COPIES OF THIS DOCUMENT NOT MARKED WITH `. t,•j _. ;i:' AN ORIGINAL OF THE PROFESSIONAL ENGINEERS _ DATE: T CALE: DWG BY: DWG NO: INKED OR EMBOSSED SEAL SHALL NOT BE —� 08/2114 AS SHOWN A.X.C. 1 CONSIDERED TO BE VALID TRUE COPIES.