HomeMy WebLinkAbout41224-Z 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.NorthForlk net PERMIT NO. 1 1'LCheck
Septic Form
N.Y.S.D.E.C.
Trustees
C.O.Application
Flood Permit
Examined 20 Single&Separate
Storm-Water Assessment Form
_...
Approved a �� ,20 i�7 , r �. Matl to
Disapproved a/c �'�, �", � oZ
Phone: t
Expiration 20
Building I specter-
PLICATION FOR BUILDING PERMIT
DEC„ [j Date , ,&
INSTRUCTIONS
a.ThlgWV3&AiVM be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
sets of plaMOMMON§D' a:le.Fee wording 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 applicant or name,if a corporation)
9
"ailing address dfapplicant)
Lagen�itect,
State whether applicant is owner,less engineer,general contractor,electrician,plumber or builder
Name of owner of premises A�.VC, '
(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 Nit,
Plumbers License No. 315f61--1-V--+>
Electricians License No.
Other Trade's License Na.
1. Location f land on which propos;d work will be done:
House Number
M
r Street � Hamlet
County Tax Map No. 1000 Section 3S Block Lot
Subdivision Filed Map No. Lot
2° State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a° Existing use and occupancy
b. Intended use and occupancy
3. Nature of word cheep which applicable): Building uild:ing-Other Addition.
r �4�a f Ater tib} W� �
Repair Removal Demolition
p
4. EstimatedFee
Cost (._. ��a
(Description)
(Tea 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,s cify nature and extent of each type of
7. Dimensions ofexisting structures,if any:Front Rear Depth
Height_ erof Stories—
Dimensions of same structure
Depth Height
alterations r additions: rout Rear
umb r of Stories
8. Height Number
io of tire new cons ction:Front Rear Depth
of Stories
9° Size of lot.Front Rear Depth
0°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 orregulation?YES NO
13.Will lot-be re-graded? S NO ill excess fill be removed from promises? NO
14.Names of Owner of premises Address Phone No.
Name ofArchitect A ess Phone No
Name of Contractor address 'Phone No.
15 a,Is this property within.100 feet of a tidal wetland or a freshwater wetland?*YES—NO
F YES,SOUTHOLD TOWN TRUSTEES D.E.C.PERMITS MAY BE REQUIRED.
b.Is this property within 300 feet of a tidal,well d?* S 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 respect to this property? S Nt3
*IF YES,PROVIDE A COPS`,
STATE OF NEW YORK)
SS:
COUNTY Cll��
being duly swom,deposes and says that(s)he is the applicant
�E'�I
(N eofindiv l signing cot)above named,
(S)He is the
(Contractor,A.gent,Pbrporate 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 mariner set forth in the application filed therewith.
Sworn to Wore arae this
20 A- ��" d
day of �
P e
°
Notary Public Signature of Applicant
tf S'0i
Town Hall Annex Telephone(631)765-1802
54375 Main Road 0311 765- 54 2
P.O.Box 1179 rc er.richeirt �b&'s li��c .n y.us f
Southold,NSC 11971-0959
I
BURD
ING DEPARTNENT
TOWNOFSOUTHOLD
APPILICATION FOR ELECTRICAL. INSPECTION
REQUESTED BY: Date'
Company Name_ ,
Name:
License No.: ,,.
s
I
Address: n -
Phone NoLill . µ
-,323
JOBSITE INFORMATION: (*Indicates required information)
e r
*Name:
*Address:
*Cross Street:
*Phone No.:
Permit No.:
Tax-Map District: 1000 Section: Bock: Lot: Z
*BRIEF DESCRIPTION OF WORK(Please Print Clearly) µ
L
�m
(Please Circle All That ply)
*Is job ready for inspection: YES/ NO Rough In Final f
*Do-you need a Temp Certificate: YES/ NO
Temp Info (If needed)
*Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other
*New Service: Re-connect Underground Number of Meters Change of Service Overhead
Additional Information: PAYMENT DDF W1 H APPLICATION
82-Request for E
nspection Form65
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GENERAC
GUARDIAN@ SERIES I
.0'122 k,W
Residential Standby Generators
Air-Cooled Gas Engine
1 !
INCLUDES: Standby IF:1ower Rating
• True Power" Electrical Technology Models D06459 0, 006461 0, 000402.0 (Steer ... Bisque) ... 15 kW 60 I....iz
• Two Line LCD Multilingual [Digital Model 006721 .0 (A,ft...inilm.ini Gray) - 10 kW 60 Hz
Evolution" Controller (English/Spanish/ Models 006729-0, 006730-0 (Steal Bisque) 20 kW 60 Hz
French/Portuguese) Models els 006551 .0, 005552-0 (AlLtirnlriLJrfl- Gray) 22 k'VV 00 &Iz
• Two Transfer Switch Options Available:
100 Amp Pre-Wired Switch or
.200 Amp Smart Switch.
See Page 4 for Details,
• Electronic Governor
• External Main Circuit Breaker, System Status &
Maintenance Interval LE® Indicators
• GFCI Culex Outlet
• Sound Attenuated Enclosure
• Flexible Fuel Line ConnectorJ
• Composite Mounting Pad
• Natural Gas or LP Gas Operation C(S)US
• 5 Year Limited Warranty USTED QUIEHESF
• Capability to be installed within 18" (457 m1m)
Note:CUL certification only applies to unbundled units and units packaged with pre-wired switches.
of a building* Units packaged with the Smart Switch are UL certified in the USA only.
*Only if located away from doors,windows and fresh air intakes,and unless otherwise directed by local codes.
FEATURES
O INNOVATIVE D I PROTOTYPE TESTI G are key components O SOLID-STATE, E COMPENSATED VOLTAGE REGULATION.
of GENERAC'S success in "IMPROVING POWER BY DESIGN." But it This state-of-the-art power maximizing regulation system is standard on
doesn't stop there. Total commitment to component testing,reliability all Generac models. It provides optimized FAST RESPONSE to changing
testing,environmental testing,destruction and life testing,plus testing load conditions and MAXIMUM MOTOR STARTING CAPABILITY by
to applicable CSA, NEMA,EGSA,and other standards,allows you to electronically torque-matching the surge loads to the engine. Digital
choose GENERAC POWER SYSTEMS with the confidence that these voltage regulation at:±1%.
systems will provide superior performance.
O TUE PO ET' ELECTRICAL TECHNOLOGY: Superior harmonics O SINGLE SOURCE SERVICE RESPONSE from Generac's extensive dealer
and sine wave form produce less than 5% Total Harmonic Distortion for network provides parts and service know-how for the entire unit,from the
utility quality power. This allows confident operation of sensitive electronic engine to the smallest electronic component.
equipment and micro-chip based appliances, such as variable speed HVAC
systems.
O GEINERAC 1f'Ir�ANSFIER SWITCHES. Long life and relhabiillkty are
O TEST CRITERIA: syncrryrrfous Mth OENi::EPAC POWER SYSTEMS, Orree reason for fflis
PROTOTYPE TESTED NEMA MG1-22 EVALUATIDN confidertce is tliat the GI:::NIERAC product line includes its own transfer
SYSTEM TORSIONAL TESTED MOTOR STARTING ABILITY systems alid coir*Us for total system compalibiliity.
GENERACr> A"
rDm';r
16/20/22 kW specifications
7�n�erat®rMM� mm. v� �� wrvWww � rvrvrv �� �
Model 00645", 461 , 62- ON72",ON730-0, 006551-0,005552-0
0,006721-0(16 k (20 k (22 W)
Rated Mayinnum Continuous Power Capacity(LP) 16.000 Watts' 20,000 Wafts' 22,000 Watts'
Rated Maximum Continuous Power Capacity(NG) 16,000 Watts" 18,000 Watts" 19,;500 W'alts`
Rated Voltage 240 240 24d' '
Rated Maximum Continuous Load Current—240 Volts(LP/NG) 66.6/66.6 83.3fd5 91.6181.13
Tonal Harmonic Distortion Lem than 5% Less than 5% Less to 5
Main Line Circuit Breaker 65 Amp 90 Amp 100 Amp
Phase 1 1 1
Number of Rotor Poles 2 2 2'
Rated AC Frequency 60 H2 60 H2 60 RZ,
Power Factor 1.0 1.0 1.0
Battery Requirement(not included) Group 26R,12 Volts and 525 CCA Minimum
Unit Weight(lb/kg) 513/232.7(Steel); 516/234.1 526/238.6
448/203.2(Aluminum)
Dimensions(L x W x H)in/mm 48 x 25 x 29/1218 x 638 x 732
Sound output in dB(A)at 23 ft(7 m)with generator operating at normal load*" 66 66 67
Sound outprut 1n dB(A)at 23 ft(7 m}with generator in Quiet-Test's lowi-speed
60 60 58
exercise mode—
Exercise duration 5 min 5 min 5 ruin;
Engine ,� w
Type of Engine GEPtERAC OHVI VTWIN GENERAC 0144 V-'fiMN GE]"kERAC o t/f V-T'MN
Number of Cylinders 2 2 2
Displacement 992 po 999 cA]�
Cylinder Block Aluminum w/Cast lrun Sleeve
Valve Arrangement . _. overhead Valve Cvorbesid Volvo _._ -- flint ted Vattie
Ignition System solid}-stale wt'Magneto Solid Mate w/Magneto So]id-state w/Magneto
Governor System Ef ctfohjcc SCe000mc. 19e rorric
Compression Ratio 9;6;1 9.5.1 9,51
Startert 2 Vr(o 12 Vile 12 n/tic
Oil Capacity Including Fitter Approx.1,9 gV1,8 L Appror; q.9 qVI 8 L Approx,IA gV'1.8 L
Operating rpm 3„6009 3,600 3,600
Fuel Consumption
Natural Gas fta/hr(ma/hr)
1/2 Load 193(5.47) 205(5.8) 184(5.21)
Full Load 312(8.83) 308(8.72) 281 (7.96)
Liquid Propane 0/hr(gal/hr)[I/hr]
1/2 Load 72.4(1.99)[7.53] 75.6(2.08)[7,87] 83(2.16)[8.16]
Full Load 130(3.57)[13.53] 140(3.85)[14.57] 127(3.68)[13.99]
Vc,Fospipe)
gust be sized Mr W JvaA PoWfed Suell rwasswo to vni k Wo a0 al)Wd r s,3..r,-7*waler cell (7-13 mw mer )for nalolW gas,1D-12” tercolic (13-22 rrVra
maercrpry)for LP gas.For'Stu content,rnufllpl+y 9t3/ha x 2500(LP)or ff Arta x't 000(NGf.For Mega]oute content,multiply rn3/hr x 93,15(IP)or m9/hr x 3726(NG)
Controls ��� awawwaPoPo��w� M��
24 inn Plain Text Multilingual LCD Display Slnrl)le;user interface for'eme of operallon.
Mode Buttons: Auto Autornatic S':art On Litilily tailure..7 Slay exerciser.
rknual Start with starter control,unit slays on.If utility fails,trrsrrsPer to load falces place,
Off Stops unit,Power i,removed.Control arid charger still Operate,
Ready Po Rr.oNMarnierrance.Messages Standard
Ergine Run I lours Indir.,alion Standard
Prograrnma.blc start delay beiwreen 2..:1 500 serxlnds Stanrlard(proggianmable by deal'o-ar Only)
UtilityVoliags;msss/Retl.m to Utility Adjustable(13townitur Setting) Fmfn'140-171 V/190-216 V
RAure,S'd C�.tpra.bde.ExerristT/Exeraise Set Errol Wiarninr., Standard
Run/Alami/Malntenanc,e Logs 50 Events I':':ari'r
Enitine Stall Sequence Cyclic cranking:16 sec on,7 rest(90 ser rnaximurn duralion).
131srtlar Lock-out S[hlter cannot re-e-Igalge until 5 sac atter rrtgine,ilas r,mpped,
rmirt Battery CI'terQer Sl.andaroi
(:halrgei f ault/Missing AC Wanninq Standard
Unit Baftpry/Braltery Prohle:rn Protert'ion and Battery Cond'it'ion Indicrahon Standard
A.fl:omalic Voltage Re,gulat.ion with Over and Under Vollagc,Protection Standard
Under-Freaguenry/Overload�'I:el:vper DiDrcurrerrt Poatectiurr Standard
Safety Fused/Fuse Pioblern I:'nat:ection Sta'adaid
Autornatfc Low Oil Pressum/ii"iigh Oil Ternpaeratu.are Shutdown Slarr(larri
Overcmnk/Crrcrsp eed 1@ 72i%/rIpSense,Loss Shutdown Standard
I Ilgh Engire,lempeyature Shutdown Standard
eternal FaulVlrlcorrecl:Wiring Protection Standard
DYTIM n Dderrial Fault Cal:labiBily Standard
Field Upgradable Forrelvar¢ laridard
"Sound levels are taken from the front orr the generator.,'.3ound levels taken frorn Mier sides of the grneratar may tw higher depending Oft'it)S llaoDr!parameters.Mix definition s-Slandby:Aptrlicable dor.supplying errrergency prier far IN duration
nC 1he.Lftly Inas cx1f age..No overbad u4mbilityr is available for Iris Dating, (All r.1.irrogs br acrrxdaria::rMith N'Ri514,4503046 and nrN6271),."Maximum wattage and current Sae suabjecl to and lin'frecl by Bhr/rnegajoula conlent,
arnbient lenapera4.ire,altitude,engine power and rondifion,etc.,,hAaArnum power decreases abfliA 3..5 per avit tur each 4,000 leer.Q304 8 rneiers)akioue=oi limit and also twill decrease atiout 1 percenB lar ear fi s"G Ila T)aline 16'(;(Cin i),
16/20/22 kW available accessories
et aenrWiw
Generac's Mobile Link allows you to check the status of your generator from anywhere that you have
006463-1 Mobile Link— access to an Internet connection from a PC or with any smart device.You will even be notified when a
change in the generator's status occurs via e-mail or text message.
005819-0 26R Wet Cell Battery Every standby generator requires a battery to start the system.Generac offers the recommended 26R
wet cell battery for use with all air-cooled standby product(excluding PowerPact@).
If the temperature regularly falls below 32°F(0°C),a cold weather kit is required to maintain optimal
006212-0 Cold Weather Kit battery and oil temperatures.Kit consists of a battery warmer and oil filter heater with built-in
thermostats.
005621-0 Auxiliary Transfer Switch Contact The auxiliary transfer switch contact kit allows the transfer switch to lock out a single large electrical
Kit load you may not need.Not compatible with 50 amp pre-wired switches.
005839-0-Bisque Fascia Base Wrap Kit* The fascia base wrap snaps together around the bottom of the new air cooled generators.This offers
005666-0-Gray (Standard on 22 kW) a sleek,contoured appearance as well as offering protection from rodents and insects by covering the
lifting holes located in the base.
005703-0-Bisque If the generator enclosure is scratched or damaged,it is important to touch-up the paint to protect
005704-0-Gray Paint Kit* from future corrosion.The paint kit includes the necessary paint to property maintain or touch-up a
generator enclosure.
006484-0-16 kW Scheduled Maintenance Kit Generac's scheduled maintenance kits provide all the hardware necessary to perform complete
006485-0-20&22 kW routine maintenance on a Generac automatic standby generator.
Completely wireless and battery powered,Generac's wireless remote monitor provides you with
006664-0 Wireless Remote Monitor instant status information without ever leaving the house.Not compatible with CorePower or EcoGen
systems.
The PMM Starter Kit consists of a 24 VAC,field installed transformer that enables the use of the 24
006199-0 PMM Starter Kit VAC Power Management Modules(P Ms)and one PMM.The standard controller(without starter kit)
can control two HVAC loads with no additional hardware.Not compatible with pre-wired switches.
Power Management Module(50 Power Management Modules are used in conjunction whh the Smart Switch to increase its power
006186-0 Amps) management capabilities.It gives the Smart Switch additional power management flexibility not found
in any other transfer switch.Not compatible with pre-wired switches.Note:PMM Starter Kit required.
*Note:Bisque kits are used in conjunction with steel enclosures.Gray kits are used in conjunction with aluminum enclosures.
dimensions & PCs
Dimensions shown are approArnate. Refer to installation manual for exact dimensions. DO NOT USE_THESE DIMENSIONS FOR iNSTALiAnON PURPOSES.
637.6 men
1218
2�m �mm Y mm
[47.9 in]
. �. ._..Y Model UPC
006459-0 696471064599
rQ 0064610 696471064612
° 006721-0 696471067217
7;114_9 mm
[26.6 in] 006729-0 696471067293
I
006730-0 696471067309
�� j °I006552-0 6964/1065527
G, 006551-0 696471065510
t„MOM
.r,� , ry
. a06462- 471064
696
629
--�.642 mm..................................
[25.3 in] 1226?rrer'r
LEFT SIDE VIEW FRONT VIEW
Generac Power Systems,Inc. ® S45 W29290 HWY59, Waukesha,WI 53189 m generac.co
00-00101011M 02014 Generac Power Systems,Inc. AN rights reserved. All specifications are subject to change without notice. Bulletin OK8458-D Prinked in U.S.A.06/19(14