HomeMy WebLinkAbout43096-Z p1pSagF�t�.COG Town of Southold 10/25/2018
3 s P.O.Box 1179
co. Fft
53095 Main Rd
O4,1 �ap� Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39994 Date: 10/25/2018
THIS CERTIFIES that the building GENERATOR
Location of Property: 470 Goose Creek Ln, Southold
SCTM#: 473889 Sec/Block/Lot: 79.-1-5
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
9/25/2018 pursuant to which Building Permit No. 43096 dated 10/3/2018
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:
ACCESSORY GENERATOR AS APPLIED FOR
The certificate is issued to Rubinstein,Richard&Alice
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 43096 10-18-2018
PLUMBERS CERTIFICATION DATED
Authorized Signature
y TOWN OF SOUTHOLD
�gUFFO(
BUILDING DEPARTMENT
y TOWN CLERK'S OFFICE
oy . SOUTHOLD, NY
.jj�l � Sao
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#: 43096 Date: 10/3/2018
Permission is hereby granted to:
Rubinstein, Richard &Alice
27 W 55th St Apt 71
New York, NY 10019
To: install generator as applied for.
At premises located at:
470 Goose Creek Ln, Southold
SCTM # 473889
Sec/Block/Lot# 79.-1-5
Pursuant to application dated 9/25/2018 and approved by the Building Inspector.
To expire on 4/3/2020.
Fees:
ACCESSORY $100.00
ELECTRIC $85.00
CO -RESIDENTIAL $50.00
Total: $235.00
OL
B f ing 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$11c5.00 jai
Date. t)l 1�
New Construction: Old or Pre-existing Building: ®® (check one)
Location of Property: �� C � L.5 � lj
House No. f� Street Hamlet
Owner or Owners of Property: R,&w-0
Suffolk County Tax Map No 1000, Section Block Lot GS
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:'
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $
Applicant Signature
�o�'I r'if SO!lr�ol
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 G Q
Southold,NY 11971-0959 �O • �o roper.riche rtl town.south old.ny.us
Cnii '
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Rubinstein
Address: 470 Goose Creek Ln City: Southold St. New York Zip: 11971
Building Permit#• 43096 Section 79 Block 1 Lot: 5
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
[Contractor, home owner DBA: License No:
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service Only
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks
Disconnect Switches Twist Lock Exit Fixtures TVSS
Other Equipment. 11 KW standby generator, 100a sub panel
Notes:
Inspector Signature: Date: October 18 2018
81-Cert Electrical Compliance Form xis
�o��OE SO(/lyO6
# TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
,.
[ ] FOUNDATION 1ST [ ] ROUGH PLEIG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ) ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
DATE r C INSPECTOR�
FIELD INSPECTION REPORT7 DATE COMMENTS
b
FOUNDATION (1ST)
--------------------------------------
'FOUNDATION (2ND)
' O
C
ROUGH FRAMING&
PLUMBING
INSULATION PER N.Y.
STATE ENERGY CODE
FINAL
ADDITIONAL COMMENTS
0
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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
Southoldtownny.gov PERMIT NO. t (l Check
Septic Form
N.Y.S.D.E.C.
Trustees
C.O.Application
Flood Permit
Examined 3 ,20 Single&Separate
Truss Identification Form
Storm-Water Assessment Form
I Contact:
Approved ,20 Mail to:
Disapproved a/c
Phone:
x
SEP 2 5 2018 BM' dm pector
APPLICATION FOR BUILDING PERMIT
BUILDINGI"It r�9
TOWN OF SOUS z A,-'D Date a, , 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 bekept 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)
O 60 L W
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
1
Name of owner of premises PC-
(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. ^
1. Location of land'on'which 'roposed work will bedone:
House Number Street Hamlet
County Tax Map No. 1000 Section Block ` Lot O'
r'
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 �
438 C) A
b. Intended use and occupancy
3. Nature of work(check which applicable):New Building Addition Alteration
Repair Removal Demolition Other Work clewgQ4%�— 11 �
(Description)
4. Estimated Cost Q� 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.
7. Dimensions of existing structures, if any: Front C40 5� Rear Si Depth (all
Height Number of Stories
' i
Dimensions of same structure with alterations or additions: Front 3 �- Rear'
Depth Height Number of Storie �s4 C�.rrl �
8. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories
yr
9. Size of lot: Front Rear 1 a Depth L� y
t:a
10. Date of Purchase s2bi-7 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 Address Phone No.
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 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
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 wo#1RIJbET 418 application;
that all statements contained in this application are true to the best of his knowledge and WK pai ji#at Aja b qW }oe
performed in the manner set forth in the application filed therewith. No.01 f,' :6224291
Qualified in Suffolk County
Sworn to before me thi My Commission Expires.lune 28,20°Zy
day of e7a&11-20 (0 n
Notary Public Signature of Applicant
BUILDING DEPARTMENT - Electrical r
TOWN OF SOUTHOLD D �tFg0 V
DD
Town Hall Annex - 54375 Main Road - Box 1179
o Southold, New York 11971- SEP 2 5 2018
y �lp� Telephone (631) 765-1802 - FAX (631) 765-9502
c roger richert(cD_town.southold.ny.us rITU "NCDr
,To
Tem WN Oa+'SGUTE[CLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED-BY: � " - - Date: �1
Company Name:
Name:
License No.: email:
Address:
Phone No.:
JOB SITE INFORMATION: (All Information Required)
Name:
Address: GGQ%,z 0-OALYL
Cross Street: o9
Phone No.:
Bldg.Permit email: =
Tax Map District: 1000 Section: Block: Lot:
BRIEF DESCRIPTION OF WORK (Please Print Clearly)
Circle All That Apply:
Is job ready for inspection?: YES / NO Rough In Final
Do you need a Temp Certificate?: YES / NO Issued On
Temp Information: (All information required)
Service Size 1 Ph 3 Ph Size: A # Meters Old Meter#
New Service - Fire Reconnect-Flood Reconnect- Service Reconnected - Underground - Overhead
# Underground Laterals 1 2 H Frame Pole Work done on Service? Y N
Additional-Information:
PAYMENT DUE WITH APPLICATION
Request for Inspection FormAs �/
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APPR VEDAS NOTED
DATE: A
B.P:I
FEE: BY: I RETAIN STORM WATER RUNOFF
NOTIFY BUILDING DEPAR TAT PURSUANT TO CHAPTER 236
70-1802 8 AM TO 4 PM FOR THE OF THE TOWN CODE.
FOLLOWING INSPECTIONS:
I. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW ELECTRICAL
YORK STATE. NOT RESPONSIBLE FOR INSPECTION REQUIREDDESIGN OR CONSTRUCTION ERRORS.
COMPLY WITH ALL CODES OF
NEW YORK STATE & TOWN CODES
AS REQUIRED AND CONDITIONS OF
-SB�kl1 r)70JrJCN MA
RD
SebTW)tDTOWNMTEES
.S.DEC
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
.A
9-22 kW GUARDIAN SERIES
AUTOMATIC HOME STANDBY GENERATORSt
SPECIFICATIONS (LP/NG)
Generator Only Model 7029 7031 7035 7038 7042
7030 7032 7036
Generator/Prewired Switch Model 100 Amp 100 Amp 100 Amp n/a n/a
Switch Switch Switch
Generator/200 Amp Service Rated Load n/a 7033 7037 7039 7043
Shedding Smart Switch Package Model#
Voltage(Single Phase) 240V
Amps®240V LPG 37.5 45.83 66.66 83.33 91.66
Amps @ 240V NG 33.3 41.66 66.6 75 81.25
al ,
Engine/Alternator RPM 3600/3600
Engine Generac G-Force
• Engine Displacement 426cc 530cc 999cc 999cc 999cc
Fuel Consumption @ 1/2 Load
NG cu.ft/hr 78 124 193 205 184
t
Fuel Consumption®Full Load
" 121 195 312 308 281
F NG cu.ft/hr
Fuel Consumption @ 1/2 Load 36(1.00) 42.8(l.18) 690.9) 81 (2.23) 78(2.16)
{s LPG cu.ft(hr(gal/hr)
Fuel Consumption @ Full Load 54(1.50) 73(2.01) 116(3.19) 140(3.85) 134(3.68)
t LPG cu.fVhr(gal/hr)
` st Quiet-Test Mode No Yes
db(A)at Exercise 62 63 60 • 60 58
db(A)at Normal Operating Load 62 63 66 66 67
Enclosure Aluminum
s¢ Enclosure Color Bisque
i?r
Warranty 5-Year Limited
Dimensions(L'x W'x H") 48 x 25 x 29
Weight(lbs.)(SteeVAluminum) 399 407 419 456 476
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