HomeMy WebLinkAbout43100-Z Town of Southold 11/29/2018
. P.O.Box 1179
53095 Main Rd
# .�e! Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40075 Date: 11/29/2018
THIS CERTIFIES that the building GENERATOR
Location of Property: 990 Bridge Ln, Cutchogue
SCTM#: 473889 Sec/Block/Lot: 97.-1-17
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. 43100 dated 10/5/2018
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 Modjeski, Lara&Westphal,Arthur
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 43100 11-27-2018
PLUMBERS CERTIFICATION DATED
Authorized Signature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
'� • +�} SOUTHOLD, NY
i'
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#: 43100 Date: 10/5/2018
Permission is hereby granted to:
Modjeski, Lara &Westphal, Arthur
29 Skyline Dr
Warren, NJ 07059
To: install generator as applied for.
At premises located at:
990 Bridge Ln, Cutchogue
SCTM # 473889
Sec/Block/Lot# 97.-1-17
Pursuant to application dated 9/25/2018 and approved by the Building Inspector.
To expire on 4/5/2020.
Fees:
ACCESSORY $100.00
ELECTRIC $85.00
CO -RESIDENTIAL $50.00
Total: $235.00
nspector
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. 641dr 61 26)9
New Construction: ,, Old or Pre-existing Building: 'Uz"� r (check one) {�
Location of Property: qqV -� ,e L� Cs ���U£ 1"c lag
House No. Street Hamlet
Owner or Owners of Property: A, L''le_-syn�N
Suffolk County Tax Map No 1000, Section (2"7 Block Q Lot 17)
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval: /
Request for: Temporary *Cate Final Certificate: y (check one)
Fee Submitted: $
Applicant Signature
pF SO!/jyOlo
Town Hall Annex Telephone(631)76.5-1802
5437.5 Main Road Fax(631)765-9.502
P.O.Box 1179 G Q
Southold,NY 11971-0959 • �o roger.riche rttc�town.southold.ny.us
'
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Arthur Westphal
Address. 990 Bridge Ln City Cutchogue St: New York Zip 11935
Building Permit#- 43100 Section: 97 Block: 1 Lot: 17
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 X 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 FixtureTime Clocks
Disconnect Switches Twist Lock Exit Fixtures TVSS 11
Other Equipment: 16 KW standby generator with 200a transfer switch
Notes.
Inspector Signature: Date: November 27 2018
81-Cert Electrical Compliance Form.xls
OF SOUIyo�
# TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] 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 �� �� INSPECTOR '�
FIELD INSPECTION REPORT DATE COMMENTS
• b
FOUNDATION (1ST)
H
------------------------------------
C
'FOUNDATION (2ND)
z
0
G
i
ROUGH FRAMING& y
PLUMBING -•�
INSULATION PER N.Y:
y
STATE ENERGY CODE
FINAL
ADDITION CO NTS
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aid
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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
South oldtownny.gov PERMIT NO. � Check
Septic Form
N.Y.S.D.E.C.-
Trustees
C.O.Application
6
Examined19 Flood Permit
=,20 Single&Separate
Truss Identification.Form
Storm-Water Assessment Form
/' rQ Contact:
Approved J 20
Mail to:
Disapproved a/c
Phone:-
xpiration 20
P
D nspector
APPLICATION FOR BUILDING PERMIT
Date 1 , 20L,9
TOWN OF SOL 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
sial I 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 tho 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,housingcode, and regulations, and to admit
authorized inspectors on premises and in building for necessary inspections.
(Signature of applicant or name,if a corporation)
AJO
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises_N?r e �p�+4,'� .}� L_0�ct Mod
(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 proposed work will bed ne:
�C Ae- L-n/ aSw-F--
House Number Street Hamlet
County Tax Map No. 1000 Section _Block 01 Lot tI
—
i
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy S►AdwC USS
b. Intended use and occupancy S(4 - UI&F
3. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work. Lj f3eoeewv—
� (Description)
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.
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
. l
8. Dimensions of entire new construction: Front Rear Depth
Height :Number of Stories .
p
9. Size of lot: Front l s.� Rear 000 ' De th 3151
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 X
13. Will lot be re-graded? YES NO�C Will excess fill be.removed.from premises? YES NO )k
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—N
* 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 work and to make and file this application;
that all statements contained in this application are true to the best of his knowledge B et.a1ftiD hh%LD)rk wi 11 be
performed in the manner set forth in the application filed therewith. Notary Public-State of New York
No.01 W-6224291
Ouali6erf in Suffolk County
Sworn to before me this p- My Commissic• i.mires June 28,20 'LL
ZIV"P4 day of s� �"'�3 - 20 D
Notary Public Signature of Applicant
BUILDING DEPARTMENT- Electra ®I � 'I50 V LS
TOWN OF SOUTHOL DD
Town Hall Annex - 54375 Main Ro - O V1 X92018
Southold, New York 11971-0959
Telephone (631) 765-1802 - FAX (631)J&"DEPT.
roger.richert(aD-town.southold.r OFSOITTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: ou'f h/KrL Date: a Zi319
Company Name:
Name: W
License No.: email:
Address:
Phone No.:
JOB SITE INFORMATION: (All Information Required)
Name: �2.s
Address: 1— 11
Cross Street:
Phone No.: rj
Bldg.Permit#: 00 email:
Tax Map District: 1000 Section: Q Block: 61 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
82-Request for Inspection Formals
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DRAWN.-PM CHECKED BY:PM SCALE:t'—ea DISTRICT:1000 SECTION:97 D •81 LOTM 17
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APPRQVED AS NOTED
DATE: 5 B.P.# bb RETAIN STORM WATER RUNOFF
FEE: BY: PURSUANT TO CHAPTER 236
Y BUILDING
NOTIFY DEPARTIIIII AT OF THE TOWN CODE.
765-1802 8 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O. ELECTRICAL
ALL CONSTRUCTION SHALL MEET THE INSPECTION REQUIRED
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS.
COMPLY WITH ALL CODES OF
NEW YORK STATE & TOWN CODE`
AS REQUIRED AND CONDITIONS OF
SO
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���ES
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
q31-D0
9-22 kW GUARDIAN SERIES ``
AUTOMATIC HOME STANDBY GENERATORS
SPECIFICATIONS (LP/NG)
• : : i
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 70337037 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
Engine/Alternator RPM 3600/3600
Engine Generac G-Force
Engine Displacement 426cc 530ce 9990C 999cc 999cc
Fuel Consumption 0 1/2 Load 78 124 193 205 184
NG cu.ft/hr
Fuel Consumption @ Full Load 121 195 312 308 281
NG cu.ft/hr
Fuel Consumption @ 1/2 Load 36(1.00) 42.8(l.18) 69(1.9) 81 (2.23) 78(2.16)
LPG cu,ft/hr(gal/hr)
as
` Fuel Consumption Q Full Load 54(1.50) 73(2.01) 116(3.19) 140(3.85) 134(3.68)
LPG cu.ft/hr(gal/hr)
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
Enclosure Color Bisque
Warranty 5-Year Limited
Dimensions(L'x W'x H") 48 x 25 x 29
Weight Obs.)(Steel/Aluminum) 399 407 419 456 476
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