HomeMy WebLinkAbout38054-Z �oFFpl�.co Town of Southold Annex 9/21/2013
30 �y P.O.Box 1179
54375 Main Road
oy Southold,New York 11971
dal
CERTIFICATE OF OCCUPANCY
No: 36522 Date: 9/21/2013
THIS CERTIFIES that the building GENERATOR
Location of Property: 200 Green Hill Ln, Greenport,
SCTM#: 473889 See/Block/Lot: 33.-3-13
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
5/15/2013 pursuant to which Building Permit No. 38054 dated 5/28/2013
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 Psaltakis,Bessie
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 38054 9/16/23
PLUMBERS CERTIFICATION DATED
Authorized Signature
�o�SOFFuc,r�a TOWN OF SOUTHOLD
�y BUILDING DEPARTMENT
y a TOWN CLERK'S OFFICE
v • SOUTHOLD, NY
r 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#: 38054 Date: 5/28/2013
Permission is hereby granted to:
Psaltakis, Bessie
200 Green Hill Ln
Greenport, NY 11944
To: Install an accessory generator as applied for.
At premises located at:
200 Green Hill Ln
SCTM # 473889
Sec/Block/Lot# 33.-3-13
Pursuant to application dated 5/15/2013 and approved by the Building Inspector.
To expire on 11/28/2014.
Fees:
ACCESSORY $100.00
CO -ACCESSORY BUILDING $50.00
T $150.00
Buildin I
Form No.6 G�� _/�
TOWN OF SOUTHOLD n lv/j—�`
BUILDING DEPARTMENT {I-'
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.. MCA, , �d
New Construction: Old or Pre-existing Building: (check one)
Location of Property: 200 been Mi 1-pile , 'rreen rj Dyy-1"t 1J J
House No. Street Hamlet
Owner or Owners of Property: bo--5s PLIC - 36�5
Suffolk County Tax Map No 1000,Section 33 Block 3 Lot 33
Subdivision Filed Map. Lot:
Permit No. J��b5 Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ S-D
�App' --t-Signature
pF SO!/ryolo
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 G roger.riche rt(a7town.southo Id.ny.us
Southold,NY 11971-0959
�lyc4UNT`I,Nct�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Bess Psaltakis
Address: 200 Green Hill Ln City: Greenport St: NY Zip: 11944
Building Permit#: 38054 Section: 33 Block: 3 -4-3 Lot: 13 -33
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: AJ's Power Inc License No: 35715-me
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 X
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: 8KW stand by generator with 50a auto transfer switch
Notes:
Inspector Signature: Date: Sept 16 2013
81-Cert Electrical Compliance Form.xls
OF SOUT��6
01
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)
REMARKS:
DATE l&, INSPECTORS-.
FIELD IRNSPECT ON REPORT DATE COMMENTS
• FOUND�i�,'ION{1ST) •
rwr.rrwrrwrwr�rrrrrr.rrrrrrrrrr .
l J
• FOUNDATION(ZND)
. o
cy
y
ROUGH FRAMING& y
PLUMBING
INSULATION PER N.Y.
STATE ENERGY CODE
' 5
FINAL
V
ADDITIONAL COMMENTS
(4-
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TOWN OF 950UTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DVPARTMENT J . 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.NorthFork.net PERMIT NO. ,R�` `��� Check
Septic Form
N.Y.S.D.E.C.
/ Trustees
�i Flood Permit
Examined J L 20__1 Storm-Water Assessment Form
Contact:
Approved 20 Mail to:
Disapproved a/c
Phone:
Expiration ,20
Building In pector
D E � C� � E
PLICATION FOR BUILDING PERMIT
MAY Date Mw 3 , 20/3
INSTRUCTIONS
BLDG.DEPT.
a.This letely 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.
APPROVED A� NOTED
(Signature of icarit or name;if a corporation)
DATE: 1 r .P.#
k1lizz �8 ,J6e1deeve" a%aaewaNy11758
(Mailing address ot applicant)
FEE: '- BY: Je
State whether aP0ffWaYt&d fi, WiWI►YRT affhitect,engineer, general contractor, electrician,plumber or builder
7 5 1802 8 AM TO 4 PM FOR THE
djAl .It� ' TIONS:
Name of owner?f�%-O sRED CAI T in J la kh s
3. .INSULATION, (As on the tax roll or latest deed)
If applicant is a orp ttio�yVpft-qie&dMLySqruthorized officer
RE COMPLETE FOR C.O. -
(Name aiALtid01QJ i &)MEET THE
nF '-nFS OF NEW
Builders Licensev.NbK ST,"-.I NOT RESPONSIBLE FOR
Plumbers LicenseWiN OR,
Electricians License No.
Other Trade's License No.
1. Lo ation of Wnd on whi h roposed work will be one:
0 n P64 N
House Number Street Hamlet
County Tax Map No. 1000 Section 23 Block Lot
Subdivision Filed Map No. Lot
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TOWII HaIl Annex
[ Telephone(631)765-1802
54375 Main Road
P.O.Sox 1179.. G� Q roger:rlchertdtow( ls'0 00115.nY us
Southold,NY 11971-0959 N
-MIMING DEPART1bMU
TOWN OF SOUTHOLD i
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: Oh 'o + i Date:
Company Name:
Q 3 2013
r
ower
Name: .
License No.:
Address: J nu
17
Phone No.: �J #=
JOBSITE INFORMATION: (*Indicates required information)
*Name:
'`Address: , ` .
N
*Cross Street:
��e
*Phone No.: / - 0014 J
Permit No.: 9 b
Tax Map District: 1000 Section: �3r 3 Block: I3 Lot: _
*BRIEF DESCRIPTION OF WORK(Please Print Clearly)
(Please Circle All-That Apply)
Is job ready for insp'eq#6 YES! O Rough In Final
*Do.you need a Temp Certificate: YES! NO
Temp Information(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 DUE WITH APPLICATION
Z24Request for Inspection Form
S
Town Hall Annex 41 4 Telephone(631)765-1802
54375 Main Road �� (631)7659502
P.O.Box 1179. G •: O rogerAchedd-toRsoutnold.n .us
Southold,NY 11971-4959
BUMDING DEPARTMENT
TOYM OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
[Address:
EQUESTED BY:
Oh 'C)f�i Date: Ma 3 i 201a3
mpany Name: ' oLer The
me: .
ense No.: I
T
l �
Phone-No.: . nu
JOBSITE fNFORMATION: (*Indicates required information)
*Name: S
*Address: 1
*Cross Street: Q
N ?
*Phone No.: _ _ 00q
Permit No.: 05Lf
Tax Map District: 1000 Section: Block: _ Lod -,;�3 .
*BRIEF DESCRIPTION OF WORK(Please Print Clearly)
eJeo4rizi h wjzr& r -aMW dueled
(Please Circle All That Apply)
*Is job ready for inspectfrk. ` YES! O Rough In Final
*Do.you need a Temp Certificate: YES! NO
Temp Information(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 DUE WITH APPLICATION
.824Request for Inspection Form
ff
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o GE Power Management Selected Circuits. SymphonyM II Power Management
a- • ^• • a •• Wotts`,LP/NG 8,000(LP Vapor) 10,000(LP Vapor)
•°• a•• : •e ° • 6.000ING) 9,000ING)
• - • a • -ai - s• Engine 500cc 570cc
Briggs&Stratton°Intek Engine Briggs&Stratton-Vanguard Engme
•- • • - • • e •a a ':. �. .: .. . -. .. .,... _ ., .,... ., _ .. ...-. ..
e ea • • • e e Operation Fully Automatic Fully Automatic
• •e - • •e Voltage 1201240V AC;Single Phase,l.Opf 120/240V AC,Single.phose 1.6pf
Amps 1240VF 33.3(LP) 41.7(LP)
o e - • e 25 ING) 37.5(k)
• - • • a - a s • • Alternator. Brushed Brushed
o•• o • ° • • e Voltage Regulation_ Automatic Automatic
e •- • -• • e a • Full Pressure
• • a • • o• sea Lubrication Yes Yes
Fuel Consumption' 37.6 ft3/hr,1.04 gal/hr(LP) 42.8 ft'/hr,1.18 gal/hr(LP)
[at V2 Load') 94 ft'/hr(NG) 111 W/hr ING)
Fuel Consumption' 56.4 ft3ft,1.57 gal/hr(LP) 65.6 ft'/fir,1.82 gal/hr{LP)
• • ' e s e (at Full Load) 121 W/hONG) 169.ft'/hrING)
Weekly Exerciser Yes Yes
e .. . • : Galvanneal steel Galvanneal steel
Enclosure Technology_
with"corrosion'resistant omt•a a / •- • with corrosionresistant paint
• e e • • - Hour Meter Yes Yes
e s• s m • •o it • Overcrank ProtectionYes Yes
Dimensions(LxWxH) 28"x 24.4"x 33.5" 28"x 24.4'x 33.5"
• - • s a Weight
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Warranty' 4 Year Limited 4 Year Limited'
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° • • e- a • •• o Basic Wireless Monitor Yes Yes
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Each system includes an hour meter; Each system includes on hour meter,
battery charger and synthetic oil. battery charger and synthetic oil.
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° °' • ° • a 'Installations mu st strictly comply with all applicable codes,industry standards,laws,regulations and
a 0 a 1. • e provided installation manual.Running engines give off carbon monoxide,an odorless,colorless,poisonous
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^Fuel consumption rates are estimated)used on normal operatingconditions at'h load.Generator operation C UL US
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Is a trademark of General Electric Company
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Briggs&Stratton Corp:reserves the right to make
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Post Office Box 702 herein,or discontinue the product described at
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a- o •� a e
Assembled in USA GESB0001-1/13