HomeMy WebLinkAbout44497-Z i
�o�gUFF�6�CaGy Town of Southold 1/15/2020
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P.O.Box 1179
53095 Main Rd
�y,�jQ1 yap Southold,New York 11971
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CERTIFICATE OF OCCUPANCY
No: 41003 Date: 1/15/2020
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 5240 Narrow River Rd, Orient
SCTM#: 473889 Sec/Block/Lot: 27.-2-4
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
12/9/2019 pursuant to which Building Permit No. 44497 dated 12/9/2019
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:
"as built"electric for well pump.
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The certificate is issued to Dacimo,Fred&Maureen
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of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF BEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 44497 12/2/2019
PLUMBERS CERTIFICATION DATED
Authorized Signature
�s�FFntK TOWN OLD
BUIL NT
CS 11 Annex TO E Telephone(631)765-1802
may,• ain Road Fax(631)765-9502
ox 1179 G Q
ou old,NY 11971-0959 B
coum,�
(THIS PERMIT MUST ON THE PREMISES
WITH ONE SET OF RRRRQVFRPkAN$AAVQ SPECIFICATIONS
UNTIL FULL COMP1f2 ID M, AUTHORIZED)
Permit#: 44497 Date: 12/9/2019
Permission is hereby granted to:
Dacimo, Fred
5520 Narrow River Rd
Orient, NY 11957
To: shed well pump
At premises located at:
5240 Narrow River Rd, Orient
SCTIVI # 473889
Sec/Block/Lot# 27.-2-4
Pursuant to application dated 12/9/2019 and approved by the Building Inspector.
To expire on 6/9/2021.
Fees:
ELECTRIC $180.00
Total: $180.00
Building Inspector
OF SO(/ly®l
Town Hall Annex ~ O Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 G sean.devlina-town.southold.nv.us
Southold,NY 11971-0959 ,r • a0
cOUM`I,��
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: Fred Dacimo
Address: 5240 Narrow River Rd Orient st: NY zip: 11957
Building Permit# 44497 Section: 27 Block- 2 Lot: 4
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: AS BUILT License No:
SITE DETAILS
Office Use Only
Residential Indoor X Basement Service Only
Commerical X Outdoor X 1st Floor X Pool
New Renovation 2nd Floor Hot Tub
Addition Survey X Attic Shed X
INVENTORY
Service 1 ph X Heat Duplec Recpt 3 Ceding Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt 2 Wall Fixtures Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel 40A A/C Blower Range Recpt Fluorescent/LED 2 Pumps
Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks
Disconnect Switches Twist Lock Exit Fixtures Combo SD/CO
Other Equipment Manual Transfer Switch for Generator Plug, 24 Circuit Sub Panel (15 Used)
Notes* " AS BUILT " " NO VISUAL DEFECTS " Pump Shed
Inspector Signature: Date: December 2, 2019
S.Devlin-Cert Electrical Compliance Form.xls
o�aoF solft, N4f'0 W �! Ver2
# TOWN OF=SOUTHOLD BUILDING DEPT.
co765-1802
INSPECTION
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[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
j ] FOUNDATION 2ND [ ] INSULATIOWCAULKING .
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE& CHIMNEY [ ] FIRE'-SAFETY INSPECTION
[ -] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL)
[ ] CODE VIOLATION ?,,] PRE C/O
REMARKS:
NA L J, s pAl
Koo61K
DATE �2 Z �' INSPECTOR
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CONSENT TO INSPECTION a NOVN2 0 2019
the undersigned, do(es) hereby,state:
Owner(s)Name(s)
That the undersigned(is) (are)the owner(s) of the premises in the Town of
Southold, located at
which is shown and designated on the Suffolk County Tax Map as District 1000,
Section 5t-7Block , Lot�.
That the undersigned(has) (have) filed, or cause to be filed, an application in the
Southold Town Building,Inspector's Office for the following:
That the undersigned do(es) hereby give consent to the Building Inspectors of the
Town of Southold to enter upon the above described properly, including any and all
buildings located thereon,to conduct such inspections as they may deem necessary with
respect to the aforesaid application, including inspections to determine that said premises
comply with all of the laws, ordinances, rules and regulations of the Town of Southold.
The undersigned, in consenting to such inspections,do(es) so with the knowledge
and understanding that any information obtained in the conduct of such inspections may
be used in subsequent prosecutions for violations of the laws, ordinances,rules or
regulations of the Town of Southold.
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Dated: -
(�ygn )
(Print Name)
(Signature)
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(Print ame)