HomeMy WebLinkAbout45481-Z �O�g�FFQ(k 1o�' Town of Southold 12/21/2020
y� P.O.Box 1179
0
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 41703 Date: 12/21/2020
THIS CERTIFIES that the building GENERATOR
Location of Property: 24850 Route 25, Orient
SCTM#: 473889 Sec/Block/Lot: 18.-6-5.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
11/10/2020 pursuant to which Building Permit No. 45481 dated 11/23/2020
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 Stevenson,Thomas&Ors.
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 45481 12/8/2020
PLUMBERS CERTIFICATION DATED
-�I-N �)��
Authorize Signature
S��Fnc�r TOWN OF SOUTHOLD
BUILDING DEPARTMENT
c A TOWN CLERK'S OFFICE
o • SOUTHOLD, NY
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#: 45481 Date: 11/23/2020
Permission is hereby granted to:
Stevenson, Thomas
24850 Route 25
Orient, NY 11957
To: install generator as applied for.
At premises located at:
24850 Route 25, Orient
SCTM # 473889
Sec/Block/Lot# 18.-6-5.1
Pursuant to application dated 11/10/2020 and approved by the Building Inspector.
To expire on 5/25/2022.
Fees:
ACCESSORY $100.00
ELECTRIC $85.00
CERTIFICATE OF OCCUPANCY $50.00
Total: $235.00
kileing I ector
o��pF SO(/l�ol
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 0� ® i0 sea n.devlin(c�town.south old.ny.us
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To. Thomas Stevenson
Address: 24850 Route 25 city,Orient st: NY zip: 11957
Budding Permit# 45481 Section: 18 Block 6 Lot: 5.1
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Shore Power Elec. Cont. License No. 42536ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service X
Commerical Outdoor X 1st Floor Generator X
New X Renovation 2nd Floor Hot Tub
Addition Survey X Attic Garage
INVENTORY
Service 1 ph X Heat Duplec Recpt Ceiling Fixtures Bath Exhaust Fan
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel 200A A/C Condenser Single Recpt Recessed Fixtures CO2 Detectors
Sub Panel A/C Blower Range Recpt Ceiling Fan Combo Smoke/CO
Transfer SwitchUC Lights Dryer Recpt Emergency Fixtures Time Clocks
Disconnect Switches 4'LED El Exit Fixtures F1 Pump
Other Equipment: 22kWGenerac Generator w/ 200A Whole House Transfer Switch
Notes* Generator
Inspector Signature: �� Date: December 8, 2020
S.Devlin-Cert Electrical Compliance Form As
i 55 Z �
pE SOGIy��
# # TOWN OF SOUTHOLD BUILDING DEPT.
Ioo765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ]- ROUGH PLBG.
[ ] 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:
NOAjAite C211 AIUMIAV� -
g-
0A
DATE INSPECTOR
TOWN OF SOUTHOLD–BUILDING DEPARTMENT
Ca Gy= Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
�y�• aQ�� Telephone(631) 765-1802 Fax(631) 765-9502 hgps://www.southoldtomm..gov
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only �
PERMIT NO. q6q�J— Building Inspector:_
ector.
' �t, - NOV 1 0 2020
Applications-and forms must be`filled out iri their entirety.,)ricomplete'
applications"will',not,be accepted. Wher`e,thd�Applicant isnot the owner;an
4
awneei'Authorizattdri form_ (Page 2)'shall be completed: '� � °
' 0 v �7�r4�iy riT IOLD
Date: Rooto
O1IVNER(5)OF'PROPERTY:
Name: SCTM#1000-
Physical Address:
— - ,*iJN—R-0AJ 046,15N_ -=N Y 1/75-
Phone
/95Phone#
Mailing Address:
CONTACT PERSON: '
Name:
Mailing Address: �-� AJa� W E<<N = o - �.� -9,-Cr-c.As 111 r.—/_L _3!�
�0,3/—SAX_6 73 C1.
Email L�
Phone#: -,
DESIGNrPROFESSIONAL INFORMATION: ;
Name: C
Mailing Address:
_
Phone#:4. 3tF— ttpAc� Email:k� wCRI�/eGTh?+�c.-GoK
CONTRACTOR INFORMATION:
Name:
Mali ftg Address:
Phone Email.-.#_�e3.1-395^�toot�n /a, amER�leC-7Ric -
DE CRIPTION OF-PROPOSED CONSTRUCTION_
El New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
%Otherso-F oUKw Sht Y g,FVLR&� $ ��84> • �o
Will the lot be re-graded? ❑Yes E4AIO Will excess fill be removed from premises? ❑Yes ANo
1
PROPERTY11NIFORMATION
Existing use of property: Intended use of property:
e- -- -br �-
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? ❑Yes WNo IF YES, PROVIDE A COPY.
❑,Che&,Box After Reading:11 owner/contract f/deign professional is responsible for all drainagiand`storm water issues as proidded by
Chapter 236 of the Town Code: APPLICATION IS HEREBY MADE to the Building Department�for_the issuance of a BuildingaPermifpursuant to the Building Zone,
Ordinance of thaTowri of Southold;suffolk;`County,New York and other'applicable laws,Ordinances or Regula"tions;fog the construction`of'buildings;
additions;aiteration's or for removal ordemolitiorias herein desciibed.`The-applicant agrees to'comply With all'applicable laws,�ordiiiances;building coder'
housing code and regulations',and to admit authorized inspectors on premises and in buildiing(s)for necessaryinspections.False statements,rriade herein are
=punishebl"e as"aClass A misdemeanor pursuant to section 230:45 of the Neuf York State Penal
Application Submitted By(pri name : /.pu,ji-fS RS(Authorized Agent ❑Owner
Signature of Applicant: Date: lr—Q-24 ZO
STATE OF NEW YORK)
IVY
COUNTY OF
LacA4.S Dr-S ,y`!S being duly sworn,deposes and says that Ohe is the applicant
(Name of individual signing contract)
)aabove named,
As
4)he is the sig7
(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/her knowledge and belief; and
that the work will be performed in the manner set forth in the application file therewith.
Sworn before me this
day of / V tw V- . 209-0
Notary Public
q',f blee$1210 Of rwyw
0'o01640594kSd/oikc PROPERTY OWNER AUTHORIZATION
_Cama�Exsioo Expires MarcA 20�
(Where the applicant�is not the owner)
Ptd A 4P os 440, residing atAgjT0 H i�(RJ., Qgf:&i4 j Iy /�QS7
do hereby authorize koas to apply on
my be a f tote own of Southold Bu ilding Department for approval as described herein.
006-<V� /I-?-
Owner' ignature Date
Print Owner's Name
2
+ q�FFftt � BUILDING DEPARTMENT-Electrical Inspector
,:S QG TOWN OF SOUTHOLD
01*4
Town Hall Annex- 54375 Main Road - PO Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1802 - FAX (631),765-9502
„roaerrCa�southoldtownny.gov sea nd0-southoldtownny-gov.
~ ` •- -- -
APPLICATION FOR ELECTRICAL- INSPECTION.
ELECTRICIAN INFORMATION (All Information Required)' Date: 8-020
Company Name:- S ho AE ._Pa wm G/P_c Ai C,+1 C°o w7�RACokq .Z_ ',!C• - -
Name: N i r h-aLts D '�M�C0
License No.: df A 536 M E email: N ir,K@ SIIoRe co�RE c i s . co/►�
Address: wr—f v 9A-A-u#4;*-A, C Rmoacchaz 14 117.5*
Phone No.:
JOB SITE INFORMATION (All Information Required)
Name: -
Address: �Lt S,j`o /�/�tiw a,g,cl OAS,eW •j / _ S 7_
Cross Street:
Phone No.: 3/-3a 3
Bldg.Permit#: L4 ex(20 email: A
Tax Map-District: 100 Section: I_ __ _---Block: (o ,_ Lot: S.
BRIEF DESCRIPTION OF WORK (Please Print Clearly) ,4//i4ou a.� ,KW
E1JElekC .G`ENP_RAfoR
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 Lateral's 1 2 H Frame - Pole Work done-on Service? Y N
Additional Information:.
PAYMENT,DUE WITH APPLICATION--
Request for Inspection FormAs ��`
LiwdA A-pos+'4L-
024 82
okisk+, NY J[gS'7
S�cIS � ALK Io-
�t��
Ip �'' I
-/v C?crte� �s-�s-4v
LR
It
a
- � w
:,t4 �• --oma:
W Y
d ! '
t7i
Z!�
f03V
eU
M co
a Cl f !
a
1'+1
n
g
Ya
P.O.B. S 48'411400"i 1
S 48*49'UO"W
kRCEL 4 18,3.07° - .c '''� 129.' S'
N 4,949"00roE s a�si•�u r 337.27'
<741 G f
4
42 SSF OR
CAIw
�A
}
Y ahc
x:...� ..�..ter......,vT.�a.�:.•...�.,,. a�-a.e..-w,a.,�ate..�...� Z) q4i ,;�i
4> g4 �I *W
441- 0MLf}IN IAA
( -
I /1�V