HomeMy WebLinkAbout47215-Z �o�OSUFfa4t Town of Southold 2/6/2022
P.O.Box 1179
W
• 53095 Main Rd
•y�o� ��o Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 42733 Date: 2/2/2022
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 5025 Route 25, Greenport
SCTM#: 473889 Sec/Block/Lot: 35.-2-11
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
12/9/2021 pursuant to which Building Permit No. 47215 dated 12/9/2021
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:
electric for golf course bathrooms. (Building 48)
The certificate is issued to King,William&Turner,David
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 47215 12/9/2021
PLUMBERS CERTIFICATION DATED
Authorized Signature
°�S�Ffoj TOWN OF SOUTHOLD
BUILDING DEPARTMENT
yg TOWN CLERK'S OFFICE
�,, • ��fi 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 #: 47215 Date: 12/9/2021
Permission is hereby granted to:
King, William
33 First St
Webster, MA 01570
To: Electric for Course Restrooms, Building # 8.
At premises located at:
5025 Route 25, Greenport
SCTM # 473889
Sec/Block/Lot# 35.-2-11
Pursuant to application dated 12/9/2021 and approved by the Building Inspector.
To expire on 6/10/2023.
Fees:
ELECTRIC $125.00
Total: $125.00
Building Inspector
OF SQ(/l�,ol
Town Hall Annex ~ Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 G Q sean.devlin(a)-town.southold.ny.us
Southold,NY 11971-0959
OUNT`1,��
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: William King
Address: 5025 Route 25 Course Bathrooms Bldg f city:Greenport st: NY zip: 11944
Building Permit#: 47215 section: 35 Block: 2 Lot: 11
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 X
Commerical X Outdoor X 1st Floor X Pool
New 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 1 Wall Fixtures Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures CO2 Detectors
Sub Panel 2pA A/C Blower Range Recpt Ceiling Fan Combo Smoke/CO
Transformer UC Lights Dryer Recpt Emergency Fixtures Time Clocks
Disconnect Switches 4'LED Exit Fixtures Pump
Other Equipment: 12 Circuit Sub Panel 5 Used
Notes: " AS BUILT NO VISUAL DEFECTS " Course Bathrooms
Inspector Signature: ,�� Date: December 9, 2021
S.Devlin-Cert Electrical Compliance Form
o�aoF souryo �" �l—�, �d`�/'o,cTM�
# # TOWN. OF SOUTHOLD BUILDING DEPT.
`ycourm ' 765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
.] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE '& CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT,CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS: r�
c-v �f 1
DATE INSPECTOR
.� OF SOUT/Yp �` J v 2 5
� 6
# # q4-
TOWN, OF SOUTHOLD BUILDING DEPT-m-
765-1,802
EPT.765-1802
ANSPECTION '.
[ '] FOUNDATION 1ST [ ] ROUGH.PLBG.
[ ] FOUNDATION-2ND [ ] INSULATION/CAULKING
[ ] FRAMING/STRAPPING [ ] FINAL
"-] ,.FIREPLACE & CHIMNEY. [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION ; [ ] -FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL)
[ ] CODE VIOLATION ] PRE C/O
REMARKS:
DATE Zot �� INSPECTOR �-
12?
BUILDING DEPARTMENT-Electrical Inspector
ACEI IN, 1=
Fn TOWN OF SOUTHOLD
202Town Hall Annex- 54375 Main Road - PO Box 1179
DEC o 3
LL-1 a' Southold, New York 11971-0959
BUILDING DEPT. Telephone (631) 765-1802 - FAX (631) 765-9502
TOWN OF sOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date:
Company Name:
Electrician's Name:
License No.: Elec. email:
Elec. Phone No: ❑1 request an email copy of Certificate of Compliance
Elec. Address.:
JOB SITE INFORMATION (All Information Required)
Name:
r� I 1.,2 {
Address: �ve 0Z
Cross Street:
Phone No.: — q 7 7—
Bldg.Permit#: rj email:
Tax Map District: 1000 Section: Block: 6,2 Lot:
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
Square Footage:
Circle All That Apply:
Is job ready for inspection?: YES❑NO [--]Rough In ❑ Final
Do you need a Temp Certificate?: El YES�10 Issued On
Temp Information: (All information required)
Service Size91 PhF-]3 Ph Size: A # Meters Old Meter#
ENw Service[]Fire Reconnect❑Flood Reconnect❑Service Reconnect❑Underground❑overhead
#Underground LateralsEL FJ2 n H Frame R Pole Work done on Service? Fly
Additional Information:
Bu -% jct-� %P:54 v-'O 0 0-- >
PAYMENT DUE WITH APPLICATION
BUILDING DEPARTMENT- Electrical Inspector
I_� TOWN OF SOUTHOLD
Fri
Town Hall Annex- 54375 Main Road - PO Box 1179
YS
DECm U Southold, New York 11971-0959
BUILDING DEPT Telephone (631) 765-1802 - FAX (631) 765-9502
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date:
Company Name:
Electrician's Name:
License No.: Elec. email:
Elec. Phone No: ❑I request an email copy of Certificate of Compliance
Elec. Address.:
JOB SITE INFORMATION (All Information Required)
Name: �- �{ .
Address: Z-2
,
Cross Street:
Phone No.: �3
BIdg.Permit#: email:
Tax Map District: 1000 Section: Block: 62— Lot:
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
Square Footage:
Circle All That Apply:
Is job ready for inspection?: El YES❑NO ❑Rough In ❑ Final
Do you need a Temp Certificate?: ❑ YES�1O Issued On
Temp Information: (All information required)
Service Size9i Ph®3 Ph Size: A # Meters Old Meter#
Eal"Service❑Fire Reconnect❑Flood Reconnect Oservice Reconnect❑Underground❑overhead
#Underground LateralsR1 H Frame Pole Work done on Service? F1 Y
Additional Information:
/a %?754 :4cs i 1�� r� arca o tftu->
PAYMENT DUE WITH APPLICATION
PERMIT# Address:
Switches
Outlets
GFI's l
Surface
Sconces
H H's
UC Lts .
Fans ... s :Fridge HW . .F.
Exha ust Oven W/D
SmokesDW Mini.
.
Carbon ......:... .._. ..;...,._ . .-..m_;: :.: IVlrcro... Generator..,.:.. ..
Combo.- Cooktop Transfer .^
Ac AH Hood Service
Amps ..., ..Have:.,,, Used
Special: _
Comments: ;::.