HomeMy WebLinkAbout48130-Z FBI c Town of Southold 8/23/2022
y P.O.Box 1179
0
W rn. 53095 Main Rd.
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 48130 Date:. 8/23/2022-
THIS
/23/2022THIS CERTIFIES that the building ELECTRICAL
Location of Property: 18603 Route 25,East Marion
SCTM#: 473889 See/Block/Lot: 17.-5-3.2
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
1/1/1900 pursuant to which Building Permit No. 48130 dated 7/29/2022
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"pool electric.
The certificate is issued to Eisman, Steven&Fergen,Valerie
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 48130 8/8/2022
PLUMBERS CERTIFICATION DATED
Authorized Signa e
suF a� TOWN OF SOUTHOLD
BUILDING DEPARTMENT
co -" TOWN CLERK'S OFFICE
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#: 48130 Date: 7/29/2022
Permission is hereby granted to:
Eisman, Steven
18603 Route 25
PO BOX 117
East Marion, NY 11939
To: as built" pool electrical work
At premises located at:
18603 Route 25, East Marion
SCTM #473889
Sec/Block/Lot# 17.-5-3.2
Pursuant to application dated 1/1/1900 and approved by the Building Inspector.
To expire on 1/28/2024.
Fees:
ELECTRIC $200.00
Total: $200.00
Building Inspector
OF SO(/j�ol
ti o
Town Hall Annex Telephone(631)765-1802
54375 Main Road
P.O.Box 1179 sean.devlina-town.southold.ny.us
Southold,NY 11971-0959 a
OUNTI,Nc�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: Steven Eisman
Address: 18603 Route 25 city:East Marion st: NY zip: 11939
Building Permit#: 48130 section: 17 Block: 5 Lot: 3.2
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Wirenuts Electric License No: 62190ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service
Commerical Outdoor X 1 st Floor Pool X
New Renovation 2nd Floor Hot Tub
Addition Survey X Attic Garage
INVENTORY
Service 1 ph 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 X 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 11 Pump 1
Other Equipment: Pump 220GFI, Light 120GFI, Heater, AutoCover 120GFI
Notes: "AS BUILT NO VISUAL DEFECTS " POOL
Inspector Signature: Date: August 8, 2022
S.Devlin-Cert Electrical Compliance Form
SO(/l�olo
# * TOWN OF SOUTHOLD BUILDING DEPT.
courm ' 631465-1502
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLRG.
[ ] 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 [ ] RENTAL
REMARKS: Hav
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DATE INSPECTOR r
# TOWN OF SOUTHOLD BUILDING DEPT-
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°ycourm, 631-765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLEG.
[ ] 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 [ ] .RENTAL
REMARKS: .'��' lN�l�
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DATE 26 ZZ INSPECTOR
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# # TOWN'OF SOUTHOLD BUILDING DEPT.
`ycourm��' 631-765-1802
INSPECTION '
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ]
FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
( ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [gam ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O [ ]' RENTAL
REMARKS: A W
DATE INSPECTOR
BUILDING DEPARTMENT- Electrical Inspector
F TOWN OF SOUTHOLD
Town II nnex - 54375 Main Road - PO Box 1179
JUL 2 8 2022 outhold, New York 11,971-0959
Telep IGWEe (631) 765-1802 - FAX (631) 765-9502
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TOWNo�.6lUtoutholdtownny.gov - seand @,southoldtownny.aov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date:
Company Name:
Electrician's Name: V
License No.: Elec. email: �N�Cp 1�St, u'�J ,'1��C.
Elec. Phone No: ao❑I request an email copy of Certificate of Compliance
Elec. Address.: Utoy 11151 .
JOB SITE INFORMATION (All Information Required) C � ,w�oo� 7,t2 S%8 191 Ir
Name: X1.5 }�J eT-JIke `e
Address: l
Cross Street:
Phone No.: 1 l • - �M�a00�1- ,�� S
Bldg.Permit#: �g/ email:
Tax Map District: 1000 Section: Block: S 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?: ❑ YES ® NO Issued On
Temp Information: (All information required)
Service Size F11 PhF—]3 Ph Size: A # Meters Old Meter#
F-1 New Service[]Fire Reconnect[]Flood Reconnect❑Service Reconnect[]Underground❑Overhead
# Underground Laterals M 1 FJ2 R H Frame r Pole Work done on Service? Y DIN
Additional Information:
PAYMENT DUE WITH APPLICATION
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