HomeMy WebLinkAbout47044-Z ��o�O��EEOty Town of Southold 10/20/2022
o -
P.O.Box 1179
co
53095 Main Rd
y o� Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 43519 Date: 10/20/2022
THIS CERTIFIES that the building HVAC
Location of Property: 845 Orchard St, Orient
SCTM#: 473889` Sec/Block/Lot: 25.-2-17.3
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
10/15/2021 pursuant to which Building Permit No. 47044 dated 10/27/2021
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:
"as built"HVAC as applied for.
The certificate is issued to Shayne,Jeffrey&Karen
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 47044 10/3/2022
PLUMBERS CERTIFICATION DATED
Au o iz d gnature
�o�suFFotp�o TOWN OF SOUTHOLD
ay BUILDING DEPARTMENT
C* z TOWN CLERK'S OFFICE
SOUTHOLD, NY
!1jp14 '
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 #: 47044 Date: 10/27/2021
Permission is hereby granted to:
Shayne, Jeffrey
20 Vincent St
Orient, NY 11957
To: legalize "as built" AC unit as applied for.
At premises located at:
845 Orchard St, Orient
SCTM #473889
Sec/Block/Lot# 25.-2-17.3
Pursuant to application dated 10/27/2021 and approved by the Building Inspector.
To expire on 4/28/2023.
Fees:
AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $400.00
CO-ALTERATION TO DWELLING $50.00
Total: $450.00
Buil ing Inspector
*pf SOUj�ol
0
Town Hall Annex Telephone(631)765-1802
54375 Main Road
P.O.Box 1179 aQ sean.devlin(cD-town.southold.ny.us
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: Jeffrey Shayne
Address: 845 Orchard St city:Orient st: NY zip: 11957
Building Permit* 47044 Section: 25 Block: 2 Lot: 17.3
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: New Power Electric License No: 4702ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt Ceiling Fixtures Bath Exhaust Fan
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures CO2 Detectors
Sub Panel A/C Blower Range Recpt Ceiling Fan Combo Smoke/CO
Transformer UC Lights Dryer Recpt Emergency Fixtures Time Clocks
Disconnect Switches 2 4'LED Exit Fixtures Pump
Other Equipment:
Notes: HVAC
Inspector Signature: Date: October 3, 2022
S.Devlin-Cert Electrical Compliance Form
ho�apF 50U1 �,
TOWN OF SOUTHOLD BUILDING DEPT.
ycou631-765-1802
.INSPECTION
[ ] FOUNDATION IST [ ] 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 [ ] RENTAL
REMARKS: NfK�(•
DATE ICy INSPECTOR
OF SOpTyO�
* # TOWN OF SOUTHOLD BUILDING DEPT.
oourm631-765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] 1 SULATION/CAULKING
[ ] FRAMING /STRAPPING [ FINAL ffVq(,1
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL
REMARKS:
wv)v- ,z Q�v
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DATE 10 '� INSPECTOR
FIELD.'INSPECTIO,N REPORT. DATE. COMMENTS,
O
FOUNDATION(IST)
----------------.-------------------
FOUNDATION(2ND)
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ROUGH FRAMING•& - l� •1
. ry
PLUMBING
Vl
INSULATION PER N.Y. y.
STATE ENERGY CODE �
FINAL
ADDITIONAL COMMENTS
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TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone(631) 765-1802 Fax (631) 765-9502 https://www.southoldtowmy.aov
Date Received
APPLICATION FOR BUILDING PERMIT
For ffice Use Only E
PERMIT NO. D Building Inspector: A / 1.
lJ
OCT 15 2021 LL .
�A lications-a BUILDING DEPT
n ornns�rnyst:166 fli'lled
t
nco
-6 Is n6tfhe owneriah-�-',--
a lica 1- -111 not ed-,Wheee th0Apollicaint TOWN OF SOUTHOLD
Or!S
Owner's ut
Date:
-,OWN
FOROPER�, ' pn
OWNER 0,
Name: 4 -e SCTM#1000-
Project Address:
Phone#: .t, 2�
Email:
Mailing Address:
CONTACT'PERSON
V"
Name:
Mailing Address: 1+5 P k+-
Phone#: Email:
GIIN'PROFESSIONAL INFORMATION
Name:
Mailing Address:
Phone#: Email:
P 4
, -
,CONTRACTOR INFORMATION:
Name:
-&E
Mailing Address: q2q k/jFttk,,. p Avg blideo, Rvrj� V
Phone#: �16 12)- Z. 12-3 Email:
OF;PROPQ$to CONSTRUCTION'
El New Structure ElAddition ElAlteration DRepair E]Demolition Estimated Cost of Project:
Elother A �c $ ID2
Will the lot be re-graded? 11Yes Oz:'.No Will excess fill be removed from premises? E1Yes1ENo
r. ',.:,7PROPER�TY� �e-,
,INFOkMATION'.��'i �,
�,z 4.:"o
Existinguse of property:__ Intended use of*property:
(
Zone or-use district in which premises is situated: Are there any covenants and restrictions with respect M.
this property? DYes $Ao IF YES, PROVIDE A COPY.
y
vided-b
q f&41Udralh
Cha'oiei 236-of theT,'dWif.,Coa6'APPMtAT10N,[S HEkEby.y,MADE16-thd Buildffig Depittmefit id"r"thb'1s9tii6C6"df;i'8 U'11 oiipig�pidliniit:obrtuant to thd=Bdilding;io�4".,
ihancibf thelbWfi Southold,Stjftlk,�C 6
61 �1,-,1� ;�1 4
�6'iihtV,.Niw,Y6rk�arid�othiit�iii3pli6i Laws,Ordinances iori
h,. construction . .....
additions,alterations r:edMbVA1,dr e`moiition:as heiein.descnbed The applicantagrejqs,tq:corpp_y;with appicabe.lawordinances,
ur
, `
housing coderand:r"egulations i&d,to-AdQinspectorsind4h lbild6j(i)f0�_Aeqss3ry,!nspe
ctions.Fa s�stat Menii:nide:fi6rdirare
punishable as'a ci!sfMisdeea drsuantI6 Sictidi
Application Submitted By(print name): ElAuthorized Agent 16Owner
Signature of Applicant: Date:
CONNIE D.BUNCH
STATE OF NEW YORK) Notary Public,State of New York
SS: No.01BU6185050
Qualified in Suffolk Counh,
COUNTY OF Commission Expires April 14. �_OAJ
being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the
(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
clay of 20� �`� 1 �
'Notary Public
PROPERTY OWNER AUTHORIZATION
(Where the applicant is not the owner)
residing at
-do hereby authorize to apply on
my behalf to the Town of Southold Building Depart t for approval as described herein.
S
Owner's Signature Date
Print Ow s Name
2
OSUFfp(,�c BUILDING DEPARTMENT- Electrical Inspector
TOWN OF SOUTHOLD
C* Town Hall Annex 54375 Main Road - PO Box 1179
o • Southold, New York 11971-0959
Telephone (631) 765-1802 - FAX (631) 765-9502
rogerr(cD-southoldtownny.gov — seand(a-southoldtownny.gov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date:
Company Name: N 0V PQwkyL
Name: Johx ko V ,
License No.: 1702 Eemail:
Phone No: r6- 42-28 3 ❑I request an email copy of Certificate of Compliance
Address.: Q k C444AA, A vt AM I� V(UA ,0
JOB SITE INFORMATION (All Information Required)
Name: &fv- A a-/,
Address: pry k i f'-i4
Cross Street: WdA/Ve (A-01+
Phone No.: ' 2. 1- 8 Z7
Bldg.Permit#: email:
Tax Map District: 1000 Section: Block:
BRIEF DESCRIPTION OF WORK (Please Print Clearly)
C Com?U'eJJP1,
Check All That Apply:
Is job ready for inspection?: WIYES ❑NO ❑Rough In ElFinal
Do you need a Temp Certificate?: DYES WNO Issued On
Temp Information: (All information required)
Service Size ❑1 Ph ❑3 Ph Size: A # Meters Old Meter#
❑New Service ❑ Service Reconnect ❑Underground ❑Overhead
# Underground Laterals ❑1 ❑2 ❑H Frame ❑Pole Work done on Service? ❑Y ❑N
Additional Information:
PAYMENT DUE WITH APPLICATION
Electrical Inspection Form 2020.xlsx
BUILDING DEPARTMENT- Electrical Inspector
O" ®G
TOWN OF SOUTHOLD .
o Town Hall Annex - 54375 Main Road - PO Box 1179
Southold, New York 11971.-0959
Telephone (631) 765-1802 - FAX (631) 765-9502
rogerr(a_southoldtownnygov — seand(a)-southoldtownny.ciov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All information Required) Date:
Company Name: X10V P4w(cyt tZ&,O�
Name: John,
License No.: 4702-E email:
Phone No: K9 ❑I request an email copy of Certificate of Compliance
Address.: V 4M 41 VIUA ,0
JOB SITE INFORMATION (All Information Required)
Name: J(Z T A Allv)4
Address: 04W f-P4
Cross Street: Ve(AA IvE (A-,ve
Phone No.: 2 i- 2/7
BIdg.Permit Lf email:
Tax Map District: 1000 Section: �j Block: Lot: 'I
BRIEF DESCRIPTION OF WORK (Please Print Clearly)
C CO/A e IrP f1 P/`
Check All That Apply:
Is job ready for inspection?: RYES ❑NO ❑Rough In nFinal
Do you need a Temp Certificate?: ❑YES QJNO Issued On
Temp Information: (All information required)
Service Size ❑1 Ph ❑3 Ph Size: A # Meters Old Meter#
❑New Service ❑ Service Reconnect ❑ Underground ❑Overhead
# Underground Laterals ❑1 ❑2 ❑H Frame ❑Pole Work done on Service? ❑Y ❑N
Additional Information:
PAYMENT DUE WITH APPLICATION
CAI o
Electrical Inspection Form 2020.xlsx vle6l
t C�
PERMIT # Address:
Switches ,I
Outlets
GFI's
Surface
Sconces
H H's
UC Lts
Fans Fridge HW
Exhaust Oven WAD
Smokes DW Mini
Carbon Micro Generator
Combo Cooktop Transfer
AC 1 AHI Hood _ Service
I Amps Have Used
Special:
Comments
y�
t
V
APPRO ED AS NOTED
DATE: B.P.#
FEE: BY:
NOTIFY BUILDING DEPAR MENT AT -
765.1802_` = B:AM- TO 4.PM FOR THE
FOLLOWING INSPECTIONS: OCCUPANCY OR
1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE USE IS UNLAWFUL
2. ROUGH`-,:FRAMING & PLUMBING
3. INSULATION '�IITH®UT CERTIFICI
4. FINAL - CONSTRUCTION MUST DF OCCUPANCY
BE COMPLETE F'
�R C.O.
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS.
COMPLY WITH ALL CODES OF
NEW YORK STATE & TOWN CODES ELECTRICAL
AS REQUIRED AND CONDITIONS OF SPECTION REQUIRED
--SOUTHOLD TOWN ZBA
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SO 40 TRUSTEES
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