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hoy��OF SOUry°�o Town of Southold * * P.O. Box 1179 ,0 53095 Main Rd °�*-COUNn a�' Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 45901 Date: 01/28/2025 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 155 Glover St Southold, NY 11971 Sec/Block/Lot: 59.-11-2 Conforms substantially to the Application for Building Permit heretofore, filed in this office dated: 10/28/2024 Pursuant to which Building Permit No. 51505 and dated: 12/23/2024 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" alterations, including non-sleeping finished basement and garage conversion to bedroom with bathroom, in existing single family dwelling as applied for. The certificate is issued to: Joshua Smith Of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL: ELECTRICAL CERTIFICATE: 51506 01/28/2025 PLUMBERS CERTIFICATION: Joshua Smith 10/28/2024 Au one Signature soaryO TOWN OF SOUTHOLD BUILDING DEPARTMENT • .� TOWN CLERK'S OFFICE y 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#: 51505 Date: 12/23/2024 Permission is hereby granted to: Joshua Smith 770 Kennys Rd Southold, NY 11971 To: legalize "as built"alterations to existing single-family dwelling as applied for. Additional certification may be required. Premises Located at: 155 Glover St, Southold, NY 11971 SCTM#59.-11-2 Pursuant to application dated 10/28/2024 and approved by the Building Inspector. To expire on 12/23/2026. Contractors: Required Inspections: Fees: As Built Alteration $1,415.00 CO-RESIDENTIAL $100.00 Total S1,515.00 Building Inspector o��OF SD!/ryol � o Town Hall Annex Telephone(631)765-1802 54375 Main Road P.O.Box 1179 G Q Southold,NY 11971-09590 JameshCa�southoldtownny.gov RUNTY, BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Joshua Smith Address: 155 Glover Street city:Southold st: New York zip: 11971 Building Permit#: 51505 Section: Block: Lot: WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: Homeowner Electrician: License No: SITE DETAILS Office Use Only Residential X Indoor X Basement Service Commerical Outdoor 1st Floor X Pool New Renovation 2nd Floor Hot Tub Addition X Survey Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt 7 Ceiling Fixtures Bath Exhaust Fan 1 Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures Smoke Detectors 1 Main Panel A/C Condenser Single Recpt Recessed Fixtures 10 CO2 Detectors Sub Panel A/C Blower Range Recpt Ceiling Fan 1 Combo Smoke/CO 1 Transfer Switch UC Lights Dryer Recpt Emergency Strobe Heat Detectors Disconnect Switches 7 4'LED Exit Fixtures 11 Sump Pump Other Equipment: 1 electric mirror Notes: ADDITION BED RM/ BATH Inspector Signature: L416t— Date: January 27, 2025 155 glover st 1 o�u �oc Town Hall Annexes Telephone(631)765-1802 54375 Main Road .< P.O.Box 1179 a{ Southold, NY 11971-0959 ,a• BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATION Date: 0(f. 211, 7AZ4 Building Permit No. S�s Owner: ,Jbskyh Stu.I (Please print) Plumber: 26W kk",Q �Je, (Please print) I certify that the solder used in the water supply system contains less than 2/10 of I%lead. ( umbers Signature) Sworn to before me this 0161, C)IW Ke-r- day of 20 ,Oy SUSAN A.RIZZO Rotary Public,State of New York No.01 RI6183459 �+l Qualified in Suffolk County Notary Public, r7d� County Commission Expires March 17,20Z8 1 �o�aOF SO1/4*1 - �IS # TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 INSPECTION [ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ I. INSULATION/CAULKING [ ] FRAMING/STRAPPING [ a4l N A L Gt s /:�;// [ ] .FIREPLACE & CHIMNEY. - f ' ] FIRE SAFETY INSPECTION [ ] _FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: -g— C-V ?"(yw .2 DATE - INSPECTOR 0FS0UTyO� c -/�a # # TOWN -OF SOUTHOLD BUILDING DEPT. cou . 631-765-1802 IV- [ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG. ] FOUNDATION'2ND [ ] INSULATIOWCAULKING [ ] FRAMING/STRAPPING [ ] .FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY`INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE'RESISTANT PENETRATION [ ] .ELECTRICAL (ROUGH) [x] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: 84 e AetA swtoke iA beJ ku i Il v` 6 ect kM ►1ee� marba& C�, -5J_e DATE a INSPECTOR N. J. MAZZAFERRO, P.E. PO Box 57, Greenport,N.Y. 11944 Phone- 516-457-5596 Consulting Engineer October 28, 2024 Design, Construction, Inspection Page 1 of 1 Town of Southold-Building Department 53095 Main Road Southold,NY 11971 Re: Smith 155 Glover Street Southold,N.Y. 11971 District-1000, Section-59. Block-11 Lot-2 Building Permit Number—As Built Alterations Inspection—Existing Garage to Bedroom Conversion -Rough Plumbing On December 23, 2022 and October 24, 2024, I inspected the interior of the garage to bedroom conversion in the existing house. The inspection covered the interior plumbing roughing for the Drainage Waste and Vent System(DWV) and the Water Supply System(WS)of the new bathroom. The inspection results are: 1 —DWV—System was exposed and readily viewed. I observed all drainage and vent lines. System constructed as required.New installation is connected to the existing system. 2—WS—System was exposed,pressurized and readily viewed. i observed all hot and cold water supply lines. System constructed as required. Result—Based upon inspection of this project and to the best of my knowledge, belief and professional judgment, construction as installed complies with the plans and applicable codes of the IRC,NYS and Southold Town Building Codes. E OF N ro M Nicholas J. Mazzaferro, P.E. z o w w Z�Fp . 05 Z� AR�FESSION��� N. J. MAZZAFERRO, P.E. PO Box 57, Greenport,N.Y. 11944 Phone - 516-457-5596 Consulting Engineer October 28, 2024 Desio, Construction, Inspection Page 1 of 1 Town of Southold-Building Department 53095 Main Road Southold,NY 11971 Re: Smith 155 Glover Street Southold,N.Y. 11971 District-1000, Section-59. Block-11 Lot-2 Building Permit Number—As Built Alterations Inspection—Existing Garage to Bedroom Conversion On December 23, 2022 and October 24, 2024, I inspected the existing interior construction at the noted location. The inspection covered the framing and insulation for the interior walls of the garage to bedroom conversion of the existing house. The areas inspected included the walls and ceiling and exterior window. The framing and insulation work included the floor, interior walls and ceilings. The inspection results are: Items inspected included lumber size, dimensional spacing, connections, and integration with the concrete foundation. The existing insulation placement was verified. The insulation(R-13 walls R-30 ceiling)meets code requirements. Result—Based upon inspection of this project and to the best of my knowledge,belief and professional judgment, construction as installed complies with the plans and applicable codes of the IRC,NYS and Southold Town Building Codes. Nicholas J. Mazzaferro,P.E. P��0 NEw ro O . tv F AR�FESSIONr� N. J. MAZZAFERRO, P.E. PO Box 57, Greenport,N.Y. 11944 Phone- 516-457-5596 Consulting Engineer October 28, 2024 Design, Construction, Inspection Page 1 of 1 Town of Southold-Building Department 53095 Main Road Southold,NY 11971 Re: Smith 155 Glover Street Southold,N.Y. 11971 District-1000, Section-59. Block-11 Lot-2 Building Permit Number—As Built Alterations Inspection—Existing Basement On December 23, 2022 and October 24, 2024, I inspected the existing basement construction at the noted location. The inspection covered the framing and 'insulation for the interior walls of the basement of the existing house. The areas inspected in the basement included the walls and ceiling and exterior egress window. The framing and insulation work included the interior walls and ceilings. The basement has one (1) egress window that conforms to the current code. The inspection results are: Items inspected included lumber size, dimensional spacing, connections, and integration with the concrete foundation. The.existing insulation placement was verified. The insulation(R-10 walls R-30 ceiling)meets code requirements. Result—Based upon inspection of this project and to the best of my knowledge,belief and professional judgment, construction as installed complies with the plans and applicable codes of the IRC,NYS and Southold Town Building Codes. R t�OF h' Y Nicholas J. Mazzaferro, P.E. 0 w �O 0570�� ROPESSI000, N. J. MAZZAFERRO, P.E. PO Box 57,.Greenport,N.Y. 11944 Phone- 516-457-5596 Consulting Engineer October 28, 2024 Design, Construction, Inspection Page 1 of 1 Town of Southold-Building Department 53095 Main Road Southold,NY 11971 Re: Smith 155 Glover Street Southold,N.Y. 11971 District-1000, Section-59. Block-11 Lot-2 Building Permit Application—As Built Alterations This is in reference to the As-Built Conditions at 155 Glover Street, Southold NY. The work included: 1 - Conversion of an existing Garage space to a Bedroom and Bathroom. 2—Conversation of an existing Basement Storage Area to a Family Room. Both projects included framing and insulation work. The garage conversation also included plumbing installations. There was no work performed on the existing main house area. This area was only refurbished with new finishes. The septic system was previously noted as a 4- Bedroom System installed in 2021. The current configuration of the house includes a total of two (2)bedrooms. The exterior dimensions of the house did not change,the setbacks shown on the survey are still current and correct. Nicholas I Mazzaferro,P.E. �- ��. � � f , . � / I } 4..... � � » • 1 �-, . . .t, A { 4 A-, Y.RY. �,�: _ _ y, ��� ,> .�" .'��` r�. �Y r t � . ��, � :� � �� a c. ,f. ��;r.: i � 1 e • ,�. �u _ _ a r ��~ 7 ,� 1 i �� _ " y. _ tiff a Y w - 6 7 V 1�\ A; t ire r , f c� !, t f LN _ -�_ �17t Ohl j�� �,,- 1 • ;�F� f Cb— •� �1,9 -•iit� j ;�� -� _ d l t N. J. MAZZAFERRO, P.E. PO Box 57, Greenport,N.Y. 11944 D E Phone - 516-457-5596 Consulting Engineer December 20, 2024 Design, Construction, Inspection Page 1 of 1 Town of Southold-Building Department 53095 Main Road Southold NY 11971 Re: 155 Glover St Southold,N.Y. 11971 District-1000, Section-59,Block-11, Lot-2 Building Permit Application for Alterations Inspection—Existing Septic System On October 23, 2022, I inspected the existing septic system at the noted location. The inspection covered the location and size of the septic system components. —The System includes a precast concrete septic box(1250 gallon)and two precast concrete leaching pools. Each pool has precast one ring(8'diameter x 6'-0"deep) and a concrete cover. System is performing as designed. -The System construction was approved by SCDOH on May 20, 2021. The approval for installation was done using the SCDOH Contractors Portal by a licensed handler. The size of the System components is based upon SCDOH Standards. The Suffolk County Install Management Number is 2400713. (copy of contractor's documents are attached). Result—Based upon inspection of this site and to the best of my knowledge,belief and professional judgment,the Septic System, as existing, complies with the SCDOH Requirements for a four(4)bedroom house. OF EW Y O Nicholas J. Mazzaferro, P.E. c� 0 a 051 AROFEssioN�`'� L 1 wcu 156 j 77 K /I l/ f J I ,f ` I i f i t Jx. 1ELD INSPECTION REPORT DATE COMMENTS -o rim FOUNDATION (IST) - --- ---- =3 ----------------------------------- — ------ - C FOUNDATION (2ND) - ROUGH FRAMING& c' PLUMBING � v I o^ - - r r� INSULATION PER N.Y. STATE ENERGY CODE � 1 FINAL -._-- ADDITIONAL COMMENTS a-�3-a �of f+ D� �1�c � ���g►5 po 0 --- m -- -- -- x _ b �SpFFOIq�v TOWN OF SOUTHOLD—BUILDING DEPARTMENT Gy; y ��' Town gull Annex 54375 Main Road.P..0.Box 1.179 Southold,NY 11971-0959 oy • Telephone(631)765-1802 Fax(631)765-9502 hgps://www.southoldtownny. Date Received APPLICATION FOR BUILDING PERMIT I � r Office Use Only Li L ! j �i PERMIT NO. Building Inspector: t OCT 2 8 2024 Applications acid forms must be filled out)n,theVenr#`t tj Incomple#e.. applicat!ons will not be accepted •:Where:AAe Apphcant..is nottfie owner,an: I'_±tlldir, I,°S3,;rty"F72ri'� Owner's Autfiorpzatlon form:(Page 2}shall be c®rialoletd ?'eai�;= u.i�o ld Date: VD ER( I. OWNSi OF PROPERTY: Name: �0s�lv c- S � Sam#1000- S�j ,� 11--• Project Address: (OkUUe x- G�AYY-b Sa,Y�AcU PY V\rl I Phone#: ��lC�. (�`� Email: ' Sl%�,S \�l�C c7 1\�s� .VA Mailing Address: ® Ice -A%)\s ":xNA.A in XONTACT;PERSON: ., J Name: C)V,) Mailing Address: Phone#: TTM DESIGN PROFESSIONAL INFORMATION: Name: `h►��.-�� �-o Mailing Address: IY OY 0160h Phone#: �j �'� 1 Email: ���ii Z'L q -e y\,-0 -V rt K , CONTRI4CTOR INFORMATION: Name: Mailing Address: Phone#: Email: DESCRIPTION:OF PROPOSED':CONSTRUCTION ' El New Structure ❑Addition XAlteration ❑Repair ❑Demolition Estimated'Cost of Project: ❑Other Will the lot be re-graded? ❑Yes No Will excess fill be removed from premises? ❑Yes XNo 1 >PROPERTY,INFORMATION Existing use of property: � � Intended use of property: 1V Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to ® this property? OYesWNo IF YES, PROVIDE A COPY. 11e k'Box After Rf'adiP g4 The oumer/contractor/design professional es responsebfeifornit dra!pge and'storm winter issues as provided b Chapter 2 of the Towwn Code..APPUCAT1oN is HEREBY P►hADE to the Building pepartment for tiieissuance of aBuitd'ing Permitpursuant to the Bteelding Zone O�dinancg'of the Town ofSouth.old;5uff,olk,County,Net York and applicable lauds,Qrdinances or Regulations;for ihe'tonstrudion of btiitdings, additions,alteratlons or for removal or demoletion;as herein,described:The applicant"agrees to comply eniith all:appticable:faws'ordiri"arises,building code, housing code and.regulatepns;end to admit authorized inspectors on premises and iq building{s)for netessary inspections.False statements made herein.are '.punishable as a Class A misdemeanor pursuant to Section 10AS ofthe New York State;Penaf LaW' ♦ c Application Submitted Bg► ri t nam �0."um 1 ❑Authorized Agent Mwner Signature of Applicant: Date: STATE OF NEW YORK) SS: COUNTY OF & I �). . )Qfih2& sfwt being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)he is the Owmr (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 L {, gday of OG�dbC✓ ,20 �' Notary Pu IicSUSAN A. RIZZO Notary Public,State of New York No.01 RI6183459 Qualified in Suffolk County PROPERTY OWNER AUTHORIZATION .Commission Expires March 17,20 (Where the applicant is not the owner) I, VFW c� M residing at V S sect O y do hereby authorize l 0Whg� t �r OH` - to apply on be alf to th own of 2Sot9hold Buildin Department for approval as described herein. G 8�d 2 Owner's Signature Date J64ker, _ Print Owner's Name 2 I N. J. MAZZAFERRO, P.E. PO Box 57, Greenport,N.Y. 11944 E I` Phone- 516-457-5596 Consulting Engineer . December 20, 2024 Design Construction Inspection' Page 1 of 1 Town of Southold-Building Department 53095 Main Road Southold NY 11971 Re: 155 Glover St Southold,N.Y. 11971 District-1000, Section-59, Block-11, Lot-2 Building Permit Application for Alterations Inspection—Existing Septic System On October 23, 2022, I inspected the existing septic system at the noted location. The inspection covered the location and size of the septic system components. —The System includes a precast concrete septic box(1250 gallon) and'two precast concrete leaching pools. Each pool has precast one ring (8'diameter x 6'-0"deep) and a concrete cover. System is performing as designed. -The System construction was approved by SCDOH on May 20, 2021. The approval for installation was done using the SCDOH Contractors Portal by a licensed handler. The size of the System components is based upon SCDOH Standards. The Suffolk County Install Management Number is 2400713. (copy of contractor's documents are attached). Result—Based upon inspection of this site and to the best of my knowledge,belief and professional judgment,the Septic System, as existing, complies with the SCDOH Requirements for a four(4)bedroom house. �PtE OF Fh'ro Nicholas J. Mazzaferro, P.E. {� 0 a w • 05? AROFFsstoN�'�' Suffolk County Department , iieallh Services fOffice of Wastewater Management 366 YaphankAvenue,Suite 2C Vaphank,New York I I080 ' (631)852-5700 OR tiealthNVN1'M@suffolkeountyny.gov CERTIFICATION OF SEWAGE DISPOSAL SYSTEM BY INSTALLER This certification shall not be used in lieu of inspections required by personnel of the Department and maybe dttpGcatcd on company letterhead,provided it contains tlae info nut(on:;below L.euye,hlnnk any items that are not applicable to the installation i Health Department Reference Number: Suffolk Tax Map##: Dist: ��3 a b 1 sect(s) Blk(s) Project Name or Address: 1 sf Applicant's Name: S,err i ` Date of System Installation: Z16--h Sketch below the measurements from.building I/A 0WTS TREATMENT UNIT corners to the access covers/ports of disposal system, Make and Model: or attach a separate sketch prepared by installer: Rated Daily Treatment Capacity(gallons): Material•_a []Concrete [] Fiberglass/Plastic SEPTIC TANK Volume(gallons): .;!!;o Material: ;61-Concrete [] Fiberglass/Plastic Shape: [] Rectangular Wylindrical Top: ' [] Slab [] Traffic Slab [h' Dome'° Name of Tank Manufacturer:C DISTRIBUTION LEA CHING POOLS.(Xf'applieable) 30 Number of Pools Diameter and Effective Depth Top: [] Slab [I Traffic Slab '],[ Dome Name of Precast Manufacturer. Lip 2 (? 1 LEACHING POOLS/GALLEYS Total Number of Pools/Galleys S 7' l Diameter/Dimensions and Effective Depth (�, .- Top: [ ] Slab [] Traffic Slab [%Dome [] N/A Name of Precast'Manufacturer. OTHER LEACHING STRUCTURES — —_- - Make and Model (if applicable): Total Linear Feet of Leaching Structure(s); DEC M COVERS AND LIDS Installed covers comply with current standards (secondary safety device installed if cover weight.less than 601bs) &'Ves [] N/A I hereby certify that the subsurface sewage disposal system,described herein,has t een installed by mein accordance with thi:approved plans andstandard of the Suffolk Count y Department of Health Services;and any and all mechanical/electrical components have been tested and are operational.` l-. .. i Installer's Signature: r Date X Installer's Name: mac' �— Company Name:" Phone 3!- s'"�/ 1 C,Mpany Address: c t, 1 c,Consumer Affairs Liquid Waste License Number and endorsement(s):_,SZ$-C THIS DOCUMENT MUST CONTAIN AN ORIGINAL SIGNATURE FROM THE INSTALLER WWM-078 (04/18) Suffolk k County Department of Health Services- A' Office of wastewater Management i 160 Yaphank Avenue,Suite 2C j Yaphank,New York.11980 (01)852-5700 OR HealthW'yM@suffolkcountypy gov; i i CERTIFICATION OF SEWAGE DISPOSAL 1 CERT SYSTEM A$ANnONMENT Healtli Department Reference Number: LL_Lot(s) Suffolk Tax Map#:Dist: Sect�s) Project Name or Address: Subdivision Name&tot# ` Applicant Name:_ �-►� f d'� - I HEREBY CERTIFY THAT: _Y 1.< The first'.septic tank/leaching,pool, from the foundation,was located and uncovered,AND 2. if liquid sewage,was noted,therein,was pumped dry by a.licensed sewage hauler, AND 3. Tank/poolwas inspected for outlet line to an overflow pool, AND i 4. Overflow pool(s) was/were'located, uncovered and items#2 and#3 were repeated until all parts.,of , sanitary system.were,located,AND 5. All parts of sanitary system were removed or filled with clean backfill and any corbelled block domes collapsed. I also certify that the sanitary system abandoned consisted of ` =First tank/pool _�feet.diameter' feet deep( )precast ( f 61ock O other First°overflow pool_feet diameter 7 feet deep{ )precast lock ( ) other Next overflow pool feet diameter feet deep,( )precast ( )block Oother Next overflow pool feet diameter feet deep( `)precast'( )block ( ) other . Company which pumped out sanitary system ifdifferent from certifying company: Name of Company: Address: Consumer Affairs License Number: ' Contractor Signature: Date .,- `2 a Print Name/Compa :CESS4�0O'S,LLC Pbone6 -25 1234 Address:1096 UDALLROAD , BAY SHORE,NY 11706 Consumer Affairs License Number: 56802-LW This certification shall not be used in lieu,,of inspections required by personnel of the-Departnient and may be duplicated on company letterhead,provided it'contaiios the above information. PHOTOCOPIES OF DOCUMENTS'WILL NOT BE ACCEPTED NVWM-080 (Rev:02/12) N DEC -J :� BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD Town Hall Annex 54375 Main Road - PO Box 1179 ® Southold, New York 11971-0959 ip 4% Sao Telephone (631) 765-1802 - FAX (631) 765-9502 Iamesh(D-southoldtownny.gov - seand(a�southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: 1,2 23 Company Name: ovwa 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: �u t Address: Cross Street: 'Phone No.: V g 62�i $ l3m- ilk @P0061dir,te,A Bldg.Permit#: , 915b g email: Tax Map District: 1000 Section: Block: Lot: BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Square Footage: o Circle All That Apply: Is job ready for inspection?: ES.❑ 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 Reconnect❑Underground❑Overhead # Underground Laterals 1 FJ2 H Frame Pole Work done on Service? Y RN Additional Information: PAYMENT DUE WITH APPLICATION q e5� �S�FFp�k� BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD v Town Hall Annex - 54375 Main Road - PO JBox 1179 N ,,. ^"�; Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 mix sjL jamesh �southoIdtownny.gov seand@southoldtownny:gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: `Z ; Company Name: V,,Vk.,t-r( 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: ��5V A S M t Address: Cross Street: q'Lcu-e-'rS K-JV-- Phone No.: g b233 S Smi V O hke A Bldg.Permit email: Tax Map District: 1000 Section: Block: Lot: BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Square Footage: c7 Circle All That Apply: Is job ready for inspection?- ES.❑ NO []Rough In ❑ Final Do you need a Temp Certificate?: '❑ YES 0 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 Reconnect❑Underground❑Overhead # Underground Laterals M 1 2 H Frame Pole Work done on Service? F1 Y N Additional Information: PAYMENT DUE WITH APPLICATION �a- PERMIT# Address: Switches Outlets ll GFI's l Surface Sconces H H's � , UC Lts Fridge HW POOL Fans Mini Fr. WAD Panel Pump Exhaust Oven Sump Heater Trnsfmr Smokes DW Generator Salt Gen. Carbon Micro GrbDis Water Bond Lights Heat Pucks ERV HOT TUB/SPA Inst Hot DeHum Transfer Disc Combo Cooktop Minisplit Blower AC AH Hood Blower Service Amps Have Used Sub Amps Have r Used Comments i-ror $0 .39 w++ e 44 0t4le 1p �M ' .�{T• r ':f' t�• .'�-"ef' per'. e• ' FNV 000, 6 , Sul04 roop j• . .,a:�•;•nyv..• Q• i^ 9r `,rti'•�'•CS,y a'!yin , .{,:�'1 �}} , ,,, ' •'`� ,i. ,4•-a•` �, '� r„'1' Rat' Y �'� jC•�',j , M '�� , F,ti 11,�y•1S . r.. AREA - 24419 sq ft. ti ►:. 1 /� Y .. � •,:'.Z"f��n1.` ••`••4v,.y,.p. �4...,%rpsr+a,t�r ./q4 n��. .TM�� a,{•I.Y%'V✓rK4. -. .�- ;fit~^::•'. It r' su it.: ,tlu -0::UrH'0LD LDTO WIV :OF UNrYr' N. Y.S&F Lk - co 1000 9 Sole �,� ' 44 cERr o rO: 1 ean►x tsars ;A�60WA0.. ,:, 'No v. 27 1989 AatlE�UE AVSTRACr ►`__. WLADYSLAWA SASAUA rDI�y�,�+Q� Freporbd/n sccord00o�r N►0 0flilriNnr�� etanduds !or title urv�yl+tlt eht�b�lih �'a':� �` �• b the t.I.A,L. roved tr, ,;1* .Y.S. L/C, NO. 4.9668 ► by stNch use.b� Ttis Ner1►Yotkte #�d �,• o g Tlt/s Assoo/etlat y. " 4968 P.C. Bob.:94s rr�`• ,r /"1 410f VP OV OAS NOTED DA P.ar FEE 1 NOTIFY BUILDING DEPARTMEWT AT 631 765.1802 SAM TO 4PM FOR THE FOLLOWING INSPECTIONS: ELECTRICAL 1. FOUNDATION-TWO REQUIRED INSPECTION REQUIRED FOR POURED CONCRETE 2. ROUGH-FRAMING&PLUMBING 3. INSULATION 4. FINAL-CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTON ERRORS COMPLY WITH ALL CODES OF Additional NEW YORK STATE&TOWN CODES AS REQUIRED AND CONDITIONS OF Certification $00OLDT ZBA May Be Required. SOIITHOLD WN PLANNING BOARD 8"0 TOWN TRUSTEES N.Y.S.D OLD HPC OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFIC'- OF OCCUPANC`! l N. J. MAZZAFERRO, P.E. PO Box 57, Greenport,N.Y. 11944 Phone - 516-457-5596 . Consulting Engineer December 20, 2024 Design, Construction, Inspection Page 1 of 1 Town of Southold-Building Department 53095 Main Road Southold,NY 11971 Re: Smith 155 Glover Street Southold,N.Y. 11971 District-1000, Section-59. Block-11 Lot-2 Building Permit,Application—As Built Alterations This is in reference to the As-Built Conditions at 155 Glover Street, Southold NY. The window installed in the converted garage area is an Egress Window. This window meets the code requirements for an egress window. Nicholas J. Mazzaferro,P.E. 1 0 Nfwy ' O M sF �O 05109� C� DEC r 2024 OAROFESSIONr� r- .I , ,�* I ;. �, -.,- .. - - . 11 - �� ..I......... �,.,: -.. . . .., - . .1 . . -,. . ..:,. � - A. , . . . .11 - -,gl!.;-i;, , .. -..% . . .... � ,:R__:i;�����!��.!Illl:�:�l!l�!i::ii:���:!i m.... . lil .., �. .. .,...:L.. . . A . I .I- 0� . . � . . . - . .. :.-!�, -'�- .0 . -'* . --.- , . --� - .... I . ...I......,...... . ....... .". :�.�-...,... . , . . I . . ::.:.,. :,". 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