HomeMy WebLinkAbout36515-ZTown of Southold
P.O. Box 1179
53095 Main Rd
Southold, New York 11971
CERTIFICATE OF OCCUPANCY
8/4/2015
No: 37690 Date: 8/4/2015
THIS CERTIFIES that the building ELECTRICAL
Location of Property: E End Rd, Fishers Island
SCTM #: 473889 Sec/Block/Lot: 5.4-3.3
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
6/27/2011 pursuant to which Building Permit No. 36515 dated 6/27/2011
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:
100 AMP SERVICE TO WELL PUMP HOUSE
The certificate is issued to Andrews III, Mark & Andrews, Elizabeth Qu
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
36515
07-15-2015
C�
Authorized Signature
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit #: 36515 Date: 6/27/2011
Permission is hereby granted to:
Andrews III, Mark & Andrews, Elizabeth Quay
30 Sutton PI
New York. NY 10022
To: Re -connect service on irrigation pumphouse
At premises located at:
E End Rd. Fishers Island
SCTM # 473889
Sec/Block/Lot # 5.-1-3.3
Pursuant to application dated 6/27/2011
To expire on 12/26/2012.
Fees:
and approved by the Building Inspector.
Total: $0.00
Building Inspector
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
r.
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 #: 36515 Date: 6/27/2011
Permission is hereby granted to:
Andrews III, Mark & Andrews, Elizabeth Quay
30 Sutton PI
New York. NY 10022
To: Re -connect service on irrigation pumphouse
At premises located at:
E End Rd. Fishers Island
SCTM # 473889
Sec/Block/Lot # 5.-1-3.3
Pursuant to application dated 6/27/2011
To expire on 12/26/2012.
Fees:
and approved by the Building Inspector.
Total: $0.00
Building Inspector
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Telephone (631) 765-1802
Fax(631)765-9502
roger. riche rt(aD_town.southold.ny.us
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Mark Andrews
Address: 1048 Castle Road #63 City: Fishers Island St: New York Zip: 6390
Building Permit #: 36515 Section: 5 Block: 1 Lot: 3.3
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: "AS BUILT" DBA: License No,
Residential
Commerical
New
Addition
X
Indoor
Outdoor
Renovation
Survey
Heat
Duplec Recpt
SITE DETAILS
Office Use Only
Basement
1st Floor
2nd Floor
Attic
INVENTORY
Service Only
Pool
Hot Tub
Garage
Service 1 ph
100A
Heat
Duplec Recpt
Ceiling Fixtures
1
HID Fixtures
Service 3 ph
Hot Water
GFCI Recpt
3
Wall Fixtures
Smoke Detectors
Main Panel
100A
A/C Condenser
Single Recpt
Recessed Fixtures
CO Detectors
Sub Panel
A/C Blower
Range Recpt
Fluorescent Fixture
Pumps
Transformer
Appliances
Dryer Recpt
Emergency Fixtures
Time Clocks
1
Disconnect
100A
Switches
1
Twist Lock
Exit Fixtures
TVSS
Other Equipment:
100A Service To Well Pump House, 1- Control Panel, 1- 1.5 HP Well Pump
Notes: AS BUILT - ELECTRICAL SURVEY- NO VISUAL DEFECTS
Inspector Signature: Date: Jully 15, 2015
Electrical 81 Compliance Form.xls
pE SOUr�,Olo
G Q
94-7
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
] FOUNDATION IST
] FOUNDATION 2ND
]
FRAMING/ STRAPPING
] FIREPLACE A CHIMNEY
] FIRE RESISTANT CONSTRUCTION
] ELECTRICAL (ROUGH)
] CODE VIOLATION
REMARKS:
[ ]ROUGH PLUMBING
[ ]INSULATION
[ ]FINAL
[ ]
FIRE SAFETY INSPECTION
C ] FIRE RESISTANT PENETRATION
[ELECTRICAL (FINAL)
[ ]CAULKING
i` %1`"i C (W4-- 0 6,S,.rf__
DATE i INSPECTOR '9��
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, NY 11971-0959
=STED BY.
ny Name:
Name:
;erase No.:
dress:
one No.:
Telephone (631) 765-1802
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
JOBSITE INFORMATION: (*Indicates required information)
*Name:
*Address:
*Cross Street:
*Phone No.:
Permit No.:
Tax -Map District:
Date:
,7' L 4 -ft-.? '6�
1000 Section: Block: __L_ Lot:
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
(Please Circle Ail That Apply)
*Is job ready for inspection: Y/ NO Rough in Final
*Do -you need a Temp Certificate: (YES NO
Temp Information (if needed)
*Service Size: 1 Phase 3Phase 100 150 200 300 350400 Other
*New Service: Re -connect Underground Number of Meters Change of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
C'
.82=Request for Inspection Fotrn
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Tome 14all Ajincx �+_ r Telephone (GSI) 765-1802
5,13751riain Road d r
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P.O. Box 1179 . ` , ,_ I'CgEr. IC
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Sou(hold,1\Y 11971-0959
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BUILDING DEPARTMENT
TOj-N OF SOUTHOLD BLDG. DEPT.
APPLICATION FOR ELECTRICAL INSPECTI N TOWN OFSOUTHOLD
REQUESTED BY: f ,� f (mac �, E Date:
Company Name: t
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Name:
License No.:
Address:
Phone No.:
JOBSITE INFORMATION: (*Indicates required information)
*Name:
*Address:
*Cross Street:
*Phone No.: 8— %2-8
Permit No.:
Tax Map District: 1000 Section: 5 Block: Lot:
*BRIEF DESCRIPTION OF WORKPlease Print Clearly)
Y) It n rpt
42 1 1,v iol
(Please Circle All That Apply)
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*Is job ready for inspection: eYE
NO Rough In Final
*Do you need a Temp Certificate: NO
Temp Information (If needed)
*Service Size: 1 Phase;
*New Service: Re- co
Additional Informa I
3Phase 100' 150 200 300 350 400
Underground Number of Meters Change of Service
PAYMENT DUE WITH APPLICATION
Other
Overhead
6-
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82 -Request for Inspection Form
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