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Fol Town of Southold 5/3/2019
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P.O.Box 1179
53095 Main Rd
�4,, o�� Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40358 Date: 5/3/2019
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 3350 W Creek Ave, Cutchogue
SCTM#: 473889 Sec/Block/Lot: 110.4-12
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
4/23/2019 pursuant to which Building Permit No. 43669 dated 4/23/2019
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:
200 AMP OVERHEAD ELECTRIC SERVICE
The certificate is issued to New Suff Properties LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 43669 04-29-2019
PLUMBERS CERTIFICATION DATED
Authorized Signature
sv oi�. TOWN OF SOUTHOLD
BUILDING DEPARTMENT
y TOWN CLERK'S OFFICE
-oy • 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#: 43669 Date: 4/23/2019
Permission is hereby granted to:
New Suff Properties LLC
Attn: Lawrence Willis
6775 New Suffolk Rd
New Suffolk, NY 11956
To: Electric Service
At premises located at:
3350 W Creek Ave, Cutchogue
SCTM #473889
Sec/Block/Lot# 110.-1-12
Pursuant to application dated 4/23/2019 and approved by the Building Inspector.
To expire on 10/22/2020.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
Town Hall Annex ® Telephone(631)765-1802
54375 Main Road C Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 ,c► ® �® roger.richert(D-town.southold.ny.us
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: New Suffolk Properties
Address: 3350 W Creek Ave City: Cutchogue St: New York Zip: 11935
Building Permit* 43669 Section- 110 Block- 1 Lot: 12
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Goodale Electric License No: 783-E
SITE DETAILS
Office Use Only
Residential Indoor Basement Service Only
Commerical X Outdoor X 1 st Floor Pool
New X Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph 200a Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel 200a A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency FixturesTime Clocks
Disconnect 200a Switches Twist Lock Exit Fixtures TVSS
Other Equipment: 200a overhead service (meter main)
Notes.
Inspector Signature: ' , -__ Date: April 29 2019
81-Cert Electrical Compliance Form.xls
OF SOUIyo�
# # TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
��
INSPECTION . "�
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
DATE INSPECTOR
�1� of sov
Town 2��QJ 4 Telephone(6311).7865--1802
soutlwia NY 1i AQP 23 a roger r1cherl� w6Ts6 o1A.ny.us
Av
BUILDING DEPARTM W
TOWN OF SOUMOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQ ESTED BY: &�, Date: L '
Coml any Name:
Nam ---- - _.. _ - - - --- - -
Licen a No.:
Add s: U old 42T 1 TI/c-cf
Phon No.:
JOB ITE INFORMATION: (Indicates required information)
*Nam : v ��J�� C Ab�
*Add : c i-A c lel
*Cr+os Street: � r_V11-� G S .
*Pho No.: /� �!
Penn No.: 9-
Tax p District 1000 Section:. Block:
Lot:
*13RIE =DESCRIPTION OF WORK(Please Print Clearly)
(Pleas Circle All That Apply) -^
Is job ready for inspection: YES/ Rough In Final
*Do y u need a Temp Certificate: CE/ NO
Temp nfonnation{If needed)
*Servs Size: 1 Phase 33hase 100 150 200 300 350 400 Other
*New ervice: Re-connect Underground Number of Meters Change of Semen Ouerhead
Addiffc al Information: PAYMENT DUE WITH APPLICATION
Ct2k -14)d -A-4-60 Zf�
82 uest for Inspection Forth