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Home My WebLink About43695-Z �pgOF OF Town of Southold 6/17/2019 0 P.O.Box 1179 T; 53095 Main Rd oyiap0 Southold,New York 11971 0 '. 01 CERTIFICATE OF OCCUPANCY No: 40447 Date: 6/17/2019 THIS CERTIFIES that the building ELECTRICAL Location of Property: 5925 Nassau Point Rd, Cutchogue SCTM#: 473889 Sec/Block/Lot: 111.-13-6 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 4/30/2019 pursuant to which Building Permit No. 43695 dated 4/30/2019 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: 150a overhead electrical service and electrical survey. The certificate is issued to Emery Ellen F 1999 Rev Tr of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 43695 5/8/2019 PLUMBERS CERTIFICATION DATED Authorized Signature Mire TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE o • 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#: 43695 Date: 4/30/2019 Permission is hereby granted to: Emery Ellen F 1999 Rev Tr 121 Somerset Ave Garden City, NY 11530 To: Electric At premises located at: 5925 Nassau Point Rd, Cutchogue SCTM # 473889 Sec/Block/Lot# 111.-13-6 Pursuant to application dated 4/30/2019 and approved by the Building Inspector. To expire on 10/29/2020. Fees: ELECTRIC $185.00 Total: $185.00 i Building ector BuildintZ Department Application AUTHORIZATION (Where the Applicant is not the Owner) j, ELLEN F. EMERY - residing at 121 Somerset Avenue, (Print properly owner's name) (Mailing Address) Garden City, NY 11530 do hereby authorize Richard F. Lark, Esq. of (Agent) Lark & Folts, Esqs. to apply on my behalf to the Southold Building Department. r (Owner's Signature) (Date) Ellen F. Emery (Print Owner's Name) LARK& FOLTS Attorneys at Law 28785 MAIN ROAD PO BOX 973 CUTCHOGUE,NEW YORK 11935 Tele.No. (631)734-6807 RICHARD F.LARK Fax No. (631)734-5651 MARY LOU FOLTS E-mail: Attys@larkandfolts.com April 30, 2019 Michael J. Verity, Chief Building Inspector Southold Town Building Department 54375 Route 25 - P.O. Box 1179 Southold, NY 11971 RE: Ellen F. Emery and Mark J. Brosnan, as Trustees of the Ellen F. Emery 1999 Revocable Trust (SCTM #1000-111-13-6) Dear Mr. Verity: In connection with the above-captioned matter, I am enclosing an Application for Electrical Inspection along with my Check No. 2494 payable to Town of Southold in the amount of $185 . 00 . Also enclosed is the Authorization of Ellen F. Emery. If you need any other information, do not hesitate to contact me. Very truly yours, chard F. La RFL/bd Enclosures o��pF SO(/l�ol � o Town Hall Annex Telephone(631)765-1802 54375 Main Road CO- Fax(631)765-9502 P.O.Box 1179 G Q • yo rogerAchert(cD-town.Southold.ny.us Southold,NY 11971-0959 O BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Ellen F Emery Address: 5925 Nassau Point Rd City: Cutchogue St: New York Zip: 11935 Building Permit#: 43695 Section: 111 Block: 13 Lot: 6 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: AS BUILT DBA: License No: SITE DETAILS Office Use Only Residential X Indoor X Basement X Service Only Commerical ' Outdoor X 1st Floor X Pool New Renovation 2nd Floor Hot Tub Addition Survey X Attic Garage INVENTORY Service 1 ph 150a Heat Duplec Recpt Ceiling Fixtures HID Fixtures Service 3 ph Hot Water GFCI Recpt 2 Wall Fixtures Smoke Detectors Main Panel 150a A/C Condenser 1 Single Recpt Recessed Fixtures 3 CO Detectors Sub Panel A/C Blower 1 Range Recpt Fluorescent Fixture Pumps Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks Disconnect 150a Switches 6 Twist Lock Exit Fixtures TVSS Other Equipment: "AS BUILT" "ELECTRICAL SURVEY' "NO VISUAL DEFECTS" Notes: 150a overhead service,1-central airconditioner (condenser and air handler),2-bathrooms,2-bath fans,lights,GFCI,s, And switches L;tpT Inspector Signature: Date: May 8 2019 81-Cert,Electrical Compliance Form.xls 50UTy0� TOWN OF SOUTHOLD BUILDING DEPT. Comm, 765-1802 INSPECTION t," qs [ ] FOUNDATION 1ST [ ] ROUGH PLEG. � 6p [ ] 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: r V(r,� DATE l INSPECTOR T7' 12btlo�� ySFFOI,t�, BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD Town Hall Annex - 54375 Main Road'- PO Box 1179 Southold, New York 11971-0959 `Telephone (631) 765-1802 - FAX (631) 765-9502 roger richertPtown.southold.ny.us APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Richard F. Lark, 'Esq. Date: April 30, 2019 Company Name: Lark & Folts, Esqs. Name: Richard F. Lark License No.: email: attys@larkandfolts.com Address: 28785 Main Road - P.O.Box 973, Cutchogue, NY 1 "3 Phone No.: (631) 734-6801 m APR 3 0 .2019 JOB SITE INFORMATION: (All Information Required) Name: Ellen Y. Emery _ Address: 5925 Nassau Point Road, Gutcho ue, New York 11935 OWNOFSOljj'j'iganieYl Cross Street: Wunneweta Road " Phone No.: (631) 734-6807 BIdg.Permit#: 5 email: Tax Map District: '[000 Section: 111 Block: 13 Lot: 6 BRIEF DESCRIPTIOR OF WORK(Please Print Clearly) "as built" electrical work Circle All That Apply: Is job ready for Inspection?: YES^ NO Rough In Final Do you need a Temp Certificate?: YES t NO Issued On Temp Information: (All information required) Service Size 1 Ph 3 Ph Size: = # Meters Old Meter# New Service- Fre Reconnect- Flood Reconnect- Service Reconnected - Underground-,Overhead # Underground'Laterals 1 2 H Frame Pole Work done on Service? Y N Additional Information: PAYMENT DUE WITH APPLICATION I 82-Request for Inspection Forrn As 000