HomeMy WebLinkAbout43771-Z �SUFFO(,�c���� Town of Southold 7/16/2019
o P.O.Box 1179
53095 Main Rd
Southold,New York 11971
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CERTIFICATE OF OCCUPANCY
No: 40508 Date: 7/16/2019
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 2125 Pine Tree Rd, Cutchogue
SCTM#: 473889 Sec/Block/Lot: 98.4-13
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
5/21/2019 pursuant to which Building Permit No. 43771 dated 5/21/2019
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:
"AS BUILT"ELECTRICAL SURVEY
The certificate is issued to Hans,Richard&Siobhan
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 43771 05-28-2019
PLUMBERS CERTIFICATION DATED
uthorized Signature
Not TOWN OF SOUTHOLD
BUILDING DEPARTMENT
x 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#: 43771 Date: 5/21/2019
Permission is hereby granted to:
Hans, Richard & Siobhan
60 Knollwood Dr
Larchmont, NY 10538
To: electrical survey
At premises located at:
2125 Pine Tree Rd, Cutchogue
SCTM # 473889
Sec/Block/Lot# 98.-1-13
Pursuant to application dated 5/21/2019 and approved by the Building Inspector.
To expire on 11/19/2020.
Fees:
ELECTRIC $120.00
Total: $120.00
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Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 �i Q
Southold,NY 11971-0959 ® ® �® roger.richert(c-town.southold.ny.us
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To. Siobhan Hans
Address: 2125 Pine Tree Rd City: Cutchogue St: New York Zip: 11935
Budding Permit#: 43771 Section: 98 Block- 1 Lot: 13
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: AS BUILT DBA: Rocky Point Electric License No: 32644-ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service Only
Commerical Outdoor X 1st Floor Pool
New Renovation X 2nd Floor Hot Tub
Addition Survey X Attic Garage X
INVENTORY
Service 1 ph Heat Duplec Recpt 2 Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water elec GFCI Recpt Wall Fixtures 2 Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel 100a A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks
Disconnect Switches F3] Twist Lock Exit Fixtures 11 TVSS
Other Equipment: "AS BUILT" "ELECTRICAL SURVEY" "NO VISUAL DEFECTS"
"GARAGE CONVERSION"
Notes: 1-paddle fan,30a electric water heater
Inspector Signature: Date: May 28 2019
81-Cert Electrical Compliance Form As
SOUlyolo
# TOWN OF SOUTHOLD BUILDING DEPT.
�ycOU765-1802
INSPECTION
I ] FOUNDATION 1ST ROUGH P S
G. � 7
[ ] 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:
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DATE INSPECTORW
OF SiNjry
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Town Hall A,MAY 2 1 2019 41
41 Telephone(631)765-1$02
54375 Main Road ,pax g p
P.O.Box 117,9._ wy,
1%6- �Er•richer�(p;OWII s)0 OIS.ny.us
Southold,NY 11971-0959 'T.
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: G Date: ,rJPt,ji9
Company Name: Zo Kt
Name:
License No.: 1�
Address: ZiTof /2 /-c ?7—
I
Phone No.: lq-q(a5
JOBSITE INFORMATION: (*Indicates required information) k, c AAJ 4 S;o�V, a.A
*Name:
*Address: /o?5 �xm
*Cross Street:
*Phone No.: (� 3 3 q -9 �/o
Permit No.:
Tax-Map District: 1000 Section. T Block: Lot:
r
*BRIEF DESCRIPTION OF WORK(Please Print Clearly)
(Please Circle All That Apply)
Is job ready for inspection: (RNO O Ro In Final
*Do-you need a Temp Certificate: YES 1 NO
Temp Information(If needed)
*Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other
*New Service: Re-connect Underground Number of Meters Change of Service Overhead
Additional In€ormation: PAYMENT DUE WITH APPLICATION
W-Request for Inspection Form �/