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43886-Z
4sp�gUFFOt,t Town of Southold � pG� 7/19/2019 0 P.O.Box 1179 W 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 40513 Date: 7/19/2019 THIS CERTIFIES that the building ELECTRICAL Location of Property: 31025 Route 25. Cutchogue SCTM#: 473889 See/Block/Lot: 102.-2-23.6 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 6/19/2019 pursuant to which Building Permit No. 43886 dated 6/19/2019 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: 200a overhead electrical service, lights and outlets. The certificate is issued to Meyer, Sandra of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 43886 6/20/2019 PLUMBERS CERTIFICATION DATED Authorized Signature Q�gUFeoa,r�oTOWN OF SOUTHOLD BUILDING DEPARTMENT 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#: 43886 Date: 6119/2019 Permission is hereby granted to: Meyer, Sandra 31025 Route 25 PO BOX 1168 Cutchogue, NY 11935 To: 200a overhead electrical service, lights and outlets. At premises located at: 31025 Route 25. Cutchogue SCTM # 473889 Sec/Block/Lot# 102.-2-23.6 Pursuant to application dated 6/19/2019 and approved by the Building Inspector. To expire on 12/18/2020. Fees: ELECTRIC $85.00 Total: $85.00 Building Inspector pF SOl�jy®�® Town Hall Annex Telephone(631)765-1802 54375 Main Road V Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 ;;t®01�® � a® roger.richerta-town.southold.ny.us ®�ff9 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To Sandra Meyer Address: 31025 Route 25 City: Cutchogue St: New York Zip: 11935 Building Permit* 43886 Section: 102 Block- 2 Lot 23.6 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 Indoor X Basement Service Only Commerical X Outdoor X 1st Floor X Pool New Renovation 2nd Floor Hot Tub Addition Survey X Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt 5 Ceiling Fixtures HID Fixtures Service 3 ph Hot Water GFCI Recpt 1 Wall,Fixtures 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 FixtureTime Clocks Disconnect Switches 2 Twist Lock Exit Fixtures 9 TVSS Other Equipment. "AS BUILT" "ELECTRICAL SURVEY" "NO VISUAL DEFECTS" BARN Notes. 100a sub panel,2-paddle fans Inspector Signature: Date: June 20 2019 81-Cert Electrical Compliance Form.xls souryOlo # TOWN OF SOUTHOLD BUILDING DEPT. cou765-1802 lNSPECTl-0N ,,,,-, . [ ] 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: /Ci4 6-5 112, 7U DATE INSPECTOR ` ,•. ..-i ' - r, ;r.• }f ,,;.. hoa71 rd of Faire-`U� I'-• ;;'�. derma•.' .flt7 :;5+;'t".,,.; ,.(•�, u' �� �, ,, city �Nurriber-ofjMet �- '�:4t��' �` � t ;,,;� .`; t �{.�t�,, •:; • = 144 .r,-, =--= Dat SizeG ?-l::z.: ,.,_°::,.,,., ` f`' u Te 20'G�f, = Phase �`' r mPorary`Certitic 7 ,•'.;<�^ :,,-. j.. _tw'- ..aF -:+5✓ 1.:''.^iitt,.; ci::,'y'�:;.j wi.:; ,:d, ,.:r, i'�i,.:<:i'.;i I� ,.. •9 t'`i, =k �dti:rl,� i':-'x;::, ;,.'"'.S+�: jf):�f13[l�C:y%OII: ..., _.-X`,n J,jT}.'. 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J' .r•. +K i'avr FORMAT(_ON.'A_LL�SPACESaMUST38E;F{IIED,IN'ORIIPPUCATIOM •Y,a ETURNED:''y;" 'tet:;' .k,,_ , AVOID,DEUIYSB(_GIGINCt_FULLANDACCURA7E,IN _ _ hM -+ `• <s";tr, T,(:t:'�' .`i`-»�*=.. :,;' r..;�;t�1`:n:l"^ :r L� i S.t.....--,'x+-, 1:3:r`"" - 'F.s::':.o-..,_t.i_`.-, r K'';y,•,''k>i- �,s i r ' L NG DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD JUN 1 2 filn Hall Annex - 54375 Main Road - PO Box 1179 • Southold, New York 11971-0959 ; Telephone (631) 765-1802 - FAX (631) 765-9502 TOS 03CI SO 'k';` d roger.richertAtown.southold.ny.us APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: �� Date: �D Company Name: l Name: License No.: email: a Address: Phone No.: JOB SITE INFORMATION: (All Information Required) Name: Address: Cross Street: Phone No.: - 7 1 6 Bldg.Permit#:Tax Map District: on:� mail: D' t ict: 1000 Secti0 ,- -�� dock: Lot: BRIEF DESCRIPTION OF WORK (Please Print Clearly) /4E*7 &1e6-XXL Circle All That Apply: Is job ready for inspection?: Tom' 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 Reconnected - Underground - Overhead # Underground Laterals 1 2 H Frame Pole Work done on Service? Y N Additional Infdrmatigq PAYMENT DUE WITH APPLICATION V19-11� JJI 82-Request for Inspection Form As