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44272-Z
aZEM offat/r. Town of Southold 10/24/2019 P.O.Box 1179 °' nom, 53095 Main Rd o4A� tai Southold,New York 11971 �4 CERTIFICATE OF OCCUPANCY No: 44272 Date: 10/24/2019 THIS CERTIFIES that the building ELECTRICAL Location of Property: 15555 New Suffolk Ave,New Suffolk SCTM#: 473889 Sec/Block/Lot: 117.-6-16.4 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/10/2019 pursuant to which Building Permit No. 44272 dated 10/10/2019 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 UNDERGROUND ELECTRIC SERVICE The certificate is issued to Schmidt,Edward&Sharon of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 44272 10-17-2019 PLUMBERS CERTIFICATION DATED Authorized Signature sUFEQi� TOWN OF SOUTHOLD BUILDING DEPARTMENT M. TOWN CLERK'S OFFICE o . SOUTHOLD, NY 0 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#: 44272 Date: 10/10/2019 Permission is hereby granted to: Schmidt, Edward ` PO BOX 263 New Suffolk, NY 11956 To: 200 AMP underground electric service At premises located at: 15555 New Suffolk Ave, New Suffolk SCTM # 473889 Sec/Block/Lot# 117.-6-16.4 Pursuant to application dated 10/10/2019 and approved by the Building Inspector. To expire on 4/10/2021. Fees: ELECTRIC $85.00 Total: $85.00 7( r Building Ins Town Hall Annex ® Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 sean.deviinA-town.southold.ny.us BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To- Edward Schmidt Address: 15555 New Suffolk Ave city:New Suffolk sr NY zip. 11956 Building Permit#. 44272 Section. 117 Block 6 Lot: 16.4 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: G&S Electric License No: 578-ME SITE DETAILS Office Use Only Residential X Indoor X Basement Service Only X Commerical Outdoor X 1st Floor Pool New X Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 1 ph X Heat Duplec Recpt Ceding 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 Fixtures Time Clocks Disconnect Switches Twist Lock Exit Fixtures Combo SD/CO Other Equipment. Meterpan, 42- Circuit Panel Notes New Service Inspector Signature: Date: October 17, 2019 S.Devlin-Cert Electrical Compliance Form.xls ho�apF SOUTyo� G/ jA- TOWNOF SOUTHOLD BUILDING DEPT. I S� 765-1802 INSPECTIONAw` ] FOUNDATION 1ST [ ] ROUGH PLBG. j ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] `FINAL FIREPLACE & CHIMNEY [ ] -FIRE SAFETY INSPECTION, [ ] FIRE RESISTANT CONSTRUCTION ( ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL)� lCi [ ] CODE VIOLATION (1 41 PRE C/O REMARKS: ;R AJ&L-, "994P 1 CM, MIS 47 DATE 116 M INSPECTOR 1 •a pfFOt,� _ BUILDING DEPARTMENT- Electrics°liispector°, 1 �; r ' o�S CSG L k TOWN OF SOOT OLD i ® Town Hall Annex - 54375 Maiu_i6a1d - x 9 a x Southold, New York 11971 9po w ^y Telephone (631) 765-1802 - FAX (631)765-9502 rogerr southoldtownny.gov - seandea.sbuthol'd,t hny:gov J x_ 'ii APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: D 9 /9 Company Name: 4 < 'r-_*Lf-:--C--(Z4 C_ Name: C.-JAan-t 4;--c--c-D License No.: email: �' 16`LkdL ,A,3 t , c.erm Address: ?o �. �� S o u o� -�► Phone No.: s! JOB SITE INFORMATION (All Information Required) Name: * l W.4&P SC /►1. r�� Address: /,SSSS. 5 .S r--r-yL-i c A !/9J'L Cross Street: GeA -jj- LjoXc_- 1Z Z::,. Phone No.: fs pool/ Bldg.Permit#: email: Tax Map District: 1000 Section: Block: Lot. ,BRIEF DESCRIPTION OF WORK (Please Print Clearly) ®o .4^%P, ! U NQr� & A.C> 'Jto 0 S �Mu c cr '7b Fo syiz,C Poica_ Al Circle All That Apply: , Is job ready for inspection?: YES / NO Rough In Final Do you need a Temp Certificate?: YES / NO Issued On I ©, Temp Information: (All information required) Service Size 1 P 3 Ph Size: ao0 A # Meters Z Old Meter# �ServiceFire Reconnect - Flood Reconnect - Service Reconnected 4nderground Overhead # Underground Laterals 2 H Frame Pole Work done on Service? Y N Additional Information: PAYMENT DUE WITH APPLICATION q Request for Inspection Form As 1/0 r