HomeMy WebLinkAbout45303-Z Town of Southold 10/30/2020
P.O.Box 1179
o'
e 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 41572 Date: 10/30/2020
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 21380 Route 25, Cutchogue
SCTM#: 473889 Sec/Block/Lot: 109.4-37
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
10/8/2020 pursuant to which Building Permit No. 45303 dated 10/8/2020
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:
electric panel in accessory barn.
The certificate is issued to Elak Jr,John
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL -
ELECTRICAL CERTIFICATE NO. 45303 10/14/2020
PLUMBERS CERTIFICATION DATED
Authorized ignature
�o�gHff 1��, � TOWN OF SOUTHOLD
ay BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
a� • SOUTHOLD, NY
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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#: 45303 Date: 10/8/2020
Permission is hereby granted to:
Elak Jr, John
21380 Route 25
Cutchogue, NY 11935
To: Electric panel in accessory barn.
At premises located at:
21380 Route 25, Cutchogue
SCTM #473889
Sec/Block/Lot# 109.-1-37
Pursuant to application dated 10/8/2020 and approved by the Building Inspector.
To expire on 4/9/2022.
Fees:
ELECTRIC $170.00
Total: $170.00
Building Inspector
Town Hall Annex ® Telephone(631)765-1802
54375 Main Road v =. W;. Fax(631)765-9502
P.O.Box 1179 .<
Southold,NY 11971-0959 � ` x�� sean.devlin(W-town.southold.ny.us
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: John Elak Jr
Address: 21380 Route 25 city,Cutchogue st: NY zip: 11935
Building Permit#: 45303 section: 109 Block 1 Lot: 37
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Lademann Electric License No:
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service
Commerical Outdoor X 1 st Floor X Pool
New Renovation 2nd Floor Hot Tub
Addition Survey X Attic Barn X
INVENTORY
Service 1 ph X Heat Duplec Recpt 1 Ceiling Fixtures Bath Exhaust Fan
Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures Smoke Detectors
Main Panel A/C Condenser Single Recpt 1 Recessed Fixtures CO2 Detectors
Sub Panel A/C Blower Range Recpt Ceding Fan Combo Smoke/CO
Transformer UC Lights Dryer Recpt Emergency Fixtures Time Clocks
Disconnect Switches 4'LED Exit Fixtures Pump
Other Equipment: Welder Outlet-240, 8 Circuit Panel w/40A Feed
Notes: AS BUILT, NO VISUAL DEFECTS " Power in Barn
Inspector Signature: Date: October 14, 2020
S.Devlin-Cert Electrical Compliance Form.xls
SO(/lyO� L4 �� 'Zi `; �V
# TOWN OF SOUTHOLD BUILDING DEPT.-
765-1802
INSPECTION
C' ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ . ] INSULATIOWCAULKING
[ ] FRAMING/STRAPPING [ ] FINAL
C ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) r>tELECTRICAL (FINAL)
[ ] CODE VIOLATION ] PRE C/O
REMARKS:
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DATE 16 I INSPECTOR �.�C�
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Ip , BUILDING DEPARTMENT-Electrical Inspector
TOWN OF SOUTHOLD BIDG DEPT. i
Town Hall Annex - 54375 Main RoadV&,' ,1149
Southold, New York 11971-0959
Telephone (631) 765-1802 - FAX (631) 765-9502 _
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APPL[GIATTION FOR ELECTRICAL INSPECTION.' s
ELECTRICIAN INFORMATION (Ali information Required) Date! 1v �
Company Name: , C/6 - --- -__
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License No.: email:
Address:- - (C2.5_S�1��JATr C _
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Phone No.: ��
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? JOB SITE INFORMATION (All Information Required)
Name:_- --
Address: --
Cross Street: Z)„, LA 3
Phone No:: -
Bldg.Permit#: J email: "¢
Tex Ma District 1-0-90- -_- Secfiorr - _ �_ ___ ___ Block: Lc� ,,_,
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-BRIEF DESCRIPTIOUOF WORK(Please - rint CI arly) _ Re�� -c� �..rJ..
Circle All That Apply:
Is job ready for inspection?: (Y4/-
NO Rough In Final i
Do you need a Temp Certificate?: YES / NO Issued-On
Temp Information01Ph
(All'information required)
A .
Service Si;e 3 Ph Size:, __ _ #Meters Old Meter# =a
New Service- Fire Reconnect-Flood Reconnect-Service Reconnected- Underground -Overhead
Underground Laterals 1 2- H Frame Pole Work done on Service? -Y N
Additional-Information:
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Request for Inspection FormAs
PERMIT# Address:
Switches
Outlets"`
GFI's C,
Surface
Sconces
,H H's
UC Lis
Fans Fridge HW
Exhaust Oven Dryer
Smokes DW Service
Carbon Micro Generator ,
Combo Cooktop Transfer
AC AH Mini
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Special:
Comments
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OCT - 5 2020
BUILDING DEPARTMENT- Electrical Inspector
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Town Hall Annex - 54375 Main Road
Southold, New York 11971-0959
Telephone (631) 765-1802 - FAX (631) 765-9502
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APPLIG, [ON FOR ELECTRICAL INSPECTION,
ELECTRICIAN INFORMATION (All information Required) Date:
Company Name:
Name:
License No.: email:
Address: IC25
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Phone No.: S)t -734(
JOB SITE INFORMATION (All information Required)
Name:
Address:
Cross Street:
Phone No.: _6 I I., 5<) 09S
Bldg.Permit email:
Tax Map District:_ 1000 —.Sqptiow770 _7 Block: Lot:,
BRIEF DESCRIPTION OF WORK (Please�rint Marl r2 -E2-e L) c
Circle All That Apply:
Is job ready for inspection?: YES / 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
1# Underground Laterals 1 2 H Frame Pole Work done on Service? Y N
Additional Informatior%'
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PAYMENT DUE WITH APPLICATION
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Request for Inspection Formals