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Home My WebLink About44257-Z Q�gU�Ftitk�p� Town of Southold 12/2/2020 P.O.Boz 1179 a 53095 Main Rd 'y,�y01 �so- Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 41647 Date: 12/2/2020 THIS CERTIFIES that the building ELECTRICAL Location of Property: 475 Rambler Rd, Southold SCTM#: 473889 Sec/Block/Lot: 88.-5-32 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/4/2019 pursuant to which Building Permit No. 44257 dated 10/4/2019 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: electric for 8 x 8 accessory shed. The certificate is issued to Cvikevich,Peter&Tange,Nobuko of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 44257 11/30/2020 PLUMBERS CERTIFICATION DATED Authorize Signature �gUFFO 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#: 44257 Date: 10/4/2019 Permission is hereby granted to: Cvikevich, Peter& Tange, Nobuko ,519 Borden Ave Apt 11J Long Island City, NY 11101 To: electric for 8 x,8 shed At premises located at: 475 Rambler Rd, Southold SCTM # 473889 Sec/Block/Lot# 88.-5-32 Pursuant to application dated 10/4/2019 and approved by the Building Inspector. To expire on 4/4/2021. Fees: ELECTRIC $90.00 Total: $90.00 Building Inspector oF sovjy®l Town Hall Annex ® Telephone(631)765-1802 54375 Main Road 411 Fax(631)765-9502 P.O.Box 1179 ® sean.devlin()-town.southold.ny.us Southold,NY 11971-0959 ®�yCOO,� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To Peter Cvikevich Address: 475 Rambler Rd city.Southold st: NY zip: 11971 Building Permit#: 44257 Section: $$ Block- 5 Lot 32 WAS EXAMINED-AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Harrison Electric License No: 35534ME SITE DETAILS Office Use Only Residential X Indoor X Basement Service Commerical Outdoor X 1 st Floor Pool New X Renovation 2nd Floor Hot Tub Addition Surrey X Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt 4 Ceiling Fixtures 1 Bath Exhaust Fan Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures 1 Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures CO2 Detectors Sub Panel A/C Blower Range Recpt Ceiling Fan Combo Smoke/CO Transformer UC Lights Dryer Recpt Emergency Fixtures Time Clocks Disconnect Switches 2 4'LED Exit Fixtures Pump Other Equipment* Notes: " AS BUILT NO VISUAL DEFECTS " Wiring of Shed Inspector Signature: < ( ti Date: November 30, 2020 S.Devhn-Cert Electrical Compliance Form.xls �O�aOf SOUTyo6 Ll Li Z 9�7 l 7 3 (R—cm 6' # # TOWN OF SOUTHOLD BUILDING DEPT. `yrouNn?�'' 765.1802 IN PECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING/STRAPPING [ ] FINAL [ ] FIREPLACE '& CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: c�� a G X10/)r o�" DATE °` INSPECTOR - ( rt oSUfFoeq-c�' OCT - 1 2019 BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD Hall Annex - 54375 Main Road - PO Box 1179 o • Southold, New York 11971-0959 4,f Telephone (631) 765-1802 - FAX (631) 765-9502 rogerr(cDsoutholdtownny.gov — seand(D_southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required Date: &//Zal Company Name: �.e� / C Name: License No.: email: Address: Q C�rwi. t/, Q Phone No.: 3 ` /S JOB SITE INFORMATION (Ail Information Required) Name: Address: 7 Cross Street: ZZ Phone No.: Z�� Bldg.Permit #: ,�� email: Tax Map District: 1000 Section: 2R Block: Lot: BRIEF DESCRIPTION OF WORK (Please Print Clearly) ' �� /e� Circle All That Apply: Is job ready for inspection?: YES / O 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 Information: PAYMENT DUE WITH APPLICATION Request for Inspection Form As 1 �S%JfFGJ/r �" OCT - 1 2019 BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD Hall Annex - 54375 Main Road - PO Box 1179 o • ` '" ' ` n `'+ 6 Southold, New York 11971-0959 'y,, Telephone (631) 765-1802 - FAX (631) 765-9502 rogerr(a�southoldtownny.gov - seand(aD-southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (Ali information Required Date: &// Company Name: 141! r-f'.1.<15 A Name: License No.: ��'- 35'S3� email: , Address: ��,�• S� { g ,� Q Phone No.: JOB SITE INFORMATION (All Information Required) Name: Az� fv/ Address: 7 l Sv Cross Street: 4" Phone No.: Bldg.Permit#: �, email: Tax Map District: 1000 Section: Block: Lot: BRIEF DESCRIPTION OF WORK (Please Print Clearly) Circle All That Apply: Is job ready for inspection?: YES / O 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 Information: — --PAYME-NT-DUE-MTH-AP-PLtC/-TION - �� Request for Inspection FormAs �1 `� PERMIT# Address: Switches 11 Outlets GFI's Surface Sconces 'WH's UC Lis Fans Fridge HW Exhaust Oven Dryer Smokes DW Service Carbon Micro Generator Combo Cooktop Transfer AC AH Mini • J Special: 1 Comments 1 ` C a � � e- L94�1 - C, cn n� ��