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Home My WebLink About46340-Z �O�S�fFO�L cry Town of Southold 6/15/2021 0 P.O.Box 1179 o _ 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 42089 Date: 6/15/2021 THIS CERTIFIES that the building ELECTRICAL Location of Property: 16505 Route 25,Mattituck SCTM#: 473889 Sec/Block/Lot: 115.-2-2.3 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 6/3/2021 pursuant to which Building Permit No. 46340 dated 6/3/2021 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"electric service and wiring in kitchen. The certificate is issued to Ruland W Revoc Trt of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 46340 6/10/2021 PLUMBERS CERTIFICATION DATED J, Authorized Signature TOWN OF SOUTHOLD BUILDING DEPARTMENT CO y� TOWN CLERK'S OFFICE y • �� SOUTHOLD, NY X01ix,i� 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#: 46340 Date: 6/3/2021 Permission is hereby granted to: Ruland W Revoc Trt 50 Mill Ln PO BOX 164 Mattituck, NY 11952 To: as built" electric for dwelling. At premises located at: 16505 Route 25, Mattituck SCTM # 473889 Sec/Block/Lot# 115.-2-2.3 Pursuant to application dated 6/3/2021 and approved by the Building Inspector. To expire on 12/3/2022. Fees: ELECTRIC $150.00 Total: $150.00 Buildingeeior OF SO(/T�®l Town Hall Annex ~ ® Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 G Q sean.devlinCD-town.southold.ny.us Southold,NY 11971-0959 Comm BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Ruland E Revoc Trust Address: 16505 Rt 25 City.Mattituck st: NY zip: 11952 Building Permit#: 46340 Section. 115 Block 2 Lot: 2.3 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: AS BUILT License No: SITE DETAILS Office Use Only Residential X Indoor X Basement X Service X Commerical Outdoor X 1st Floor X Pool New Renovation 2nd Floor Hot Tub Addition Survey X Attic Garage INVENTORY Service 1 ph X Heat Duplec Recpt 6 Ceiling Fixtures 2 Bath Exhaust Fan Service 3 ph Hot Water GFCI Recpt 2 Wall Fixtures Smoke Detectors Main Panel 100A A/C Condenser Single Recpt Recessed Fixtures CO2 Detectors Sub Panel A/C Blower Range Recpt Ceiling Fan 1 Combo Smoke/CO Transformer UC Lights Dryer Recpt 30A Emergency Fixtures Time Clocks Disconnect Switches 6 4'LED Exit Fixtures 11 Pump Other Equipment Fridge, Gas Oven W/D, DW Notes: " AS BUILT NO VISUAL DEFECTS " New Wiring in Kitchen and Newer Service Inspector Signature: Z Date: j V Py' to b �� S.Devlin-Cert Electrical Compliance Form As g SOUIyO� q # # TOWN OF SOUTHOLD BUILDING DEPT. ycou765-1802 INSPECTION [ ] 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) p [ ] CODE VIOLATION [/ ] PRE C/O REMARKS:_ C L)l- T = N t DATE `� INSPECTOR SUFFOt,t=i, BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD C* - Town Hall Annex- 54375 Main Road - PO Box 1179 - I I Southold, New York 11971-0959 14,- �bp� Telephone (631) 765-1802 - FAX (631) 765-9502 ro-gerr(aD-southoldtownny.gov — seand(aD-southoldtownny.aov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: 6/3/2021 Company Name: Name: License No.: email: Phone No: ❑I request an email copy of Certificate of Compliance Address.: JOB SITE INFORMATION (Ali Information Required) Name: The William Ruland Revocable Trust Mill Lane Farm LLC Address: 16505 Main Rd Mattituck NY 11952 Cross Street: Mill Lane Phone No.: 631-806-6773 Bldg.Permit#: qv-,Jo email: rulandfarm@yahoo.com Tax Map District: 1000 ection: 115 Block: 2 Lot: 2.3 BRIEF DESCRIPTION OF WORK (Please Print Clearly) Electrical inspection for house for pre-CO Check All That Apply: Is job ready for inspection?: ❑✓ YES NO ❑Rough In [Z]Final Do you need a Temp Certificate?: DYES _ ❑✓ NO Issued On Temp Information: (All information required) Service Size ❑1 Ph ❑3 Ph Size: A #Meters Old Meter# ❑New Service ❑ Service Reconnect ❑ Underground ❑Overhead # Underground Laterals ❑1 ❑2 ❑H Frame❑Pole Work done on Service? ❑Y ❑N Additional Information: PAYMENT DUE WITH APPLICATION ' w -.5 L 5 JUN 3 2021 y Electrical Inspection Form 2020.xlsx FIVJUIPT4.G VT—FrT. PERMIT# Address: Switches o � Outlets a GFI's Surface Sconces H H's UC Lts r FansFridge I HW I ttl/ Exhaust Oven Dryer J,� Smokes DW , Service �� . uta Carbon Micro Generator Combo Cooktop Transfer AC AH Mini Special: A Comments 6-,-, C- 06��