HomeMy WebLinkAbout46191-Z •ram
�os�FFoc,�cpG_ Town of Southold 8/26/2021
y� P.O.Box 1179
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V' x 53095 Main Rd
y Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 42291 Date: 8/26/2021
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1035 Sebastians Cove Rd,Mattituck
SCTM#: 473889 Sec/Block/Lot: 100.-3-11.14
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
5/5/2021 pursuant to which Building Permit No. 46191 dated 5/5/2021
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:
existingunderground electric service to be re-energized.
The certificate is issued to Zhang,Vivian
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 46191 5/14/2021
PLUMBERS CERTIFICATION DATED
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Authorized Signature
o�SufFo"`i TOWN OF SOUTHOLD
BUILDING DEPARTMENT
y x ' TOWN CLERK'S OFFICE
oy • SOUTHOLD, NY
poi � Sao
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#: 46191 Date: 5/5/2021
Permission is hereby granted to:
Zhang, Vivian
212 Sea Cliff Ave
Sea Cliff, NY 11579
To: existing underground electric to be turned back on.
At premises located at:
1035 Sebastians Cove Rd, Mattituck
SCTM #473889
Sec/Block/Lot# 100.-3-11.14
Pursuant to application dated 5/5/2021 and approved by the Building Inspector.
To expire on 11/4/2022.
Fees:
ELECTRIC $85.00
Total: $85.00
Bui ing Inspector
* # TOWN OF SOUTHOLD BUILDING DEPT:
courm��' 765-1802
1- INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATIOWCAULKING
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY-INSPECTION
[_ ] FIRE-RESISTANT CONSTRUCTION [ ] FIRE,RESISTANT PENETRATION =
[ ] ELECTRICAL (ROUGH) /- ELECTRICAL (FINAL-)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
� U
DATE S G V INSPECTOR ���--
Tinvn IIall-Annex x Telephone(631)765-1$02.
5437.5 Main Road � � Fax(631)765-9502
P.0_Sox 3179
Southold.NY 11971-0959 44d
BUILDING DEP-ARTNIENT
TOWN OF SOL3TEIOILD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: Vivian Zhang
Address: 1035 Sebastians Cove Rd city.Mattituck st: NY zip: 11952
Building Permit* 46191 section 100 Block- 3 Lot: 11.14
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Home Ownew License No:
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service X
Commerical Outdoor X 1 st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey X Attic Garage
INVENTORY
Service 1 ph X Heat Duplec Recpt Ceiling Fixtures Bath Exhaust Fan
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel 200A 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 4'LED Exit Fixtures 11 Pump
Other Equipment-
Notes: AS BUILT NO VISUAL DEFECTS " Inspected Service to Re-Energize
Inspector Signature. < ( Date: May 14, 2021
sean.deviin(a-town.soumola.ny.us
Electrical Compliance Form As
BUILDING DEPARTMENT- Electrical Inspector
TOWN OF SOUTHOLD
N Town Hall Annex- 54375 Main Road - PO Box 1179 .
® Southold, New York 11971-0959
Telephone (631) 765-1802 - FAX (631) 765-9502
roaerra-southoldtownny.gov - seand@southoldtownny.gov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date: -S-2.,z,k
Company Name: ow ys-�
Name:
License No.: email:
Phone No: ❑I request an email copy of Certificate of Compliance
Address.:
JOB SITE INFORMATION (All Information Required)
Name:
Address: 0 m i" s Cy d ve- c� �� `�5Z
Cross Street:
Phone No.: 6Sk
Bldg.Permit#: email:
Tax Map District: 1000 Section: , 00 Block: Lot: .
BRIEF DESCRIPTION OF WORK (Please Print Clearly) 6!1EC41-�C � 'g-:5� & O-h)
Check All That Apply:
Is job ready for inspection?: PYES ❑NO ❑Rough In ❑Final
Do you need a Temp Certificate?: EJYES [—]NO Issued On
Temp Information: (All information required)
Service Size [:�1 Ph ❑3 Ph Size: �Lb A # Meters Old Meter#
❑New Service Easervice Reconnect 1� Underground FOd
# Underground Laterals ❑1 ❑2 ❑H Frame Opole Work done on Service? ❑Y [�N
Additional Information:
PAYMENT DUE WITH APPLICATION 0
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