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Home My WebLink About45985-Z ¢ S�1F�1kc t Town of Southold 12/29/2021 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 42652 Date: 12/29/2021 THIS CERTIFIES that the building ELECTRICAL Location of Property: 12800 Route 25, Mattituck SCTM#: 473889 Sec/Block/Lot: 114.-11-15 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 3/26/2021 pursuant to which Building Permit No. 45985 dated 3/26/2021 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: 200 amp underground electric service. The certificate is issued to Wickham Road LLC of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 45985 12/3/2021 PLUMBERS CERTIFICATION DATED c. Authorize ignature ��o�os�FFot TOWN OF SOUTHOLD BUILDING DEPARTMENT a y` TOWN CLERK'S OFFICE 0 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#: 45985 Date: 3/26/2021 Permission is hereby granted to: Wickham Road LLC 134 Wickham Rd Garden City, NY 11530 To: 200a underground electric service. At premises located at: 12800 Route 25, Mattituck SCTM #473889 Sec/Block/Lot# 114.-11-15 Pursuant to application dated 3/26/2021 and approved by the Building Inspector. To expire on 9/25/2022. Fees: ELECTRIC $125.00 Total: $125.0.0 B ' ing Inspector o�*pF SOUTy�I Town Hall Annex ~ O Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 • CoQ sean.devlina-town.southold.ny.us �lyC0U01 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Wickham Road LLC Address: 12800 Route 25 city:Mattituck st: NY zip: 11952 Building Permit#: 45985 Section: 114 Block: 11 Lot: 15 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: License No: SITE DETAILS Office Use Only Residential X Indoor X Basement Service X Commerical Outdoor X 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 1 ph 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: 200A Service Inspector Signature: Date: December 3, 2021 S.Devlin-Cert Electrical Compliance Form -- OF SOUlyo! TOWN OF SOUTHOLD-BUILDING DEPT. �yInurm��' 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND" [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ '] FIREPL"ACE'& CHIMNEY [ ] FIRE SAFETY INSPECTION-" [ ] FIRE RESISTANT CONSTRUCTION [ -] FIRE RESISTANT PENETRATION ] ELECTRICAL (ROUGH) rl ELECTRICAL (FINAL) [ ] CODE VIOLATION PRE C/O REMARKS: DATE INSPECTOR rq4f 80 ct # TOId OF SOUTHOLD BUILDING DEPT. Comm, 765.1802 I NSPECTION [ ] FOUNDATION 1ST [' ] ROUGH.PL13G. [ ] FOUNDATION 2ND" [ ]_ANSULATION/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: �L . . DATE �` INSPECTOR o�guFFOIK�,QG BUILDING DEPARTMENT-Electrical Inspector cz TOWN OF SOUTHOLD C4 29 Town Hall Annex-54375 Main Road-PO Box 1179-Southold, NY 11971-0959 dx�l �a0 Telephone (631)765-1802-FAX(631)765-9502 'Temporary Certificate # Date 2021 Customer Name Electrician Name � � Cu ;L Address _. ._ n v G Phone L e-mail e-mail r Ne, ^ License# Phone 5-16 Size �.�Q A Phase Overhead Underground #of Meters Remarks #of Underground LateralsgY/NFlood 2 New "H" Frame or PoleP Fire Reconnect Was work done on Service? Reconnect Old Meter# Service Reconnected Application for electrical service equipment is on file with the town of Southold.on the applicant's notification that this installation is complete,the town will conduct a premises inspection of the service equipment. This verification is valid for 0 days from the d bove. Authorized by >F144-e BUILDING DEPARTMENT- Electrical Inspector p TOWN OF SOUTHOLD Town' Hall Annex- 54375 Main Road 'RO Box 11.CS o . Southold, New York 11971-0069 dl Telephone (631) 765-1802 - FAX (631);76 02 o .richertCcs town.southoId n .us MA 1 2021 r qer >�c APPLICATION FOR ELECTRICAL INSPECTION REQUESTED"BY .... . ----------------- - ------- - - -Date: ompany Name: r' ' m10 Vame: _icense No.: S 2 2,�-,Cf email: sr 2 Ce Address: Phone No.: 2 2 JOB SITE INFORMATION: (All Information Required) Name: 7 aJ0 ' Address: r 1 '7 V e- Cross Street: Phone No:: 16 BIdg.Permit#: 14 .51 t_ email: Tale Map District: 1000 Section: 1B:lock: Lot: BRIEF DESCRIPTION OF WORK(Please Print Clearly) Circle All That.Apply Is job ready for inspection?: Y S/ NO Rough In Final Do you need a Temp Certificate?:. (:Y:E / 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:. /O£ul PAYMENT DUE WITH APPLICATION - vJ r 146, 7" q Request for Inspection Fortn.xls U FFOjk BUILDING DEPARTMENT- Electrical Inspector p TOWN OF SOUTHOLD _ Town Hall Annex - 54375 Main Road -iR0 tBox'1'179 • Southold, New York 11971=0-959 f ; dlp� Telephone (631) 765-1802- FAX (631):,76 -9P02 > roger.richertt"�town.southold.ny.usA 1 8 2021 APPLICATION FOR ELECTRICAL INSPECTION ..,-_ = - -.._.._._.._; -- -Date: .. REQUESTED-BY:.-.. .-_. - - ✓s-� ,Cod company Name: >✓ ' e game: email: -icense No.: S _ ,� s7-�/L �cT,Q-G 4ddress: �tT Phone No.: JOB SITE INFORMATION: (All Information Required) Name: ydQZ <7'01WIVO # gp4p 24c 4.1 Address: A/ G Cross Street: Phone No.: J6T Bidg.Permit#: email: '- Tax Map District: 1000 Section: �� Block: 9 Lot: 41 BRIEF DESCRIPTION OF WORK(Please Print Clearly) Circle All That Apply: Is job ready for inspection?: Y S/ NO Rough In Final Do you need a Temp Certificate?: YE / NO Issued On Temp Information: (All information required). Service Size 113h 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'lnformation: it?EW i0+`G4-' PAYMENT DILE WITH APPLICATION Request for Inspection FormAs � �' • ��