HomeMy WebLinkAbout47240-Z ��oS11EF0(k�p�y Town of Southold 1/8/2022
P.O.Box 1179
o ` 53095 Main Rd
y��! �: Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 42665 Date: 1/8/2022
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 36980 CR 48,Peconic
SCTM#: 473889 Sec/Block/Lot: 69.-4-8.5
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
12/17/2021 pursuant to which Building Permit No. 47240 dated 12/17/2021
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 overhead electric service.
The certificate is issued to Ciaglo Jr,Chester
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 47240 12/28/2021
PLUMBERS CERTIFICATION DATED
Authorized S' ure
o�su�ena�co
TOWN OF SOUTHOLD
�� ay BUILDING DEPARTMENT
y x TOWN CLERK'S OFFICE
Wow • 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#: 47240 Date: 12/17/2021
Permission is hereby granted to:
Ciaglo Jr, Chester
36980 CR 48
Peconic, NY 11958
To: 200A overhead electric service.
At premises located at:
36980 CR 48, Peconic
SCTM # 473889
Sec/Block/Lot# 69.4-8.5
Pursuant to application dated 12/17/2021 and approved by the Building Inspector.
To expire on 6/18/2023.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
0�,t,0f S0�/r�,®l
Town Hall Annex ~ O Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 sean.deviinCa-)town.southold.ny.us
Southold,NY 11971-0959
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: Chester Ciaglo Jr
Address: 36980 CR 48 city:Peconic st: NY zip: 11958
Building Permit#: 47240 Section: 69 Block: 4 Lot: 8.5
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 Service X
Commerical Outdoor X 1st Floor Pool
New X Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph X Heat Duplec Recpt Ceiling Fixtures Bath Exhaust Fan
Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures Smoke Detectors
Main Panel 200A A/C Condenser Single Recpt Recessed Fixtures CO2 Detectors
Sub Panel 50A A/C Blower Range Recpt Ceiling Fan Combo Smoke/CO
Transformer UC Lights Dryer Recpt Emergency Fixtures Time Clocks
Disconnect Switches 3 4'LED Exit Fixtures Pump
Other Equipment: 200A Panel 42 Circuit/ 9 Used, 50A Sub 16 Circuit/ 12 Used
Notes: Service
Inspector Signature: Date: December 28, 2021
S.Devlin-Cert Electrical Compliance Form
'pf SO Ll
* # TOWN OF SOUTHOLD BUILDING DEPT.
�ycou765-1802
INSPECTION
] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ -:] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING/STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE'SAFETY-INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ . ] ELECTRICAL (ROUGH) KA ELECTRICAL (FINAL)
[ ] CODE VIOLATION ]] PRE C/O
REMARKS: &4;;5
DATE Z t INSPECTOR
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of SOUIyo Zai a e o &f 416
7
#
Tr"OWN SO THOLD BUILDING DEPT.
caurm `' 765-1802
INSPECTI-ON
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] 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: : V
J
DATE - 42J -2,7 INSPECTOR ��
v AFFOLA,.0,
y� BUILDING DEPARTMENT-Electrical Inspector
y z TOWN OF SOUTHOLD
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• Town Hall Annex-54375 Main Road-PO Box 1179-Southol;d, NY 11971-0959
y��4 �� Telephone (631) 765-1802-FAX (631) 765-9502
Temporary Certificate #__1LGa#__1Date 1 2021
Customer Name Electrician Name*K3 C® '
Address 10 L4 / Phone
e-mail e-mail zf ,
Phone License##
Size 6) A Phase�_Overhead�Underground #of Meters
Remarks
#of Underground Laterals 1 2 New
"H" Frame or Polel H P Fire Reconnect
Was work done on Service? Y/N Flood 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 90 days from the date above.
Authorized by � �
OS�¢Fat�t' BUILDING DEPARTMENT-Electrical Inspector
TOWN OF SOUTHOLD
Town Hall Annex- 54375 Main Road - PO Box 1179
o • �, Southold, New York 11971-0959
Telephone (631) 765-1802 - FAX (631) 765-9502
roqerrO
southoldtownny.gov seandCa)_southoldtownnv.gov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (AII Information Required) Date: 11Z-61—;?-1
Company Name:
Electrician's Name: /7a
License No.: 1 7—11,yJ Elec. email:
Elec. Phone No: 6 '3 3 S-751612- 21"request an email copy of tertificate of Compliance
Elec. Address.: 3;ia � 4n r ti,R
JOB SITE INFORMATION (All Information Required)
Name: Chesf-rr- C f"g910
Address: 36V0 (wo Rag I8 Pe cops,C ivy I
Cross Street:
Phone No.: 6 3 l " �� °j 6°J j
email:
Bldg.Permit#: 4�aP,'tie vctrs I mdtScA� � a d�ccs -A1n
Tax Map District: 1000 Section: Block: Lot:
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
Square Footage:.
Circle All That Apply:
Is job ready for inspection?: YES ❑ NO [:]Rough In Final
Do you need a Temp Certificate?: CYES NO Issued On
Temp Information: (All information required)
Service Size1 Ph❑3 Ph Size: �LVy A #Meters ✓ Old Meter#
❑
New--Service[]Fire Reconnect❑Flood Reconnect❑Service Reconnect❑Und - nd verhead
# Underground Laterals M1 2 H Frame El Pole Work done on Service. r IN
Additional Information.:
PAYMENT DUE WITH APP (CATION ��
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