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Home My WebLink About47118-Z �o�Og11EFOLf(�OG Town of Southold 1/8/2022 o y< - P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 42673 Date: 1/8/2022 THIS CERTIFIES that the building ELECTRICAL Location of Property: 4500 Westphalia Rd.,Mattituck SCTM#: 473889 Sec/Block/Lot: 113.-11-13 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 11/17/2021 pursuant to which Building Permit No. 47118 dated 11/17/2021 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: "as built" 100 amp electric service and electrical survey, The certificate is issued to Schmidt,Rita of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 47118 12/16/2021 PLUMBERS CERTIFICATION DATED Authorized ignature gOFFQlK TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE o . SOUTHOLD, NY 0 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#: 47118 Date: 11/17/2021 Permission is hereby granted to: Schmidt, Rita 1460 Westview Dr Mattituck, NY 11952 To: as built" 100 amp electric service and electrical survey. At premises located at: 4500 Westphalia Rd., Mattituck SCTM # 473889 Sec/Block/Lot# 113.-11-13 Pursuant to application dated 11/17/2021 and approved by the Building Inspector. To expire on 5/19/2023. Fees: ELECTRIC $170.00 Total: $170.00 Building Inspector 0f SO!/ry�l Town Hall Annex ~ ® Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Q roper.richerte-town.south old.ny.us Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Rita Schmidt Address: 4500 Westphalia Rd City: Mattituck St: New York Zip: 11952 Building Permit#: L�-I 112 Section: 13 Block: I I Lot: 13 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: AS BUILT DBA: License No: SITE DETAILS Office Use Only Residential X Indoor X Basement Service Only Commerical Outdoor X 1st Floor X Pool New Renovation 2nd Floor Hot Tub Addition Survey X Attic Garage INVENTORY Service 1 ph 100a Heat oil Duplec Recpt 9 Ceiling Fixtures 3 HID Fixtures Service 3 ph Hot Water elect GFCI Recpt 4 Wall Fixtures Smoke Detectors Main Panel 100a A/C Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks Disconnect 100a Switches 4 Twist Lock Exit Fixtures TVSS Other Equipment: "AS BUILT" "ELECTRICAL SURVEY' "NO VISUAL DEFECTS" Notes: 4-GFCI circuit breakers Inspector Signature: Date: December 16 2021 81-Cert Electrical Compliance Form.xls C �OFFQL,rSOV 2��1 F.PLIPING DEPARTMENT-Electrical Inspector TOWN OF SOUTHOLD C4 Z BUILDING DE n Hall Annex - 54375 Main Road - PO Box 1179,. • TOWN OF SOUTH Southold New York 11971-0959 oy�o� a�l, Telephone (631) 765-1802 - FAX (631) 765-9502 rogerr a-southoldtownny.aov- sea nda-southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION'(AII Information Required) Date: Company Name: Electrician's Name: License No.: Elec. email: Elec. Phone No:, 0 1 'request an.email copy of Certificate of Compliance Elec. Address.: JOB SITE INFORMATION (All Information Required) Horne Name: Vi l Uia-sm._Schmid.'l" r Ri o. Schmid' owner Address: y500.. . aLt4. d:. a ck 1 Cross Street: g e' e, Phone No. 1,31 - 0198 - y5 Bldg.Permit#: L-'71 email: WSmct,1 'i- uck@ o-hoo, cora 4-..� Tax Map,District: 1000. Section: 1:J 3 Block: 11 Lot: 13 BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Need EL ed t-'caL lnspec 'io;.n on RenfiaL Proper Y. The properPR&;EXIS7I'XG . Square Footage: Circle All That Apply: Is job ready for inspection?: YES / NO Rough In Final "Do you need a Temp Certificate'?: 2 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 ��v