HomeMy WebLinkAbout47361-Z Town of Southold 1/31/2022
P.O.Box 1179
0
C* 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 42721 Date: 1/31/2022
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1155 Jasmine Ln., Southold
SCTM#: 473889 Sec/Block/Lot: 69.-3-24.4
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
1/18/2022 pursuant to which Building Permit No. 47361 dated 1/20/2022
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 electric service.
The certificate is issued to Rolle,Michael
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 47361 1/20/2022
PLUMBERS CERTIFICATION DATED
Authorized Signature
TOWN OF SOUTHOLD
}oOSUFF01 BUILDING DEPARTMENT
z TOWN CLERK'S OFFICE
co
F SOUTHOLD, NY
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- 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#: 47361 Date: 1/20/2022
Permission is hereby granted to:
Rolle, Michael
1155 Jasmine Ln
Southold, NY 11971
To: 200A electric service upgrade.
At premises located at:
1155 Jasmine Ln., Southold
SCTM # 473889
Sec/Block/Lot# 69.-3-24.4
Pursuant to application dated 1/18/2022 and approved by the Building Inspector.
To expire on 7/22/2023.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
OF SO!/ryol
Town Hall Annex ~ Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 Q sean.devlin@town.southold.ny.us
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: Michael Rolle
Address: 1155 Jasmine Ln city:Southold st: NY zip: 11971
Building Permit#: 47361 Section: 69 Block: 3 Lot: 24.4
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 1st 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 N LED Exit Fixtures Pump El
Other Equipment: 200A Service
Notes: " AS BUILT NO VISUAL DEFECTS " Service Upgrade
Inspector Signature: Date: January 20, 2022
S.Devlin-Cert Electrical Compliance Form
S ILDING DEPARTMENT- Electrical Inspector
TOWN OF SOUTHOLD
.o ` Town Hall Annex - 54375 Main Road - PO Box 1179
• ,' T.
WN OF oU HOLD
Southold, New York 11971-0959
'yll Off„ TO Telephone (631) 765-1802 FAX (631) 765-9502
rogerr(cD-southoldtownny.gov — sea nd(a-southoldtownny.gov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date: 1.12.22
Company Name: Element Energy
Electrician's Name: Jamie Minnick
License No.: 52689-ME Elec., email:permits@e2sys.com
Elec. Phone No: 6317797993 O I request an email copy of Certificate of Compliance
Elec. Address.: 7470 Sound Ave Mattituck NY 11952
JOB SITE INFORMATION (All Information Required)
Name: i d') ad
Address: 11��S J�' f
Cross Street:
Phone No. 6-1$8
Bldg.Permit#: 1 73Cc,-� email:_permits@ e2sys,com
Tax Map District: 1000 . Section. (09 Block: _ 3. . Lot:�,7,k -
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly).
Electrical Service Upgrade 100-200amp.
Square Footage:
Circle All That Apply:
Is job ready for inspection?: YES ❑ NO ❑Rough In ❑ Final
Do you need a Temp Certificate?: ❑ YES ❑ NO Issued On
Temp Information: (All information required)
Service SizeFv-11 Ph❑3 Ph Size: A # Meters Old Meter#
❑New Service❑Fire Reconnect❑Flood Reconnect❑Service Reconnect ' Underground❑Overhead
# Underground Laterals FJ1 2 H Frame Pole Work done on Service? Y N
Additional Information:
�/ .
PAYMENT DUE WITH APPLICATION a
pec