HomeMy WebLinkAbout47438-Z N==--z—
Town of Southold 2/11/2022
P.O.Box 1179
o _ 53095 Main Rd
o Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 42773 Date: 2/11/2022
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1005 Pequash Ave, Cutchogue
SCTM#: 473889 See/Block/Lot: 103.-7-21
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
1/1/1900 pursuant to which Building Permit No. 47438 dated 2/9/2022
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:
"as built"electrical to existing accessory garage.
The certificate is issued to Doroski Wilma C Irry Trust
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 47438 2/4/2022
PLUMBERS CERTIFICATION DATED
Authorize ignature
TOWN OF SOUTHOLD
o�gUfF0iKC0 .
aye BUILDING DEPARTMENT
y TOWN CLERK'S OFFICE
"oy • 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#: 47438 j Date: 2/9/2022
Permission is hereby granted to:
Doroski Wilma C Irry Trust
3000 Pequash Ave
Cutchogue, NY 11935
To: legalize electric work done in accessory garage
At premises located at:
1005 Pequash Ave, Cutchogue
i
SCTM #473889
Sec/Block/Lot# 103.-7-21
'i
Pursuant to application dated 1/1/1900 and approved by the Building Inspector.
i
To expire on 8/11/2023.
Fees:
ELECTRIC $180.00
Total: $180.00
Building Inspector
o��oF sovTy®l
� o
Town Hall Annex Telephone(631)765-1802
54375 Main Road
P.O.Box 1179 sean.devlinCcD-town.southold.ny.us
Southold,NY 11971-0959 Q
lyc0UNT1,�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: Doroski Wilma C Irry Trust
Address: 1005 Pequash Ave city,Cutchogue st: NY zip: 11935
Building Permit#: 47438 Section: 103 Block: 7 Lot: 21
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
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey X Attic Garage X
INVENTORY
Service 1 ph Heat Duplec Recpt Ceiling Fixtures 1 Bath Exhaust Fan
Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures Smoke Detectors
Main Panel 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 4'LED Exit Fixtures Pump
Other Equipment:
Notes: " AS BUILT NO VISUAL DEFECTS " Garage Wiring
Inspector Signature: Date: February 10, 2022
S.Devlin-Cert Electrical Compliance Form
o��S�FFO(�COG BUILDING DEPARTMENT- Electrical Inspector
TOWN OF SOUTHOLD
COD z Town Hall Annex- 54375 Main Road - PO Box 1179
5 • Southold, New York 11971-0959
y o� Telephone (631) 765-1802- FAX (631) 765-9502
rogerr()_southoldtownny.gov - seanda-southoldtownny.aov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (Ali information Required) Date:
Company Name:
Electrician's Name:
License No.: Elec. email:
Elec. Phone No: ❑I request an email copy of Certificate of Compliance
Elec. Address.:
JOB SITE INFORMATION (All Information Required)
Name: pwo 14� rdvf- (66,pul .e_, P#w(UCZl,� Tdv
Address: pp 5 PC,QWI 8416' � � ! g 3 S
Cross Street:
Phone No.:
1(P 772X5"5"
Bldg.Permit#: t.(�j �'� email:
Tax Map District: 1000 Section: 3 Block: Lot:
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
fit; bol# cls ��� c�9 �-
Square Footage: S o
Circle All That Apply: .
Is job ready for inspection?: ❑ YES ❑ NJ ❑Rough In ❑ Final
Do you need a Temp Certificate?: ❑ 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 Reconnect❑Underground❑Overhead
# Underground Laterals 1 n2 H Frame Pole Work done on Service? Y N
Additional Information:
PAYMENT DUE WITH APPLICATION