HomeMy WebLinkAbout47428-Z oOS�EfOIA 2 Town of Southold 4/10/2023
P.O.Box 1179
o _ 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 43129 Date: 6/4/2022
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 260 New Suffolk Rd, Cutchogue
SCTM#: 473889 Sec/Block/Lot: 102.-6-5
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
2/8/2022 pursuant to which Building Permit No. 47428 dated 2/8/2022
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:
electrical survey of main fire house.
The certificate is issued to Cutchogue Fire Dist
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 47428 2/8/2022
PLUMBERS CERTIFICATION DATED
Authorize ignature
141 i fojM o TOWN OF SOUTHOLD
c�yr BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
Wo • SOUTHOLD, NY
ti 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#: 47428 Date: 2/8/2022
Permission is hereby granted to:
Cutchogue Fire Dist
260 New Suffolk Rd
Cutchogue, NY 119352037
To: electrical survey
At premises located at:
260 New Suffolk Rd, Cutchogue
SCTM # 473889
Sec/Block/Lot# 102.-6-5
Pursuant to application dated 2/8/2022 and approved by the Building Inspector.
To expire on 8/10/2023.
Fees:
ELECTRIC $120.00
Total: $120.00
Buil g Inspector
OF soOpyo�
# TOWN OF SOUTHOLD BUILDING DEPT.
�`ycourm ' 765-1802
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING/STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) TA ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
DATE INSPECTOR
pF SOUryolo
Town Hall Annex Telephone(631)765-1802
54375 Main Road
P.O.Box 1179 �Q roger.richert(aD-town.southold.ny.us
Southold,NY 11971-0959 Q
�y�OUNTV,N�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION,
Issued To: Cutchogue Fire District--Main House
Address: 260 New Suffolk Road City: Cutchogue St: New York Zip: 11935
Building Permit#: 47428 Section: 102 Block: 6 Lot: 5
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Roslak Electric Inc License No: 3677-ME
SITE DETAILS
Office Use Only
Residential Indoor X Basement X Service Only
Commerical X Outdoor X 1st Floor X Pool
New Renovation 2nd Floor X Hot Tub
Addition Survey X Attic X Garage
INVENTORY
Service 1 ph Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel 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 Switches Twist Lock Exit Fixtures 11 TVSS
Other Equipment: "AS BUILT" ELECTRICAL SURVEY" "NO VISUAL DEFECTS"
Notes: Inspection to include,but not limited to-truck bays,offices,kitchen,meeting rooms,furnace room,lavatories,radio room,elevator,
,stand by generator.
Inspector Signature: Date: February 8 2022
81-Cert Electrical Compliance Form.xls
�gUFFo(,t� BUILDING DEPARTMENT- Electrical Inspector
TOWN OF SOUTHOLD
= Town Hall Annex - 54375 Main Road - PO Box 1179
4, Southold, New York 11971-0959
Telephone (631) 765-1802 - FAX (631) 765-9502
roger.richert c(D.town.southold.ny.us
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: � Date: p
Company Name: s t
Name: i�.�-1��
License No.: email: j
Address: `�.C; /� (�, •�:
Phone No.: 3
JOB SITE INFORMATION: (All Information Required)
Name: (a 7-�L1 dUr7� �"1 R `p 'S% 1' M �✓ I�
Address:
Cross Street:
Phone No.: 03Z3—
Bldg.Permit#: - �-7 ►-} g email:
Tax Map District: 1000 Section: Block: (0 Lot: 5
BRIEF DESCRIPTION OF WORK (Please Print Clearly)
Circle All That Apply:
Is job ready for inspection?: YES / NO Rough In Final
Do you need a Temp Certificate?: YES 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 '-�� L= L-`M
-4 1�� ``'
� t,G )um� I J � F E B - 8 2022
82-Request for Inspection FormAs iTjia,r i E.PT.