HomeMy WebLinkAbout47829-Z 9 ��oS11E OF ly; Town of Southold 6/10/2022
a P.O.Box 1179
y rn z 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 43139 Date: 6/10/2022
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 4550 Stillwater Ave., Cutchogue
SCTM#: 473889 Sec/Block/Lot: 137.-2-7
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
5/18/2022 pursuant to which Building Permit No. 47829 dated 5/18/2022
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, panel and transfer switch.
The certificate is issued to Annabel,Rose
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 47829 5/31/2022
PLUMBERS CERTIFICATION DATED
Authorized ignature
BUILDING DEPARTMENT
y TOWN CLERK'S OFFICE
"o r 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#: 47829 Date: 5/18/2022
Permission is hereby granted to:
Annabel, Rose
4550 Stillwater Ave
Cutchogue, NY 11935
To: Electric panel.
At premises located at:
4550 Stillwater Ave., Cutchogue
SCTM # 473889
Sec/Block/Lot# 137.-2-7
Pursuant to application dated 5/18/2022 and approved by the Building Inspector.
To expire on 11/17/2023.
Fees:
ELECTRIC $170.00
Total: $170.00
Building Inspector
oF so�ryol
h O
Town Hall Annex Telephone(631)765-1802
54375 Main Road
P.O.Box 1179 �Q sean.devlin(-a)-town.southold.ny.us
Southold,NY 11971-0959 COUm��
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: Rose Annabel
Address: 4550 Stillwater Ave city:Cutchogue st: NY zip: 11935
Building Permit#: 47$29 Section: 137 Block: 2 Lot: 7
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: AS BUILT License No:
SITE DETAILS
Residential X Indoor X Basement X Service X
Commerical Outdoor X 1st Floor X Pool
New Renovation 2nd Floor Hot Tub
Addition Survey X Attic Garage
INVENTORY
Service 1 ph 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
Transfer Switch 200A LIC Lights Dryer Recpt Emergency Fixtures Time Clocks
Disconnect Switches 4'LED Exit Fixtures Pump
Other Equipment: 200A Panel w/ 200A Manual Transfer Switch
Notes: AS BUILT NO VISUAL DEFECTS " Service & Transfer Switch
Inspector Signature: Date: May 31, 2022
S.Devlin-Cert Electrical Compliance Form
OF SOUIyo! l !TI i
ES-TOWN OF SOUTHOLD BUILDING DEPT.
cou631-765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] 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 [ ] RENTAL
REMARKS:
DATE 5— 221, INSPECTOR
MAY
BUILDING DEPARTMENT- Electrical Inspe for
TOWN OF SOUTHOLD 7.0&/zD/,Vc
i ' Town Hall Annex- 54375 Main Road - PO Box 11of�0IJ
Southold, New York 11971-0959
Telephone (631) 765-1802 - FAX (631) 765-9502
1 ' ' rogerr(c-southoldtownny.gov - seandC@,southoldtownny.gov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date: j p
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: i ce_ (- c)
Address: S �� w a PN
Cross Street:'
Phone No.: b J -()') CSP -
Bldg.Permit 7 $'29 email:
Tax Map District: 1000 Section: Block: Lot:
P. = -nFSr', ,►P- p� T_I OF
WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
4-
Square Footage:
Circle All That Apply:
Is job ready for inspection?: YES ❑ NO F-]Rough In 1:1 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 F1 1 2 H Frame M Pole Work done on Service? M Y FIN
Additional Information:
PAYMENT DUE WITH APPLICATION
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