HomeMy WebLinkAbout48123-Z QgpFFOlr Town of Southold 8/23/2022
P.O.Box 1179
{� 53095 Main Rd
1 Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 43362 Date: 8/23/2022
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1355 Watersedge Way, Southold
SCTM#: 473889 Sec/Block/Lot: 88.-5-69
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
7/27/2022 pursuant to which Building Permit No. 48123 dated 7/27/2022
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:
Relocation of 200A electric panel.
The certificate is issued to Bujnowski,Peter
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 48123 8/5/2022
PLUMBERS CERTIFICATION DATED
Authorized Signature
�Sv FF a lld�tTOWN OF SOUTHOLD
moo GGy BUILDING DEPARTMENT
y TOWN CLERK'S OFFICE
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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#: 48123 Date: 7/27/2022
Permission is hereby granted to:
Bujnowski, Peter
Attn: Marjorie Bujnowski
161 Bartholomew Hill Rd
Goshen, CT 06756
To: Relocate 200A electric panel.
At premises located at:
1355 Watersedge Way, Southold
SCTM #473889
Sec/Block/Lot# 88.-5-69
Pursuant to application dated 7/27/2022 and approved by the Building Inspector.
To expire on 1/26/2024.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
pF SOUr�ol .
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Town Hall Annex Telephone(631)765-1802
54375 Main Road
P.O.Box 1179 sean.deviin(a-town.southold.ny.us
Southold,NY 11971-0959 Q
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: Peter Bujnowski
Address: 1355 Watersedge Way city:Southold st: NY zip: 11971
Building Permit#: 4$123 Section: $$ Block: 5 Lot: 69
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: North Fork Electrical License No: 2300ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service X
Commerical Outdoor 1 st 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 4'LED Exit Fixtures 11 Pump
Other Equipment: 200A Panel 54 Circuit/42 Used
Notes: Moved Panel Out of Bathroom Into Garage
Inspector Signature: Date: August 5, 2022
S.Devlin-Cert Electrical Compliance Form
SOUTy�Io Li '07
# TOWN OF/SOUTHOLD BUILDING DEPT.
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INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATIOWCAULKING
[ ] 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 S INSPECTOR. `
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oS�FFp��.c UILDING DEPARTMENT- Electrical Inspector
TOWN OF SOUTHOLD
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7n�7 T n all Annex - 54375 Main Road - PO Box 1179
CA JUL 2 1 _ ew York 11971-0959
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y�j�l O BUILDING DEP . Telephone (631), 765-1.8 - FAX (631) 765-9502 ,
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APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORM -- ION All Information Required) Date: Z �Z
Company Name: 02 �� /� <'1.
Name:
License No.: 2300 YAC email: `.L,` S2 .�
Address: Scna
Phone No.: _ to-
JOB SITE INFORMATION (All Information Required)
Name: TL4er �ve ttiow��l
Address: Wcc efls ja e WO.&I % -44,T
Cross Street:
Phone No.: -7 10-2 -
Bldg.Permit#: Qi email: e4�, 6V•,w.:;,, (- lona iT --
Tax Map District: 1000 Section: gj$ Block: 5 Lot: (�
BRIEF DESCRIPTION OF WORK (Please Print Clearly) Dc .m%- -e- Lag
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Circle All That Apply:
Is job ready for inspection?: YE O Rough In Final
Do you need a Temp Certificate?: YES J� Issued On
Temp Information: (All information required)
Service Size 1 Ph 3 Ph Size: _<:2 � 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: (`n�� .P�� r �e-0.k -
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PAYMENT DUE WITH APPLICATION
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Request for Inspection Formals
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