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Home My WebLink About48053-Z f� :. gUFf01r Town of Southold 9/13/2022 P.O.Box 1179 o - �' x y 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 43401 Date: 9/13/2022 THIS CERTIFIES that the building ELECTRICAL Location of Property: 135 Dogwood Lane Ext.,East Marion SCTM#: 473889 Sec/Block/Lot: 37.-1-10 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 7/11/2022 pursuant to which Building Permit No. 48053 dated 7/11/2022 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: electric for an existing accessory shed. The certificate is issued to Matzen,Lawrence of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 48053 8/31/2022 PLUMBERS CERTIFICATION DATED fj AV z ignature TOWN OF SOUTHOLD yt4N g' FO Ilk BUILDING DEPARTMENT TOWN CLERK'S OFFICE 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#: 48053 Date: 7/11/2022 Permission is hereby granted to: Matzen, Lawrence 601 Gulf Dr N #105A Bradenton Beach, FL 34217 To: Electric to accessory shed. At premises located at: 135 Dogwood Lane Ext., East Marion SCTM # 473889 Sec/Block/Lot# 37.-1-10 Pursuant to application dated 7/11/2022 and approved by the Building Inspector. To expire on 1/10/2024. Fees: ELECTRIC $90.00 Total: $90.00 Building Inspector pF SOUT�,�I - 0 Town Hall Annex Telephone(631)765-1802 54375 Main Road P.O.Box 1179 �Q sean.devline-town.southold.ny.us Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Lawrence Matzen Address: 135 Dogwood Lane Ext city,East Marion st: NY zip: 11939 Building Permit#: 48053 Section: 37 Block: 1 Lot: 10 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 House X New Renovation 2nd Floor Hot Tub Addition Survey X Attic Garage INVENTORY Service 1 ph X Heat Duplec Recpt 4 Ceiling Fixtures Bath Exhaust Fan Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures Smoke Detectors Main Panel A/C Condenser . Single Recpt Recessed Fixtures 4 CO2 Detectors Sub Panel A/C Blower Range Recpt Ceiling Fan Combo Smoke/CO Transformer UC Lights Dryer Recpt Emergency Fixtures Time Clocks Disconnect X Switches 4 4'LED Exit Fixtures Pump Other Equipment: Notes: " AS BUILT NO VISUAL DEFECTS " Pool House Inspector Signature: Date: August 31, 2022 S. Devlin-Cert Electrical Compliance Form as SOUTy ! 4 s�GS� L---V� # f TOWN OF SOUTHOLD BUILDING EP `ycou631-765-1802 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: S an DATE 2 INSPECTOR hO��pF 50UTyO� '�"� �V _/ ► 3 S �jmgg fit/'o-0 * # TOWN OF SOUTHOLD BUILDING�DEPT. cou631-765.1802 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) [ ELECTRICAL (FINAL) [ ] CODE VIOLATION [( ] PRE C/O [ ] RENTAL REMARKS: PADATE Z /S2, INSPECTOR hO�a0F 50Uly0lo 1 ILl Ll (o f J 9 ej p� oo� � 1 # # TOWN OF SOUTHOLD BUILDMG DEPT. ' `ycourm N�' 631-765.1802 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: �aa L OtAM P9 be A JyAm DATE ZZ INSPECTOR �� U ING DEPARTMENT- Electrical Inspector �O TOWN OF SOUTHOLD �U� 1 Dow II Annex- 54375 Main Road - PO Box 1179 d, New 59 ®y p =' �owN o�°vQTelephone (631JWG DF-PT 1) 765-1802 k FAX (639) 765-9502 a 1 '" ro4err cni southoldtownny.aov seand@southoldtownny.ciovsoutholdtownny.gov FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (Ali information Required) Date: 7111ZZ Company Name: Electrician's Name: License No.: Elec. ern ail: 1� x0e Ce Elec. Phone No: ,us 19"c-'r ❑I request an email copy of Certificate of Compliance Elec. Address.:,:,4-e,? S,� e" JOB SITE INFORMATION (All Info ation Required) Name: Address: s ,FT Cross Street: Phone No.: 4/, Bldg.Permit#: &/1 41 S0,'� email: Tax Map District: _ 1000 Section: Block: 0 Lot: BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Square Footage: Circle All That Apply: Is job ready for inspection?: k1EJ1YES ❑ NO ❑Rough In anal 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 2 n H Frame M Pole Work done on Service? Y nN Additional Information: PAYMENT DUE WITH APPLICATION ,�1 5 VV ad Lt� j; V1@73U11DING DEPARTMENT- Electrical Inspector �O n TOWN OF SOUTHOLD Wk- ' ,Town-Hall Annex- 54375 Main Road - PO Box 1179 jNG Df:-P�a Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 rogerr a_southoldtownny aov - seand(cbsoutholdtownny.aov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: 7 / GL Company Name: e/A 6 6- 1✓�i'nI-07-6,?J Electrician's Name: e& )/ License No.:J EIec. email: 1 Elec. Phone No: � 'S 7 ❑1 request an email copy of Certificate of Compliance Elec. Address.:,Dg S5 OVfe - �� i/li� ✓D J /c JOB SITE INFORMATION (All Info ation Required) Address: ,� c� ¢� 1 G :T �%�Iii;�is '�G�r� �� 2 Cross Street: Phone No.: S/ 4/,-5�F Bldg.Permit #: _�,�/�' 4 S®�� email: Tax Map District: . 1000 Section: Block: Lot: BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):J Square Footage: Circle All That Apply: Is job ready for inspection?: YES O NOE]Rough In final Do you need a Temp Certificate?: O YESF—] NO Issued On Temp Information: (All information required) Service SizeD Ph03 Ph Size: A # Meters Old Meter# ❑New Service®Fire Reconnect OFlood ReconnectOService ReconnectOUnderground Doverhead # Underground Laterals 1 2 H Frame M Pole Work done on Service? MY nN Additional Information: PAYMENT DUE WITH APPLICATION q �1 5 LN • PERMIT 4 Address: Switches I 1 Outlets G FI's Surface Sconces I I H H's ( \ l UC Lts Fans Fridge HW Exhaust Oven W/D Smokes DW Mini Carbon Micro Generator Combo Cooktop Transfer AC AH Hood Service a Amps Have Used Special: n�"J n 1 S C ;v / Y V Comments