HomeMy WebLinkAbout46628-Z �11fFUli� `
Town of Southold 12/20/2022
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE-OF OCCUPANCY
No: 43692 Date: 12/15/2022
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1625 Naugles.Dr.,Mattituck
SCTM#: 473889 Sec/Block/Lot: 99.4-18
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
7/28/2021 pursuant to which Building Permit No. 46628 dated 7/28/2021
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"electric wiring for non-habitable cottage#1.
The certificate is issued to 622 Church Ln LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 46628 9/16/2021
PLUMBERS CERTIFICATION DATED
Au 0ri ed ig ature
rY` TOWN OF SOUTHOLD
�o��QfFUIk
y BUILDING DEPARTMENT
co 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#: 46628 Date: 7/28/2021
Permission is hereby granted to:
2 Peconic Rd LLC
c/o Lupovici
225 Fifth Ave Apt 9J
New York, NY 10010
To: Cottage #1 - Electric wiring and baseboards.
At premises located at:
1625 Naugles Dr., Mattituck
SCTM # 473889
Sec/Block/Lot# 99.-4-18
Pursuant to application dated 7/28/2021 and approved by the Building Inspector.
To expire on 1/27/2023.
Fees:
ELECTRIC $180.00
Total: $180.00
Building Inspector
Town Hall Anne " fr' ( 7'
Annex - `r Telephone(631)765-1802
54375 Main Road z-,' Fax(63 1)765-9502
.,
P.O.Box 1179 '�� `'=' ''� `I I q-"
~�; ;1P'-' sean.devlin(cD-town.southold.nv.us
Southold,NY 11971-0959
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: 2 Peconic Rd LLC
Address: 1625 Naugles Dr Cottage # 1 city,Mattituck st: NY zip: 11952
Building Permit#: 46628 Section: 99 Block: 4 Lot: 1$
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 X
Commerical Outdoor X 1st Floor X Pool
New Renovation 2nd Floor X Hot Tub
Addition Survey X Attic Garage
INVENTORY
Service 1 ph X Heat Duplec Recpt 5 Ceiling Fixtures 4 Bath Exhaust Fan
Service 3 ph Hot Water Elec. GFCI Recpt 2 Wall Fixtures 2 Smoke Detectors 1
Main Panel 200A A/C Condenser Single Recpt Recessed Fixtures CO2 Detectors
Sub Panel A/C Blower Range Recpt Elec. Ceiling Fan Combo Smoke/CO 1
Transformer UC Lights Dryer Recpt Emergency FixturesTime Clocks
Disconnect Switches 4 4'LED Exit Fixtures Pump
Other Equipment: Fridge, Elec. Oven, 200A Panel 30 Circuit/7 Used
Notes: " AS BUILT NO VISUAL DEFECTS "
Inspector Signature: Date: September 16, 2021
S.Devlin-Cert Electrical Compliance Form
o��OE SOUTyO L4 6&96
# TOWN OF SOUTHOLD BUILDING DEPT.
765-1$02
INSPECTION
[ ] FOUNDATION 1ST j ] -ROUGH PL13G.
[
]--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
REMARKS:
DATE INSPECTOR
of SOUT�ayo ✓ (,F�
�0 �
* TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE'SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [\/I\ ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
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t
DATE INSPECTOR
IL
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JUL 2 6 2021 l DING DEPARTMENT-Electrical Inspector
TOWN OF jSOUTHOLD
Town Hall Annex- 54375 Main Road - PO Box 1179
'z U[t .D0 Southold, New York 11971-0959
Telepflone (631) 765-1802 - FAX (631) 765-9502
1 ' rogerr(cDsoutholdtownny.aov —seand(&_southoldtownnygov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date: `7, If Z I
Company Name:
Name:
License No.: email:
Phone No: DI request an email copy of Certificate of Compliance
Address.:
JOB SITE INFORMATION (All Information Required) cs�w�•
Name: C? eeco►1('C'P45,08
zz � LSC
Address:
Cross Street:
Phone No.:
Bldg.Permit#: (oa email:_pcM
Tax Map District: 1000 Section:/ Block: t4r . Lot:
BRIEF DESCRIPTION OF WORK (Please Print Clearly)
�D1 GE Wf 1 m _L4V n o 10aA_fr-QS
Check All That Apply:
Is job ready for inspection?: DYES D NO [:]Rough In ❑Final
Do.you need a Temp Certificate?: DYES [:]No Issued On;
Temp Information: (All information required_ )
Service Size 01 Ph 03 Ph- Size: A -#Meters Old Meter#
Ne" Service . E]Service Reconnect [] Underground 0Overhead
#.Underground Laterals 01 []2 ❑H Frame OPole Work done on Service? Ely ❑N
Additional Information:
PAYMENT DUE WITH APPLICATION
��o
Electrical Inspection Form 2020.xlsx ` \
PERMIT# Address:
Switches
Outlets
GFI's I
Surface
Sconces
H H's
UC L#s
Fans Fridge HWJ ( P/
Exhaust 10ven W/D
5:mokes. V1W . IVlini,::-
;:..: .,
_IVlicro.:.: :. .. ... .. : ..:. ,::.. ::=; `:.: •:,';Gerie:rator
ComboCooktop.. Trarisfer
ACqH : Hood Service
Amps. Mave > :_Used:.
Special: '0'l H
_
Corhments:..
L
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f BUILDING DEPARTMENT- Electrical Inspector
�� L 2 � TOWN OF SOUTHOLD
Town Hall Annex- 54375 Main Road - PO Box 1179
CIO
o sSouthold, New York 11971-0959
70Y�j Telephone (631) 765-1802 - FAX (631) 765-9502
rogerrO-southoldtownny.gov-seandO-southoldtownny gov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (AII Information Required) Date: y. lrZ I
Company Name:
Name:
License No.: �erriail:
Phone No: ❑I request an email copy of Certificate of Compliance
Address.:
JOB SITE INFORMATION (AII Information Required) amu_ ��'""
Name: ZZ Chu(& ru LZG
Address: (-(, — • �5�
Cross Street:
Phone No.: ¢i
Bldg.Permit M q (ooh email: s•Ca
Tax Map District: 1000 Section: c Block: Lot:
BRIEF DESCRIPTION OF WORK (Please Print Clearly)
t c ns s hive nu(�rx�,a-rQs
Check All That Apply:
Is job ready for inspection?: [-]YES ❑NO [-]Rough In OFinal
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 ❑ Service Reconnect ❑ Underground []overhead
# Underground Laterals ❑1 ❑2 ❑H Frame❑Pole Work done on Service? ❑Y ❑N
Additional Information:
PAYMENT DUE WITH APPLICATION
Electrical Inspection Form 2020.xlsx �/