HomeMy WebLinkAbout49046-Z Town of Southold
OGy� 5/24/2023
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P.O.Box 1179
o 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 44126 Date: 5/24/2023
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 775 Wood Ln, Peconic
SCTM#: 473889 Sec/Block/Lot: 86.-6-9
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
3/17/2023 pursuant to which Building Permit No. 49046 dated 3/21/2023
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:
Dock Convenience Outlets
The certificate is issued to Henderson,Oliver&Leong, Stefanie
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 45675 9/13/2021
PLUMBERS CERTIFICATION DATED
Authorize Signature
�Su ai�co TOWN OF SOUTHOLD
BUILDING DEPARTMENT
y TOWN CLERK'S OFFICE
"may • �g 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#: 49046 Date: 3/21/2023
Permission is hereby granted to:
Henderson, Oliver
181-49 Tudor Rd
Jamaica, NY 11432
To: Dock Convenience Outlets
At premises located at:
775 Wood Ln, Peconic
SCTM #473889
Sec/Block/Lot# 86.-6-9
Pursuant to application dated 3/17/2023 and approved by the Building Inspector.
To expire on 9/19/2024.
Fees:
ELECTRIC $90.00
Total: $90.00
Building Inspector
oF so�ryolo
Town Hall Annex Telephone(631)765-1802
54375 Main Road
P.O.Box 1179 �Q sean.devlinCcD-town.southold.ny.us
Southold,NY 11971-0959 Q�y�DUNTY,Nc�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: Oliver Henderson
Address: 775 Wood Ln city:Peconic st: NY zip: 11958
Building Permit#: 45675 Section: 86 Block: 6 Lot: 9
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Devaney Electric License No: 4144ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service X
Commerical Outdoor 1st Floor X Pool
New Renovation X 2nd Floor X Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph X Heat Duplec Recpt 50 Ceiling Fixtures 19 Bath Exhaust Fan 4
Service 3 ph Hot Water 30A GFCI Recpt 11 Wall Fixtures 10 Smoke Detectors 2
Main Panel 200A A/C Condenser 2 Single Recpt Recessed Fixtures 28 CO2 Detectors
Sub Panel A/C Blower 2 Range Recpt Gas Ceiling Fan 2 Combo Smoke/CO 2
Transformer 95W UC Lights 12' Dryer Recpt 30A Emergency Fixture Time Clocks
Disconnect 1 Switches 39 Track Light 20' 1 Exit Fixtures 11 Pump 1
Other Equipment: Hood, Gas Oven, DW, W/D, Mini Fridge, (2) Mini Splits, 200A Meter Main Disconneci
Gas FP, Two Dock Outlets
Notes: Service & First and Second Floor Renovation, Dock Outlets
Inspector Signature: _ Date: September 13, 2021
S. Devlin-Cert Electrical Compliance Form
ho�a0FSoUTyolo y s& 75- 7
# # TOWN OF SOUTHOLD BUILDING DEPT.
co 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 ,Z[ ,] RENTAL
REMARKS: � �-�--
I�VVAV -OK
L
DATE INSPECTOR
BUILDING DEPARTMENT- Electrical Inspector
TOWN OF SOUTHOLD
Town Hall Annex - 54375 Main Road - PO Box 1179
w � Southold, New York 11971-0959
Telephone (631) 765-1802 - FAX (631) 765-9502
rogerr _southoldtownny.gov — sea nd(cDsoutholdtownny.gov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date: "� I'l 23
Company Name: �('3 ����,�-r;�Q Co r
Electrician's Name: e, �- K so tA
License No.: GI 2 Elec. email:
Elec. Phone No: 6 -�I-'I it -S-y ❑I request an email copy of Certificate of Compliance
Elec. Address.:
FescA,9 L (e111-741
JOB SITE INFORMATION (All Information Required)
Name: OL)VFR 14e4,c u& r, 4- (5�e- L 20 0
Address: "7-7 S- LL)cg,1 I,�e
Cross Street: N e-.K
Phone No.: Co ) - 7 _ -7 N
Bldg.Permit#: 1�rj ��s email:
Tax Map District: 1000 Section: Block: Lot:
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Plea/se Print Clearly):
)
V p+v,.p CD4\V%e.^L0e- Ce-L AK �vf �vo+ei..� Oft/ Qorift!
1 Square Footage:
Circle All That Apply:
Is job ready for inspection?: KYES ❑ NO ❑Rough In ®'Final
Do you need a Temp Certificate?: 1:1YES VNO Issued On
Temp Information: (All information required)
. Service Size❑1 PhF—]3 Ph Size: A # Meters Old Meter#
❑New Service❑Fire Reconnect❑Flood Reconnect❑Service Reconnect❑Underground❑Overhead
# Underground Laterals D 1 2 0 H Frame Pole Work done on Service? Y FIN
Additional Information:
PAYMENT DUE WITH APPLICATION �`�-1 �3 :T o"7p(, n O
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