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HomeMy WebLinkAbout49159-Z r Town of Southold 6/17/2023 P.O.Box 1179 o s 53095 Main Rd :� Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 44195 Date: 6/10/2023 THIS CERTIFIES that the building ELECTRICAL Location of Property: 26755 Route 25, Cutchogue SCTM#: 473889 Sec/Block/Lot: 109.-2-14 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 4/25/2023 pursuant to which Building Permit No. 49159 dated 4/25/2023 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: 200 amp overhead electric service. 6/17/2023 Corrected for Certificate of Occupancy number only. The certificate is issued to Mistretta,Patricia of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 49159 5/10/2023 PLUMBERS CERTIFICATION DATED r Authorized Signature S�FFOL,�c Town of Southold o� o� 6/10/2023 0 y� P.O.Box 1179 53095 Main Rd h Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 44151 Date: 6/10/2023 THIS CERTIFIES that the building ELECTRICAL Location of Property: 26755 Route 25,Cutchogue SCTM#: 473889 Sec/Block/Lot: 109.-2-14 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 4/25/2023 pursuant to which Building Permit No. 49159 dated 4/25/2023 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: 200200 ampoverhead electric service electric service. The certificate is issued to Mistretta,Patricia of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 49159 5/10/2023 I PLUMBERS CERTIFICATION DATED Authorized Sig e �SUFFo�i TOWN OF SOUTHOLD Sao aye BUILDING DEPARTMENT N TOWN CLERK'S OFFICE "may • � ,.�' SOUTHOLD, NY .viol � ya�iti� 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#: 49159 Date: 4/25/2023 Permission is hereby granted to: Mistretta, Patricia PO BOX 1038 Cutchogue, NY 11935 To: 200 amp Electrical OH Service At premises located at: . 26755 Route 25, Cutchogue SCTM #473889 Sec/Block/Lot# 109.-2-14 Pursuant to application dated 4/25/2023 and approved by the Building Inspector. To expire on 10/24/2024. Fees: ELECTRIC $85.00 Total: $85.00 Building Inspector hO��pF SO(/Tyo! 0 Town Hall Annex Telephone(631)765-1802 54375 Main Road P.O.Box 1179 �Q sean.devlin -town.southold.ny.us Southold,NY 11971-0959 �yOOUNTV,� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Patricia Mistretta Address: 26755 Route 25 city:Cutchogue st: NY zip: 11935 Building Permit#: 49159 section: 109 Block: 2 Lot: 14 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: Electrician: Custom Lighting of Suffolk License No: 38893ME SITE DETAILS Office Use Only Residential X Indoor Basement Service Commerical Outdoor 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey 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 UC Lights Dryer Recpt Emergency StrobeHeat Detectors Disconnect 200A Switches 4'LED Exit Fixtures Sump Pump Other Equipment: Meter Main Disconnect 200A, 200A Panel 30 Circuit/ 30 Used Notes: Service Inspector Signature: Date: May 10, 2023 S.Devlin-Cert Electrical Compliance Form qso # # TOWN OF SOUTHOLD BUILDING DEPT. `ycouto", 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: DATE INSPECTOR w. BMWING O.EPARTMENC-Electricatjn,spector TOWN i} .SL?tJTtiC)LD' 3 := ARW 5�€ .. Town:MiI1 Annex 75 attain Road-PO Box 1479 tJi#i3ofd :Nev�r.Yai'k i,971-0959- so ,. Tefephcziie (637.,3765=1:8U `� AC(831.):7fi5-9E12: rac�etr(a?southolci#awnnv:q©v_a se; a'5ouftiolcftownri►:rov. API3LI;CATION FG1:R'�LECTRIC�4L I�ISPECTIC�.N EL ECTAIC Ate# 1( FCS M.A-T,10N: Date: Company:Itiiaine;.:Gus#om°L igh#in ttf.Sbf.f�Ik.1rnG . Ei . ti`ICI1t1.S N e: B.6hiA 17iC1.Dor ski License Nv: 38893WE Stec:em:I GLC Sa1700gcti2�ii:com . . .....:...... .:.:....... .. Ei ci Phv e.Mcg,:53)'- 8-4.5$S.. i request'ai :email copy:.of Certificate of;Compliance: Elec;. ddi`ess '::F?O:BoX.:188 Mattiucl °NY 1.1952 .. 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'#(�tefer�: : � 01d .: '*.NewiceQi=Tre:Recl7nnecf.�� ft�.t#d:<teconnectruice(eerir�eck" Uri€ieigroti�' verhd #:Underground Laterals.. 1 .;. 2 H'i=rams:.:.;:.'''Pyle Wrtine Y. MdWpr a1:1i fai aattnrt P!1�'VRMEIVT 13.U �NiTHA(?:PLICAT(EXN ����� �u� / 2c�e'2— lU��� �e ,�,/ ► Suffolk County Dept. of f . Labor, Licensing & Consumer Affairs .y MASTER El FCTRICAI. 1_ICFNS= Name BENJAK41N DOROSKI Business Name Fhis certrtfes !I jat the )earer is dWy li sensed CUSTOM 1.1GH1 1NG OF SUFFOLK INC jy We County of suffolk License Nu nher: ME-38893, Rosalie ter, qta issued , 11/22t2005 Expires.- 1,1/01/2023 This license is the property of Suffolk County . Depawtment of Labor, Licensing $ Consumer Affairs. ' Possession of this license ('oes not guarantee its valioirj Additional Business Name License Category AW. , . ACO® DATE(MMIDD/YYYY) `�. CERTIFICATE OF LIABILITY INSURANCE 04/25/2023 THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Camille Wadsworth NAME: E A Funk&Associates,Inc. HONE Ext): (631)467 4747 FAX No); (631)467-5160 1919 Middle Country Road E-MAIL SS: cwadsworth@ericfunkagency.com ADDRE Suite 300A INSURER(S)AFFORDING COVERAGE NAIC# Centereach NY 11720 INSURERA: Merchants Mutual Insurance Company 23329 INSURED INSURER B: New York State Insurance Fund Custom Lighting Of Suffolk Inc INSURER C: PO Box 1698 INSURER D: INSURER E: Mattituck NY 11952-0904 INSURER F: COVERAGES CERTIFICATE NUMBER: CL232905519 REVISION NUMBER: THIS IS TO CERTIFY THATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DDY EFF MMIDD POLICY EXP LIMITS X COMMERCIALGENERALLIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE �OCCUR PREMISES Ea occurrence $ 500,000 MED EXP(Any one person) $ 15,000 A BOP1077647 02/10/2023 02/10/2024 PERSONAL a ADV INJURY $ GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICYJECOT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident ANYAUTO BODILY INJURY(Per person) $ A OWNED X SCHEDULED CAPI062397 02/10/2023 02/10/2024 BODILY INJURY(Per accident) $ AUTOS ONLY /� AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident X UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 4,000,000 A EXCESS LIAB CLAIMS-MADE CUP9148288 02/10/2023 02/10/2024 AGGREGATE $ 4,000,000 DED I X RETENTION$ 101000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ NIA E.L.EACH ACCIDENT $ B OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Patricia Mistretta ACCORDANCE WITH THE POLICY PROVISIONS. 26775 Main Rd AUTHORIZED REPRESENTATIVE Cutchoque NY 11935 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD NYSI F New York state Insurance Fund PO Box 66699,Albany,NY 12206 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE AAAAAA 113617088 EA FUNK AND ASSOCIATES INC 1919 MIDDLE COUNTRY RD#300A CENTEREACH NY 11720 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER CUSTOM LIGHTING OF SUFFOLK,INC PATRICIA MISTRETTA PO BOX 1698 26775 MAIN ROAD MATTITUCK NY 11952 CUTCHOQUE NY 11935 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE 12584186-7 258037 02/10/2023 TO 02/10/2024 4/25/2023 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2584186-7, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW, AND, WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK, TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY. IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY,INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WEBSITE AT HTTPS://WWW.NYSIF.COM/CERT/CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION. PRESIDENT BENJAMIN DOROSKI CUSTOM LIGHTING OF SUFFOLK INC ONE PERSON CORPORATION THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STATE SUR NCE FUND T t / DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 185804640 U-26.3