HomeMy WebLinkAbout49183-Z IYX=%cam
�`�OSUFFotK y Town of Southold 9/24/2023
P.O.Box 1179
H x 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 44590 Date: 9/24/2023
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 555 Founders Path, Southold
SCTM#: 473889 Sec/Block/Lot: 64.-2-36
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
4/28/2023 pursuant to which Building Permit No. 49183 dated 4/28/2023
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:
"as built"200 amp electric service.
The certificate is issued to Molloy,Paul&June
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 49,183 9/21/2023
PLUMBERS CERTIFICATION DATED
Au orize Si afore
J
�suFFot,��
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
cao
SOUTHOLD, NY
`dol L � ��
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#: 49183 Date: 4/28/2023
Permission is hereby granted to:
Molloy, Paul
23 Ocean Ave
Manasquan, NJ 08736
To: As bit service upgrade to 200 amp
At premises located at:
555 Founders Path, Southold
SCTM # 473889
Sec/Block/Lot# 64.-2-36
Pursuant to application dated 4/28/2023 and approved by the Building Inspector.
To expire on 10/27/2024.
Fees:
ELECTRIC $170.00
Total: $170.00
Building Inspector
so�ryQl
0
Town Hall Annex Telephone(631)765-1802
54375 Main Road
P.O.Box 1179 sean.deviinatown.southold.ny.us
Southold,NY 11971-0959 '�
OWN
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: Paul Molloy
Address: 555 Founders Path city:Southold st: NY zip: 11971
Building Permit#: 49183 Section: 64 Block: 2 Lot: 36
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: Electrician: Roslak Electric License No: 3677ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service X
Commerical Outdoor X 1st Floor Pool
New X Renovation 2nd Floor Hot Tub
Addition Survey 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
Transfer Switch UC Lights Dryer Recpt Emergency StrobeHeat Detectors
Disconnect Switches 4'LED Exit Fixtures Sump Pump
Other Equipment: 200A Panel 40 Circuit/20 Used
Notes: Service Upgrade
Inspector Signature: Date: September 21, 2023
S.Devlin-Cert Electrical Compliance Form
SOUT'yo
# TOWN OF SOUTHOLD BUILDING DEPT.
coo631-765-1802
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 �VIPREC/O [ ] RENTAL
REMARKS:
DATE INSPECTOR
�t
o��pf SOUTyo L4 1 l ---
# # TOWN OF SOUTHOLD BUILDING DEPT.
��y�0urm� 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:
r �M
crylc_
DATE INSPECTOR
�oguFFO Vic. BUILDING DEPARTMENT- Electrical Inspector
Fp�A TOWN OF SOUTHOLD
Town Annex- 54375 Main Road - PO Box 1179
Southold, New York 11971-0959
eleone (631) 765-1802 - FAX (631) 765-9502
.a� �����OF� � r(c�southoldtownny.gov a seand@southoldtownny.aov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date:
Company Name:
c L/
v
Electrician's Name: 9 ; . /,
License No.: 3 7 7-,M Elec. email: sr f �e �7 C
Elec. Phone No: _ t •6 ❑1 request an email copy of Certificate of Compliance
Elec. Address.: jP 0 , - --
JOB SITE INFORMATION (All Information Required)
Name: t aL t e I�L IL f-- Il 1 c �
Address: 5 0 o dd ,,-V
Cross Street: ► ,, �,
Phone No.:
Bldg.Permit#: T05email:
Tax Map District: 1000 Section: Block: 2 Lot: �3
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
Square Footage:
Circle All That Apply:
Is job ready for inspection?: YES❑ NO ❑Rough In E] Final
Do you need a Temp Certificate?: ❑ YES❑NO Issued On
Temp Information: (All information required)
Service Size[-11 PhF-]3 Ph Size: A #Meters Old Meter#
❑New Service[-]Fire Reconnect❑Flood Reconnect[]Service Reconnect❑Underground❑Overhead
#Underground Laterals 1 2 H Frame El Pole Work done on Service? Y nN
Additional Information:
PAYMENT DUE WITH APPLICATION
9 ��1
BUILDING DEPARTMENT- Electrical Inspector
Ai W
TOWN OF SOUTHOLD
Towni Hal) Annex - 54375 Main Road - PO Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1802 - FAX (631) 765-9502
OF0
ri@southoidtownnv.gov - seand(c_)southoldt wnny.gov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All information Required) Date:
Company Name: /-Z
fli 0 P Ir
Electrician's Name: R 4-
License No.: 3 7 7-. Elec. email: k ) J,K, e 0"Jq
Elec. Phone No: 6, 7,/ 5' -Li-&I/ El I request an"email copy of-Certificate of Compliance
Elec. Address.:
JOB SITE INFORMATION (All Information Required)
Name: IL C-
Address:
Cross Street: ak,
Phone No.: 97- Y 4f-7 C, / i-
Bldg.Permit#: ml email:
Tax Map District: 1000 Section: Block: Lot: ;-:3
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
4 J r-square Footage:
Circle All That Apply:
Is job ready for inspection?- J� (ES 0 NOE]Rough In E] Final e,
Do you need a Temp Certificate?: F-1 YES❑ NO issued On
Temp Information: (All information required)
Service SizeF11 Ph❑3 Ph Size: A # Meters Old Meter#
❑New ServiceE]Fire Reconnect E]Flood Reconnect®Service Reconnect Elunderground Eloverhead
# Underground Laterals n 1 [712 M H Frame F] Pole Work done on Service? M Y FIN
Additional Information:
PAYMENT DUE WITH APPLICATION