HomeMy WebLinkAbout48960-Z �o�OS��F�t cGY Town of Southold 8/5/2023
P.O.Box 1179
o • 53095 Main Rd
y?j01 `taofirf}' Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 44409 Date: 8/5/2023
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 4375 Mill Ln.,Mattituck
SCTM#: 473889 Sec/Block/Lot: 107.4-2.5
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
2/24/2023 pursuant to which Building Permit No. 48960 dated 2/24/2023
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"electric to an existing 42 x 24 accessory building
The certificate is issued to Piacente,Keith&Christine
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 48960 6/30/2023
PLUMBERS CERTIFICATION DATED
Authorized Signature
�o�SUFFot,�oo TOWN OF SOUTHOLD
ay BUILDING DEPARTMENT
y TOWN CLERK'S OFFICE
SOUTHOLD, NY
sol ,
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#: 48960 Date: 2/24/2023
Permission is hereby granted to:
Piacente, Keith
4375 Mill Ln
Mattituck, NY 11952
To: Legalize "as built" electric to an existing 38 accessory building.
Ll a x. a'-4
At premises located at:
4375 Mill Ln., Mattituck
SCTM # 473889
Sec/Block/Lot# 107.4-2.5
Pursuant to application dated 1/1/1900 and approved by the Building Inspector.
To expire on 8/25/2024.
Fees:
ELECTRIC $180.00
Total: $180.00
0
Building Inspector
pF SOUjyOlo
Town Hall Annex Telephone(631)765-1802
54375 Main Road
CA
P.O.Box 1179 sean.devlina_town.Southold.ny.us
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: Keith Piacente
Address: 4375 Mill Ln city:Mattituck st: NY zip: 11952
Building Permit#: 48960 Section: 107 Block: 4 Lot: 2.5
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: Electrician: Home Owner License No:
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey X Attic Garage X
INVENTORY
Service 1 ph Heat Duplec Recpt 2 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 CO2 Detectors
Sub Panel A/C Blower Range Recpt Ceiling Fan Combo Smoke/CO
Transfer Switch UC Lights Dryer Recpt Emergency Strobe Heat Detectors
Disconnect Switches 2 4'LED 4 Exit Fixtures Sump Pump
Other Equipment:
Notes: Bldg. 3
Inspector Signature: Date: June 30, 2023
S. Devlin-Cert Electrical Compliance Form
5i SOUTyolo L1 S' 1 6o 1 7 5- M 1
* # TOWN OF SOUTHOLD BUILDING DEPT.
`Comm, 631-765-1802
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:
4 e�
r_
DATE P /2,3 INSPECTOR
# TOWN OF SOUTHOLD BUILDING DEPT.
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 �.
BUILDING DEPARTMENT- Electrical Inspector
TOWN OF SOUTHOLD I
-� Town Hall Annex- 54375 Main Road - PO Box 1179 U>) N�-
CID New York 11971-0959
Southold,
Telephone l658 (s31) O
0 seand outo dtownnV 9ov
rogerr c_ t odtownnVov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date:7TI
Company Name: 0 ,% ' )fir` `--
Electrician's Name:
License No.: Elec. email:
Elec. Phone No: ❑1 request an email copy of Certificate of Compliance
Elec. Address.:
JOB SITE INFORMATION (All Information Required) 7), (�
Name:
Address: i
Cross Street:
Phone No.: (u 3 f � C �i 77
Bldg.Permit .. email: .
� a
Z Lot:
Tax Map District: 1000 ection: ; i j Block: -�E
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print learly):
i
Square Footage:
Circle All That Apply:
Is job ready for inspection?: El YES� NO �Rough In E] Final
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 Service0 Fire ReconnectOFlood ReconnectF]Service Reconnect❑Underground QOverhead
# Underground LateralsF] 2 H Frame Pole work done on Service? Y N
Additional Informat;on:
PAYMENT DUE WITH APPLICATION
f'� On
PERMIT H Address:
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Exhaust Oven W/D
Smokes DW Mini
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