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Home My WebLink About49107-Z OF0 Kit . CpG� Town of Southold 8/5/2023 a P.O.Box 1179 53095 Main Rd py�j p� 4 Southold,New York 11971 ' CERTIFICATE OF OCCUPANCY No: 44394 Date: 8/5/2023 THIS CERTIFIES that the building ELECTRICAL Location of Property: 210 Glenwood Rd, Cutchogue SCTM#: 473889 Sec/Block/Lot: 110.-6-4 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 4/11/2023 pursuant to which Building Permit No. 49107 dated 4/11/2023 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 underground electric service. The certificate is issued to Lake,Kathleen r I of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 49107 6/12/2023 PLUMBERS CERTIFICATION DATED uthorized Sig ature TOWN OF SOUTHOLD �SufEoc�r�o BUILDING DEPARTMENT y x TOWN CLERK'S OFFICE "oy • o� 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#: 49107 Date: 4/11/2023 Permission is hereby granted to: Lake, Kathleen Glenwood Rd PO BOX 135 Cutchogue, NY 11935 To: Electric service change to underground At premises located at: 210 Glenwood Rd, Cutchogue SCTM # 473889 Sec/Block/Lot# 110.-6-4 Pursuant to application dated 4/11/2023 and approved by the Building Inspector. To expire on 10/10/2024. Fees: ELECTRIC $85.00 Total: $85.00 Building Inspector pF SOUjyol 0 Town Hall Annex Telephone(631)765-1802 54375 Main Road P.O.Box 1179 sean.deviinl�-town.southold.ny.us Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Kathleen Lake Address: 210 Glenwood Rd city:Cutchogue st: NY zip: 11935 Building Permit* 49107 Section: 110 Block: 6 Lot: 4 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: Electrician: Tucker Electric License No: 4926ME 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 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 Strobe Heat Detectors Disconnect Switches 4'LED Exit Fixtures Sump Pump Other Equipment: 200A Panel 30 Circuit/ 11 Used Notes: Service Inspector Signature: c Date: June 12, 2023 S.Devlin-Cert Electrical Compliance Form ,�-� ��orr., � .•�- �( _, - �wii,, a ' , -�. �';.. . ,,�.. - ,:,,, 1 A - A► �• �.W .. T. �p. :,.... �...r.�.. - � i .. .t ' ,� 1 f ,f � _ ' � + •' i I v « 1 ' �� J� I .• �� y.!".--� r. � � ' '_` .` i Y laE SOUI,yOIo l O � C� L # * TO NOF SOUTHOLD BUILDIN T. • .ao cou631-765-1802 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) LECTRICAL (FINAL) [ ] CODE VIOLATION ] PRE C/O [ ] RENTAL REMARKS: Ll QA i I ( V 4, - - r. Ci -� "ni:e tlo &I fl e DATE 2- 3 INSPECTOR SVFFCIt APRi`, 2023 I DING DEPARTMENT- Electrical Inspector �O Gy duwNUDEPT TOWN OF SOUTHOLD TOWN OF30Uffin n Hall Annex- 54375 Main Road - PO Box 1179 co Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 rogerr(cDsoutholdtownny.. ov seand(aD-southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: April 10, 2023 Company Name: Tucker Electric Inc. Electrician's Name: Frank Raynor Jr License No.: ME-4926 Elec. email:frank.raynor@yahoo.com Elec. Phone No: 631-478-2801 211 request an email copy of Certificate of Compliance Elec. Address.: PO Box 1065, Cutchogue, NY 11935 JOB SITE INFORMATION (All Information Required) Name: Kathleen Lake Address: 210 Glenwood Road, Cutchogue NY 11935 Cross Street: Hamilton Ave Phone No.: 631-734-5435 Bldg.Permit#: email: Tax Map District: 1000 Section: Block: Lot: BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Service change from overhead to underground Square Footage: Circle All That Apply: Is job ready for inspection?: ❑ YES ❑✓ NO ❑Rough In ❑ Final Do you need a Temp Certificate?: YES ❑ NO Issued On 04/11/23 f L/ / Temp Information: (AII information required) Service SizeFV]1 PhF-13 Ph Size: 200 A # Meters 1 Old Meter# 971212804 r_1 New Service❑Fire Reconnect[]Flood Reconnect❑Service Reconnect ✓❑Underground[]Overhead # Underground Laterals ✓ 1 02 ✓ H Frame Pole Work done on Service? R1 Y N Additional Information:Service change for overhead to underground PAYMENT DUE WITH APPLICATION 4114 c� �'j I of ';Vl Q1U f� 202VDING DEPARTMENT- Electrical Inspector T TOWN OF SOUTHOLD EFI e0V,gN0F8007Nrvn Hall Annex- 54375 Main Road - PO Box 1179 Southold, New York 11971-0959 p� Telephone (631) 765-1802 - FAX (631) 765-9502 rogerr(Dsoutholdtownny.gov — seand ccDsoutholdtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: April 10, 2023 Company Name: Tucker Electric Inc. Electrician's Name: Frank Raynor Jr License No.: ME-4926 Elec. email:frank.raynor@yahoo.com Elec. Phone No: 631-478-2801 DI request an email copy of Certificate of Compliance Elec. Address.: PO Box 1065, Cutchogue, NY 11935 JOB SITE INFORMATION (All Information Required) Name: Kathleen Lake Address: 210 Glenwood Road, Cutchogue NY 11935 Cross Street: Hamilton Ave Phone No.: 631-734-5435 Bldg.Permit#: email: Tax Map District: 1000 Section: Block: Lot: BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Service change from overhead to underground Square Footage: Circle All That Apply: Is job ready for inspection?: ❑ YES❑✓ NO ❑Rough In ❑ Final Do you need a Temp Certificate?: 0 YES ❑ NO Issued On 04/11/23 Temp Information: (All information required) Service Size�1 PhF-]3 Ph Size: 200 A # Meters 1 Old Meter# 971212804 ❑New Service[]Fire Reconnect[]Flood Reconnect❑Service Reconnect ✓❑Underground❑Overhead # Underground Laterals P11 FJ2 ✓ H Frame Pole Work done on Service? ✓ Y FIN Additional Information:Service change for overhead to underground PAYMENT DUE WITH APPLICATION 0�� 4 2Rv �z � 11 BUILDING DEPARTMENT-Electrical Inspector $� TOWN OF SOUTHOLD o � Town Hall Annex-54375 Main Road-PO Box 1179-Southold, NY 11971-0959 ��O��y� Telephone (631) 765-1802 1 V Temporary Certificate # N61 Date — 2023 Customer Name A ,eeo anf ElectricianName Tk d4te- 51-ec�4L Address y1 v `,em ( Dod yM C4 tq Phone �j aj q-7g/ 6��-D j e-mail,, e-mail ,�J4 q� by Q a hoo, Com Phone 10� ��Lr ._.5��5 License# M Lf-�d l0 Size77 �A Phase Overhead Underground #of Meters I Remarks #of Underground Laterals 1 2 New "H" Frame or Pole P Fire Reconnect Was work done on Service? N 'y Flood Reconnect Old Meter# q7 ra lago Service Reconnected Application for electrical service equipment is on file with the town of Southold.On the applicant's notification that this installation is complete,the town will conduct a premises inspection of the service equipment. This verification is valid for 90 days from the date above. Authorized by ---------------------------------------------- f