HomeMy WebLinkAbout50103-Z �o�QSUF OLD Town of Southold 12/12/2023
a " P.O.Box 1179
o • 53095 Main Rd
y o� Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 44806 Date: 12/12/2023
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 135 Mockingbird Ln, Southold
SCTM#: 473889 Sec/Block/Lot: 55.-6-15.61
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
12/8/2023 pursuant to which Building Permit No. 50103 dated 12/8/2023
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:
electric for existing HVAC installed when house was constructed
The certificate is issued to Chabot,David
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 50103 12/11/2023,
PLUMBERS CERTIFICATION DATED
Authorize ignature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
oy • � � SOUTHOLD, DIY
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#: 50103 Date: 12/8/2023
Permission is hereby granted to:
Chabot, David
135 Mockingbird Ln
Southold, NY 11971
To: HVAC system installed when house was constructed
At premises located at:
135 Mockingbird Ln, Southold
SCTM # 473889
Sec/Block/Lot# 55.-6-15.61
Pursuant to application dated 12/8/2023 and approved by the Building Inspector.
To expire on 6/8/2025.
Fees:
ELECTRIC $100.00
Total: $100.00
Building Inspector
*pF SO!/j�,o
Town Hall Annex Telephone(631)765-1802
54375 Main Road
P.O.Box 1179 G Q
Southold,NY 11971-0959 �oly� � �o sean.devlinCaD-town.southold.ny.us
outm,
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: David Chabot
Address: 135 Mockingbird Ln city,Southold st: NY zip: 11971
Building Permit#: 50103 Section: 55 Block: 6 Lot: 15.61
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: Electrician: AS BUILT License No:
SITE DETAILS
Office Use Only
Residential X Indoor X Basement X Service
Commerical Outdoor X 1 st Floor X Pool
New Renovation 2nd Floor Hot Tub
Addition Survey X Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt Ceiling Fixtures Bath Exhaust Fan
Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures Smoke Detectors
Main Panel A/C Condenser 1 Single Recpt Recessed Fixtures CO2 Detectors
Sub Panel A/C Blower 1 Range Recpt Ceiling Fan Combo Smoke/CO
Transfer Switch UC Lights Dryer Recpt Emergency Strobe Heat Detectors
Disconnect 1 Switches 1 4'LED Exit Fixtures Sump Pump
Other Equipment:
Notes: " AS BUILT NO VISUAL DEFECTS " HVAC
Inspector Signature: Date: December 11, 2023
S.Devlin-Cent Electrical Compliance Form
OF SOUlyOlo GCi*j
* * 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: VA-(�
DATE INSPECTOR
E E E .
��SufFO(� I ING DEPARTMENT- Electrical Inspector
° DEC - 7 2Q� TOWN OF SOUTHOLD
z t own II Annex - 54375 Main Road - PO Box 1179
Southold, New York 11971-0959
0 ding De pa`�MT#lephone (631) 765-1802 - FAX (631) 765-9502
Terra c�, „oufhold
Te
rogerr(@-southoldtownny.gov — seand(a-southoldtownny.gov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date: �p�, —OF—
Company Name:
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) ))
Name:
Address: ,S" k e CY,
Cross Street:
Phone No.:
Bldg.Permit#: 'S Q Q email:
Tax Map District: 1000 Section: Block: Lot:
BRIEF DESCRIPTION OF WORK,, I1NC�,L,UQ9E SQUARE FOOTAGE (Please Print Clearly): /
06_( 3�
rYl l�'t/(l C�C�' �N,skit C
n b Ywde.,�-w►-1krs Cat ' 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
Temp Information: (All information required)
Service Size❑1 Ph❑3 Ph Size: A # Meters Old Meter#
❑New Service❑Fire Reconnect❑Flood Reconnect❑Service Reconnect❑Underground❑Overhead
# Underground Laterals 1 2 D H Frame Pole Work done on Service? Y RN
Additional Information:
PAYMENT DUE WITH APPLICATION OoO
�U
2 �.�