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a y� P.O.Box 1179
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Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 44856 Date: 1/11/2024
THIS CERTIFIES that the building ELECTRICAL
Location of Property: ` 2520 Beebe Dr,Cutchogue
SCTM#: 473889 Sec/Block/Lot: 103.-3-11
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
12/19/2023 pursuant to which Building Permit No. 50144 dated 12/19/2023
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 electrical service.
The certificate is issued to Kass, Samuel&Wagner,Alexandra
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 5014 1/8/2024
PLUMBERS CERTIFICATION DATED
Authorized Signature
TOWN OF SOUTHOLD
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BUILDING DEPARTMENT
y z TOWN CLERK'S OFFICE
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#: 50144 Date: 12/19/2023
Permission is hereby granted to:
Kass, Samuel
220 Water St#434
Brooklyn, NY 11201
To: 200 amp overhead service
At premises located at:
2520 Beebe Dr, Cutchogue
SCTM #473889
Sec/Block/Lot# 103.-3-11
Pursuant to application dated 12/19/2023 and approved by the Building Inspector.
To expire on 611912025.
Fees:
ELECTRIC $100.00
Total: $100.00
im
Building Inspector
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Town Hall Annex Telephone(631)765-1802
54375 Main Road
P.O.Box 1179 G Q
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Southold,NY 11971-0959 Q
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: Alex Wagner/ Sam Kass
Address: 2520 Beebe Drive city,Cutchogue st: New York zip: 11935
Building Permit#: 50144 section: 103 Block: 3 Lot: 11
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: Custom Lighting of Suff Electrician: Benjamin Doroski License No: 38893-ME
SITE DETAILS
Office Use Only
Residential x Indoor x Basement Service
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 Strobe Heat Detectors
Disconnect Switches 4'LED Exit Fixtures Sump Pump
Other Equipment:
Notes:
OVERHEAD SERVICE
Inspector Signature: Date: January 8, 2024
2520 beebe dr service
�OFSOUI oro
# # TOWN OF SOUTHOLD BUILDING DEPT.
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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) [xJ ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL
REMARKS: kwA
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DATE INSPECTOR
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ff(a ; BUILDING DEPARTMENT-Electrical Inspector
TOWN OF SOUTHOLD
DEC 1 9 2023
= Town Hall Annex-54375 Main Road - PO Box 1179
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Southold, New York 11971-0959 �, "
Telephone (631) 765-1802 - FAX(631) 765;9602,`
rogerr _southoldtownny.gov-seandi-southoldtownny.gov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date:
Company Name: Custom Lighting of Suffolk Inc
Electrician's Name: Benjamin Doroski
License No.: 38893-ME Elec. email: CLOS5170@gmall.com
Elec. Phone No: 631-298-4588 01 request an email copy of Certificate of Compliance
Elec. Address.: PO Box 1698 Mattituck NY 11952
JOB SITE INFORMATION (All Information Required)
Name: Alex Wagner / 6wn k-GI 5 S
Address: 2520 Beebe Drive Cutchogue
Cross Street: Emory Road
Phone No.: 631-298-4588
Bldg.Permit M email:
Tax Map District: 1000 Section: Block: Lot:
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
New 200 Amp Overhead Serviceer$er
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: 200 A #Meters 1 Old Meter#
❑New Service[-]Fire Reconnect[]Flood Reconnect❑✓ Service Reconnect❑Underground ✓❑Overhead
#Underground Laterals 1 2 H Frame Pole Work done on Service? MY ✓ N
Additional Information:
-S �.
PAYMENT DUE WITH APPLICATION
JG�n 11d S" , t� .~'_s DEC 1 9 2023
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r-�,,. BUILDING DEPARTMENT-Electrical InSpector
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TOWN OF SOUTHOLD DEC 1 9 2023
Town Hall Annex-54375 Main Road - PO Box 1179
Southold, New York 11971-0959 DPTY
Telephone (631) 76571802 - FAX(631) 765=9:502'
rogerr(&-southoldtownnyrgov - seand(cDsoutholdtownny.gov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (Ail Information Required) Date:
Company Name: Custom Lighting of Suffolk Inc
Electrician's Name: Benjamin Doroski
License No.: 38893-ME Elec. email: CLOS5170@gmail.com
Elec. Phone No: 631-298-4588 01 request an email copy of Certificate of Compliance
Elec. Address.: PO Box 1698 Mattituck NY 11952
JOB SITE INFORMATION (All Information Required) ,
Name: Alex Wagner / -5arn IK,-GI 5 5
Address: 2520 Beebe Drive Cutchogue
Cross Street: Emory Road
Phone No.: 631-298-4588
Bldg.Permit M /1-141 email:
Tax Map District: 1000 Section: J(}� Block: Lot:
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
New 200 Amp Overhead Service a eAger
J
Square Footage:
Circle All That Apply: I8 'Z4
Is job ready for inspection?: YES® NO ®Rough In` ❑✓ Final
Do you need a Temp Certificate?: ❑ YES ❑NO Issued On
Temp Information: (AII information required)
Service Size❑✓ 1 Ph❑3 Ph Size: 200 A # Meters 1 Old Meter#
❑New Service❑Fire Reconnect❑Flood Reconnect ✓❑Service Reconnect[]Underground ✓❑Overhead
# Underground Laterals 1 2 M H Frame Pole Work done on Service? Y ✓ N
Additional'Information:
PAYMENT DUE WITH APPLICATION
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PERMIT 0 Address:
Svvitches
Outleis
GFI's
Surface
Sconces
H H's
UC Lts
Fans Fridge HW
Exhaust Oven W/D
Dmokes DW Mini
-arbon Micro Generator
-ombo Cooktop Transfer
aC AH Hood Service
Amps Have Usec
.pedal.
omments