HomeMy WebLinkAbout50521-Z o�QS�FFOr Town of Southold 5/4/2024
o� y P.O.Box 1179
o - 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 45163 Date: 5/4/2024
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1020 Cox Neck Rd,Mattituck
SCTM#: 473889 Sec/Block/Lot: 111-14-6
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
4/8/2024 pursuant to which Building Permit No. 50521 dated 4/8/2024
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 bathroom renovation.
The certificate is issued to Hance,Michael&JoAnn
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 50521 4/17/2024
PLUMBERS CERTIFICATION DATED
Authorized Signature
�SOFFot,rco TOWN OF SOUTHOLD
BUILDING DEPARTMENT
y x TOWN CLERK'S OFFICE
oy • o� v 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#: 50521 Date: 4/8/2024
Permission is hereby granted to:
Hance, Michael
1020 Cox Neck Rd
Mattituck; NY 11952
To: Electrical - Bathroom Switches/Renovation
At premises located at:
1020 Cox Neck Rd, Mattituck
SCTM #473889
Sec/Block/Lot# 111-14-6
Pursuant to application dated 4/8/2024 and approved by the Building Inspector.
To expire on 10/8/2025.
Fees:
ELECTRIC $200.00
Total: $200.00
Building Inspector
pF SO!/r�ol
Town Hall Annex Telephone(631)765-1802
54375 Main Road
P.O.Box 1179 �Q sean.devlin(aD-town.southold.ny.us
Southold,NY 1 1 97 1-0959
COW
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: Michael Hance
Address: 1020 Cox Neck Rd city:Mattituck st: NY zip: 11952
Building Permit#: 50521 Section: 113 Block: 14 Lot: 6
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: Electrician: AIISafe Electric License No: 52216ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service
Commerical Outdoor 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey X Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt Ceiling Fixtures Bath Exhaust Fan 1
Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures 2 CO Detectors
Sub Panel A/C Blower Range Recpt Ceiling Fan Combo Smoke/CO
Transfer Switch UC Lights Dryer Recpt rq
Emergency Strobe Heat Detectors
Disconnect Switches 2 4'LED Exit Fixtures Sump Pump
Other Equipment: W/D
Notes: " AS BUILT NO VISUAL DEFECTS " Bathroom & W/D, Did not see rough wiring
Inspector Signature: Date: April 17, 2024
S. Devlin-Cert Electrical Compliance Form
SOUly�lo 2 I ', Cy Alck
# # TOWN OF SO THOLD BUILDING DEPT.
631-765-1802
INSPECTION�
[. ] FOUNDATION 1 ST/ REBAR [ ] 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: Ax r � o
W"
r vv
DATE "1 INSPECTOR
� F $pj BUILDING DEPARTMENT-Electrical,Inpe �� _ 2p24 k
TOWN OF-SOUTHOLD
Town-Hall Annex-54375Main Road -PO 19
Southold, .New York 11971-095M-1,6502
Telephone (631) 765-1802 - FAX (631)
iamesht-southoldtownny.gov - seand(a?_southoldtownny_gov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Inforration Required) Date: Solo
Company-Name: S9-p F A-;Q,� 2
Electrician's Name: _ — [1gT
-License-No.: -E.lecc.-email:
Elec.-Phone-No: 63 - ? - -736 i rEquest an email copy of Certificate of Compliance
Elec.Address_: I Gw �
JOB SITE INFORMATION (AII Information Required)
Name: 0 - tirc -
Address: d 2 IJ . ,%r r r tic-
Cross Street: M 1 n D Ljz- fL
Phone No.: - 17 21 - 3 g 63 —
BIdg.Pem�it#: Sd�o'Z J email: Pic- uc�co�sr2vc�Iojve,on ,,s ���rAr�
Tax-Map District: 1-000 Section: Block: tot: •`''°``
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
Square Footage:
Circle All That Apply: hsio
Is job ready for inspection?: YES❑NO ❑Rough Ih Lt " 7 ❑ Final
Do you need a Temp Certificate?: ❑ YES❑NO Issued On
Temp Information: (All information required)
Service SizeF]1 Ph-aS Ph Size: A #Meters Old Meter#
❑New Serviced Fire Reconnect OFlood Reconnect Service ReconnectElUnderground QOverhead
#Underground Laterals 1 2 n H Frame Pole Work done on Service? 0 Y N
Additional-information:
PAYMENT DUE WITH APPLICATION
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BUILDING DEPARTMENT- Electrical iispect% 024
W
TOWN OF SOUTHOLD
Town Hall Annex-54375 Main Road -POA =pc�
15 Southold, New York 11971-095,9.0
4. Telephone (631) 765-1802 - FAX (631) 165Z'0"�;501'2�
am sh@southoldtownny.-gov - seandC@-southoldtownnv.q v
APPLICATION -FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All information Required) Date:
I I r
Company-Name: ALC.,SA_F7F
Electrician's Name: '3T- &J ArL_pri g T-
License-No.: K-E-_,;g:zi(, -Elec email:7
-Elec.-Phone-No: 631- - -7369 Eal request an email copy of Certificate of Compliance
Elec.Address-: Aor, Sigj �c7,� p i 1-7qj
9
JOB SITE INFORMATION (All Information Required)'
Name: -j-6A,,,)Ajr, j4h1iC,-,,
Address: /0?,o C -t-))c g f,-) .
Cross Street: Mlbr)Lg_ IL
Phone No.: (01 ) -
-Bldg.-Permit-#:
Tax Map District: 1000 Section: Block: Lot:
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
k_/15
Square Footage: JL16-
Circle All That Apply: I 1r)
Is job ready for inspection?: YES F-1 NO F-1 Rough!51C it/ 17 E] Final
Do you need a Temp Certificate?: F-1 YES E]NO issued On
Temp Information: (All information required)
Service SizeFll Ph-FJ3 Ph Size:- A #Meters Old Meter#
New Serviceo Fire ReconnectoFlood Reconnect Oservice Reconnect Elunderground ElOverhead
#Underground Laterals*D 1 [712 f_1 H Frame Pole Work done on Service? F]Y nN
Additional Information:
PAYMENT DUE WITH APPLICATION
ve c4 / ol 11 -7
PERMIT# Address:
Switches I I
Outlets
GFI's
Surface
Sconces
H H's 1
UC Lts Fridge HW POOL
Fans Mini Fr. W/D
- Panel
Pump
Exhaust Oven Sump Heater
Trnsfmr
Smokes DW Generator Salt Gen.
Carbon Micro GrbDis Water Bond ,
Lights
Heat Pucks ERV
HOT-TUB/SPA
Inst Hot DeHum Transfer Disc
Combo Cooktop Minisplit Blower
AC AH Hood Blower
-
Service Amps Have Used
Sub Amps Have Used
Comments