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HomeMy WebLinkAbout50315-Z �o�Dsu1FQt�coGw Town of Southold 10/9/2024 y� P.O.Box 1179 v _ 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 45640 Date: 10/9/2024 THIS CERTIFIES that the building ELECTRICAL Location of Property: 2900 Grand Ave,Mattituck SCTM#: 473889 Sec/Block/Lot: 107.-2-5 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 2/7/2024 pursuant to which Building Permit No. 50315 dated 2/7/2024 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: 200 amp overhead electric service upgrade and lighting in living Room& 1st floor bathroom. The certificate is issued to Prowisiero,Andrea of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 50315 9/18/2024 PLUMBERS CERTIFICATION DATED Authorized Signature �sofFnlX�v TOWN OF SOUTHOLD BUILDING DEPARTMENT y x 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 WORKAUTHORIZED) Permit#: 50315 Date: 2/7/2024 Permission is hereby granted to: Polyn, Randolph 2900 Grand Ave Mattituck, NY 11952 To: Electrical -Addition to Lighting in Living Room & Bathroom. Service Upgrade - 200amp OH At premises located at: 2900 Grand Ave, Mattituck SCTM # 473889 Sec/Block/Lot# 107.-2-5 Pursuant to application dated 2/7/2024 and.approved by the Building Inspector. To expire on 8/812026. Fees: ELECTRIC $200.00 Total: .$200.00 Building Inspector �O�aOF SOUIyO� TOWN. OF SOUTHOLD BUILDING PT. 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: r �" DATE ` INSPECTOR �f SOGTyO ( © 3!S C2900 V,avt d / W e- ti � # TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 INSPECTION [ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE& CHIMNEY [ ] FIRE SAFETY INSPECTION_ [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE'RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [XI ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: . l 1 �f . Q_ 8a�� orp-5 �%V�fA VALA1.5 all n?'\-d k-i 2 Ebl e cf e c b R_, S-i�A_fe oe_6 ct- ts� 1�60 I ar,ie V6f le btaArki_ COl%j flu fo Co opt -F 4�- DATE 0��0 02 INSPECTOR OF 50UTy0� # # TOWN'OF SOUTHOLD BUILDING DEPT. `ycooKr+ `i� 631-765-1802 INSPECTION ' [ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. [ . ] -FOUNDATION 2ND [ ] INSULATIOWCAULKING [ ] 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: reV6 & ���� G`e �. dvb per P5 F wow 41 4!�� DATE Q Rq . _ INSPECTOR �• laf so yO6 5(3 /f s" e2- q cc a f e,��. # TOWN OF SOUTHOLD BUILDING DEPT. cou�n� 631-765-1802 INSPECTION [ ] FOUNDATION 1ST/.REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] .INSULATIOWCAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL) [ ] CODE VIOLATION rl PRE C/O [ "] RENTAL REMARKS: &IVIC4r DATE �1 L INSPECTOR r C SO(�jyolo Town Hall Annex . Telephone(631)765-1802 54375 Main Road P.O.Box 1179 G Q Southold,NY 1 1 97 1-0959 sean.devlinCa�town.southold.ny.us 4UNTV, BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Randolph Polyn Address: 2900 Grand Ave city,Mattituck st: NY zip: 11952 Building Permit#: 50315 Section: 107 Block: 2 Lot: 5 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: Electrician: Current Electrical... License No: 65941 ME SITE DETAILS Office Use Only Residential X Indoor X Basement X Service X Commerical Outdoor X 1st Floor X Pool New X Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt 3 Ceiling Fixtures 2 Bath Exhaust Fan 1 Service 3 ph- Hot Water GFCI Recpt 2 Wall Fixtures 1 Smoke Detectors 3 Main Panel A/C Condenser Single Recpt Recessed Fixtures 2 CO Detectors Sub Panel A/C Blower Range Recpt Ceiling Fan 1 Combo Smoke/CO 3 Transfer Switch UC Lights Dryer Recpt Emergency Strobe Heat Detectors Disconnect Switches 7 4'LED Exit Fixtures 11 Sump Pump Other Equipment: Cable Lighting 32', 200A Panel 40 Circuit/27 Used (4) 115Arc Fault Breakers Notes: Lighting in Living Room, Bathroom 1st FI, Service & Smokes Everywhere Inspector Signature: Date: September 18, 2024 S.Devlin-Cert Electrical Compliance Form Copy �o�s�FFoc,��oG y1 BUILDING DEPARTMENT-Electrical Inspector TOWN OF SOUTHOLD • Town Hall Annex-54375 Main Road-PO Box 1179-Southol;d, NY 11971-0959 Telephone(631)765-1802 Temporary Certificate # /G 26- Date - / 202'/ Customer Name Electrician NameC�y�. Address 910O 6,ra,tJ L Ic, Phone !03! •4LG• 90i� e-mail o ra�r✓�S t EKo nt¢ii�c a s-mailIU&M s& ac�ca»� Phone License# rn E 4 S9 V / Size Q00 A Phase I Overhead Underground #of Meters l Remarks #of Underground Laterals 1 2 New "H" Frame or Pole H P Fire Reconnect Was work done on Service? Y N p Flood Reconnect Old Meter# ) 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 a date above. Authorized by f OS�FFQj,�c BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD c Town Hall Annex - 54375 Main Road - PO Box 1179 o Southold, New York 11971-0959 p� Telephone (631) 765-1802 - FAX (631) 765-9502 jamesh(cDsoutholdtownny gov - seand(@-southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFO MATION (AII Information Required) Date: a/1-A ZZ( Company Name: rlz&-vim Z' --r Ty? lG-•Lr n,,,e, Electrician's Name: I c . License No.: jy1L- (Q S-9q( Elec. email: Ccc�,�# �✓��t 67' 77411. Cow Elec. Phone No: 5`;01/ EMI request an email'copy of Certificate of Compliance Elec. Address.: 6e_ I.V7,�s 6111*IG- CO— JOB SITE INFORMATION (All Information Required) Name: L=/-o POR6V&Isl Address: gZgoo AA/�.> AVi'- M 1UGGL �l Cross Street: Phone No.• -- , Bldg.Permit#: ,�3/5 4 - to F email: Tax Map District: "1-G0.0- `Section: Block: Lot: BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): 1 rv(r, , L ICZ�tilS70 1-1 V� r ti� 2�dMv 1�/9?�l�ZCJON'i 2C=i✓ O. 6V V� Square Footage: 3s0- Circle All That Apply: '. J Is job ready for inspection?: YES NO ❑Rough In ❑ Final r� NODo you need a Temp Certificate?: YES Issued On eoic" (, Temp Information: (All information required) Service Size 1 Ph❑3 Ph Size: OO A # Meters Old Meter# El New Service❑Fire Reconnect❑Flood Reconnect❑Service Reconnect❑Underground 60v rhead # Underground Laterals 1 2 H Frame Pole Work done on Service? Y Additional Information: PAYMENT DUE WITH APPLICATION �(? -,11 �. -,& 2�oaa r PERMIT 9 [ Address: Switches 1 L Outlets GFI's L l Surface Sconces H H's !l UC Lts Fans Fridge HW Exhaust Oven W/D Smokes 1�l DW Mini -arbon Micro Generator -ombo Cooktop Transfer aC AH Hood Service Amps Have Usec pedal: 12 ((! q� Q� l(—q 0 Z—/,7 :omments sRea- cs 1 a I-AS