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Town of Southold Annex 2/11/2014
P.O. Box 1179
54375 Main Road
Southold, New York 11971
CERTIFICATE OF OCCUPANCY
No: 36759 Date: 2/11/2014
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 4690 Mill Ln, Mattituck,
SCTM 473889 Sec/Block/Lot: 100.4-2.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
12/6/2013 pursuant to which Building Permit No. 38551 dated 12/9/2013
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:
150 AMP UNDERGROUND ELECTRICAL SERVICE
The certificate is issued to Caracciolo Jr, Louis & Caracciolo, Lisa
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 38551 02-07-2014
PLUMBERS CERTIFICATION DATED
° Authorized Signature
sit TOWN OF SOUTHOLD
Z+f~ BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, NY
f
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 38551 Date: 1219/2013
Permission is hereby granted to:
Caracciolo Jr, Louis & Caracciolo, Lisa
4450 Mill Ln
Mattituck, NY 11952
To: 150 Amp Underground New Electrical Service
At premises located at:
4690 Mill Ln, Mattituck
SCTM # 473889
Sec/Block/Lot # 100.-4-2.1
Pursuant to application dated 12/6/2013 and approved by the Building Inspector.
To expire on 6/10/2015.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
Sobjyolo
Town Hall Annex Telephone (631) 765-1802
54375 Main Road Fax (631) 765-9502
P.O. Box 1179
Southold, NY 11971-0959 • ~O roper. richert(a)town.Southold. ny.us
Cow N
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Shade Tree Nursery (Caracciolo)
Address: 4690 Mill Lane City: Mattituck St: NY Zip: 11952
Building Permit 38551 Section: 100 Block: 4 Lot: 2.1
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Brian Brooks Electrical Inc License No: 3613-e
SITE DETAILS
Office Use Only
Residential Indoor Basement Service Only X
Commerical X Outdoor 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey X Attic Garage
INVENTORY
Service 1 ph 150a Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel 150a A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks
Disconnect Switches Twist Lock Exit Fixtures TVSS
Other Equipment: 150a underground service with 3 circuit breakers as disconnects (1-30a,2-20a)
Notes:
Inspector Signature: Date: Feb 7 2014
81-Cert Electrical Compliance Fomi.xls
DEC - 2013
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Southold, NY 11971-0959
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13UELDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: Irian roB Date: ~oZ
Company Name:
Name: ,
License No.: f3_~
rddress:
/Vot
hone No.: - - a
JOBSITE INFORMATION: (*Indicates required information)
*Name;
`Address: g4ct 0 MdJ Igo
`Cross Street: _ S~unA, 4
`Phone No.:
Permit No.:
Tax-Map District: 4000 Section: Block: Lot:
'BRIEF DESCRIPTION WORK (Please Print Clearly)
Nag - f2h 1 &m`n j/n to cazn4e
(Please Circle All That Apply)
*Is job ready for inspection: YES Rough In Final
*Do you need a Temp Certificate: (~NO
Temp Information (If needed)
*Service Si 1 kas 3Phase 100-6i:) 200 300 350 400 Other
eW Servl e--connect Underground Number of Meters Change of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
New 'rte, Will &P~er t>iQUi A m don ramiaAlk
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82-Request far Inspection Form