HomeMy WebLinkAbout42972-Z ���gU�FFiJt,fQo�� Town of Southold 9/13/2018
a P.O.Box 1179
a -
�' 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39898 Date: 9/13/2018
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 2375 Sigsbee Rd, Laurel
SCTM#: 473889 Sec/Block/Lot: 144.-2-23
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
8/27/2018 pursuant to which Building Permit No. 42972 dated 8/27/2018
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:
electrical survey for an existing dwelling_
The certificate is issued to Ellinghaus,Joy
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 42972- 9/4/2018
PLUMBERS CERTIFICATION DATED
Authorized Signature
�gUf�nt,��oTOWN OF SOUTHOLD
�4 y BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
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#: 42972 Date: 8/27/2018
Permission is hereby granted to:
Ellinghaus, Joy
620 Pelham Rd Apt 2A
New Rochelle, NY 10805
To: Electric Survey
At premises located at:
2375 Sigsbee Rd, Laurel
SCTM # 473889
Sec/Block/Lot# 144.-2-23
Pursuant to application dated 8/27/2018 and approved by the Building Inspector.
To expire on 2/26/2020.
Fees:
ELECTRIC $85.00
Total: $85.00
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Town Hall Annex Telephone(631)765-1802
54375 Main Road co Fax(631)765-9502
P.O.Box 1179 G Q
Southold,NY 11971-0959 �� • �o roger.richertaatown.Southold.nV.us
COWN
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Joy Ellinghaus
Address: 2375 Sigsbee Rd City: Mattituck St: New York Zip: 11952
Building Permit#. 42972 Section: 144 Block: 2 Lot- 23
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Alan Hubbard Electric License No: 4285-ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service Only
Commerical Outdoor 1st Floor X Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic 'Garage
INVENTORY
Service 1 ph Heat Duplec Recpt Ceiling,Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt 3 Wall Fixtures Smoke Detectors 2
Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors 1
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances DRryer Recpt EmerRgency Fixtures Time Clocks
Disconnect Switches Twist Lock Exit Fixtures TVSS
ROther Equipment. "DEFECTS REMOVED"
Notes GFCI recpticles installed in kitchen for,counter,gas range,and refrigerator,smoke'and c/o detectors installed.
Inspector Signature: Date: September 4 2018
81-Cert Electrical Compliance Form As
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SOUIyO�
TOWN OF SOUTIHOLD BUILDING DEPT.
°�ycourm,��' 765-1602
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLEG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) KELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
DATE �� �� INSPECTOR
o � `�
g11fFQ1,� IY6 DEPARTMENT- Electrical Inspector
C TOWN OF SOUTHOLD
_ AUG 2 12V I-fall Annex - 54375 Main Road -
PO Box 1179
"D Southold, New York 11971-0959
I YMDUTG-M fione (631) 765-1802 - FAX (631) 765-9502
-roger.riche rt(a-)town.southoId.ny.us
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: - - - - Date: $/ o 7 1/ff -
Company Name: �, cc�,��r� elni6e-lcax
Name: /"
License No.: email: u�j ndr Q�S �e QD/.
Address: AqCLtL/ llq3y
Phone No.: &31 b C ?
JOB SITE INFORMATION: (All Information Required)
Name: )(I Jou E' la10how 5
Address: YC a, S E 5 /Q�• LC y
Cross Street: X Da'in 9d
Phone No.: X
Bldg.Permit#: )( >(— email:]� 0 e ll e'Qh0-U5 (0)2!Q D. A A
Tax Map District: 1000 Section: Block: Lot:
d
BRIEF DESCRIPTION 9F WORK lease Print Clearly)
6
CC-Al'—
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 Reconnected - Underground - Overhead
# Underground Laterals 1 2 H Frame Pole Work done on Service? Y N
Additional Information:
PAYMENT DUE WITH APPLICATION
Request for Inspection FormAs y