HomeMy WebLinkAbout43359-Z �5�1FMir � Town of Southold 1/15/2019
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40168 Date: 1/15/2019
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1175 Home Pike, Mattituck
SCTM#: 473889 Sec/Block/Lot: 114.4-3.3
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
12/31/2018 pursuant to which Building Permit No. 43359 dated 12/31/2018
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:
ELECTRIC IN DETACHED GARAGE
The certificate is issued to Raynor,Dorothy
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 43359 01-02-2019
PLUMBERS CERTIFICATION DATED
Authorized Signature
O�g�FFOt,�c� TOWN OF SOUTHOLD
BUILDING DEPARTMENT
a 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#: 43359 Date: 12/31/2018
Permission is hereby granted to:
Raynor, Dorothy
1175 Point Pleasant
PO BOX 187
Mattituck, NY 11952
To: electric for garage.
At premises located at:
1175 Home Pike, Mattituck
SCTM # 473889
Sec/Block/Lot# 114.-1-3.3
Pursuant to application dated 12/31/2018 and approved by the Building Inspector.
To expire on 7/1/2020.
Fees:
ELECTRIC $90.00
Total: $90.00
l
ui ing nspector
pF SO(�j�®l
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 %c® ® �o roper.riche rt(c-town.south old.ny.us
I�COUN N
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Dorothy Raynor
Address: 1175 Home Pike City: Mattituck St- New York Zip: 11952
Budding Permit# 43359 Section. 114 Block. 1 Lot: 3.3
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: AS BUILT DBA: License No:
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service Only
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey X Attic Garage X
INVENTORY
Service 1 ph 100a Heat Duplec Recpt 4 Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel 100a A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency FixtureTime Clocks
Disconnect 100a Switches Twist Lock Exit Fixtures TVSS
Other Equipment. "AS BUILT" "ELECTRICAL SURVEY" "NO VISUAL DEFECTS"
Notes "DETACHED GARAGE"
Inspector Signature: Date: January 2 2019
81-Cert Electrical Compliance Form.xis
OF SO(/l�o�
# # TOWN OF SOUTHOLD BUILDING DEPT.
co 765-1802
02-
INSPECTION '' 1 -3 -3 �s
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
is
DATE INSPECTOR '
BUILDING DEPARTMENT- Electrical Inspector
TOWN OF SOUTHOLD
o Town Hall Annex - 54375 Main Road - PO Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1802 - FAX (631) 765-9502
roger.richert(jjtown.sou thol d.ny.us
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY:
eA 00—r kJ �IAJVQ Date* IQ
Company Name:
Name:
License No.: email:
Address:
Phone No.: ===4
JOB SITE INFORMATION: (All Information Required)
Name. A V A® -r Ile, tbc
's A*
Address:
Cross Street-, ca q
Phone No.: 6 21 3 (4, 4- '- /a-V2
BIdg.Permit#: I fA3 email:
ITax Map District: 1000 Section: Block: Lot:
BRIEF DESCRIPTION OF WORK (Please Print Clearly) ie-446C-
Circle All That Apply:
Is job ready for inspection?: as)/ 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
N,
82-Request for Inspection Form As