HomeMy WebLinkAbout39156-Z ,,per Town of Southold 2/14/2019
P.O.Box 1179
53095 Main Rd
'Fo3Southold,New York 11971
�NsCERTIFICATE OF OCCUPANCY
No: 40206 Date: 2/14/2019
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 8805 Oregon Rd, Cutchogue
SCTM#: 473889 Sec/Block/Lot: 95.-1-11.3
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
9/8/2014 pursuant to which Building Permit No. 39156 dated 9/8/2014
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.
The certificate is issued to Domaleski,Theodore&Geraldine
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 39156 1/11/2019
PLUMBERS CERTIFICATION DATED
u ho ' Signature
z. TOWN OF SOUTHOLD
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 #: 39156 Date: 9/8/2014
Permission is hereby granted to:
Domaleski, Henry
8745 Oregon Rd
Cutchogue, NY 11935
To: change of electric service
At premises located at:
8805 Oregon Rd, Cutchogue
SCTM # 473889
Sec/Block/Lot# 95.-1-11.3
Pursuant to application dated 9/8/2014 and approved by the Building Inspector.
To expire on 3/9/2016.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
pF SO�ryolo
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9.502
P.O.Box 1179 G Q
Southold,NY 11971-0959 �� • �o roger.richert(cDtown.southold.ny.us
'''40u '
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To. Henry Domaleski
Address. 8805 Oregon Rd City- Cutchogue St: New York Zip 11935
Building Permit#• 39156 Section: 95 Block: 1 Lot: 113
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: AS BUILT DBA. Roslak Electric License No 3677-ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement X Service Only X
Commerical Outdoor X 1 st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey X Attic Garage
INVENTORY
Service 1 ph 100a Heat Duplec Recpt 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 9 TVSS
Other Equipment: "AS BUILT" "ELECTRICAL SURVEY" "NO VISUAL DEFECTS"
Notes: 100a overhead service
Inspector Signature: Date: January 11 2019
81-Cert Electrical Compliance Form.xls
pf SOUTyo6
# TOWN OF SOUTHOLD BUILDING DEPT.
�rnurnr ' 765-1802
INSPECTION
.
[ ] FOUNDATION 1ST [ ] ROUGH PLBG. -�
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) J, ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
DATE I 1 1 INSPECTOR '
O��OF S+�ir
Town Hall Annex #i Tckp6one(631)765-1802
54375 Man Rad _.But(68l}766,9d4�
P.O.Hat 1179I:riCi19
8019tltoK NY 119714M
BUILDING DEPARTNWNr
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTi N
REQUESTED 8) . `, C Date: r
Company Name: ,
Name:
License No.: ,C-
No.: 3 )7
JOSSITE INFORMATION: (*Indicates required information)
*Name;
*Address: ,�-
*Cross Street: ,� � =2
*Picone No.. Qe 3>— ' -`2-7
Pam*No.:
Tax-Map District: 1000 Section: Block: Lot
*BRIEF DESCRIPTION OF WORK(Tease Print Clearly)
(Please Circle All That Apply)
*is job ready for inspection: / NO Rough In Incl
*Do-you need a Temp Certificate: YES NO
Tamp inform don( needed)
'Service Size: 3Ph8se 100 150 200 300 350 400 Other
*New SeMee: Ro-oonneat Underground Number of Meters Change of Service
Additional Information: PAYMENT DUE WN
82419gioe fw lnspecUon Form �LQ G-