HomeMy WebLinkAbout43626-Z c�ufFOtM
Town of Southold - 5/1/2019
o� P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40352 Date: 5/1/2019
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 22355 CR 48, Cutchogue
SCTM#: 473889 Sec/Block/Lot: 84.4-26.3
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
4/9/2019 pursuant to which Building Permit No. 43626 dated 4/9/2019
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:
SERVICE RE-INSPECTION FOR PSEG
The certificate is issued to 372 Jericho Corp
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Authorized Signature
l
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
t 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#: 43626 Date: 4/9/2019
Permission is hereby granted to:
372 Jericho Corp
C/O Lewis & Murphy Realty
47 Hillside Ave
Manhasset, NY 11030
To: electric service re-inspection for PSEG.
At premises located at:
22355 CR 48, Cutchogue
1
SCTM #473889
Sec/Block/Lot# 84.-1-26.3
Pursuant to application dated 4/9/2019 and approved by the Building Inspector.
To expire on 10/8/2020.
Fees:
ELECTRIC $85.00
Total: $85.00
Bui din nspector
Town Hall Annex Telephone(631)765-1802
54375 Main Road y Fax(631)765-9502
P.O.Box 1179 G
Southold,NY 11971-0959 .®l�� �® roger.riche rtR-town.south old.ny.us
®6�tl69 1 0 9
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: 372 Jericho Corp (Peconic Water Sports LLC)
Address: 22355 County Rd 48 (unit#9) City: Cutchogue St: New York Zip: 11935
Building Permit#• 43626 Section: 84 Block: 1 Lot 26.3
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: GJS Electric LLC License No: 4839-ME
SITE DETAILS
Office Use Only
Residential Indoor X Basement Service Only X
Commerical X Outdoor X 1st Floor 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 100a 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 Fixture Time Clocks
Disconnect 100a Switches Twist Lock Exit Fixtures TVSS
Other Equipment Service re-inspection for PSEG-LI, OK to reconnect
Notes:
Inspector Signature: - Date: April 9 2019
81-Cert Electrical Compliance Form.xls
boy
o��11fF0�, cD � ' BUI ING DEPARTMENT-Electrical Inspector
add TOWN OF SOUTHOLD
ToJonel
i nex- 54375 Main Road - PO Box 1179
y' • uthold, New York 11971-0959
01 i ' (631) 765-1802 - FAX(631) 765-9502
�O ro n er:richert town:southold.n '.us
a - - y
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: Dater
Company Name: _ Cie z LL
Name:
License No.: L4 84 M4�E email: rLt h v
Address: I — c�
Phone No.: _ 5
JOB SITE INFORMATION: (All Information Required)
Name: J 2 Le cAn <45 LLC -
Address: 35q v' �F� (fajz'&o
Cross Street:
Phone No.:
Bldg.Permit#: �j(®�(p email:
Tax Map, District: 1000 Section: Block: Lot: a 3
BRIEF DESCRIPTION OF WORK(Please Print Clearly)
�� ?5
Circle All That Apply:
Is job ready for inspection?: YE / NO g In Fin
Do you need a Temp Certificate?: E / NO Issued On — r
,Temp Information: (All information required)
Service.Size 1 Ph3 P Size: _A #Meters Old Meter#
New Service- Fire Reconnect- Flood Reconnec =ndergroun - Overhead
# _ derground Laterals - 1 H Frame Pole Work done on Service? . Y N -
Additional Information. PSE - o
PAY ` T , APPLICATION V
® � , a2o1g a�
82-Request for inspection Form. �� �
pQ
,�®vim