HomeMy WebLinkAbout43846-Z �Si�FF oc
0�0 �oG a Town of Southold 8/31/2019
, P.O.Box 1179
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.� 53095 Main Rd
Southold,New York 11971
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CERTIFICATE OF OCCUPANCY
No: 40666 Date: 9/3/2019
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 355 Cases Ln, Cutchogue
SCTM#: 473889 Sec/Block/Lot: 109.-6-2.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
6/10/2019 pursuant to which Building Permit No. 43846 dated 6/10/2019
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:
150a underground electrical service.
The certificate is issued to Old House Society Inc
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 43846 7/2/2019
PLUMBERS CERTIFICATION DATED
Authorized Signature
TOWN OF SOUTHOLD
i�'gy�FFO�����•
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, NY
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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#: 43846 Date: 6/10/2019
Permission is hereby granted to:
Old House Society Inc
c/o Wickham Wickham &
13015 Route 25
Mattituck, NY 11952
To: 150a underground electrical service.
At premises located at:
355 Cases Ln, Cutchogue
SCTM # 473889
Sec/Block/Lot# 109.-6-2.1
Pursuant to application dated 6/10/2019 and approved by the Building Inspector.
To expire on 12/9/2020.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
pF SOUTH,®l
Town Hall Annex ~ ® Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 G • roger.richert@town.southold.nV.us
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To- Old House Society Inc
Address: 355 Cases Lane City: Cutchogue St: New York Zip: 11935
Building Permit#: 43846 Section- 109 Block. 6 Lot. 2.1
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: REP Electric License No: 45288-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 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 Fixtures Time Clocks
Disconnect 150a Switches Twist Lock Exit Fixtures TVSS
Other Equipment. Service up grade, 150a underground
Notes*
Inspector Signature: Date: July 2 2019
81-Cert Electrical Compliance Form.xls
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S�1FF0t�' BUILDING DEPARTMENT-Electrical Inspector
TOWN OF SOUTHOLD
Town Hall Annex - 54375 Main Road - PO Box 1179
oy • �� Southold, New York 11971-0959
�O1 Telephone (631) 765-1802 - FAX(631) 765-9502
rocier.richert@town*.southold.nv.us
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: LCMaDate:��'
Company Name: REP EAf&t3k L_L�
Name: �-
License No.: email:R - G �(� t
Address: m hCG W I lq5�-
Phone No.: , -7UQSEA
JOB SITE INFORMATION: (All Information Required)
Name: r � � n -�l'►-Q
Address:(055� "T�
Cross Street:
Phone No.:
BIdg.Permit#: email:
Tax Map District: 1000 Section: l b q Block: Lot:
BRI F DESCRIPTION OF WORK(Please Print Clearly) _
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Circle All That Apply:
Is job ready for inspection?: YES /� 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:Ago A #Meters � Old Meter#
New Service Fire Reconnect- Flood Reconnect-Service Reconnected Und ound Overhead
#Underground Laterals 1 2 Frame Pole Work done on Service? Y N
Additional Information:
PAYMENT DUE WITH APPLICATION
cc?(h 7
82-Request for InspecdonForm As
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