HomeMy WebLinkAbout45119-Z �o�OgpEFQI Town of Southold 4/10/2023
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P.O.Box 1179
o .� 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 41419 Date: 9/5/2020
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 61505 Route 25, Southold
SCTM#: 473889 Sec/Block/Lot: 56.4-1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore fled in this office dated
8/18/2020 pursuant to which Building Permit No. 45119 dated 8/18/2020
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:
200a overhead electric service.
The certificate is issued to Main Road Brokerage II LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 45119 8/27/2020
PLUMBERS CERTIFICATION DATED
Authorize ignature
�o�asz�z'-o, TOWN OF SOUTHOLD
G BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
Way • � 4 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#: 45119 Date: 8/18/2020
Permission is hereby granted to:
Main Road Brokerage II LLC
PO BOX 937
Southold, NY 11971
To: Electric 200A overhead service.
At premises located at:
61505 Route 25, Southold
SCTM # 473889
Sec/Block/Lot# 56.-4-1
Pursuant to application dated 8/18/2020 and approved by the Building Inspector.
To expire on 2/17/2022.
Fees:
ELECTRIC $125.00
Total: $125.00
l
Building Inspector
Town Hall Annex ® Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 roger.richert(c'bi_town.Southold.nv.us
Southold,NY 11971-0959 ® �®
®lyOwn
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Main Road Brokerage
Address: 61505 Route 25 City: Southold St: New York Zip: 11971
Building Permit#: 45119 Section: 56 Block- 4 Lot* 1
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Roslak Electric License No: 3677-ME
SITE DETAILS
Office Use Only
Residential Indoor 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 200a Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures Smoke Detectors
Main Panel 200a 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 200a Switches Twist Lock Exit Fixtures TVSS
Other Equipment: 200a, pole mounted , overhead service
Notes.
Inspector Signature: Date: August 27 2020
81-Cert Electrical Compliance Form.xls
r'�"�p�n
u no TOWN OF SOUTHOLD
ac wn Hall Annex - 54375 Main Road - PO Box 1179
lJG 1 7 2020 Southold, New York 11971-0959
Telephone (631) 765-1802 - FAX (631) 765-9502
� g_CD'E ®g roger.riche rt(atown.southold.ny.us
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY. may a-1-��-- DateO(4 2,Z-a Zo
Company Name: / s/ t t
Name: ��-
License No.: '3 4 7email: a �
Address: D, 6, I G , _ r= AJ, t
Phone No.: ( � ) 73 L/ G
JOB SITE INFORMATION: (All Information Required)
Name: 'k4"� t-'�-
Address: ®Srr�-rte
Cross Street:
Phone No.: 4-V) 734- 5-?,7e>
Bldg.Permit #: g/1email:,
Tax Map District: 1000 Section: Block: Lot:
BRIEF DESCRIPTION OF WORK (Please Print Clearly)
Circle All That Apply:
Is job ready for inspection?: YES NO Rough In Final
Do you need a Temp Certificate?: a�( NO Issued On ?-a6-aD
Temp Information: (All information required)
Service Size ClPh 3 Ph Size: s,Zao A # Meters Old Meter#
ew Service - Fire Reconnect - Flood Reconnect- Service Reconnected - Underground ver ea
# Underground Laterals 1 2 H Frame Pole Work done on Service? Y N
Additional Information:
PAYMENT DUE WITH APPLICATION /V ®o I- �J`
dD82-Request for Inspection FormAs `