HomeMy WebLinkAbout36696-Z o�g1)FFO[��oG Town of Southold 10/4/2023
P.O.Box 1179
53095 Main Rd
Way o�g�� Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 44631 Date: 10/4/2023
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 845 Mill Creek Dr, Southold
SCTM#: 473889 Sec/Block/Lot: 135.-3-36.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore, filed in this office dated
9/19/2011 pursuant to which Building Permit No. 36696 ' dated 9/19/2011
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:
200 amp electric service.
The certificate is issued to Forestieri C Family Trt.
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 36696 9/16/2011
PLUMBERS CERTIFICATION DATED
Authorize ignature
r._"' TOWN OF SOUTHOLD
�oo�SUFFot� BUILDING DEPARTMENT
w y� 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 #: 36696 Date: .9/19/2011
Permission is hereby granted to:
Forestieri, Helen
740 E Broadway
Long Beach, NY 11561
To: overhead electric service
At premises located at:
845 Mill Creek Dr, Southold
SCTM # 473889
Sec/Block/Lot# 135.-3-36.1
Pursuant to application dated 9/19/2011 and approved by the Building Inspector.
To expire on 3/20/2013.
Fees:
Total: $0.00
Building Inspector
pF SOUIyOIo
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 roger.richert(a)-town.southold.ny.us
Southold,NY 11971-0959
C4UNT1,Nc�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: John Forestieri
Address: 845 Mill Creek Dr City: Southold St: NY Zip: 11971
Building Permit#: Section: 1� Block: Lot:
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Alan Hubbard Electrical CO License No: 4285-me
SITE DETAILS
Office Use Only
Residential X Indoor Basement Service Only X
Commerical Outdoor 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph 200 Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel 200 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 200 Switches Twist Lock Exit Fixtures TVSS
Other Equipment: 200a overhead service
Notes:
Inspector Signature: Date: Sept 16 2011
81-Cert Electrical Compliance Form
�pf Sppry�
Town 14A Annex Telephone(631)765.1802
54375 MAn Road e� ax(631 76 �95�
P.O.Box 1179 ro erAchert town._ ou no .ny s
Southak6 NY 11711.4959
BUMMING DEPARTNMgT
TOWN OF SOUTHOLD
APPLICATION FgR_.ELECTRICAI� INSP CT-ION
REQUESTED BY: ,9�,1� �{r,� ?`7i}yQ,[) Date: /�—
Company Name: iA.
Name:
License Na.:
Address. d
Phone No.: 7/
JOBSITE INFORMATION: (*Indicates required information)
*Name:
*Address: SILI
*Gross Street: ,,t.., U-0—
*Phone No.:
Permit No.:
Tax-Map District: 1000 Section: Block: Lot:
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
C4 i ra k1
(Please Circle All That Apply)
*Is Job ready for Inspection: YES NO Rough In Fina
*Do you need a Temp Certificate: YES NO
Temp Information(if.needed)
*Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other
*New Service:' Re-connect Underground Number of Meters hangs of.Service Overhead
Additional Information: PAYMENT_DUE WITH APPLICATION
Axl
mAequetst her Inspection Form
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