HomeMy WebLinkAbout35908-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
NO: Z-34591
Date: 10/04/10
THIS CERTIFIES that the building ELECTRIC RE-CONNECT
Location of Property: 18900 MAIN RD
(HOUSE NO.) (STREET)
County Tax Map No. 473889 Section 115 Block 6
Subdivision
Filed Map No. Lot NO. __
MATTITUCK
Lot 6
(HAMLET)
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 1, 2010 pursuant to which
Building Permit No. 35908-Z dated. OCTOBER 1, 2010
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 EMERGENCY OVERHEAD ELECTRIC SERVICE RE-CONNECT AS APPLIED FOR.
The certificate is issued to ANTHONY C & KATHLEEN M PASCA
(OWNER)
of the aforesaid building.
SUFFOLK COI~FrYDEPARTMENT OF H]~ALTHAPPROVAL N/A
EI~L-r~ICAL C~KTIFICATE NO. 35908 10/04/10
CERTIFICATION DA-r~u N/A
~ ~ignature
Rev. 1/81
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
(THIS
BUII~)ING PERMIT
PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO.
35908 Z
Date OCTOBER 1, 2010
Permission is
hereby granted to:
ANTHONY C & KATHLEEN M PASCA
18900 MAIN ROAD
MATTITUCK, NY 11952
for :
EMERGENCY RE-CONNECT ELECTRIC SERVICE AS APPLIED FOR.
at premises located at
County Tax Map No. 473889 Section 115
pursuant to application dated OCTOBER
Building Inspector to expire on APRIL
18900 MAIN RD MATTITUCK
Block 0006 Lot No. 006
1, 2010 and approved by the
1, 2012.
Fee $ 85.00
Authorized Signature
ORIGINAL
Rev. 5/8/02
Town ! lall Ampex
,51.375 Main ltoml
P.O. Box 1179
Soulhold, NY I 1971-0959
Telephone (631) 765-1802
Fax (631) 765-9502
ro.qer, richert~,,town, so uthold, ny. us
B! iII,DIN(; DEPARTMENT
TOWN OF $OUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Tony Pasca
Address: 18900 r[ 25 City: Mattituck St: NY Zip: 11952
BuildingPermit#: '~---.~ ~Oc,:~ Section: I[~' Block: (,~ Lot: ~
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Brian Brooks Electric LicenseNo: 3613-e
SITE DETAILS
Office Use Only
Commerical Outdoor 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 3 ph Hot Water GFCI Recpt
Main Panel AJC Condenser Single Recpt
Sub Panel NC Blower Range Recpt
Transformer Appliances Dryer Recpt
Disconnect Switches Twist Lock
Other Equipment:
Ceiling Fixtures ~r--I[E~ HID Fixtures
Wall Fixtures I I Smoke Detectors
Recessed Fixturesl I CO Detectors
Fluorescent Fixture Pumps
Emergency Fixture Time Clocks
Exit Fixtures [__~ TVSS
Re install 150a overhead service, down due to storm damage
Notes:
Inspector Signature:
Date: Oct 4 2010
81-Cert Electrical Compliance Form
Towu Hall Aratex
P.O..Box 1179
. Sou~old, NY 11971.09~9
Btm r~ING DF_,PARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
BY:
Name:
Date:
Box too { d..,;-
JOBSITE INFORMATION: (*!ndi~ates required information)
*Name:~ ~ ~
*Address: [~q~ ~+ ~ ~_, ~r~,~
. *Cross Street:
*Phone No.:
Permit No.:
Tax Map District: 1000 Section: . } [ ~ Block: ~ Lot:
*BRIEF DEscRIPTION OF WORK (Please Print. clearly) _~-{-~ ~,/~-~2-~A ~
(Please Cimle NI: That ~p[y)l
*Is.job ready for inspection:
.*Do you need a Temp Certificate:
Temp'lnformation {If needed}.
Rough In
Final
*Service size: ~ 3Phase 100 ~ 200 300: 350 400 Other
*NewService~"'~e-con~ Underground Number of Meters ChangeofServic~verh~
Additional Inf0rm~atior~. PAYMENT DUE WITH' APPLICATION
.,
82-Re°uest for InsoectJon Form