HomeMy WebLinkAbout36588-ZTown of Southold Annex
54375 Main Road
Southold, New York 11971
CERTIFICATE OF OCCUPANCY
7/29/2011
No: 35093
Date: 7/29/2011
Location of Property:
SCTM #: 473889
Subdivision:
THIS CERTIFIES that the building ELECTRICAL
55765 Route 25, Southold,
Sec/Block/Lot: 63.-3-8
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
7/29/2011 pursuant to which Building Permit No. 36588 dated 7/29/2011
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:
Service Re-Connect (overhead electric service)
Long Island Coffee Roasters
The certificate is issued to
Stocken Dev I LLC
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
36588 07/18/2011
~re
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
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 #: 36588
Date: 7129/2011
Permission is hereby granted to:
Stocken Dev I LLC
183 Smithtown Blvd
Nesconset, NY 11767
To:
Service Re-Connect
At premises located at:
55765 Route 25
SCTM # 473889
Sec/Block/Lot # 63.-3-8
Pursuant to application dated
To expire on 1/2712013.
Fees:
71291201
and approved by the Building Inspector.
ELECTRIC
Total:
$90.00
$90.00
Building Inspector
Town Hall Annex
54375 Main Road
P,O. Box I 179
Southold, New York 11971 0959
Telephone (631 ) 765-1802
Fax (631) 765-9502
ro.qor, dchort~town southold.n¥.us
BUILDING DEPARTMENT
TOWN OF' SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To; Long Island Coffee Roaster
Address: 55765 Rt 25 City: Southold St: NY Zip: 11971
Building Permit #: Section: Block: Lot:
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: as built DBA: License No:
SITE DETAILS
Office Use Only
Residential ~ Indoor ~ Basement ~ Service Only ~
Commerical Outdoor 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
Service I ph L
Service 3 ph
Main Panel
Sub Panel
Transformer
Disconnect
Other Equipment:
INVENTORY
Hot Water GFCI Recpt
A/C Condenser Single Recpt
NC Blower Range Recpt
Appliances Dryer Recpt
Switches Twist Lock
Ceiling Fixturese~[~~ HID Fixtures
Wall Fixtures II Smoke Detectors
Recessed Fixture~ I I CO Detectors
Fluorescent Fixtur Pumps
Emergency FixturesL~ Time Clocks
Exit Fixtures TVSS
200a overhead service-OK for LIPA to re-connect
Notes:
Inspector Signature:
Date: July 18 2011
81-Cert Electrical Compliance Form
REQUESTED BY:
Company Name:
Name:
License No.:
Address:
Phone No.:
Tow~ Hall
54375 Main Road
P.O. Box 1179
Southold. I'PY 11971-0959
'APPLICATION FOR ELECTRICAL INSPECTION
-~ ,~1[ ~- Telephone (631 ) 765-1802
.. ,q . cnert~,town.sou[no~o.ny:t~s
Date:
JOBSITE INFORMATION: (*Indicates required information)
*Name:
*Address:
*Cross Street:
*Phone No.:
Permit No.:
Tax-Map District:
1000 Section: Block: Lot:
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
"~,Please Circle AIl That APply) ~ "Q .'
'IS job ready for inspection:., . YES/NO Rgd~h In I ,~[1 ~/"Flnal
*D° Y°U need a Temp CerUficate: . YES/NO /
· ' "'
New Service: (Re-conne~ Underground Numberof-.Mefers/ Change of Service Overhead ,,~.~
Additional I nform alio.~ ~ PAYMENT DUE W~iOATiO N~~(L~
Qo -""
82~Request for Inspection Form