HomeMy WebLinkAbout36590-ZTown of Southold Annex
54375 Main Road
Southold, New York 11971
CERTIFICATE OF OCCUPANCY
7/29/2011
No: 35094 Date: 7/29/2011
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 4200 Depot Ln, Cutchogue,
SCTM #: 473889 Sec/Block/Lot: 96.-5-10
Subdivision: Filed Map No.
conforms substantially to the Application for Building Permit heretofore
7/29/2011 pursuant to which Building Permit No.
was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for
Lot No.
filed in this officed dated
36590 dated 7/29/2011
which this certificate is issued is:
overhead electric service upgrade.
The certificate is issued to
Sawicki, Joan & Glowacki, Patricia
(OWNERi
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
36590 07/22/2011
Authorized Signature
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 #: 36590
Permission is hereby granted to:
Sawicki, Joan & Glowacki, Patricia
1645 Delmar Dr
Laurel, NY 11948
To:
Service up-grade
Date: 7/29/2011
At premises located at:
4200 Depot Ln
SCTM # 473889
Sec/Block/Lot # 96.-5-10
Pursuant to application dated
To expire on 1/27/2013.
Fees:
7/29/2011
and approved by the Building Inspector.
ELECTRIC
Total:
$85.00
$85.00
Building Inspector
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold. New York 11971-0959
Telephone (631 ) 765- 1802
Fax (631 ) 765-95(12
ro.qer, richert~town southold.ny.us
BUILDING DEPARTMENT
TOWN OF SOUTI-IOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Guy Valerioti
Address: 4200 Depot Lane City: Cutchogue St: NY Zip: 11935
Building Permit #: Section: 96 Block: 5 Lot: 10
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: T Metz Electric Corp LicenseNo: 4525-me
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 GFCl Recpt
Main Panel NC Condenser Single Recpt
Sub Panel A/C Blower Range Recpt
Transformer Appliances Dryer Recpt
Disconnect Switches Twist Lock
Other Equipment: 200a overhead service, sub panel in 1st floor and garage
Ceiling Fixtures [~ HID Fixtures
Wall Fixtures [ I Smoke Detectors
Recessed Fixtures[~ CO Detectors
Fluorescent Fixture ~ Pumps
Emergency Fixtures~I Time Clocks
Exit Fixtures ~ TVSS
Notes;
Inspector Signature:
Date: July 22 2011
81-Cert Electrical Compliance Form
,765-180~
Company Name:
Name:
Licen~ No.:
~ddresS:
~hone No.:
/
*Cross Street:
*Phone No.:
Permit No.:
Tax.Map District:
JOBSITE INFORMATION: (*Indicates required information)
*Name: ~/
*Address: ~.~ ~,,o ¢,,Z /~,~ ~_,~..
1000 Section: <~. I_~ Block:
Lot:
*BRIEF DESCRIPTION OF WORK (Please Print Clearly) ~o
(Please Circle All That Apply)
*Is job ready for inspectiOn:
*Do you need a Temp Certificate:
Temp, Information (If needed)
*Service Size: ~ 3PhaSe
*New Service: Re-connect'
Additienal Information:
82~Request fo~lnspe~fit~n Fon~
100
Underground
.¥
_~ NO Rough Ir~ d __ In~al~
150 (~ 300 350 400 Other
Number of Meters C~nge ~
.PAYMENT DUE WITH APPLICATION