HomeMy WebLinkAbout36508-ZTown of Southold Annex
54375 Main Road
Southold, New York 11971
7/31/2011
CERTIFICATE OF OCCUPANCY
No: 35095 Date: 7/31/2011
THIS CERTIFIES that the building
Location of Property:
SCTM #: 473889
Subdivision:
ELECTRICAL
410 Blossom Bend, Mattituck,
Sec/Block/Lot: 115.-6-27
Filed Map No.
conforms substantially to the Application for Building Permit heretofore
Lot No.
filed in this officed dated
6/22/2011 pursuant to which Building Permit No.
36508 dated 6/22/2011
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:
overhead electric service.
The certificate is issued to
Christy, James & Christy, Elizabeth
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
36508 7/15/11
AuthoriZed Si~natur~
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold. New York 11971 0959
Telephone (631) 765- 1802
Fax (631 ) 765-9502
ro.qer, richert~town.southold.ny.us
BUILDING DEPARTMENT
TOWN OF SOUTI-IOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Christy
Address: 410 Blossom Bend City: Mattituck St: NY Zip: 11952
9uilding Permit #: ,~' ~.~0~ Section: 115 Block: 6 Lot: 27
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Doroski Electric lnG LicenseNo: 2941-e
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
INVENTORY
Service 3 ph Hot Water GFCI Recpt
Main Panel NC Condenser Single Recpt
Sub Panel NC Blower Range Recpt
Transformer Appliances Dryer Recpt
Disconnect Switches Twist Lock
Other Equipment: 200a overhead service
Ceiling Fixtures ~ HID Fixtures
Wall Fixtures ] ] Smoke Detectors
Recessed Fixtures~ CO Detectors
Fluorescent Fixture ~.~ Pumps
Emergency Fixture1.~ Time Clocks
Exit Fixtures [__~ TVSS
Notes:
Inspector Signature:
Date: July 15 2011
81-Cert Electrical Compliance Form
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 #: 36508
Permission is hereby granted to:
Christy, James & Christy, Elizabeth
Blossom Bnd
PO BOX 564
Mattituck, NY 11952
To:
overhead electric service
Date: 6/2212011
At premises located at:
410 Blossom Bend, Mattituck
SCTM # 473889
Sec/Block/Lot # 115.-6-27
Pursuant to application dated
To expire on 12/21/2012.
Fees:
6/22/2011 and approved by the Building Inspector.
ELECTRIC $85.00
Total: $85.00
~ Building Inspector
,5~?$ Maiu Road
P.O, Box. 1179
Souihold, ~ 1197i-~9
BU~G D~AR~CF
~ OF SO~OLD
Tclcphoc~ iii31) 76.~1802
[REQUESTED BY: ~"J~:.~ C. t ~ C. -~ Date:
[Company Name: ~'x.,~x.~_.-" ~.-,-,-,-,-,-,-,-,-,~.c..ls-,-', ~. I/M 6,_ ,
Name: G~ '~'"-"~ o,,,~k',~
U~n, No.: -~,S~ ~ .,~
Phone No.: ~_.,.j~ '7~c~ '?,.._~'~',~"(
JOB,SITE INFORMAT! :',N: (*Indicates required information) ~o ~c-~
,Cross St~t: ........ ,, _
*Phone No,: ~ 0 ~ '
Pe~ No.: ....
0o,~, ..............
Tax Map ~ct: ~ S~on: "~':~ ~ B',cck: ~ , Lot:
-~ c. o ~ o. ~.~ ' ___
(Pleaae Cimle NI That ~p~)
*',,b mady for In,,,ion ~NO
Tem~ In~aa~ (E n~ch~d]
*S~ Sl~: 1 ~a~ 3P~ 100 150 ~ 300 350
*N~ ~: Re-~nn~ Un~mu~ Number of Meters Cha~e ~ Se~oe
Additional In~rmation' ~T DU ...........
-- T~ -~ ~ ~~'w!tHAPPLJCATION
APPL,'LPATION FOR ELECTRICAL~~