HomeMy WebLinkAbout36717-ZTown of Southold Annex
54375 Main Road
Southold, New York 11971
9/28/2011
CERTIFICATE OF OCCUPANCY
No: 35250 Date: 9/28/2011
THIS CERTIFIES that the building ELECTRICAL
Location of Property:
SCTM #: 473889
11500 Route 25, Mattituck,
Sec/Block/Lot: 122.-3-6
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
9/27/2011 pursuant to which Building Permit No. 36717 dated 9/27/2011
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:
electric service repair
The certificate is issued to
Six Kings LLC
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
36717 9/27/11
~-4~Uth~ure
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, NY 11971-0959
Telephone (631) 765-1802
Fax (63 I) 765-9502
rofler, dchert~.town.southold.nv.us
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Steve King (East End Sporting Goods)
Address: 11500 Main Rd City: Mattituck St: NY Zip: 11952
Building Permit #: '~{47'~ / '~' Section: Block: Lot:
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Glens Electric LicenseNo: 4770-me
SITE DETAILS
Office Use Only
Residential [~ Ind°°r [~ Basement I~] Service 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 A/C Condenser Single Recpt
Sub Panel NC Blower Range Recpt
Transformer Appliances Dryer Recpt
Disconnect Switches Twist Lock
Other Equipment: replace meter pan only, on existing 2008, 3 phase service
Ceiling Fixtures ~[~ HID Fixtures
Wall Fixtures I I Smoke Detectors
Recessed Fixtures I I CO Detectors
Fluorescent Fixtun ~ Pumps
Emergency Fixture Time Clocks
Exit Fixtures ~ TVSS
Notes:
Inspector Signature:
Date: Sept 27 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 #: 36717
Date: 9127/2011
Permission is hereby granted to:
Six Kings LLC
PO BOX 863
Mattituck, NY 11952
To:
electric service repair
At premises located at:
11500 Route 25, Mattituck
SCTM # 473889
Sec/Block/Lot # 122.-3-6
Pursuant to application dated
To expire on 3/28/2013.
Fees:
9/27/2011 and approved by the Building Inspector.
ELECTRIC
Total:
$85.00
$85.00
Building Inspector
To~m Hail Annex
,~,375 Mah Road
P.O..Box 1179
. Soudlold, NY ! 1971.09,~
er. '-- '~(~3u 7~
ro~ ncner~,town.soumo~,n¥.us
TOWN OF SOUTHOLD
,APPLICATION. FOR ELECTRICAL INSPECTION·
IESTED BY:
CompanY Name:
No:.:
No.:
*Address:
· . *Cross Street: *Phone No.:
Permit No.: .
Tax Map District:
JOBSITE INFORMATION: (*IndiCates required information)
//~,,x~ .-'m,~,~
1000 Se~on: ./?~ aock:
*BRIEF 'DEsC~PTION OF WORK (Plea~ P~nt
· (Please Circle N! That ApPly)
*Is job ready for Inspection: '/~ NO Rough In
.*DO you need a Temp Certificate: (~/ NO '
Temp'lnformation (If needed}. . · '
'SeedS"e: .1.h~" ~ ~oo 1~o(~ ~o0 ~5o ~0o '~her
*New Set,ce: Re-conneot Under, round Numberor~eter. Change of Ser~oe r-gv'er~ad '
Additional Information: PAYMENT DUE WITH' APPLICATION