HomeMy WebLinkAbout36750-ZTown of Southold Annex
54375 Main Road
Southold, New York 11971
CERTIFICATE OF OCCUPANCY
11/10/2011
No: 35282
Date: 11/10/2011
THIS CERTIFIES that the building
Location of Property:
SCTM #: 473889
Subdivision:
ELECTRICAL
445 Walnut P1, Mattituck,
Sec/Block/Lot: 142.-1-16.2
Filed Map No.
conforms substantially to the Application for Building Permit heretofore
10/13/2011 pursuant to which Building Permit No. 36750
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:
Lot No.
filed in this officed dated
dated 10/13/2011
Outside Electrical Service Repair.
The certificate is issued to
Dohm Jr, Walter & Dohm, Kinta
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
36750
10/28/11
' ~ Aut-horiZ~-§ignature
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, New York I 1971-0959
Telephone (631) 765 1802
Fax (631) 765-9502
roger, dchert~town.southold.n¥.us
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Walter Dohm
Address: (445) 265 Walnut Place City: Mattituck St: NY Zip: 11952
Building Permit #: ~-"~-'-'~ --~O Section: 142 Block: 1 Lot: 167
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: MD Electric Inc License No: 4925-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 Wall Fixtures Smoke Detectors
Main Panel NC Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel NC Blower Range Recpt Fluorescent Fixture ~.~ Pumps
Transformer Appliances Dryer Recpt Emergency Fixturesl.~ Time Clocks
Disconnect Switches Twist Lock Exit Fixtures ~ TVSS
Other Equipment: service repair-out side only-to existing 150a overhead service
Notes:
Inspector Signature:
Date: Oct 28 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 #: 36750
Permission is hereby granted to:
Dohm Jr, Walter & Dohm, Kinta
PO BOX 977
Mattituck, NY 11952
Date: 10/13/2011
To:
Outside Electrical Service Repair
At premises located at:
445 Walnut PI, Mattituck
SCTM # 473889
Sec/Block/Lot # 142.-1-16.2
Pursuant to application dated
To expire on 4/13/2013.
Fees:
10/13/2011 and approved bythe Building Inspector.
ELECTRIC
Total:
$85.00
$85.00
Building Inspector
TowlX~An~
P.O.,.B.~ 11/9
· Somflold, NY i 19714]959
BL~LD~G D~Alfl~l~
TO~N 01~
· CA N OR E AL ECl' '
JOBSITE INFORMATION: (*!'ndi~atea required information)
*Name:
P~.:
Tax Map ~ 1000 8eetlon:~. I ~.~- filo~k:. · . ~,...,.
q~RJEF DESCRIPTION OF WORK (Please P~nt Clearly)
(Plemee .Clrole Alt That,~Ipply} '. ' · ' '
· M.JOb ready for klspecli0n:
,q:]o you need a T.emp Certffica~e: ROugh In' Final
Temp, *lnformalion~ded),
*New Sm'vice: ~
Additional Intbrmalion:
U"d~r°unl~]0 N~f~ 300 aso 400 ~Olher
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