HomeMy WebLinkAbout36895-ZTown of Southold Annex
54375 Main Road
Southold, New York 11971
CERTIFICATE OF OCCUPANCY
1/6/2012
No: 35384
Date:
1/6/2012
THIS CERTIFIES that the building
Location of Property:
SCTM #: 473889
Subdivision:
ELECTRICAL
26600 CR 48, Cutchogue,
Sec/Block/Lot: 84.-5-2
Filed Map No.
Lot No.
conforms substantially to thc Application for Building Permit heretofore filed in this ofllced dated
12/29/2011 pursuant to which Building Permit No. 36895 dated 12/29/2011
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:
Electrical Service Change
The certificate is issued to
Looney, Matthew
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
36895 1/4/12
VAuthorized Signature
Town Hall Annex
54375 Main Road
P.O. Box I 179
Southo}d, NY 11971 0959
Telephone (631 ) 765-1802
Fax (631 ) 765-9502
rofler.richert~,town.southold.n¥.us
BUILDING DEPARTMENT
TOWN OF 8OUTI-IOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Fred & Karen Lee
Address: 26600 County Rd 48 City: Cutchogue St: NY Zip: 11935
Building Permit #: ~.~ ~ ~' ~ ~- Section: Block: Lot:
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Doroski Electric Inc License No: 2941-e
SITE DETAILS
Office Use Only
Residential [~ Indoor [~] Basement ~ SewiceOnly [~
Commerical Outdoor 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Servicelph ~ Heat ~ DuplecRecpt ~
Service 3 ph Hot Water GFCl Recpt
Main Panel A/C Condenser Single Recpt
Sub Panel NC Blower Range Recpt
Transformer Appliances Dwer Recpt
Disconnect Switches Twist Lock
Other Equipment: service change, 200a overhead service
Ceiling Fixtures r-----Ir~l[~ HID Fixtures
Wall Fixtures I I Smoke Detectors
Recessed Fixtures I I CO Detectors
Fluorescent Fixtur~E~ Pumps
Emergency Fixture Time Clocks
Exit Fixtures TVSS
Notes:
Inspector Signature:
Date: Jan 4 2012
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 #: 36895
Permission is hereby granted to:
Lee, Fred & Karen
26600 CR 48
Cutchogue, NY 11935
To:
Electrical Service Change
Date: 12/29/2011
At premises located at:
26600 CR 48, Cutchogue
SCTM # 473889
Sec/Block/Lot # 84.-5-2
Pursuant to application dated
To expire on 6/29/2013.
Fees:
12/29/2011
and approved by the Building Inspector.
ELECTRIC
Total:
$85.00
$85.00
Building Inspector
Town Hall knnex
54375 Main Road
P.O. Box 1179
Sou&old, NY 11971-0959
Telephone (631) 765-180'2
· ...~ (631) 76,5:~50,~,
rofler, r cnor[~iown.soutno~a.ny,us
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAl. INSPEGTIO~N
REQUESTED BY:
Company Name:
Name:
License No.:
Address:
Phone No.:
JOBSITE INFORMATION: (*Indicates required information)
*Name: '~'-~-~ ~
*Address:
*Cross Street:
*Phone No.:
Permit No.:
Tax Map District: 1000__ Section: ~;~ Block:
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
Lot:
(Please Circle All That Apply)
*Is job ready for inspection:
*Do you need a Temp Cert ficate:
Temp Information (If needed}
*Service Size: 1 Phase
*New Service: Re-connect
Additional Information:
YES / NO
3Phase 100 150 2(IL~J~ 300 350 400 Other
Underground Number of Met~-" Change of Sent c~_~verhead
PAYMENT DLIE WITH APPLICATION ~
82-Request for Inspection Form