HomeMy WebLinkAbout37008-ZTown of Southold Annex
P.O. Box 1179
54375 Main Road
Southold, New York 11971
2/24/2012
CERTIFICATE OF OCCUPANCY
No: 35455
Date:
2/24/2012
THIS CERTIFIES that the building
Location of Property:
SCTM #: 473889
Subdivision:
ELECTRICAL
1100 Hyatt Rd, Southold,
Sec/Block/Lot: 50.-1-10
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
2/24/2012 pursuant to which Building Permit No. 37008 dated 2/24/2012
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:
underground electric service.
The certificate is issued to
Kemeny, Mary
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIHCATION DATED
37008 2/22/12
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 #: 37008
Date: 2/24/2012
Permission is hereby granted to:
Kemeny, Mary
36 Perry St
New York, NY 10014
To:
underground electric service.
At premises located at:
1100 Hyatt Rd, Southold
SCTM # 473889
Sec/Block/Lot # 50.-1-10
Pursuant to application dated
To expire on 8/25/2013.
Fees:
2/24/2012
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, NY 11971 0959
Telephone (631) 765-1802
Fax (63 l) 765-9502
ro.qer, richert~,town.southold.ny.us
BUILDING DEPARTMENT
TOWN OF' SOUTI-IOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Mart Margaret Kemeny
Address: 1100 Hyatt Rd City: Southold St: NY Zip: 11971
Building Permit #: '~',~ ~ ~ {~' Section: 50 Block: 1 Lot: 10
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Custom Lighting of Suffolk License No: 38893-me
SITE DETAILS
Office Use Only
Residential ~] Indoor ~ Basement ~ ServioeOnly ~
Commerical Outdoor 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Servicelph ~ Heat ~ DuplecRecpt ~
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 underground service
Ceiling Fixtures [~ HID Fixtures
Wall Fixtures ~ Smoke Detectors
Recessed Fixtures ~ CO Detectors
Fluorescent Fixtur(~ Pumps
Emergency Fixture Time Clocks
Exit Fixtures [~J TVSS
Notes:
Inspector Signature:
Date: Feb 22 2012
81-Cert Electrical Compliance Form.xls
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southokt, NY 11971-0959
Telephone (§31 ) 765-1802
FO ' (631) 7 5
.qer. n~ert(~ff, t~n.so~l~So~.n¥.us
BUI!.F~ING DEPAKIMF, NT
TOWN OF $OUTHOLIi
.APPLICATION FOR ELECTRICAL INSPECTION
Company Name:
Name:
License No.:
Address:
Phone No.:
*Phone No.:
Permit No.:
Tax Map District:
Date:
JOBSITE INFORMATION: (*indicates required information) ~'c4f~e_,r~-,~
*c o s Street: L( ;,' ' '-
/ Lot:
1000 Section: ~'"O Block:
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
)/NO
;/NO ~"A~o.~ ~. t.fo-/,-/ (~'-/~ ]-- h
Templnformation(Ifneeded} ~( · "~c~oro~,;(~ OPt~nl,~¢
· Service S~e: ~ 3PhaSe 100 ~ Other
150 300 ~0 4~
· N~ Se~: ~ ~~ Number of Mete~e o~ Ove~d
AddEienal Info~ation: ~AYMENT DUE WITH APPLICATION
(Please Circle All That Apply)
*Is job ready for inspection:
*Doyou need a Temp Certificate:
82~Request for Inspection Form _