HomeMy WebLinkAbout36622-ZTown of Southold Annex
54375 Main Road
Southold, New York 11971
9/12/2011
CERTIFICATE OF OCCUPANCY
No: 35205
Date: 9/12/2011
THIS CERTIFIES that the building
Location of Property:
SCTM #: 473889
Subdivision:
ELECTRICAL
5245 Pcquash Ave, Cutchogue
Sec/Block/Lot: 110.-4-6
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
8/12/2011 pursuant to which Building Permit No. 36622 dated 8/12/2011
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 Upgrade
The certificate is issued to Benson-Hill, Ann
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
~Aut~ture
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 #: 36622
Permission is hereby granted to:
Benson-Hill, Ann
5245 Pequash Ave
Cutchogue, NY 11935
To:
Electdc Service Upgrade
Date: 8/12/2011
At premises located at:
5245 Pequash Ave
SCTM # 473889
Sec/Block/Lot # 110.-4-6
Pursuant to application dated
To expire on 2110/2013.
Fees:
8112/2011
and approved by the Building Inspector.
ELECTRIC $85.00
Total: $85.00
/ Building Inspector
Town Hall Annex
54375 Main Road
P.O. Box I 179
Southold, New York I 1971-0959
Telephone(631)765-1802
Fax(631)765-9502
rofler, richedC, town.southold.ny, us
BUILDING DEPARTMENT
TOWN OFSOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: David Hill
Address: 5245 Pequash Ave 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: Hildebrandt Electric LicenseNo: 38496-me
SITE DETAILS
Office Use Only
Residential ~ Indoor ~ Basement ~ ServioeOnly ~
Commedcal Outdoor 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
Service 1 ph
Service 3 ph
Main Panel
Sub Panel
Transformer
Disconnect
Other Equipment:
Heat ~
Hot Water
NC Condenser
NC Blower
Appliances
1200~ Switches
200a overhead service
INVENTORY
Duplec Recpt ~
GFCI Recpt
Single Recpt
Range Recpt
Dryer Recpt
Twist Lock
Ceiling Fixtures [~ HID Fixtures
Wall Fixtures ~ Smoke Detectors
Recessed Fixtures ~.~ CO Detectors
Fluorescent Fixture[~ Pumps
Emergency Fixturesl.~ Time Clocks
Exit Fixtures L~J TVSS
Notes:
Inspector Signature:
Date: Aug 17 2011
81-Cert Electrical Compliance Form
Touna Hall Pumex
54375 Main Road
P.O. Box 1179
Southold, NY 11971-0959
Telephone (631) 765-1802
· ....F. ax (63t) 765.-,95q2,
ro,qer.nchert~,town.soutnola.ny.us
BUILDING DEPARTMENT
TOWN O~' $OUTHOI.I~
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY:
Company Name:
Name:
_icense No.:
~,ddress:
Phone No.:
JOBSITE INFORMATION: (*Indicates required information)
*Name:
*Address:
*Cross Street:
*Phone No.:
Permit No.:
Tax Map District:
1000 Section: \ \o Block: L'I Lot:
*BRIEF DESCRIPTION OF WORK (Please Pdt)
(Please Circle All ThatApply~[~ , ~ ' /
*ls job ready for inspect'o : [ ~ ~/NO/ Roughln
*Do you need a Temp Ce~ific~te:
Temp Information (If needed~
*New Se~ice:
Final
Additional Information:
82-Request for Inspection Form
PAYMENT DUE WITH APF
/
AUG 1 0 ~011
BLDG DEPT.
TOWN OF SOUYHOLD
400 Other
Re-connect Underground Number of Meters .Change of Service ~