HomeMy WebLinkAbout37124-ZTown of Southold Annex
P.O. Box 1179
54375 Main Road
Southold, New York 11971
4/16/2012
CERTIFICATE OF OCCUPANCY
No: 35538 Date: 4/16/2012
THIS CERTIFIES that the building
Location of Property:
SCTM #: 473889
Subdivision:
ELECTRICAL
9945 Route 25, Mattituck,
Sec/Block/Lot: 142.-1-27
Filed Map No.
conforms substantially to the Application for Building Permit heretofore
4/9/2012 pursuant to which Bnilding Permit No.
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:
outside dedicated electric circuit.
Lot No.
t'fled in this officed dated
37124 dated 4/9/2012
The certificate is issued to
GAMA Properties-Deer lnc
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
37124
4/9/12
Authorized Signature
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 #: 37124
Permission is hereby granted to:
GAMA Properties-Deer Inc
320 Front Pond Rd
Old Brookville, NY 11545
Date: 4/9/2012
To:
outside dedicated electric circuit.
At premises located at:
9945 Route 25, Mattituck
SCTM # 473889
Sec/Block/Lot # 142.-1-27
Pursuant to application dated 4/9/2012
To expire on 10/912013.
Fees:
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 (631 ) 765-9502
ro.qer, richertC, town.southold.ny us
BUILDING DEPARTMENT
TOWN OF ISOUTI-IOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
ssued To: 7-Eleven
~,ddress: 9945 Main Rd City: Mattituck St: NY Zip: 11952
Permit#: ~"~l~.L~ Section: 142 Block: 1 Lot: 27
~uilding
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Statewide Elec License No: 35491-me
SITE DETAILS
office Use Only
Residential ~ Indoor ~ Basement ~] ServiceOn[y ~
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 NC Condenser Single Recpt
Sub Panel NC Blower Range Recpt
Transformer Appliances Dryer Recpt
Disconnect Switches Twist Lock
Other Equipment:
Ceiling Fixtures I~ HID Fixtures
Wall Fixtures I'~ Smoke Detectors
Recessed Fixtures I'~ CO Detectors
Fluorescent Fixture~ Pumps
Emergency Fixturel.~ Time Clocks
Exit Fixtures LI TVSS
install dedicated line to outside DVD vending machine, to include out side disconn
Notes:
Inspector Signature:
Date: April 9 2012
81-Cert Electrical Compliance Form.xls
Town H~ Annex
~,375 ~ ~
P.O. lk~ 1179
$o~d. NY 1 l~71.0~g
~ ~ /~1 7
TOWN OF ~O~YI~IOLD
,,APP.LICATION FOR ELECTRICAL INSPECTION
Company Name: :~3-~ C.Z~Cv,,j ,C.~T_ t~ ~ ~ ~ [ C ~C[
Name:- ~= ~ ~~ ~ ,
JOBSITE INFORMATION: (*lnai~tes mqu~ info~tion)
*Name:
*Address:
*Cross Street:
*Ph°ne No.:
Pen'nit No.:
Tax-Map District: ·
1000 Section:
Block:
· BRIEF DESCRIPTION OF WORK (Please Print Clearly)
Lot:
(P.lemse Cimle All That Apply)
*is job ready for inspection:
*Do. you nccd a Temp Certificate:
Temp Information (if. needed]
*F~'vice Size: 1 Phase
*New ,~n/ioe: Re-oonneot'
Add~enal Information:
~que~ f~ I~ ~,~ Form
Rough In
Final
3Phsse 100 150 200 300 350 400 Other
PAYMENT DUEg]~Ht~l~~-~ "i)i