HomeMy WebLinkAbout37322-ZTown of Southold Annex
P.O. Box 1179
54375 Main Road
Southold, New York 11971
6/28/2012
CERTIFICATE OF OCCUPANCY
No: 35786
Date: 6/28/2012
THIS CERTIFIES that the building
Location of Property:
SCTM #: 473889
Subdivision:
ELECTRICAL
735 Westphalia Rd, Mattituck,
Sec/Block/Lot: 141.-3-21
Filed Map No.
conforms substantially to the Application for Building Permit heretofore
6/25/2012 pursuant to which Building Permit No. 37322
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
Lot No.
filed in this officed dated
dated 6/25/2012
The certificate is issued to
MAR JAM 50 LLC
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLIERS CERTIFICATION DATED
37322 06/25/2012
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 #: 37322
Date: 6/25/2012
Permission is hereby granted to:
MAR JAM 5O LLC
cio Mitchell Kahn
125 Jericho Tpke
Jericho, NY 11753
To:
Service Upgrade
At premises located at:
735 Westphalia Rd, Mattituck
SCTM # 473889
Sec/Block/Lot # 141 .-3-21
Pursuant to application dated
To expireon 12/2512013.
Fees:
6/25/2012
and approved by the Building Inspector.
ELECTRIC
Total:
$85.00
$85.00
~VE~nspector
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, NY 11971-0959
Telephone (631 ) 765-1802
Fax (631) 765-9502
roger, richert~,town, so uthold, ny. us
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Madam (residence)
Address: 735 Westphalia Rd City: Mattituck St: NY Zip: 11959
Building Permit #: Section: Block: Lot:
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
.~ontractor: DBA: License No:
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
Servicelph ~ Heat ~ DuplecRecpt ~ CeilingFixtures [~ HIDFixtures ~s~[ [~
Service 3 ph Hot Water GFCI Recpt Wall Fixtures L.~ Smoke Detectors
Main Panel NC Condenser Single Recpt Recessed Fixtures U CO Detectors
Sub Panel NC Blower Range Recpt Fluorescent Fixture [~ Pumps
Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks
Disconnect Switches Twist Lock Exit Fixtures ~ TVSS
Other Equipment: 200a overhead service
Notes:
Inspector Signature:
Date: June 25 2012
81-Ced Electrical Compliance Form.xls
Tram Hdl Ampex
54375 M~n Ro~d
P.O. Box 1179
~ NY 11971-~,~
T~ (6~1)
BUII.I~ING DEPARTMENT
· TOWN OF SO~I'HOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: ~/"~Ad ~ ~,~:::r,~.~
Company Name: (~'~-~'~.T- ~;7 ~-'-r_~C~c
Name: ..........
License No.:
Address:
Phone No.:
Date:
JOBSITE INFORMATION: (*Indicates required information)
*BRIEF DESCRIF~'ION OF WORK (Please Pdnt Clearly)
*Name:
*Addrass:
*Cross Streel:
*Phone No.:
Permit No.:
Tax Map District
(Please Circle All That Apply)
*Is job rea~. y for inspection:
*Do you need a Temp Cedir, cate:
Block:
Rough In ~
Temp Infomtatlon (If needed)
150 (~ 300 350 400 Other
~AYMENT DUE WITH APPUCATION
BtDG D£Pf.
TOWI~,' OF SOIJTNf~l n
*Service Size:
*New Sewice:
Additional Inform
82-RJKlU~t for Inspec~ Form