HomeMy WebLinkAbout37333-ZTown of Southold Annex
P.O. Box 1179
54375 Main Road
Southold, New York 11971
7/9/2012
CERTIFICATE OF OCCUPANCY
No: 35809
Date: 7/9/2012
THIS CERTIFIES that the building
Location of Property:
SCTM #: 473889
Subdivision:
ELECTRICAL
25350 Route 25, Orient,
Sec/Block/Lot: 18.-6-14.5
Filed Map No.
conforms substantially to the Application for Building Permit heretofore
6/28/2012 pursuant to which Building 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:
Lot No.
filed in this officed dated
37333 dated 6/28/2012
chan~e electric panel and reconnect electric
The certificate is issued to
Ezair, Khedouri
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
37333 07/02/2012
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 #: 37333
Date: 6/28/2012
Permission is hereby granted to:
Ezair, Khedouri
931 Madison Ave
New York, NY 10021
To:
change electric panel and reconnect electric
At premises located at:
25350 Route 25, Orient
SCTM # 473889
Sec/Block/Lot # 18.-6-14.5
Pursuant to application dated
To expire on 12/28/2013.
Fees:
6/28/2012 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 (631) 765-9502
ro,qer.richert~,town.southold .ny.us
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Ezari Khedouri
Address: 25300 Main Rd City: Orient St: NY Zip: 11957
3uilding Permit #: '~"~ ~'5~ Section: t~ Block: ~ Lot: )q,5
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
C, ontractor: DBA: Arthur Ruroede LicenseNo: 2334-e
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
Service 3 ph Hot Water GFCI Recpt
Main Panel NC Condenser Single Recpt
Sub Panel A/C Blower Range Recpt
Transformer Appliances Dryer Recpt
Disconnect Switches Twist Lock
Other Equipment:
Ceiling Fixtures [----J~[~ HID Fixtures
Wall Fixtures I I Smoke Detectors
Recessed Fixtures CO Detectors
Fluorescent Fixtur( ~J~ Pumps
Emergency Fixture Time Clocks
Exit Fixtures I I TVSS
replace panel, re-connect existing 200a underground service
Notes:
Inspector Signature:
Date: July 2 2012
81-Ced Electrical Compliance Form.xls
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TOWN OF SOTJT~Ot.n
APPLICATION FOR ELECTRICAL INSPECTION
ESTED BY:
~ Name:
JOBSITE INFORMATION:
*Name:
*Address: ~ ~0
*Cross Street:
*Phone No.:
(*IndiCates. required information)
c.; ~- I'~ h ~,.[ o ~ r i
Permit No.:
Tax Map District: 1000 Section: .~ ~ Block: (~ Lot:
*BRIEF
OF
WORK
(Please
Print.
cleady)
.(Please Cimle All That Apply)
*Is Job ready for inspection:
.DO you need a Temp Certificate:
Rough In' Final
Temp'lnformation (If needed}. · ·'
*Service size:· -~Pha--~ '3Phase 100 150 ~ 300. 350 400 'Other
· New Service: ~/~-dergmu~ Number of Metem Change of Service Overhead
Additional Inf0rmationF - ~ ~
' : PAYMENT DUE WITH· AppLICATION ,,~
' ,