HomeMy WebLinkAbout37047-ZTown of Southold Annex
P.O. Box 1179
54375 Main Road
Southold, New York 11971
9/4/2012
CERTIFICATE OF OCCUPANCY
No: 35930
Date: 9/4/2012
THIS CERTIFIES that the building ELECTRICAL
3245 Camp Mineola Rd, Mattituck,
Sec/Block/Lot: 123.-6-12.2
Location of Property:
SCTM#: 473889
Subdivision: Filed Map No.
conforms substantially to the Application for Building Permit heretofore
3/7/2012 pursuant to which Building Permit No.
Lot No.
filed in this officed dated
37047 dated 3/7/2012
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:
new electric service
The certificate is issued to
Browne, Mona
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
37047
08/30/2012
horized 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 #: 37047
Permission is hereby granted to:
Anne Hommel, Estate
CIO Patricia Ann Wenerowicz
152 Stillbrook Trl
Enterprise, FL 32725
To:
new electric service
Date: 3/7/2012
At premises located at:
3245 Camp Mineola Rd, Mattituck
SCTM # 473889
Sec/Block/Lot # 123.-6-12.2
Pursuant to application dated 3/7/2012
To expire on 9/6/2013.
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 (63 I) 765-9502
ro.qer, richert~,,town southo d ny us
BUILDING DEPARTMENT
TOWN OF' SOUTItOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Mona Browne
Address: 3245 Camp Mineola Rd City: Mattituck St: NY Zip: 11952
~uilding Permit #: Section: 123 Block: 6 Lot: 12.2
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Hubbard Electric LicenseNo: 4709-me
SITE DETAILS
Office Use Only
Residential R Ind°°r ~ Basement ~ Service Only~
Commerical Outdoor 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
ServiceServicelph ~ Heat3 ph Hot Water ~ Duplec Recpt ~ Ceiling Fixtures ~ HID FixtureSGFci Recpt~
Wall Fixtures Smoke Detectors
Main Panel NC Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel NC Blower Range Recpt Fluorescent Fixture I I Pumps
Transformer Appliances Dryer Recpt Emergency Fixture~ I Time Clocks
Disconnect Switches Twist Lock Exit Fixtures L.J TVSS
Other Equipment: 200a underground service
Notes:
Inspector Signature:
Date: Aug 30 2012
81-Cert Electrical Compliance Form.xls
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
FOUNDATION 1ST
FOUNDATION 2ND
FRAMING / STRAPPING [
FIREPLACE & CHIMNEY [
FIRE RESISTANT CONSTRUCTION [
ELECTRICAL (ROUGH)
[ ] ROUGH PLBG.
[ ] INSULATION
] FINAL
] FIRE SAFETY INSPECTION
] FIRE RESISTANT PENETRATION
[~J(~._ELECTRICAL (FINAL)
REMARKS:
DATE
TOWN OF 80U'I~OT ~
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY:
Name:
No.:
JOBSITE iNFORMATION: (*Indicates required information)
*Name:
*AcId~ss:
*Cross Street:
Permit Ne.:
Tax. Map District:.
1000 . se~.:: ~ ~.'~. Block:
*BRIEF DESCRIPTION OF WORK (PJease Print Clea~)
' (P!ease arch Afl That App.)
*Is job ready for inspecifon:
*Do. you need a Temp Ce~liilca~:
*Sen~ce Size:1 Phase 3Phase 100
YES / NO. Rough In
YES / NO
Final
Number of Mel~s ~of~ Ove~e~
Addi0erml Information: PAYMENT DUE WITH APPLiCATIO~. '