HomeMy WebLinkAbout37655-ZTown of Soutbold Annex
P.O. Box 1179
54375 Main Road
Southold, New York 11971
12/11/2012
CERTIFICATE OF OCCUPANCY
No: 36080
Date: 12/11/2012
THIS CERTIFIES that the building
Location of Property:
SCTM ti: 473889
Subdivision:
ELECTRICAL
985 Monsell Ln, Cutchogue,
Sec/Block/Lot: 138.-1-6
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore ~ed in this officed dated
11/28/2012 pursuant to which Building Permit No. 37655 dated 11/28/2012
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:
Electrical Service Up~rade.
The certificate is issued to
Monsell, Jacqueline
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
37655 12/5/12
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 #: 37655
Permission is hereby granted to:
Monsell, Jacqueline
509 First St
Greenport, NY 11944
Date: 11/2812012
To:
Electrical Service Upgrade
At premises located at:
985 Monsell Ln, Cutchogue
SCTM # 473889
Sec/Block/Lot # 138.-1-6
Pursuant to application dated
To expire on 5/30/2014.
Fees:
11/28/2012
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.southo d ny us
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Jacqueline Monsell
Address: 985 Monsell Lane 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: Custom Lighting of Suffolk License No: 38893-me
SITE DETAILS
Office Use Only
Residential R Ind°°r ~ Basement [~ Service Only
Cornrnerical Outdoor 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Servicelph ~ Heat ~ Duplec Recpt ~ Ceiling Fixtures
Service 3 ph Hot Water GFCl Recpt Wall Fixtures
Main Panel A/C Condenser Single Recpt Recessed Fixtures
Sub Panel NC Blower Range Recpt Fluorescent Fixtur~
Transformer Appliances Dryer Recpt Emergency Fixture
Disconnect Switches Twist Lock Exit Fixtures
Other Equipment: 2008 underground service
HID Fixtures
Smoke Detectors
CO Detectors
Pumps
Time Clocks
TVSS
Notes:
Inspector Signature:
Date: Dec 5 2012
81-Cert Electrical Compliance Form.xls
Towa H~I1 Annex
54375 ~ Road
P.O. Box 1179
So.hold, NY 11971-0959
Telephone (63t) 765-180<2
BUILDING DI~ARTMENT
TOWN OF SOUTHOg.~
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY:
company Name:
Name:
License No.:
Address:
Phone No.:
*Name:
*Address:
*Cross Street:
*Phone No.:
Permit No.:
Tax Map District:
JOBSITE INFORMATION: (*Indicates required information)
1000 Section: ~q~ ~ B~ck:
Date:
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
Lot:
(Please Circle NI That Apply)
ready for
inspection:
(~/NO Rough In
.*Do you need a Temp Certificate: ~ NO
Temp Information (If needed) ·
· ServiCe Size:' ~) 3Phase 100 150 2~.~) 300 350 400
· New Service:f ~'"-"/' Re-connect
Additional Information:
Number of Meters~- Change of Service
PAYMENT DUE WITH APPLICATION
Other
Overhead
82-Request for Inspection Form