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Home My WebLink About37993-ZTown of Southold Annex P.O. Box 1179 54375 Main Road Southold, New York 11971 5/2/2013 CERTIFICATE OF OCCUPANCY No: 36221 Date: 5/2/2013 THIS CERTIFIES that the building Location of Property: SCTM #: 473889 Subdivision: ELECTRICAL 1850 Main Bayview Rd, Southold, Sec/Block/Lot: 75.-4-28 Filed Map No. conforms substantially to the Application for Building Permit heretofore 5/2/2013 pursuant to which Building Permit No. 37993 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 ofliced dated dated 5/2/2013 electric for commercial range. The certificate is issued to LI Head Start Child Dev (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 37993 5/2/13 PLUMBERS CERTIFICATION DATED '~ 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 SPECIFICATIONR UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit #: 37993 Permission is hereby granted to: LI Head Start Child Dev Date: 51212013 98 Austin St Patchogue, NY 11772 To: electric for commercial range. At premises located at: 1850 Main Bayview Rd, Southold SCTM # 473889 Sec/Block/Lot # 75.-4-28 Pursuant to application dated To expire on 11/1/2014. Fees: 5~2~2013 and approved by the Building Inspector. ELECTRIC $85.00 Total: $85.00 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: North Fork Head Start Address: 1850 Main Bayview Rd City: Southold St: NY Zip: 1197' Building Permit #: Section: Block: Lot: WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: as built 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 ~ 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: installation of commercial range with 2-200a disconnects Ceiling Fixtures [~ HID Fixtures Wall Fixtures [~ Smoke Detectors Recessed Fixtures ~.~ CO Detectors Fluorescent Fixture J.~ Pumps Emergency Fixtures~ Time Clocks Exit Fixtures [~ TVSS Notes: Inspector Signature: Date: May 1 2013 81-Cert Electrical Compliance Form.xls BUILDING ~'- ?~. ~-~ .- ~ -/~ ~ TOWN o~ SO.mOLD APP,L CATION FOR ELECTRICAL INSpECTiON REQUESTED BY: Company Name: Name: License No.: Address: Phone No.: dOB$1T~ INF©RMATI©N: (*Indicates roquirod information) *Address: *Cross Street: *Phone No.: Date: It'777_ Permit No.: f ~ ~ Tax.Map District: 1000 . Section:_~-7~--- Block: *BRIEP DESCRIPTION OF WORK (Please Print Cleady) (Please Circle All That Apply) *Is job ready for inspection: *Do-you need a Temp Certificate: Temp Iflfoi marion (If- needed) ~ Size: 1 Phase 3Phase 100 ~'New Service: Re-oonne~t Underground Additienal Information: YES I NO. Rough In Final YES I NO 150 250 300 ~ .400 Other Number of Meters Change of Service Overhead PAYMENT DUE WITH APPLICATION for InspeclJon Fom~