HomeMy WebLinkAbout38009-ZTown of Southold Annex
P.O. Box 1179
54375 Main Road
Southold, New York 11971
CERTIFICATE OF OCCUPANCY
5/29/2013
No: 36264
Date:
5/29/2013
THIS CERTIFIES that the building
Location of Property:
SCTM #: 473889
Subdivision:
ELECTRICAL
4350 Camp Mineola Rd, Mattituck,
Sec/Block/Lot: 122.-9-8
Filed Map No.
Lot No.
conforms substantially to thc Application for Building Permit heretofore filed in this officed dated
5/8/2013 pursuant to which Building Permit No. 38009 dated 5/8/2013
was issued, and conforms to all of thc requirements of the applicable provisions of the law. The occupancy for
which this certificate is issued is:
ELECTRIC SERVICE CHANGE
The certificate is issued to
Crilly, Gerard
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
38009 05-22-2013
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 #: 38009
Permission is hereby granted to:
Crilly, Gerard
4350 Camp Mineola Rd
Mattituck, NY 11952
To:
electric service change
Date: 5/8/2013
At premises located at:
4350 Camp Mineola Rd, Mattituck
SCTM # 473889
Sec/Block/Lot # 122.-9-8
Pursuant to application dated
To expire on 11/7/2014.
Fees:
518/2013
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
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Telephone (631) 765-1802
Fax (631) 765-9502
ro.qer,richert(~,town.southold, ny.us
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Mike DeFonzo (Crilly)
Address: 4350 Camp Mineola Rd City: Mattituck St: NY Zip: 1195,c
Building Permit #: 38009 Section: 122 Block: 9 Lo(:
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Ramp Electric License No: 50177-me
SITE DETAILS
Office Use Only
Commedcal Outdoor I st Floor Pool
New Renovation 2nd Floor Ho( Tub
Addition Survey Attic Garage
INVENTORY
Se~ce 3 ph Ho( Water GFCI Recpt
Main Panel NC Condenser Single Recpt
Sub Panel NC Blower Range Recpt
Transformer Appliances Dryer Recpt
Disconnect Switches Twist Leck
Other Equipment: re-locate 200a main electrical panel
Ceiling Fixtures~~ ~ HID Fixtures
Wall Fixtures I I Smoke Detectors
Recessed Fixtures CO Detectors
Fluorescent Fixture Pumps
Emergency Fix/ures Time Clocks
Exit Fixtures I I TVSS
Inspector Signature:
Date: May 22 2013
ElectricalCertificate.xls
INSPECTION
] FOUNDATION 1ST
] FOUNDATION 2ND [
[ ] FRAMING/STRAPPING [
[ ] FIREPLACE & CHIMNEY [
[ ] FIRE RESISTANTC0NSTRUCTION [
[ ] ELECTRICAL (ROUGH)
REMARKS:
[ ] ROUGH PLBG.
] INSULATION
] FINAL
] FIRE SAFETY INSPECTION
] FIRE RESISTANT PENETRATION
~:~ ELECTRICAL (FINAL)
DATE
54375 ~ I{md
P.O. Box 1179
,~m~old, NY 119"/I-0959
Td~phon~ (6~t) 765-1802
~I 7
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY:
Company Name:
Name:
License No.:
Address:
)hone No.:
Date:,.
JOBSITE INFORMATION: (*Indicates required information)
*Address: ~..~3Z~ (-~-~¢.-~ //~/~e~/'~ ~
*C~ss Street: /'
*Phone No.:
Peri'nil No.:
Tax. Map District: 1000 Section:_) ~
*BRIEF DESCRIPTION OF WORK (Please Print Cleady)
(Please Circle All That Apply)
*Is job ready for inspection: YES I NO
*Do.you need a Temp Certificate: ~ NO
Temp Information I.~eeded)
*Servlce Size: ~e~3Phase 100 150 ~
*NewBervJce: i~R~nn~ Underground Number of Meters
Additienal Information:
Rough In
300 350 400
Change of Service
PAYMENT DUE WITH APPLICATION
Final
Other
Overhead