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Town of Southold Annex 11/12/2013
P.O. Box 1179
54375 Main Road
Southold, New York 11971
CERTIFICATE OF OCCUPANCY
No: 36605 Date: 11/12/2013
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 9280 Sound Ave, Mattituck,
SCTM 473889 Sec/Block/Lot: 122.-2-3
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
10/24/2013 pursuant to which Building Permit No. 38448 dated 10/25/2013
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:
1.00 AMP OVERHEAD ELECTRIC SERVICE
The certificate is issued to Cheshire, David
(OWNER) - -
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 38448 10-29-2013
PLUMBERS CERTIFICATION DATED
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Authorized Signature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
'$q 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 38448 Date: 10/25/2013
Permission is hereby granted to:
Cheshire, David
9280 Sound Ave
PO BOX 27
Mattituck, NY 11952
To: Electric Service
At premises located at:
9280 Sound Ave, Mattituck
SCTM # 473889
Sec/Block/Lot # 122.-2-3
Pursuant to application dated 10/24/2013 and approved by the Building Inspector.
To expire on 4126/2015.
Fees:
ELECTRIC $85.00
Tol$85.00
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Town Hall Annex y Telephone (631) 765-1802
54375 Main Road T Fax (631) 765-9502
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P.O. Box 1179
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Southold, NY 11971-0959 BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: David Cheshire
Address: 9280 Sound Ave City: Mattituck St: NY Zip: 11952
Building Permit 38448 Section: 122 Block: 2 Lot: 3
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: C-Cat Electric License No: 953-me
SITE DETAILS
Office Use Only
Residential X Indoor Basement Service Only X
Commerical Outdoor 1 st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey H Attic Garage
INVENTORY
Service 1 ph 100a Heal Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks
Disconnect 60a Switches Twist Lock Exit Fixtures TVSS
Omer Equipment: 100a overhead service with 60a disconnect
Notes:
Inspector Signature: Date: Oct 29 2013
81-Cert Electrical Compliance Form.xls
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Town Hall Amen * Telephone (631) 7~65-11802
P OS BoMain a 1179 r oaer.rdM 710DVm1)soUill -ny.us
Southold, NY 11971-0930
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BURRING DEPARTWUgT
TOWN OF SOMBOI D
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: Date: p
Company Name:
Name.
License No.:
Address:
Phone No.:
JOBSITE INFORMATION: (*Indicates required information)
*Name: 9 OAEatijtC-i
*Address: 9A Qo J C %a & n A4 )F= M 6 J~-j U-1l.~~/ l4 2
*cross Sheet
*Phone No.:~
Permit No.:
Tax Map District 1000 Section: Block Lot
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
C.xylcr!
(Please Circle All That Apply)
*Is job ready for Inspection: YES NO Rough In Final
*Do you need a Temp Certificate: YE NO
Temp Information (If needed)
*Service Size: Phase 3Phase d% 150 200 300 350 400 Other
New Service: neat Underground Number of Meters Change of Service Overhead
A on nfonnation: PAYMENT DUE WITH APPLICATION
7$ 16
5
20 C- I k~
82-Request for hwpewon Form