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fFOI Town of Southold Annex 12/10/2013
P.O. Box 1179
54375 Main Road
Southold, New York 11971
CERTIFICATE OF OCCUPANCY
No: 36648 Date: 12/10/2013
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1285 Bayberry Rd, Cutchogue,
SCTM 473889 Sec/Block/Lot: 118.-3-9
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this ot5ced dated
5/9/2013 pursuant to which Building Permit No. 38011 dated 5/10/2013
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:
Change Overhead Electrical Service to Underground
The certificate is issued to Ponderosa Ent LLC
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 38011 11-26-2013
PLUMBERS CERTIFICATION DATED Authorized Signature
TOWN OF SOUTHOLD
It BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
ati9 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 38011 Date: 5/10/2013
Permission is hereby granted to:
Dipillo, Danielle & Dipillo Frank
12 Roberts Rd
Warren, NJ 07059
To: Change Overhead Electrical Service to Underground
At premises located at:
1285 Bayberry Rd, Cutchogue
SCTM # 473889
Sec/Block/Lot # 118.-3-9
Pursuant to application dated 5/9/2013 and approved by the Building Inspector.
To expire on 11/9/2014.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
hO~apF SO!/ryOlo
Town Hall Annex y Telephone (631) 765-1802
54375 Main Road Fax (631) 765-9502
P.o. Box 1179 Q roger. richert(a)town.southold.ny.us
Southold, NY 11971-0959 COIINTI 0
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Pondorosa Ent LLC (Dipillo)
Address: 1285 Bayberry Rd City: Cutchogue St: NY Zip: 11935
Building Permit 38011 Section: 118 Block: 3 Lot: 9
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 X Indoor Basement Service Only X
Commerical Outdoor 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey X Attic Garage
INVENTORY
Service 1 ph 200a Heat 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 Switches Twist Lock Exit Fixtures TVSS
Other Equipment: 200a underground service
Notes:
Inspector Signature: 'Al t Date: Nov 26 2013
81-Cert Electrical Compliance Form.xls
S
Town Hall Annex Telephone (68811)) 7y6~5--11802
54375 Main Road
Box 1179 a rimer.richertL(DtoYtm~S0UV101G.nY.us
Southold, NY 11971-0959
"VUlrl 1,
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: Date: /
Company Name: Ll tr
Name: t ~o
License No.:
Address:
Phone No.: (o
JOBSITE INFORMATION: (*Indicates required information)
*Name: OM 9
*Address-. kC4
*Cross Street:
*Phone No.: (a
Permit No.: .
Tax Map District: 1000 Section: } 1 B Block:_ Lot:
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
(J E~OIIU t [ /1 ~S' V (~JL
(Please Circle All That Apply)
*Is job ready for inspection: (YESY NO Rough In Fina.
*Do you need a Temp Certificate: NO
Temp information (I d}
*Service Size: 1 has 3Phase 100 150 200 300 350 400 Other
*New Service : a nnec ergroun Number of Meters I Change of Service Overhead
Additional Inform PAYMENT DUE WITH APPLICATION
C.
82-Request for Inspection Form ' I