HomeMy WebLinkAbout38347-Z
Town of Southold Annex 12/10/2013
P.O. Box 1179
54375 Main Road
96 Southold, New York 11971
CERTIFICATE OF OCCUPANCY
No: 36649 Date: 12/10/2013
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 5275 CR 48, Mattituck,
SCTM 473889 Sec/Block/Lot: 140.-1-11
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
1/1/1900 pursuant to which Building Permit No. 38347 dated 9/20/2013
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:
UNDERGROUND ELECTRIC SERVICE
The certificate is issued to Martin, Rita
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 38347 12-02-2013
PLUMBERS CERTIFICATION DATED
Authorized Signature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, NY
f
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 38347 Date: 9/20/2013
Permission is hereby granted to:
Martin, Rita
3406 SE Glacier Ter
Hobe Sound, FL 33455
To: underground electric service
At premises located at:
5275 CR 48, Mattituck
SCTM # 473889
Sec/Block/Lot # 140.-l-11
Pursuant to application dated 1/1/1900 and approved by the Building Inspector.
To expire on 3/22/2015.
Fees:
ELECTRIC $85.00
Total: $85.00
uilding Inspector
pf SOplyolo
Town Hall Annex y Telephone (631) 765-1802
54375 Main Road T Fax (631) 765-9502
P.O. Box 1179 G Q roper.riche rt(aDtown.southold.nv.us
Southold, NY 11971-0959 .t%
couto,
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Rita Martin
Address: 35 Maiden Ln (5275 CR 48) City: Mattituck St: NY Zip: 11952
Building Permit 38347 Section: 140 Block: 1 Lot: 11
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: License No:
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 2-10 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 2-10 Switches Twist Lock Exit Fixtures TVSS
Omer Equipment: 200a underground service with 2 meters, 2-100a disconnects
Notes:
Inspector Signature:[. Date: Dec 2 2013
81-Cert Electrical Compliance Form.xls
q so
Town Hall Amex 411 411 Telephone (631) 765-1802
54375 Main Road C02 (Cifox W1131.) 161-~5OF
n
P.O. Box 1179 ell- rogerrichert sout od.nv.us
Southold, NY 11971-0959
4 . UAM
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: Date:
Company Name:
Name:
License No.:
Address:
Phone No.: n"I ORCI~_l
JOBSITE INFORMATION: (*Indicates required information)
*Name: 'CkJ5- ~
*Address: .35 Moi4u~ I-NOC
*Cross Street: C&Avarl -F#"Ae- Ab
*Phone No.:
Permit No.:
Tax Map District: 1000 Section Block: Lot: -
*BRIEF DESCRIPTION OF WORK (Please Print Clearly) lpirmbqc
V
w5AAU_ W-J~ U V&ftyo W4FeLeA.~na,,I, _WV
WAeq--
(Please Circle All That Apply)
*Is job ready for inspection: (aE
,V NO Rough In Final
*Do you need a Temp Certificate: YES / NO
Temp Information (if needed)
*Service Size: C~rPhas 3Phase 100 150 300 350 400 Other
*New Service: Re-connect Underground NumberofIVIeters ChangeofService Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
8 -Request for Inspection Form
2