HomeMy WebLinkAbout38590-Z
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~'agiFpl, rN Town of Southold Annex 1/24/2014
P.O. Box 1179
54375 Main Road
Southold, New York 11971
CERTIFICATE OF OCCUPANCY
No: 36735 Date: 1/24/2014
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 4930 Stillwater Ave, Cutchogue,
SCTM 473889 See/Block/Lot: 137.-2-11
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
12/23/2013 pursuant to which Building Permit No. 38590 dated 12/23/2013
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:
200 AMP OVERHEAD ELECTRIC SERVICE
The certificate is issued to Belvedere, Donna
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 38590 01-21-2014
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 SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit 38590 Date: 12/23/2013
Permission is hereby granted to:
Belvedere, Donna
20 Grundy PI
Merrick, NY 11566
To: 200a overhead electric service.
At premises located at:
4930 Stillwater Ave, Cutchogue
SCTM # 473889
Sec/Block/Lot # 137.-2-11
Pursuant to application dated 12123/2013 and approved by the Building Inspector.
To expire on 6/24/2015.
Fees:
ELECTRIC $85.00
Total: $85.00
Bui ding Inspector
pF SOl/lyolo
Town Hall Annex yy Telephone (631) 765-1802
54375 Main Road T Fax (631) 765-9502
F Box 1179
Southold, , NY 11971-0959 roger. riche rt(a)town.southoId.ny.us
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Donna Belvedere
Address: 4930 Stillwater Ave City: Cutchogue St: NY Zip: 11935
Building Permit* 38590 Section: 137 Block: 2 Lot: 11
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Citera Electric Corp License No: 5108-me
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service Only X
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey 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 200a 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 200a Switches Twist Lock Exit Fixtures TVSS
Other Equipment: 200a overhead service
Notes:
7
Inspector Signature: Date: Jan 21 2014
81-Cert Electrical Compliance Form.xls
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TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLEIG.
( ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL)
REMARKS:
A- c2 v~
DATE INSPECTOR
i
~o~~oF stWr~6
Town Hall Annex T Telephone (631) 765.1802j;
54375 Main Road ~~ra~u (631) 7
P.O. Box 1179 r!OS1er.richert6ft n.SODUIOIO.ny US
Southold, NY 11971-0959 1
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BUHDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY. An+ 4\o a. j G ~ +-(f r a Date: _L2 -16-13
Company Name: i o r c, I C ; c Cv r
Name: v\,' L, i e r c~_
License No.: 1 C u F_ K C U~n+
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Address: 5o Rc~d 6L, rv\ 2• Caw,w,acic N / L j
Phone No.: C 0-31) 6 u- a 3 q Ce f l '516 go 7 -g s~ -q
JOBSITE INFORMATION: (*Indicates required information)
*Name: ~p vl n a 13 e I Ued & r e- 6e0 (91 1) X175 -y036
*Address: LG30 5~, lI W0. er /due. Cln-fc_koq(Ae-
*Cross Street: No4 uas [ Aue.
*Phone No.: :355 q > c~ec+~ 4l con+~k~r r ~nth~. / C'+Prc
Permit No.:
Tax Map District: 1000 Section: 13 7 Block: Lot:
*BRIEF DESCRIPTION OF WORK (Please Print Clearly) 6~oa Am n c yer n Pc~_4
~Q (-V i C P In A G e- 7 ' '6e4a e (/a_(/ F Q ( lnit~i
1~ SCkP~u(C' %r? pPC~F~G?1
(Please Circle All That Apply)
*Is job ready for inspection: _6~/ NO Rough In Final
*Do you need a Temp Certificate: <jj~/ NO
I
Temp Information (If needed)
*Service Size: 1 Pha 3Phase 100 150 c h `i 300 350 .400 Other
*New Service: Re-connect Underground um~er of Mete hangs a rhea
Additional Information: PAYMENT DUE WITH APPLICATION
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82-Request forlnspection Form
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