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Town of Southold Annex 1/28/2014
P.O. Box 1179
54375 Main Road
'J? Southold, New York 11971
CERTIFICATE OF OCCUPANCY
No: 36742 Date: 1/28/2014
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 25350 Route 25, Orient,
SCTM 473889 Sec/Block/Lot: 18.-6-14.5
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
1/28/2014 pursuant to which Building Permit No. 38645 dated 1/28/2014
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:
200a overhead service for shop.
The certificate is issued to Ezair, Khedouri
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 38645 1/27/14
PLUMBERS CERTIFICATION DATED
Authorized Signature
t 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 38645 Date: 1/28/2014
Permission is hereby granted to:
Ezalr, Khedouri
931 Madison Ave
New York, NY 10021
To: 200a overhead service for shop.
At premises located at:
25350 Route 25, Orient
SCTM # 473889
Sec/Block/Lot # 18.-6-14.5
Pursuant to application dated 1/28/2014 and approved by the Building Inspector.
To expire on 7/30/2015.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
fjf so
Town Hall Annex Telephone (631) 765-1802
54375 Main Road Fax (631) 765-9502
P.O. Box 1179
Southold, NY 11971-0959 roger. richert(O)town. Southold. ny. us
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRIC[AL COMPLIANCE
SITE LOCATION
Issued To: Khedouri Ezair
Address: 25350 Main Rd-Rt 25 City: Orient St: NY Zip: 11957
Building Permit* 38645 Section: 18 Block: 6 Lot: 14.5
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: All Pro Electric License No: 33703-me
SITE DETAILS
Office Use Only
Residential Indoor Basement Service Only
Commerical Outdoor 1 at Floor Pool
New Renovation 2nd Floor HotTub
Addition Survey N 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 Fixtures Time Clocks
Disconnect 200a Switches Twist Lock Ext Fixtures TVSS
Other Equipment: 200a overhead service
Notes:
Inspector Signature: Date: Jan 27 2014
V
81-Cert Electrical Compliance Form.xis