HomeMy WebLinkAbout38786-Z Town of Southold Annex 4/23/2014
P.O.Box 1179
54375 Main Road
Southold, New York 11971
CERTIFICATE OF OCCUPANCY
No: 36871 Date: 4/23/2014
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1356 Grand Ave, Mattituck,
SCTM#: 473889 Sec/Block/Lot: 107.-3-11.5
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
4/17/2014 pursuant to which Building Permit No. 38786 dated 4/17/2014
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:
200 AMP OVERHEAD ELECTRIC SERVICE
The certificate is issued to Zaloom III,Charles&Michelle,Knox
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 38786 04-22-2014
PLUMBERS CERTIFICATION DATED
Authorized Signature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
,4 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#: 38786 Date: 4/17/2014
Permission is hereby granted to:
Zaloom III, Charles & Michelle, Knox
1356 Grand Ave
PO BOX 68
Mattituck, NY 11952
To: Electrical Service
At premises located at:
1356 Grand Ave, Mattituck
SCTM # 473889
Sec/Block/Lot# 107.-3-11.5
Pursuant to application dated 4/17/2014 and approved by the Building Inspector.
To expire on 10/17/2015.
Fees:
ELECTRIC $85.00
Total: $85.00
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Building Inspector
SO!/lyolo
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 C010
roper.riche rt(aD-town.southo Id.ny.us
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Zaloom
Address: 1356 Grand Ave City: Mattituck St: NY Zip: 11952
Building Permit#: 38786 Section: 107 Block: 3 Lot: 11.6
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Glens Electric License No: 4770-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 Fixtures Time Clocks
Disconnect 200a Switches Twist Lock Exit Fixtures TVSS
Other Equipment: 200a overhead service
Notes:
Inspector Signature: Date: April 22 2014
81-Cert Electrical Compliance Form.xls
i
APR 16 2014 "
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own Hall Aotx _- - Telephone(631)765-1802 h
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.P.O.Box 1179 roger.richert A S nV.us
Southold,NY 11971-0959 �O
BUILDING DEPARTMENT
ENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
[Address:UESTED BY: Date:.
pany Name: _ �..
e:
se No.:
e No.:
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JOBSITE INFORMATION: (*Indicates required information)
*Name: 3
*Address:
/.351. G.e.4iy� 09y6
*Cross Street:
*Phone No.. .7 SS 3
Permit No.. L4!
Tax-Map District: 9000 Section: Block: 7t� Lot: (. 5
*BRIEF DESCRIPTION OF WORK(Please Print Clearly)
t
I
(Please Circle All That Apply)
*is job ready for inspection:
ES NO. Rough In Fina
*Do you need a Temp Certificate: E / NO
Temp Information(If needed)
*Se 3Phase 100 150 20 300 350 400 Other
New Service: Re-conned Underground Number of Meters Change of Service Overhead
Additiona nformation: PAYMENT DUE WITH APPLICATION
I -
8Mequest for Inspection Form 1