HomeMy WebLinkAbout39040-Z �'y1FF0,�r Town of Southold Annex 8/20/2014
P.O. Box 1179
54375 Main Road
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 37095 Date: 8/20/2014
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 3100 Soundview Ave, Mattituck,
SCTM#: 473889 Sec/Block/Lot: 94.-2-4
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
7/22/2014 pursuant to which Building Permit No. 39040 dated 7/22/2014
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:
OVERHEAD 200 AMP ELECTRIC SERVICE
The certificate is issued to Cedeno, Sylvia&Diaz-Albertini,William
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 39040 08-14-2014
PLUMBERS CERTIFICATION DATED
Authorized Signature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
' TOWN CLERK'S OFFICE
o SOUTHOLD, NY
Vam '!
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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 #: 39040 Date: 7/22/2014
Permission is hereby granted to:
Cedeno, Sylvia $ Diaz-Albertini, William
31 Mercer St 5A
New York, NY 10013
To: 200a overhead electric service.
At premises located at:
3100 Soundview Ave, Mattituck
SCTM # 473889
Sec/Block/Lot# 94.-2-4
Pursuant to application dated 7/22/2014 and approved by the Building Inspector.
To expire on 1/21/2016.
Fees:
ELECTRIC $85.00
Total: $85.00
,t
uilding Inspector
ho��pF SO�ryOlo
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax (631)765-9502
P.O. Box 1179 iQ roger.richert(aD-town.Southold.ny.us
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: William Albertini
Address: 3100 Soundview Ave City: Mattituck St: NY Zip: 11952
Building Permit#: 39040 Section: 94 Block: 2 Lot: 4
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 Basement Service Only X
Commerical Outdoor 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 A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency FixtureTime Clocks
Disconnect Switches 11 Twist Lock Exit Fixtures TVSS
Other Equipment: 200a overhead service
Notes:
Inspector Signature: _ 74Date: Aug 14 2014
81-Cert Electrical Compliance Form.xls
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Town Hall Annex Telephone(631)765-1802 is
54375 Main Road p�aaxx
P.O.Box 1179 Q ym Sou 0 .
roger.richert ony.uS
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION '
REQUESTED BY: / {ar Date: '
. Company Name:
Name:
License No.:
Address:
0 sox
' Phone No.: ..Z _�S - �
JOBSITE INFORMATION: (*Indicates required information)
*Name:
*Address: w Ave.
*Cross Street: fop
�* •�__
*Phone No.:
Permit No.:
Tax Map District: 1000 Section: Block: Lot:
*BRIEF DESCRIPTION OF WORK(Please Print Clearly)
(Please Circle All That Apply)
*Is job ready for inspection: YES�U NO Rough In Fina ,'
*Do- need a Temp Certificate: ,iJN
YE-q4
Temp Information(If needed)
*Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other
*New Service: Re-connect Underground Number of Meters Change of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
�-
82=Request for Inspection Form �