HomeMy WebLinkAbout39109-Z Town of Southold Annex 8/20/2014
P.O.Box 1179
�= 54375 Main Road
�'► Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 37094 Date: 8/20/2014
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1545 Ruth Rd, Mattituck,
SCTM#: 473889 Sec/Block/Lot: 106.-7-11
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
8/15/2014 pursuant to which Building Permit No. 39109 dated 8/15/2014
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:
REPLACEMENT OF 150a MAIN BREAK PANEL
The certificate is issued to Cidone,Robert&Cidone,Veronica
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 39109 08-19-2014
PLUMBERS CERTIFICATION DATED
Authorized Signature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
'awl 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 #: 39109 Date: 8/15/2014
Permission is hereby granted to:
Cidone, Robert & Cidone, Veronica
1545 Ruth Rd
Mattituck, NY 11952
To: replace circuit breaker panel 150a
At premises located at:
1545 Ruth Rd, Mattituck
SCTM # 473889
Sec/Block/Lot# 106.-7-11
Pursuant to application dated 8/15/2014 and approved by the Building Inspector.
To expire on 2/14/2016.
Fees:
ELECTRIC $85.00
Total: $85.00
uilding In r
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Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 G �Q roger.riche rt(p7town.southold.ny.us
Southold,NY 11971-0959 CUUNTY,��
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Robert Cidone
Address: 1545 Ruth Rd City: Mattituck St: NY Zip: 11952
Building Permit#: 39109 Section: 106 Block: 7 Lot: 11
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Pumillo Electric License No: 2300-me
SITE DETAILS
Office Use Only
Residential X Indoor X Basement X Service Only
Commerical Outdoor 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt 1 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 Fixture Time Clocks
Disconnect Switches Twist Lock Exit Fixtures TVSS
Other Equipment: replace 150a main breaker panel only
Notes:
G
Inspector Signature: Date: Aug 19 2014
81-Cert Electrical Compliance Form.xls
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Town Hall Annex Telephone(631)765-1802
54375 Main Road cn y� p�aaxx(631)765-g5Q2�
P.O.Box 1179 G Q roger.richert_iown.SOut�Ola nV us
Southold,NY 11971-0959 �'
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
- REQUESTED BY: , ��� �,(�� C7 Date:
Company Name:
License No.:
Address:
Phone No.: �p
JOBSITE INFORMATION: (*Indicates required information) I
1
*Name:
*Address: O/> /YJ f�7�T (t,�C
*Cross Street: (;rte �
*Phone No.:
Permit No.: ---- I�
Tax-Map District: 1000 Section:_ 1 cx-P. Block:'_ Lot:— I
*BRIEF DESCRIPTION OF WORK(Please Print Clearly) 111
570 A-P-P
(Please Circle All That Apply)
*Is job ready for inspection: YES NO Rough In Final
*Do-you need a Temp Certificate: YES
Temp Information(If needed) '
*Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other I .
*New Service: Re-connect Underground Number of Meters Change of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
82=Request for Inspection Formes ��� 1