HomeMy WebLinkAbout39041-Z Town of Southold Annex 11/3/2014
" P.O.Box 1179
= 54375 Main Road
i3 1W Southold, New York 11971
s
CERTIFICATE OF OCCUPANCY
No: 37251 Date: 11/3/2014
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 2690 Westphalia Rd, Mattituck,
SCTM#: 473889 Sec/Block/Lot: 114.-7-7
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
7/23/2014 pursuant to which Building Permit No. 39041 dated 7/23/2014
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:
150A OVERHEAD ELECTRIC SERVICE
The certificate is issued to Pope,Anna
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 39041 10-22-2014
PLUMBERS CERTIFICATION DATED
Authorized Signature
y,r' y�FFo�t TOWN OF SOUTHOLD
a BUILDING DEPARTMENT
tel
:l TOWN CLERK'S OFFICE
,gad'tit'' 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#: 39041
Permission is hereby granted to: Date: 7/23/2014
Pope, Anna
10 Valle View Dr
Ramsey, NJ 07446
150a overhead electric service.
At premises located at:
2690 Westphalia Rd, Mattituck
SCTM #473889
Sec/Block/Lot# 114.-7-7
Pursuant to application dated 7/23/2014 and approved by the Building Inspector.
To expire on 1/22/2016.
Fees:
ELECTRIC $85.00
Total: $85.00
Q
Building Inspector
SOUryQlo
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 Q roger.richert(fD-town-Southold.ny.us
Southold,NY 11971-0959 Q
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Anna Pope
Address: 2690 Westphalia Rd City: Mattituck St: NY Zip: 11952
Building Permit#: 39041 Section: 114 Block: 7 Lot: 7
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Glen's 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 150a Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel 150a 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 150a Switches Twist Lock Exit Fixtures TVSS
Omer Equipment: 150a overhead service
Notes:
Inspector Signature: Date: Oct 22 2014
81-Cert Electrical Compliance Form.xls
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Town Hall Annex 41 Telephone(631)765-1802
54375 Main Road H (631)7x95
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Southold,NY 11971-0959 '�yArTV
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: '� -nb��. Date:
Company �
p y Name:
I
Name:
License No.: 4•, .j �.,.r! I
Address: t. ' .r. .. t
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Phone No.:
JOBSITE INFORMATION: (*Indicates required information)
*Name: `L ,,
*Address: --
*Cross Street:
*Phone No.:
Permit No.: Q
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Tax-Map District: 1000 Sectio- n: T' Block: Lot:
*BRIEF DESCRIPTION OF WORK(Please Print Clearly) f '
(Please Circle Ali That Apply)
*Is job ready for inspection: YES/ NO Rough In Final
*Do�you need a Temp Certificate: YES/ NO
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
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82=Request for inspection Form Z� J
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Town Hall Annex f Te��lerarphone(631)
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Southold,NY 11971.0959
WaDINC DEPARTMENT 3
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: �I&V Date:
Company Name:
Name:
License No.:
Address: o
Phone No.:
JOBSITE INFORMATION: (*Indicates required information)
i
*Name:
eAe
*Address:
*Cross Street:
*Phone No.:
Permit No.: t
Tax-Map District: 1000 Section: Block: Lot:
*BRIEF DESCRIPTION OF WORK(Please Print Clearly)
c
(Please Circle All That Apply)
*Is job ready for inspection: CYE
}/ANO Rough In Final
*Do-you need a Temp Certificate: YE
. S /`Nam,
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 Form b J