HomeMy WebLinkAbout39284-Z Town of Southold Annex 11/3/2014
P.O. Box 1179
54375 Main Road
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 37253 Date: 11/3/2014
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 12700 New Suffolk Ave, Cutchogue,
SCTM#: 473889 Sec/Block/Lot: 116.-6-14
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
10/20/2014 pursuant to which Building Permit No. 39284 dated 10/20/2014
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:
100A OVERHEAD ELECTRIC SERVICE
The certificate is issued to Stiles Wm H Fam 2010 Irr Trt&Stiles J R F
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 39284 10-16-2014
PLUMBERS CERTIFICATION DATED
Authorized Signature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
"a • :, 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#: 39284 Date: 10/20/2014
Permission is hereby granted to:
Stiles Wm H Fam 2010 Irr Trt & Stiles J R Fam 2010 Irrev Trt
12700 New Suffolk Ave
PO BOX 494
Cutchogue, NY 11935
To: Electric Service
At premises located at:
12700 New Suffolk Ave, Cutchogue
SCTM # 473889
Sec/Block/Lot# 116.-6-14
Pursuant to application dated 10/20/2014 and approved by the Building Inspector.
To expire on 4/20/2016.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
*pF SO(/j�,
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 roper.richert(�town.Southold.ny.us
Southold,NY 11971-0959
COUNTY'
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: william Stiles
Address: 12700 New Suffolk Ave City: Cutchogue St: NY Zip: 11935
Building Permit#: 39284 Section: 116 Block: 6 Lot: 14
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: BJ Electric License No: 2670-me
SITE DETAILS
Office Use Only
Residential X Indoor Basement Service Only X
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph 100a 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 Fixture Time Clocks
Disconnect Switches Twist Lock Exit Fixtures TVSS F1
Other Equipment: install new meter pan only,-----100a overhead service
Notes:
Inspector Signature: `( Date: Oct 16 2014
81-Cert Electrical Compliance Form.xls
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tJF 301/lyo01
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Town Hall Annex Telephone(631)765-1802 is
54375 Main Road p�aaxx QQg
P.O.Box 1179 G Q roger.rlcherdiio'W 1 SOUhgg OItl nV us
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: oe Date: ���- XV-
Company Name:
Name:
D -
License No.: :
Address:
i
Phone No.: -
JOBSITE INFORMATION: (*Indicates required information)
*Name:
*Address:
*Cross Street: j
*Phone:No..
Permit No..
Tax-Map District: 1000 ection: Block: Lot:
*BRIEF DESCRIPTION OF WORK(Please Print Clearly)
i
(Please Circle All That Apply)
Is job ready for inspection:
<YE�SO Rough In
*Do-you need a Temp Certificate: Y ! NO
i
3
Temp Information(if needed)
*Service Size: 1 Phase 3Phase UO2-0-1150 200 300 350 . 400 Other
*New Service: Re-connect Underground Number of Meters Change of Service Overhead '
Additional Information: PAYMENT DUE WITH APPLICATION
i
82=Request for inspection Form f
I.