HomeMy WebLinkAbout39661-ZNo: 37511
Town of Southold
P.O. Box 1179
53095 Main Rd
Southold, New York 11971
CERTIFICATE OF OCCUPANCY
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 4105 Deep Hole Dr, Mattituck
4/15/2015
Date: 4/15/2015
SCTM #: 473889 Sec/Block/Lot: 115.46-23
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
4/8/2015 pursuant to which Building Permit No. 39661 dated 4/8/2015
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:
ELECTRIC SERVICE TO ACCESSORY GARAGE
The certificate is issued to Doherty, Peter
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 39661 04-09-2015
PLUMBERS CERTIFICATION DATED
Authorized Signature
aso�Fot�-�oTOWN OF SOUTHOLD
�y BUILDING DEPARTMENT
y a TOWN CLERK'S OFFICE
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 #: 39661 Date: 4/8/2015
Permission -is hereby granted to:
Doherty, Peter
PO BOX 644
New Suffolk. NY 11956
To: electric service to accessory garage
At premises located at:
4105 Deep Hole Dr. Mattituck
SCTM # 473889
Sec/Block/Lot # 115.-16-23
Pursuant to application dated
To expire on 10/7/2016.
Fees:
4/8/2015
and approved by the Building Inspector.
ELECTRIC
Total:
Building Inspector
$85.00
$85.00
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Telephone (631) 765-1802
Fax(631)765-9502
roger. riche rtl-town.southold.ny.us
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Peter Doherty
Address: 4105 Deep Hole Drive City: Mattituck St: New York Zip: 11952
Building Permit #: 39661 Section: 115 Block: 16 Lot: 23
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor. "AS BUILT' DBA: License No:
SITE DETAILS
Office Use Only
Residential X Indoor Basement
Commerical Outdoor 1st Floor
New Renovation 2nd Floor
Addition Survey Attic
INVENTORY
Service Only
Pool
Hot Tub
Garage X
Service 1 ph
Heat
GAS
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
40A
A/C Blower
Range Recpt
Fluorescent Fixture
5
Pumps
Transformer
Appliances
Dryer Recpt
Emergency Fixtures
Time Clocks
Disconnect
Switches
5
Twist Lock
Exit Fixtures Id
TVSS
Other Equipment:
Supply Electric Power, to Existing Garage
Notes:
Inspector Signature: Date: April 9, 2015
Electrical 81 Compliance Form.xls
OE SOUTyolo
rrAA TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
I l FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) r] ELECTRICAL (FINAL)
REMARKS:
DATE INSPECTOR
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, NY 11971-0959
OF SOfjjyo�
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p�t�i� COQ
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Telephone (631) 765-1802
Co7: �orogerrichertIwnsud.ny.us
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: Date:
Company Name:
Name:
License No.:
Address -
'Phone No.:
JOBSITE INFORMATION: (*Indicates required information)
*Name:
*Address:
*Cross Street:
*Phone No.:
Permit No.:
Tax -Map District:
S/6-3�3- 326 q�-�1�12lo�rC _.�.
1000 - Section: 11
:. ,
Lot: �2 3
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
cce550 C, 6e4 C,
(Please Circle All 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
.82=Request for Inspection Form O _ls