HomeMy WebLinkAbout39704-ZTown of Southold
P.O. Box 1179
53095 Main Rd
Southold, New York 11971
CERTIFICATE OF OCCUPANCY
No: 37610 Date:
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 2800 Deep Hole Dr, Mattituck
SCTM #: 473889
Subdivision:
Sec/Block/Lot: 123 . -4-12
Filed Map No.
6/17/2015
6/17/2015
Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
4/23/2015 pursuant to which Building Permit No. 39704 dated 4/23/2015
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:
Electrical Upgrade - 200A Overhead Service
The certificate is issued to Harrod, Walter
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
39704
06-10-2015
Authorized Signature
TOWN OF SOUTHOLD
�� ry BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
A-1 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 #: 39704 Date: 4/23/2015
Permission is hereby granted to:
Harrod, Walter
30 S Franklin Ave
Vallev Stream. NY 11580
To: Electrical Upgrade
At premises located at:
2800 Deep Hole Dr, Mattituck
SCTM # 473889
Sec/Block/Lot # 123.4-12
Pursuant to application dated 4/23/2015
To expire on 10/22/2016.
Fees:
and approved by the Building Inspector.
ELECTRIC $85.00
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, NY 11971-0959
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Telephone (631) 765-1802
Fax (631) 765-9502
roger. riche rtptown.southold.ny.us
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Henry Silverman (Harrod)
Address: 2800 Deep Hole Drive City: Mattituck St: New York Zip: 11952
Building Permit #: 39704 Section: 123 Block: 4 Lot: 12
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: Home Owner DBA: License No:
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service Only X
Commerical Outdoor X 1st Floor X 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 200A A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks
Disconnect 200A Switches Twist Lock Exit Fixtures TVSS
Other Equipment: Install New 200A Over Head Service
Notes:
Inspector Signature: Date: June 10, 2015
Electrical 81 Compliance Form.xls
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Town Hall Annex Telephone (631) 765-1802
54375 Main Road D�pr�a'axx 99 QQ
P.O. Box 1179 G Q rownrichert( -10W11 s utlioE ny us
Southold, NY 11971-0959 �r�•. �0
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: _
• �v U� Date:
Company Name:
Name:
License No.:
Address:
Phone No.:
JOBSITE INFORMA
'Name:
"Address:
"Cross Street:
'Phone No.:
'ermit No.:
(*Indicates required information}
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rax -Map District: 9000 Section:Block: 0 Lot:
`BRIEF DESCRIPTION OF WORK (Please Print Clearly) A)
Please Circle All That Apply)
Is job ready for inspection: YES NO - Rough In
Do- you need a Temp Certificate: YES NO
'emp Inforination (If -needed)
Service Size: 1 Phase 3Phase 100 150 200 300 350 400
New Service:
►dditional
Re -connect Underground
't
i
Ann Air,
it
for I I specUon Form
Number of MetersChange of Servi
PAYMENT DUE WITH APP ATION
Final
Other
Overhead
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