HomeMy WebLinkAbout39963-Z 4;�gq1FFO[67�o Town of Southold 8/12/2015
A �� P.O.Box 1179
. A, 53095 Main Rd
wci; x^54'
*40 #' Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 37715 Date: 8/12/2015
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 280 Madison St, Greenport
SCTM#: 473889 Sec/Block/Lot: 33.-5-23
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
7/21/2015 pursuant to which Building Permit No. 39963 dated 7/21/2015
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 Survey
The certificate is issued to Madison Street Kids LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 39963 07-30-2015
PLUMBERS CERTIFICATION DATED
Authorized Signature
TOWN OF SOUTHOLD
e3,7 F®1�e, BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
,� o �� SOUTHOLD, NY
of
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#: 39963 Date: 7/21/2015
Permission is hereby granted to:
Madison Street Kids LLC
3120 Albertson Ln
Greenport, NY 11944
To: Electric Survey
At premises located at:
280 Madison St, Greenport
SCTM # 473889
Sec/Block/Lot# 33.-5-23
Pursuant to application dated 7/21/2015 and approved by the Building Inspector.
To expire on 1/19/2017.
Fees:
ELECTRIC $120.00
Total: $120.00
110,
Bu :in• Ynspector
Town Hall Annex i 4 I .. ' . O Telephone(631)765-1802
54375 Main Road �i m�ax 631 765-93Q
P37 Box Road
. O �� roger.richert(a�toWn.SOUtfI 1 .ny.us
TSorthold,NY 11J71-0959 = ,.,' `: )lf _``f?i,o�
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I JUL 21 20I� I' LL
J BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: Date: --,/,y7--
Company Name: 77/m 97J
Name:
License No.: %3
Address: -
Phone No.:
JOBSITE INFORMATION: (*Indicates required information)
*Name: AY)19 7-, 1,os 1'l " ,
*Address: ,?, a) `G 3r
*Cross Street: IS
*Phone No.: (03/ "Ili S—?WC/
Permit No.: Ti.)Cl y(03
Tax.Map District: 1000 Section: Block: Lot:
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
S!K . Y2Jl l _ q(
(Please Circle All That Apply)
*Is job ready for inspection: Qom► 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 (1
'New Service: Re-connect Underground Number of Meters Change of Service Overhead ��6
kdditionai Information: PAYMENT DUE WITH APPLICATION ci(jg
1\()A\'‘)
82-Request for Inspection Form
Iff
ry -
Town Hall Annex �,s-z O.
; Telephone(631)765-1802
54375 Main Road %; Fax(631)765-9502
cerj
P.O.Box 1179 O a�l�,' roger.richert(a�town.southold.ny.us
Southold,NY 11971-0959 : ® 1
-_ °.
siiiii I
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Madison Street Kids LLC
Address: 280 Madison Street City: Greenport St: New York Zip: 11944
Building Permit#: 39963 Section: 33 Block: 5 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 X Basement X Service Only
Commerical Outdoor X 1st Floor X Pool
New Renovation 2nd Floor Hot Tub
Addition Survey X Attic Garage X
INVENTORY
Service 1 ph 150A Heat OIL Duplec Recpt 47 Ceiling Fixtures 6 HID Fixtures
Service 3 ph Hot Water GFCI Recpt 5 Wall Fixtures 3 Smoke Detectors 3
Main Panel 150A NC Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel 1 NC Blower Range Recpt 40A Fluorescent Fixture 8 Pumps
Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks
Disconnect 150A Switches 21 Twist Lock Exit Fixtures TVSS
Other Equipment: AS BUILT - Electric Survey - No Visual Defects -
Notes: 6-Paddle Fans, 1-Exhaust Fan, 1-Heat Lamp,2-Deck Lights
Inspector Signature: ._ _,IC? Date: July 30, 2015
Electrical 81 Compliance Form.xls