HomeMy WebLinkAbout40036-Z ,
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, Town of Southold 11/6/2015
( ° P.O.Box 1179
o 53095 Main Rd
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.. '' Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 37886 Date: 11/6/2015
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 74825 Route 25, Greenport
SCTM#: 473889 Sec/Block/Lot: 45.-4-8.3
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
8/27/2015 pursuant to which Building Permit No. 40036 dated 8/27/2015
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 WIRING OF DOCTOR'S OFFICE
The certificate is issued to 74825 Main Road LLC
of the aforesaid building.
SUFFOLK COUNTY'DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 40036 11-02-2015
PLUMBERS CERTIFICATION DATED
Authorized Signature
�.SaFFn�, TOWN OF SOUTHOLD
BUILDING DEPARTMENT
y. TOWN CLERK'S OFFICE
ti o .
v 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#: 40036 Date: 8/27/2015
Permission is hereby granted to:
74825 Main Road LLC
PO BOX 1675
Southold, NY 11971
To: Electric wiring doctor's office -
At premises located at:
74825 Route 25, Greenport
SCTM # 473889
Sec/Block/Lot# 45.-4-8.3
Pursuant to application dated 8/27/2015 and approved by the Building Inspector.
To expire on 2/25/2017.
Fees:
ELECTRIC $125.00
Total: $125.00
Building nspector
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Town Hall Annex � ~ % Telephone(631)765-1802
54375 Main Road ; ill( 1111Fax(631)765-9502
P.O.Box 1179 % N � ��
Southold,NY 11971-0959 l �oQ�•►` roger.richert(a�town.southold.ny.us
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: 74825 LLC
Address: 74825 Route 25 City: Greenport St: New York Zip: 11944
Building Permit#: 40036 Section: 45 Block: 4 Lot: 8.3
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Paul Burns Electric License No: 3897-ME
SITE DETAILS
Office Use Only
Residential Indoor X Basement Service Only
Commerical X Outdoor X 1st Floor X Pool
New Renovation X 2nd Floor X Hot Tub
Addition Survey Attic X Garage
INVENTORY
Service 1 ph Heat GAS Duplec Recpt 115 Ceiling Fixtures 20 HID Fixtures
Service 3 ph Hot Water GFCI Recpt 20 Wall Fixtures 4 Smoke Detectors
Main Panel NC Condenser 1 Single Recpt Recessed Fixtures 17 CO Detectors 3
Sub Panel 4 NC Blower 1 Range Recpt 2-40/ Fluorescent Fixture 61 Pumps
Transformer Appliances 2-DN Dryer Recpt 2-30/ Emergency Fixtures 18 Time Clocks
Disconnect Switches 43 Twist Lock Exit Fixtures 1 TVSS
Other Equipment: 4- Exhaust Fans, 6- Combination "Exit/Emergency" Fixtures
Notes:
Inspector Signature: Date: November 2, 2015
Electrical 81 Compliance Form.xls
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TOWN OF SOUTHOLD BUILDING DEPT.
,
765-1802
INSPECTION
, , FOUNDATION 1ST [ ] ROUGH PLUMBING
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
49o,—rELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
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DATE / iir INSPECTOR
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4,00-36e _ TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH"PLUMBING
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
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DATE - INSPECTOR B" •
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Town Hall Annex ` * * Telephone(631)765-1802
54375 Main Road + ax(631)765 95Q
• P.O.Box 1179 Q � rOQ@GriChe O1Ml.SOU 0 .ny.US
Southold,NY 11971-0959 ' .e7111'
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
- ; REQUESTED BY: .gob s cel,$ Date: 0-7//S t
Company Name: ���t 3t.J rASCl -*•r; c e. 1 eari.761-c.c_- rr
Name: i��v( 12. ao:rin,S
License No.: 3E1-2 wt-
Address: I70 Ek JabI s - N•ole . 'U r 11f7/
' Phone No.: C3 i''3G 4/73.)—
.
JOBSITE INFORMATION: (*Indicates required.information)
*Name: 7 Y$2-S"
*Address: 74.(5 2_5-M A i r Pj
*Cross Street: rt40vtc LA.,��;
`Phone No.:
Permit No.: Lpo (P
Tax•Map District: 1000 Section: 4'5 Block: c( Lot: 5, 3
*BRIEF DESCRIPTION OF WORK(Please Print Clearly)
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(Please Circle All That Apply)
*Is job ready for inspection: NO Rough I Final
- *Do you need a Temp Certificate: YES 635)
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 ^,1 CP
r .
Additional Information: PAYMENT DUE WITH APPLICATION /1)' \�.�i'
.82=Request for Inspection Form
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