HomeMy WebLinkAbout39421-Z ,+o�5�GF0(p�% Town of Southold 3/1/2016
'4' P.O.Box 1179
o 53095 Main Rd
4101 �yo� Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38126 Date: 3/1/2016
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 400 Cardinal Dr, Mattituck
SCTM#: 473889 Sec/Block/Lot: 115.-4-19
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
12/16/2014 pursuant to which Building Permit No. 39421 dated 12/16/2014
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:
200 AMP UNDERGROUND ELECTRIC SERVICE
The certificate is issued to Piscitelli,Mark
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 39421 02-17-2016
PLUMBERS CERTIFICATION DATED
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Authorized Signature
,,suFFnc. TOWN OF SOUTHOLD
c�y: BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
oy o� / 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#: 39421 Date: 12/16/2014
Permission is hereby granted to:
Piscitelli, Mark
400 Cardinal Dr
Mattituck, NY 11952
To: Installation of 200 Amp Underground Electrical Service
At premises located at:
400 Cardinal Dr, Mattituck
SCTM # 473889
Sec/Block/Lot# 115.-4-19
Pursuant to application dated 12/16/2014 and approved by the Building Inspector.
To expire on 6/16/2016.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
•o' V\pFSOVI'70 ,
, \
Town Hall Annex ~ ® : Telephone(631)765-1802
54375 Main Road $ Alli 4111 ; Fax(631)765-9502
P.O.Box 1179 ;
iff Of
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Southold,NSC 1197I-0959 ,` �C _'` ,.$ ' I u DEC 1 6 •
,� 2014
BUILDING DEARTMENT BLDG DEPT
TOWN
TOWN OF SOUTHOLD
sourHOLo
APPLICATION FOR ELECTRICAL INSPECTION
.
- REQUESTED BY: '77
tAr-t'co Date: 2.-/f,S//
Company Name: I(\o o2N 1 1, ecZ rzic LI:A-S A-ST c
Name: `��
I r �,os iG
License No.: `1 aS 3 r E
Address: P. , Go-2c 3a i /774 7- I T t,�GI�iNN , A \ C7
• Phone No.: S-7 to -9 03 _,7/5-1
I:
JOBSITE INFORMATION: (*Indicates required information)
*Name: On A-2 K lei S c t TE i_t.. 1
*Address: 17/00 C - 4 J. bR t v h ) p 7 i T S
*Cross Street: 20.- e o` 1? o ci7
*Phone No.: •
' f
Permit No.:
Tax.Map District: 1000 Section: / /5- Block: O y Lot: j / -
*BRIEF DESCRIPTION OF WORK(Please Print,CClleariy) •
.1 -e-L-Tiv o aQo Ftm N r
(Please Circle All That Apply)
*Is job ready for inspection: 132ti NO Rough In Final
*Do-you need a Temp Certificate: YES. NO
Temp Information(If.needed)
*Service Size: 1 Phase 3Phase 100 150 (2(78) 300 350 400 Other
Re-connect Undergroun Number of MetersjChange of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
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8Z=Request for Inspection Form �'