HomeMy WebLinkAbout40519-Z ,�'4S J FOI'�co Town of Southold 4/12/2016
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:'47 Gym P.O.Box 1179
't v' 4 53095 Main Rd
Gdtti �0 Southold,New York 11971
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CERTIFICATE OF OCCUPANCY
No: 38223 Date: 4/12/2016
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 200 Skunk Ln, Cutchogue
SCTM#: 473889 Sec/Block/Lot: 97.-3-6.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
3/11/2016 pursuant to which Building Permit No. 40519 dated 3/11/2016
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 OVERHEAD ELECTRIC SERVICE
The certificate is issued to 200 Skunk Ln LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 40519 03-31-2016
PLUMBERS CERTIFICATION DATED
c- -C-1. -.4f- - ------ -,
��' Authorized Signature
SUFEaI, �oG M1 TOWN OF SOUTHOLD
BUILDING DEPARTMENT
ti g?' TOWN CLERK'S OFFICE
SOUTHOLD, NY
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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#: 40519 Date: 3/11/2016
Permission is hereby granted to:
200 Skunk Ln LLC
3535 Cedar Beach Rd •
Southold, NY 11971
To: Electric Service
At premises located at:
200 Skunk Ln, Cutchogue
SCTM #473889
Sec/Block/Lot# 97.-3-6.1
Pursuant to application dated 3/11/2016 and approved by the Building Inspector.
To expire on 9/10/2017.
Fees:
ELECTRIC $85.00
Total: $85.00
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Town Hall Annex ; �® ®� �® : Telephone(631)765-1802
54375 Main Road C % Fax(631)765-9502
P.O.Box 1179 pit roger.richert(a�town.southold.ny.us
Southold,NY 11971-0959 : ,e' `- 1
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To. 200 Skunk
Address: 200 Skunk Lane City: Cutchogue St: New York Zip: 11935
Building Permit# 40519 Section* 97 Block. 3 Lot: 6.1
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Jim Shaw Electric Inc. License No: 33381-ME
SITE DETAILS
Office Use Only
Residential X Indoor Basement Service Only X
Commerical Outdoor X 1st Floor 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: 200A OVERHEAD SERVICE
Notes:
Inspector Signature: Ce--- Date: March 31, 2016
Electrical 81 Compliance Form xls
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1-- . sooy, ' - :E: ` 'BUILDING' DEPARTMENT.•. - -o _ . . :
i *t:;',„, e -: TOWN -.OP
,fi, Town Hall Annex.•.54375 M=airkRoad•PC Box 1x179•Southold, NY 11971-0959" . -
: (660, ,...''..' - . Telephone(631)765-1802.•.Fax,(631);765-9502; _ --
a r ` . k-; _Date•a 3/�.'t�',__ ,.20'-.'1. .'
Number of,Meters• • . ' , ._ - Temporary Certificate ,
L, ::Size'M. 2 t30 'T r.phase' }+ `-p .26.-to --,-41-4---/Q� ,
- :Overhead`0.'PUnder-rourid. .-.).f-'''' '
. tr.-,','1,-, --:- , -',,NewService L]' Chari e'of':Setvice_:-: Re'connect=Existing'Service .,L •
.'Location 2:0_ _., _ :S (ttiI4- :L`l ,C •ffe2 ' ' '
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,=that this installation is:complete,the:town-will conduct'a`prert ises inspection:of theser ice:equipment.:- .
`• ?°^ - i.. -This verifi tion'is valid for 90,clays fr tiaeabovedater ° -
Autho'rized.ty;
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Town Hall Annex
� � Telephone(631)765-1802
54375 Main Road � (631)765-95o2.
P.O.Box 1179 G Q �� roger.nchert(a7FtOwnsoutfio[tl.ny.us
Southold,NY 11971-0959 0 �O,11
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: ;,., S)" Ck,
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Company Name: J l�^-. S - �1 p c�i G �� Date: •
IName: 5)\,`~ 5V/Kr w .
License No.: 133 V- a) G ,
Address: /i ;c j j-O j JZ..d 6 - -- y // ? V
Phone No.: . - Cr,3 )— 553 53 f-7 ` (CaSa -Cop_ --9.p
JOBSITE INFORMATION: (*Indicates required information) -
*Name: 0-7:11,7 0 LO P-e Z, •
*Address: „oma S k ur,*- - Lo, C v i(10,(J2 M. 11735- . .
*Cross Street: -i ZS
*Phone No.: y)- ' W Y,. cjyq)
Permit No.:
Tax.Map District: 1000 . Section:' Block: Lot: •
*BRIEF DESCRIPTION OF WORK(Please Print Clearly)
ip ct.e .. 200 A--y--y)- La c-- -i`c°r( S.(10 GQ. -1-1) x-,.S;- 1,cAJ sp .
(Please Circle All That Apply) Fina!
*Is job ready f. .1°I::2 't : -: / NO Rough In
*Do-you eed a Temp Certificate: / NO
Temp Information (If ded) '
*Service Size: 1 Phase - 3Phase 100 150 . 200 300 350 400 0 er
'New Service: e-connect Underground Number of Metersi Change of Service verhead AD
Additional Information: PAYMENT DUE WITH APPLICATION -* ,.,� bar(
,
82-Request for Inspection Form SD