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40638-Z
is ,r'Q�sUFF0I'�coG-,,l Town of Southold 6/3/2016 i'i- y z P.O.Box 1179 cf,i 13 53095 Main Rd .lye / Southold,New York 11971 1 � CERTIFICATE OF OCCUPANCY No: 38332 Date: 6/3/2016 THIS CERTIFIES that the building ELECTRICAL Location of Property: 4885 Cox Ln, Cutchogue SCTM#: 473889 Sec/Block/Lot: 96.-2-9 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 4/21/2016 pursuant to which Building Permit No. 40638 dated 4/21/2016 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: 150a overhead electric service. The certificate is issued to LIV2MAX LLC of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 40638 5/24/2016 PLUMBERS CERTIFICATION DATED 'Authorized Signature , TOWN OF SOUTHOLD �,�o�g�����ioa'; BUILDING DEPARTMENT TOWN CLERK'S OFFICE •oy �`� SOUTHOLD, NY ti dol, ,�ao) 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#: 40638 Date: 4/21/2016 Permission is hereby granted to: Broderick, Jane PO BOX 637 Mattituck, NY 11952 To: 150a overhead service upgrade. At premises located at: _ 4885'Cox Ln, Cutchogue SCTM # 473889 Sec/Block/Lot# 96.-2-9 Pursuant to application dated 4/21/2016 and approved by the Building Inspector. To expire on 10/21/2017. Fees: ELECTRIC' $85.00 Total: $85.00 • nspector 0 ti0Town Hall Annex �� 4 1, Telephone(631)765-1802 54375 Main Road Ali illit Fax(631)765-9502 • P.O.Box 1179 : `" Southold,NY 11971-0959 15;1� 4o4��` roger.richert(c�town.southold.ny.us i BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Broderick(Geppel) Address: 4885 Cox Lane City: Cutchogue St: New York Zip: 11935 Building Permit#: 40638 Section. 96 Block: 2 Lot: 9 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Raymond Electrical Cont. License No: 5141-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 150A Heat Duplec Recpt Ceiling Fixtures HID Fixtures Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors Main Panel 150A NC Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel NC Blower Range Recpt Fluorescent Fixture Pumps Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks Disconnect 150A Switches Twist Lock Exit Fixtures TVSS Other Equipment. SERVICE UPGRADE TO 150A OVERHEAD Notes. Inspector Signature: c`p'`-' Date: May 24, 2016 z Electncal 81 Compliance Form(2).xls e *la BOUT s • .7...., Town Hall f�nnex i * �_.'_ _ + _.; Telephone(631)765-1802 - �- 54375 Main Road • + az(o"3i)io5=5�2 P.O.Box L179 '• " " &1' Mer tichert(a'�`,townsouigio i.ny.us ei 1 Southold,NY 11971-0959 \ O - - ,I' lyCOU M% #1°� BUILDING DEPARTMENT - • TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION - • REQUESTED BY: , ,fiity Date: ,/.0( I 1Coman Name: .epic-,� ' - A Y -�.���Z G'©.moi_ C27/-.1).„ �- -Name: /09y ./9 . . - - License No.: .sje-p- fi.iE . . Address: ‘/ 2 26;�.e l Ay/ex .4e '& //7q, . Phone No.: 3:1- 6.--).-7 /— _ JOBSITE INFORMATION: ( Indicates required information) - * OcOdaeick Name: - /O.11 Cri=_"/9, G- 30;►�1�e, `(� • *Address: . • - f f ea L'9 _ - C" c/fafe,t ,cry ao-- c� vA� *Cross Street: Cies yr y/€2 9 ' - *Phone No.: -s'/(-5-0?6-55/'� _ _ . Permit No.: _ {O(62 3c _ - Tax-Map District - 1000 _ Section: °j (p - Biocic A Lot ,4' *BRIEF DESCRIPTION OF WORK(Please Print Clearly) 00 'b -t 5, ,za1c4--- 4e6 -a: (Please Circle All That Apply) - • *Is job ready for inspection: • . a i No. Rough in Ka F need a Temp Certifcate: _ YES - - Temp Information(If n- -dedj . - . *Service Size: 1 Phas- 3Phase 100 150 200 300 350 400 Other *New Service: Re-connect Underground Number of Meters/ Chan•e o -. '••- •Overhea, : Additional Information: PAYMENT DUE WITH APPLICATION - . e7s---, -- . B2:-Request for Inspection Form