HomeMy WebLinkAbout40739-Z �o�OgUFFaI,�4:9- Town of Southold 6/18/2016
i cf, y P.O.Box 1179
d' 53095 Main Rd
'l%*0 0I- Southold,New York 11971
,'
.r r
CERTIFICATE OF OCCUPANCY
No: 38348 Date: 6/20/2016
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 6580 New Suffolk Rd,New Suffolk
SCTM#: 473889 Sec/Block/Lot: 117.-4-33
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
6/1/2016 pursuant to which Building Permit No. 40739 dated 6/1/2016
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 AGACG LLC -
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Authorized Signature
T - TOWN OF SOUTHOLD
guFEofr`V: BUILDING DEPARTMENT
eatTOWN CLERK'S OFFICE
•oy �` 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#: 40739 Date: 6/1/2016
Permission is hereby granted to:
AGACG LLC
PO BOX 206
New Suffolk, NY 11956 •
To: 150a overhead electric service.
At premises located at:
6580 New Suffolk Rd, New Suffolk
SCTM # 473889
Sec/Block/Lot# 117.-4-33
Pursuant to application dated 6/1/2016 and approved by the Building Inspector.
To expire on 12/1/2017.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
IP
IIS•0_,t ®f SOOPq
Town Hall Annex ; �®
f2_,
t4 : Telephone(631)765-1802
54375 Main Road % Fax(631)765-9502
P.O.Box 1179 c/, Q ,��
Southold,NY 11971-0959 ,_ ..\ 0 roger.richert(a�town.southold.ny.us
COUNTd, ....
.
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: AGACG LLC
Address: 6580 New Suffolk Road City: New Suffolk St: New York Zip: 11956
Building Permit#: 40739 Section: 1 117 Block. 4 Lot: 33
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
I
Contractor: DBA: Dan Wilcenski Electric License No. 4723-ME
SITE DETAILS
Office Use Only
Residential Indoor X 1 Basement Service Only
Commerical X Outdoor X ' 1st Floor X Pool
New Renovation 1 2nd Floor Hot Tub
Addition Survey 1 Attic Garage
INVENTORY
Service 1 ph Heat Duple Recpt Ceiling Fixtures HID Fixtures
Service 3 ph 150A Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel 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: 150A - 3 Phase Over Head Service
Notes:
Inspector Signature: Date: June 9, 2016
9
z Electncal 81 Compliance Form(2)xls
•
I
, ',f i'1A,V3if"04k\ , -
TownHall Annex I *1 Telephone(631)765-1802 _
r(631)765L�5Q2�
54375 Main
p Box Road ,+ roger riche ownsouulo1a.nY.us
Southold,NY 11971-0959 ,Q ���
BUILDING DEPARTMENT F
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: ' .. l l C-CiA Si:` Date: g,1` 6
Company Name: ►` \AA,\ c ci,,,c 14.< £ 1 e c_-4,0'&, ,
- Name: - -
License No.: /7 2 °3-- /N 6 ,
•
Address: P. 0 , jeo sz "5 I g - 4 So t, i J I ( .''Z (
Phone No.: . - 7 (c, I°-- Z g-cP
JOBSITE INFORMATION: (*Indicates required information)
*Name: p A-IC Si 8-e , CcnL s- ,ty t- cs;.. `.x',,- . LA +C& LLe>
*Address: 1,5 F--(D 1f )- S 3-F'-t c ( IC P-0,01- D .
*Cross Street Nie w s',, .-r c v ( I< A-v r - •
*Phone No.: - 4 7/— 2.-3 C. , 6 .i C- e_.14(
Permit No.: � (b
Tax•Map District: 1000 . Section: ) 11 . Blocfk: Lot:
*BRIEF DESCRIPTION OF WORK(Please Print Clearly) - Ne_v ( S o ,,- •
* ' -3 11 .g e..,- (../1 (--z_._ C cry-r..,- 4 r__c_...,,j .1.... -
(Please Circle All That Apply)
*Is job ready for inspection: O Rough In .
*Oo.you need a Temp Certificate: S NO -
Temp information(If.needed)
*Service Size: 1 Phase Phas 100 50 . 200 300 ' 350 400 Other
*New Service: Re-connect Underground Number of Meters Change of Service Overhead
Additional Information: - PAYMENT DUE WITH APPLICATION
' .M. .
. it-
l�� 4. 0:► CN--)Is�
882-Request for I •ection Form i__ L-I--1
.......<