HomeMy WebLinkAbout40738-Z $gOWljt, Town of Southold 10/20/2016
yet P.O.Box 1179
C3
o i 53095 Main Rd
�j Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38607 Date: 10/20/2016
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 5675 Mill Rd, Mattituck
SCTM#: 473889 Sec/Block/Lot: 106.-6-2
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. 40738 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:
100A UNDERGROUND ELECTRIC SERVICE FOR DOCK
The certificate is issued to JC Miller Management Inc
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 40738 10-05-2016
PLUMBERS CERTIFICATION DATED
Authorized Signature
o�gUGFotir I TOWN OF SOUTHOLD
�� ay BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
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#: 40738 Date: 6/1/2016
Permission is hereby granted to:
JC Miller Management Inc
538 Edwards Ave
Calverton, NY 11933
To: underground electric service for dock.
At premises located at:
5675 Mill Rd, Mattituck
SCTM # 473889
Sec/Block/Lot# 106.-6-2
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
oF sovey®l
� o
Town Hall Annex Telephone(631)765-1802
54375 Main Road N Q� Fax(631)765-9502
P.O.Box 1179 G
Southold,NY 11971-0959 .P®l �® roger.riche rt(a�town.southoId.ny.us
CoUNT`l,�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: JC Miller Management
Address: 5675 Mill Road City: Mattituck St: New York Zip: 11952
Building Permitt 40738 Section: 106 Block: 6 Lot: 2
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Brosnan Electric License No: 53956-ME
SITE DETAILS
Office Use Only
Residential X Indoor Basement Service Only
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph 1 OOA Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures Smoke Detectors
Main Panel 100 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 11001 Switches Twist Lock 1-50 Exit Fixtures TVSS
Other Equipment: 100A Underground Service to Supply Power to Dock.
Notes:
Inspector Signature: � p� Date: October 5, 2016
0-81-Cert Electrical Compliance Form.xls
Town Hall AnnexTelephone(631)765-1802
5WJ Main Road
76
UTR051j�.DXUS
P.O.Box 1179 Mer-ri e S
Southold,NY 11971t959
Pon
BUILDING DEPARTMOT
TOWN OF SOUTHOLD
APPLICATION LO-8�ELEQTRICAL 1MP9G—TQN
. F REQUESTED BY. RD6C4/t Date: lci�
Company Name: 5V0-5Vt0- L&-
Name-
License No.: 5 CcLvij�j G3q-5(oM6--
Address:
0- D i K
lPhone No.: (51 1Z 12 5-0,— -7
JOBSITE INFORMATION: {*Indicates required information)
*Name-,
J6 11e41—
*Address:
*Cross Street:
*Phone No.:
Permit No.:
Tax,Map District: 1000 SecHow—L(Ma- Block: Lot:
*BRIEF DESCRIPTION OF WORK(Please Print Clearly)
(Please Circle All That Apply)
*Is job ready for inspection: t NO
Rough In Final
*Do-you need a Temp Cerfiffoate: YES NO
Temp Information fitneAded)
*Service Size: ( 9 Ph
_ S3Phase ( 1�OO IsO 200 300 350 400 Other
Service: _W�6onect Underground Number of Meteri Change of Service Overhead
AdditJonal Information: PAYMENT DUE WITH APPLICATION
82-Request for lWodon Form IL