HomeMy WebLinkAbout40917-Z ��Qe�UfGtJt���� Town of Southold 10/20/2016
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38610 Date: 10/20/2016
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 340 Pine Rd, Southold
SCTM#: 473889 See/Block/Lot: 54.-9-10
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
8/18/2016 pursuant to which Building Permit No. 40917 dated 8/18/2016
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:
200A UNDERGROUND ELECTRIC SERVICE
The certificate is issued to DeMartmi,Raymond
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 40917 09-13-2016
PLUMBERS CERTIFICATION DATED
Authorized Signature
p�51 fol lrea TOWN OF SOUTHOLD
h� BUILDING DEPARTMENT
C* TOWN CLERK'S OFFICE
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#: 40917 Date: 8/18/2016
Permission is hereby granted to:
DeMartini, Raymond
1588 Earl Rd
Wantagh, NY 11793
To: Electric Service
At premises located at:
340 Pine Rd, Southold
SCTM # 473889
Sec/Block/Lot# 54.-9-10
Pursuant to application dated 8/18/2016 and approved by the Building Inspector.
To expire on 2/17/2018.
Fees:
ELECTRIC $85.00
Total: $85.00
&uildipector
rjv so
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 a� roper.richertRtown.southold.ny.us
Southold,NY 11971-0959 '®
COUNTY,�
BUELDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: DeMartini
Address: 340 Pine Road City: Southold St: New York Zip: 11971
Budding Permit#: 40917 Section 54 Block. 9 Lot: 10
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Pro Electric License No: 41413-ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement X 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 200 A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency FixturesTime Clocks
Disconnect 200 Switches Twist Lock El Exit Fixtures TVSS
Other Equipment Change 200A Service to Underground
Notes:
Inspector Signature: Date: September 13, 2016
0-81-Cert Electrical Compliance Form.xls
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Town Hall Annex ] e
54375 Main Road _
P.O.Box 1179 G Q r0 er.rlc pa
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Southold,
NY 11971-0959
AUG 1 2016
BUILDING DEPARTMENT BUILDING DFS
TOWN OF SOUTHOLD TOWN OF SOUTHOLID
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: ����� ���z,C``I Date:
Company Name:
Name:
License No.: 41_j— M 6
Address:
Phone No.:
j
JOBSITE INFORMATION: (*Indicates required information)
*Name: �` �0- crbc
*Address: �c o, � leo
*Cross Street:
*Phone No.: -
1
Permit No.: Q�
Tax Map District: 1000 Section: Block: Lot: Q
i
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
edeuj \&
1
(Please Circle All That Apply)
*Is job ready for inspection: YES/ NO Rough In Final
*Do you need a Temp Certificate: YES/ NO
I
Temp Information (If n ed)
*Service Size: 1 Pha 3Phase 100 150 200 00 350 400 Other
*New Service:. Re-connect Underground Number of Meters hange of Sery Overhead '
Additional Information: PAYMENT DUE WITH APPLICATION
82-Request for Inspection Form (� r