HomeMy WebLinkAbout40791-Z ��� g11FFOtfcpG� Town of Southold 1/24/2017
o P.O.Box 1179
a' .w 53095 Main Rd
oy + O`er Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38673 Date: 1/23/2017
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1285 Marratooka Ln,Mattituck
SCTM#: 473889 Sec/Block/Lot: 115.4-33.3
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
5/23/2016 pursuant to which Building Permit No. 40791 dated 6/23/2016
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:
ELECTRIC UPGRADE
The certificate is issued to R17 Corp
t
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 40791 01-05-2017
PLUMBERS CERTIFICATION DATED
Authorized Signature
TOWN OF SOUTHOLD
oy� BUILDING DEPARTMENT
y a TOWN 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#: 40791 Date: 6/23/2016
Permission is hereby granted to:
R17 Corp
578 Seaman Ave
Baldwin, NY 11510
To: Electric
At premises located at:
1285 Marratooka Ln, Mattituck
SCTM # 473889
Sec/Block/Lot# 115.4-33.3
Pursuant to application dated 5/23/2016 and approved by the Building Inspector.
To expire on 12/23/2017.
Fees:
ELECTRIC $125.00
Total: $125.00
7
uildin Ins ector
pE SOUj�ol
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Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
cos
P.O.Box 1179 G Q
Southold,NY 11971-0959 �� • ao roger.riche rt(aD-town.southoId.ny.us
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: R17 Corp
Address: 1285 Marratooka Lane City: Mattituck St: New York Zip: 11935
Building Permit#: 40791 Section: 115 Block- 4 Lot: 33.3
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: "HOME OWNER" DBA: License No:
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service Only
Commerical Outdoor 1st Floor X Pool
New Renovation X 2nd Floor Hot Tub
r
Addition Survey Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt 12 Ceiling Fixtures 2 HID Fixtures
Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures 21 CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks
Disconnect Switches r 12 Twist Lock Exit Fixtures 11 TVSS
Other Equipment:
Notes:
Inspector Signature: Date: January 5, 2017
0-Cert Electrical Compliance Form.)ls
OF SO(/j�,olo f
-7
40
40 /
j 7-U� TOWN OF SOUTHOLD BUILDING DEPT.
m 765-1802
INSPECTION
[ ] FOUNDATION IST - [ ] ROUGH PLUMBING
[ ] FOUNDATION 2ND [ ] INSULATION
[ ]
FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
f ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
°[ �] CODE VIOLATION [ ] CAULKING
REMARKS:
DATE /
INSPECTORZ'
SOUTyolo
moo! • �o
- y�OUNi`I,p�
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLEIG.
[ ] -FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL)
REMARKS:
DATE 7 ANSPECTOR
-
� l0
Town Hall Annex 7f J Telephone(631)765-1802
54375 Main Road cn m�ax(631)765- 5Q2
P.O.Box 1179 G Q roger.richert(cvtown.south�o d ny us
Southold,IVY 11971-0959 YO
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: J, ^
— , Date:
1 j
Company Name: d Q/
Name: l F ,--�J �'�11���
License No.: -Aal
Address:
Phone No.:
JOBSITE INFORMATION: (*Indicates requirod information)
*Name: (,o 1 r (� 4
*Address: '
*Cross Street:
*Phone No.:
Permit No.:
Tax-Map District: 1000 Section: Block: _ Lot: `
*BRIEF DESCRIPTION OF WORK(Please Print Clearly) n
(Please Circle All That Apply)
*Is job ready for inspection: YES/ NO ugh In �L� Fina!
*Do-you need a Temp Certificate: YES/ NO
Temp Information (if needed) elf
'Service Size: 1 Phase 3Phase 100 150 200 300 400 Other
'New Service: Re-connect Underground Number of Meters Change of Service Overhead
4dditional Information: PAYMENT DUE WITH APPLICATION
s
82-Request for Inspection Form