HomeMy WebLinkAbout35697-Z 4%4fF044Gy� Town of Southold 5/9/2017
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P.O.Box 1179
d' rh
S 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38935 Date: 5/9/2017
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 505 AZALEA RD MATTITUCK
SCTM#: 473889 Sec/Block/Lot: 115.-6-8
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
7/8/2010 pursuant to which Building Permit No. 35697 dated 7/8/2010
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 OVERHEAD ELECTRIC SERVICE
The certificate is issued to EUGENE&IRENE O'CONNOR
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 35697 05-03-2017
PLUMBERS CERTIFICATION DATED
Authorized Signature
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, 'N.Y.
BUILDIING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 35697 Z Date JULY 8, 2010
Permission is hereby granted to:
i
EUGENE & IRENE W CONNOR
505 AZALEA ROADI
MATTITUCK,NY 11952
for
ELECTRIC UPGRADE TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR
at premises located. at 505 AZALEA RD MATTITUCK
County Tax Map No. 473889 Section 115 Block 0006 Lot No. 008
pursuant to application dated JULY 8, 2010 and approved by the
Building Inspector to expire on JANUARY; 8, 2012 .
Fee $ 85 . 00
Authorized Signature
I,
I
ORIGINAL
Rev. 5/8/02
OF SOUr�,®l
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Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 G Q
Southold,NY 11971-0959 •® • �o roger.rich ert(aD-town.southoId.ny.us
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: O'Connor
Address: 505 Azalea Road City: Mattituck St: New York Zip: 11952
Building Permit#: 35697 Section: 115 Block: 6 Lot: 8
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Roslak Electric License No: 3677-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 200A Heat Duplec Recpt Ceding Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel 200A A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks
Disconnect 20 AA Switches Twist Lock Exit Fixtures TVSS
Other Equipment: 200A OVERHEAD SERVICE
Notes:
Inspector Signature: Date: May 3, 2017
0-Cert Electrical Compliance Form.)ls
SOulyolo
Town Hall Annex Telephone(631)765-1802
54375 Maze Road N ��;;ax(631)765.9
P.O.Box 1179 ® Q roger.richert(wtown.southo d.nv.us
Southold,NY 11971-0959 'Q
�y�OUNTY,��
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: ® S Date: 7 b 1J
Company Name: c c.� ���, �C
Name:
lAddrLicense No.: Ml-
Address:
ess: � �7Z-�L?L-A (�
Phone No.: 73 y-- S--�Z-20 _57 W 3
JOBSITE INFORMATION: (*Indicates required information)
*Name:
*Address: �c� z,4t_r�,� - ►� cc G
*Cross Street:
*Phone No.: �!�- 00.3'�>
Permit No.: 5-tr�-7
Tax Map District: 1000 Section: Block: Lot:
*BRIEF DESCRIPTION OF WORK (Please Print Clearly) C,2eo'4-. p
(Please Circle All That Apply)
*Is job ready for inspection: YES / NO Rough In I? F'
*Do you need a Temp Certificate: <Y�ES NO
Temp Information (If needed)
*Service Size: 1APhase 3Phase 100 150 / 20 300 400 Other
*New Service: Re-connect Underground Number of Meter Change of Servic a ea
Additional Information: PAYMENT DUE WITH APPLICATION
82-Request for Inspection Form