HomeMy WebLinkAbout41454-Z o�guFFOLKCo Town of Southold 4/19/2017
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P.O.Box 1179
o " 53095 Main Rd
'ffj _ o'"' Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38908 Date: 4/19/2017
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 25350 Route 25, Orient
SCTM#: 473889 Sec/Block/Lot: 18.-6-14.5
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
3/22/2017 pursuant to which Building Permit No. 41454 dated 3/22/2017
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 Ezair,Khedouri
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 41454 04-12-2017
PLUMBERS CERTIFICATION DATED
Authorized Signature
o�gnFEot�coTOWN OF SOUTHOLD
BUILDING DEPARTMENT
a 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#: 41454 Date: 3/22/2017
Permission is hereby granted to:
Ezair, Khedouri
931 Madison Ave
New York, NY 10021
To: Electric Service
At premises located at:
25350 Route 25
SCTM # 473889
Sec/Block/Lot# 18.-6-14.5
Pursuant to application dated 3/22/2017 and approved by the Building Inspector.
To expire on 9/21/2018.
Fees:
ELECTRIC $85.00
Total: $85.00
Build pector
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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 • �® roger.richert(a)-town-so uthold.ny.us
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Ezair
Address: 25350 Route 25 City: Orient St: New York Zip: 11957
Building Permit#: 41454 Section: 18 Block. 6 Lot: 14.5
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: All Pro Electric License No: 33703-ME
SITE DETAILS
Office Use Only
Residential Indoor X Basement Service Only X
Commerical X Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph 200A 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 200A Switches Twist Lock Exit Fixtures TVSS
Other Equipment: 200A, 3-Phase Underground Service.
Notes:
Inspector Signature: Date: April 12, 2017
0-Cert Electrical Compliance Form.xls
i
OF SOUTyolo
cOUNi`1,0c�
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) 7P ELECTRICAL (FINAL)
REMARKS:
ue-
DATE ,� v f INSPECTOR
r •
Town Hall Annex fe e
54375 Main Road
P.O.sox 1179 ro er.richett wn.s .n -in
Southold,NY 11971-0959 0� D
MAR 2 2 2017
B MDING DEPARTMENT BUMDING DEPT.
TOWN OF SOUTHOli D TOWN OF 3OU'IHOLD
APPLICATION FOR ELECTRICAL. INSPECTION
REQUESTED BY: oil KO Date: 3 – ZZ– 14 .
;ompany Name: &I3C-
Vame: Pau CLrof).
_Icense No.: 33-'-D 3 �
n kddress: V. 0 bo UC n ve. q
3
'hone No.: P 9nC 631 2-q'[– ®Ddu 9*3 S83–y 1
IOBSITE INFORMATION: (Indicates required information) -
Name: EZ A-1 R
Address: 25 O j ... Il S
Cross Street:
Phone No.: 2t? qW - rg o O
'ermit No.: 41 q-614
'ax-Map District: - 1000 Section:----t 6— Block: Lot: s
31RIEF DESCRIPTION OF WORK(Please Print Clearly)
;tease Circle All That Apply)
s job ready for inspection: Y / NO- Rough In final
)o"you need a Temp Certificate: YES 11 NO -
amp Information(If needed)
ietvice Size: 9 Phase 3Phase 100 150 200 300 350 400 Other
Jew Service: Re-connect- Underground Number of Meters Change of Service Overhead
lditional Information: PAYMENT DUE WITH APPLICATION
1
:82=Request ibr Inspection Form p�
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