HomeMy WebLinkAbout41596-Z rf�r
Town of Southold 6/23/2017
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P.O.Box 1179
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Southold,New York 11971
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CERTIFICATE OF OCCUPANCY
No: 39026 Date: 6/23/2017
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 125 Pasture Ln,Mattituck
SCTM#: 473889 Sec/Block/Lot: 115.47-17.6
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
5/2/2017 pursuant to which Building Permit No. 41596 dated 5/2/2017
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:
ELECTRIC IN BASEMENT
The certificate is issued to Brandow, Edward&Geller,Georgia
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 41596 06-07-2017
PLUMBERS CERTIFICATION DATED
utb rized Signature
�suF�ot,r TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
O • SOUTHOLD, NY
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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#: 41596 Date: 5/2/2017
Permission is hereby granted to:
Brandow, Edward & Geller, Georgia
125 Pasture Ln
Mattituck, NY 11952
To: electric in basement
At premises located at:
125 Pasture Ln, Mattituck
SCTM # 473889
Sec/Block/Lot# 115.-17-17.6
Pursuant to application dated 5/2/2017 and approved by the Building Inspector.
To expire on 11/1/2018.
Fees:
ELECTRIC $90.00
Total: $90.00
4BInspectb�..
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Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 A ® Q roger.richert(aD-town.southold.ny.us
Southold,NY 11971-0959 Q
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Brandow
Address: 125 Pasture Lane City: Mattituck St: New York' Zip: 11952
Building Permit#: 41596 Section- 115 Block 17 Lot- 17.6
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Widwood Electric License No: 1563-E
SITE DETAILS
Office Use Only
Residential X Indoor X Basement X Service Only
Commerical Outdoor 1st Floor Pool
New Renovation X 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt 7 Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures Smoke Detectors
Main Panel 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 F-1 Switches 1 Twist Lock Exit Fixtures TVSS
Other Equipment:
Notes:
Inspector Signature: _? Date: June 7, 2017
0-Cert Electrical Compliance Form.xls
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TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLEIG. �4
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ] ELECTRICAL (FINAL)
REMARKS:
DATE 2 INSPECTOR
hO�*pF SOUjyol
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Town Hall Annex 1� Telephone(631)765-1802
54375 Main Road ax(631)765- 5 2
P.O.Box Ro roaer.richert(aRown.sout o d.ny.us
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Southold,NY 11971-09590
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: Date: /APRIL a. 7
Company Name: W j LU o® O
Name: -
License No.: 1%!r4 'g c_-
Address: /0 f�, C.�7C eZ>d LV4 410 R1 VGe— A) /I -7 47 9—
Phone No.: GC's 6,3/ eoQ �
JOBSITE INFORMATION: (*Indicates required information)
*Name: = &PRA)0 OW" g)e_ -
*Address: la, . AAST-UP,6 24oJ&t7 /TvC,�nJ)/
*Cross Street:
*Phone No.: /t9'*4P
Permit No.: 8,9L
Tax Map District: 1000 Section: 11%<oD Block: f7 D,o o Lot: 0/7,',006.
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
/g.-;,VO L"j 0,V,9,W,4 Cl 400-7-,S A k 7 -yL" d c�'TLCI
(Please Circle All That Apply)
*Is job ready for inspection: ES NO Rough In Final
*Do,you need a Temp Certificate: YES
Temp Information (If needed)
*Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other
-connect Underground Number of Meters Change of Service Overhead
Knol'! n PAYMENT DUE WITH APPLICATION
BUMDING DEFT.
T0WX?dpS6MGRotion Form