HomeMy WebLinkAbout41678-Z Q�SUFF�I,fC�G, Town of Southold 7/26/2017
y� P.O.Box 1179
0
.� 53095 Main Rd
o4,1 � Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39081 Date: 7/26/2017
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1550 Smith Rd, Peconic
SCTM#: 473889 Sec/Block/Lot: 98.-3-23
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
5/30/2017 pursuant to which Building Permit No. 41678 dated 5/30/2017
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:
200 AMP OVERHEAD ELECTRIC SERVICE
The certificate is issued to Cashin,Francis&Grace
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 41678 07-12-2017
PLUMBERS CERTIFICATION DATED
Authorized Signature
TOWN OF SOUTHOLD
��o�stlFEO(�c0�, BUILDING DEPARTMENT
TOWN CLERKS OFFICE
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#: 41678 Date: 5/30/2017
Permission is hereby granted to:
Cashin, Francis & Grace
366 Stewart Ave Apt C-10
Garden City, NY 11530
To: 200a overhead electric service.
At premises located at:
1550 Smith Rd, Peconic
SCTM # 473889
Sec/Block/Lot# 98.-3-23
Pursuant to application dated 5/30/2017 and approved by the Building Inspector.
To expire on 11/29/2018.
Fees:
ELECTRIC $85.00
Total: $85.00
Buil r
OF SOU��®C
Town Hall Annex Telephone(631)765-1802
54375 Main Road C Fax(631)765-9502
P.O.Box 1179 roger.richertCa)town.southold.ny.us
Southold,NY 11971-0959
C®U1111
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Cashin
Address: 1550 Smith Road city:Peconic st: New York zip: 11958
Budding Permit#. 41678 Section: 98 Block: 3 Lot. 23
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Doroski Electric License No: 2941-E
SITE DETAILS
Office Use Only
Residential X Indoor Basement Service Only
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph 200 A Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel 200 A A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency FixtureTime Clocks
Disconnect 200 A Switches Twist Lock Exit Fixtures TVSS
Other Equipment: 200A OVERHEAD SERVICE
Notes:
Inspector Signature: Date: July 12, 2017
0-Cert Electrical Compliance Form.xls
Of SOUTyo�
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLEIG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [�'J ELECTRICAL (FINAL)
REMARKS:
DATE - 7110---117INSPECTOR vo
l ;
'Gown Hi11 Annex T�sieryhoi�t(631)MS-1802
58 Main Road nuc(6$�11�7�G�
439 F, � s1��d4�sfs�r �
P.O.ux 1:99
Soudwid,NY 11971.0959 '
BUILDING DEPARTI►i;F.N'I'
T01A N OF 80'[ T1Htt'1►1L )._._.
P ?LGATI FQ,�3„g,L�,CTRIC��l ���
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FRFOUESTED 6Y: �-�� IG Date:
Company Name'.
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Name:
License No,'. ft 41 1- �
Address: F-1 a. Qax
Phone No.: G •-rs� 7a ci 23
=ur.r�r�trrrr�orww'
J06SITE INFORMATION: (Indicates required informatlon)
`Name:
'Address: /S6 �%►�.; 1;5 `Y�o g X54 `' T cco.�; c 116
*Cross Street: f _--
Thone No.: S/r✓ "t a 3 ::..:r_._
Permit No.: —i
Tax Map District: 10,00 Section. IIk: Lot; 3
'BRIEF DWRiPTION OF WORK(Please Print Clearly)
++
/G O / � D c3 i4 nr p . .�.,C�\!••etc hid �.,.1 �r •-
co Vj
(Please Circle All That APPIV)
`IS job ready for Inspe0jon: YE / NO Rough in Firs
*Do you nsed'a Temp(Uirttficate: NO
Temp Inforr»stion.(If nesded)
*Service S4Za: 1 Phase 3Phose 100 450 20 300 300 400 00-ar
*New Service: Reconnect Under4round Number of NWIsrs Change of Serv ,Civ,
Additional Information: AYIUi N1 WE WITH APPLICATION
82-Request hN Insryeotlon Form / C, ' C)
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