HomeMy WebLinkAbout41764-Z FBI
x�a�i Town of Southold 8/16/2017
P.O.Box 1179
a
x 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39136 Date: 8/16/2017
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1250 New Suffolk Rd, Cutchogue
SCTM#: 473889 Sec/Block/Lot: 109.-6-10
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
6/27/2017 pursuant to which Building Permit No. 41764 dated 6/27/2017
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 ELECTRIC SERVICE UPGRADE
The certificate is issued to Mack Horton LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 41764 08-02-2017
PLUMBERS CERTIFICATION DATED
Authorized Signature
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 G
roper.richert(aD-town.southold.ny.us
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To, Mack Horton LLC
Address: 1250 New Suffolk Road city:Cutchogue st: New York zip: 11935
Building Permit#: 41764 Section: 109 Block: 6 Lot: 10
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 X Basement X Service Only
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 200A Switches Twist Lock Exit Fixtures TVSS
Other Equipment: 200A SERVICE UPGRADE
Notes:
Inspector Signature: Date: August 2, 2017
O=Cert Electrical Compliance Form.xls
�SUFFot,r�, TOWN OF SOUTHOLD
BUILDING DEPARTMENT
W z TOWN CLERK'S 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#: 41764 Date: 6/27/2017
Permission is hereby granted to:
Horton Jr, Richard
1465 Pine Tree Rd
Cutchogue, NY 11935
To: Upgrade to 200A Electrical Service
At premises located at:
1250 New Suffolk Rd, Cutchogue
SCTM # 473889
Sec/Block/Lot# 109.-6-10
Pursuant to application dated 6/27/2017 and approved by the Building Inspector.
To expire on 12/27/2018.
Fees:
ELECTRIC $85.00
Total: $85.00
Building/Inspector
pF SO01
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Town Hall Annex' Telephone(631)765-1802
54375 Main Road
P.O.Box 1179 G Q rOaend hent townS�Mt M
Southold,MC 11971-0959 ��t �� ' LS V LSII
I.
JUN 2 6 2017 DD
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
BUILDING DEI=T.
APPLICATION FOR ELECTRICAL INSPECTION TOWN OFSOUTHOLD
REQUESTED BY- Z
. , �'!'�t 20 S G,r�-J � Date:
Company Name: ;.
Name: ori �, 2 PS A V_ '-
Licedse No.: '36 7 6 ;
Address: ZV �
Phone No.: 3 J� 3 -5Zl f +
i
JOBSITE INFORMATION: (*Indicates required information) 1
* qz
Name: �Nia Th � v Z i o 1
*Address:
*Cross Street:
"Phone No.: "31)73 q-,!5'2-74?
I
Permit No.: AJ64 L4 Ob
Tax-Map District: ' 1000 Section:_ C. _ Block: �L Lot: f
*BRIEF DESCRIPTION OF WORK(Please Print Clearly) � �
'� I
tF
�o
(Please Circle All That Apply) 3
Is job ready for inspection: / NO Rough In Fina
*Do you need a Temp Certificate:
Z�V/ NO
Temp Information(if needed)
*Service Size: 1 Phase 3Phase 100 150 410) 300 350 . 400 Other I .
*New Service: Re-connect Underground Number of Meters Change of Servicverhea
f
Additional Information: PAYMENT DUE WITH APPLICATION
82-Request forinspec6on Form ��