HomeMy WebLinkAbout41788-Z ��Q�QSUFH?t�CoG Town of Southold 8/16/2017
y P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39134 Date: 8/16/2017
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 65490 Route 25, Greenport
SCTM#: 473889 Sec/Block/Lot: 53.-5-12.6
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
5/18/2017 pursuant to which Building Permit No. 41788 dated 7/5/2017
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 UNDERGROUND ELECTRIC SERVICE UPGRADE(COTTAGE#3)
The certificate is issued to Breezy Shores Comnty Inc
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 41788 08-15-2017
PLUMBERS CERTIFICATION DATED
Authorized Signature
o�g�FFo���o TOWN OF SOUTHOLD
BUILDING DEPARTMENT
y TOWN CLERK'S OFFICE
o . SOUTHOLD, NY
0
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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#: 41788 Date: 7/5/2017
Permission is hereby granted to:
Breezy Shores Comnty Inc
PO BOX 925
Mattituck, NY 11952
To: Cottage#3 upgrade overhead electric service to 200 amp underground service.
At premises located at:
65490 Route 25, Greenport
SCTM # 473889
Sec/Block/Lot# 53.-5-12.6
Pursuant to application dated 5/18/2017 and approved by the Building Inspector.
To expire on 1/4/2019.
Fees:
ELECTRIC $85.00
Total: $85.00
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Building Inspector
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pF SO!/ry®lo
Town Hall Annex Telephone(631)765-1802
54375 Main Road N Fax(631)765-9502
P.O.Box 1179 ® �� roger.rich ert(a)-town.southold.ny.us
Southold,NY 11971-0959 Q
lyMUNTY,��
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Columbo (Breezy Shores) Unit#3
Address: 65490 Route 25 (Sage Blvd.) city,Greenport st: New York zip: 11944
Building Permit#: 41788 Section: 53 Block: 5 Lot- 12.6
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Custom I-lighting of Suffolk License No: 38893-ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement 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 FixtureTime Clocks
Disconnect 20 AA Switches Twist Lock Exit Fixtures TVSS
Other Equipment- 200A UNDERGROUND SERVICE UPGRADE.
Notes:
Inspector Signature: Date: August 15, 2017
0-Cert Electrical Compliance Form.xls
Town Hall Annex Telephone(631)765-1802
54375 Main Road
G {631)765
P.O.Box 1179 -
roger.richert down.sout 5Q2�ollQQ.ny.us
Southold,NY 11971-0959 Q ��
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: Date:
Company Name: ni
Name: Yv1l
License No.: (�
Address:
Phone No.:
JOBSITE INFORMATION: (*Indicates required information)
Name: Elmo, Cn1-urw-\)po
"Address: ,rte �- ►JY Il°i`-�=:
"Cross Street:
Phone No.: i46q
'ermit No.. _- —-- ---- --- --- - J-- - `
rax-Map District: 4000 Section: - Block: _ Lot: I a. .(o -
`BRIEF DESCRIPTION OF WORK (Please Print Clearly)
Please Circle All That Apply)
Is Job ready for inspection: NO Rough In Final
Do you need a Temp Certificate: YES NO
'emp Informatio
Service Size: 4 Phase 3P 100 15 200 400 Other
New Service: Re-conn t Underground umber of Me ers Change of Servic Overhead
►dditional Information: PAYMENT DUE WI ON
(2,t G cV)Q)�
82-Request for Inspection Form