HomeMy WebLinkAbout41765-Z Town of Southold 12/27/2017
. _ P.O.Box 1179
l.. 53095 Main Rd
4 ! hp's Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39419 Date: 12/27/2017
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 830 Monsell Ln, Cutchogue
SCTM#: 473889 Sec/Block/Lot: 97.-8-23
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. 41765 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:
ELECTRIC SERVICE UPGRADE
The certificate is issued to Doroski,Benjamin
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 41765 12-19-2017
PLUMBERS CERTIFICATION DATED
Authorized Signature
� TOWN OF SOUTHOLD
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al BUILDING DEPARTMENT
y z 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#: 41765 Date: 6/27/2017
Permission is hereby granted to:
Verity, George
PO BOX 374
Peconic, NY 11958
To: Electric Upgrade
At premises located at:
830 Monsell Ln, Cutchogue
SCTM #473889
Sec/Block/Lot# 97.-8-23
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
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Town Hall Annex Telephone(631)765-1802
54375 Main Road CA Fax(631)765-9502
P.O.Box 1179 ® aQ roger.richert(aD-town.southold.ny.us
Southold,NY 11971-0959 ®l�C®U '��
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Doroski (Verity)
Address: 830 Monsell Lane city,Cutchogue st: New York zip: 11935
Building Permit#: 41765 Section: 97 Block: 8 Lot: 23
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Custom 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 Heat Duplec Recpt Ceding Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt 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 FixtureTime Clocks
Disconnect Switches Twist Lock Exit Fixtures 9 TVSS
Other Equipment: 300A Service Upgrade, 2- Meters, 200A Service to House, 100A Service to Barn.
Notes:
Inspector Signature: Date: December 19, 2017
0-Cert Electrical Compliance Form.xls
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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) P/JELECTRICAL (FINAL)
REMARKS:
DATE / 4 INSPECTOR�� � '
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54375 NiaEIIa 7m Road I I
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P.O.Box 1179
rooer.dichert
Southold,INN 11971-0059
JUN 2 7 2017
BUILDING DU'AIMMENIT BUMDING DEPT.
TOWN OF SOHOLD TOWN OF SOUTHOLD
APPLICATION FOR ELECT RICAL INSPECTION
REQ11JESTED BY: Date:
Company Name:
Name:
Licxanse No.:
35�a3—
Address:
Phone No,: Lq3N
JOBSITE INFORMATION: (*Indicates required informatio
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*Address- a-50 Mh
*Cross Street: eLW2Lt___
*Phone No.:'
Permit No.:
Tax Map District: - 1000 Section: Block: Lot:
*SRIF-F DESCRIPTION OF WORK (Please Print CD/learly) a,4 9- U) (1W
0_k)WV_0_f
(Please Circle All That Apply)
1e,job ready for inspection: YES 1 NO Rough In Final
*Do you need a Temp Certificate: NO
'remp'Information (if needed)
*Seniice Size- C I Phase 3Phase 100 150200 0 400 Other
MeJarte
3-9
*New Service: Re-connect Underground Number os
e f i�;ritice Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
8�_,-Feqjesf for Inspecijon Form
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