HomeMy WebLinkAbout37387-Z �cp• Town of Southold 4/12/2018
P.O.Box 1179
0
' 53095 Main Rd
Southold, New York 11971
CERTIFICATE OF OCCUPANCY
No: 39594 Date: 4/12/2018
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1255 Stillwater Ave, Cutchogue
SCTM#: 473889 Sec/Block/Lot: 103.-1-17
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
7/24/2012 pursuant to which Building Permit No. 37387 dated 7/24/2012
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 UPGRADE
The certificate is issued to Fritz,Kimberly
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 37387 04-10-2018
PLUMBERS CERTIFICATION DATED
Authorized Signature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
a 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 #: 37387 Date: 7/24/2012
Permission is hereby granted to:
Brown, Patricia Ann & Kosciusko, Steven
345 Knollwood Ln
Mattituck, NY 11952
To: 200 amp Service Upgrade
At premises located at:
1255 Stillwater Ave, Cutchogue
SCTM # 473889
Sec/Block/Lot# 103.-1-17
Pursuant to application dated 7/24/2012 and approved by the Building Inspector.
To expire on 1/23/2014.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
pF SOUryQI
Town Hall Annex Telephone(631)765-1802
54375 Main Road y Fax(631)765-9502
P.O.Box 1179 Q roger.richert(cDtown.southold.ny.us
Southold,NY 11971-0959 Q
UNTY,N
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Fritz (Brown - Kosciusko)
Address: 1255 Stillwater Avenue city Cutchogue st: New York zip: 11935
Building Permit#- 37387 Section: 103 Block: 1 Lot: 17
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
contractor: DBA: Peconic Electric License No: 43457-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 Ceiling 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 Over Head Service Up Grade.
Notes:
Inspector Signature: Date: April 10, 2018
0-Cert Electrical Compliance Form.As
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TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLEIG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ELECTRICAL (FINAL)
REMARKS:
DATE �� INSPECTOR
O C-D
so�ryol
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Telephone(631)765-1802
�f m�ax(631)765- St�2�
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C 3 d • Q roger richert(a-town.soutgo .nV.us
ou;hid,NY 11971
U L 2012
BLDG.DEPT BUILDING DEPARTMENT
TOWN OF SOUTHOLD TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICALINSPECTION
REQUESTED BY: P- - w Date: F- i I
Company Name: �� o� �- LZcZT✓L
Name: 74 d
License No.: L4 S
Address: oil l "3 �4D�
Phone. No.: 3 1!v r--, 91
JOBSITE INFORMATION: (*Indicates required information)
*Name:
*Address: uJ:y r-1--
*Cross Street: /tl f/A✓ 21),
*Phone No.: Q/ 7 - -5-4, --
Permit No.: /1/l"q
Tax Map District: 1000 Section: Block: Lot:
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
(Please Circle All That Apply)
*Is job ready for inspection: Y NO Rough In Final
*Do you need a Temp Certificate: YES / NO
Temp Information If n ed. d)
*Service Size: 'i Pha 313hase 100 150 =200, 300 400 Other
*New Service: Re-connect Underground Number of MetersChange_of S Overhead
Additio al Information: _ PAYMENT.DUE WITH APPLICATION I
82-Request for Inspection Form