HomeMy WebLinkAbout42756-Z ��uEFO(,�ca Town of Southold 6/8/2018
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P.O.Box 1179
53095 Main Rd
P4A �`�� Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39697 Date: 6/8/2018
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 240 Freeman Ave,Mattituck
SCTM#: 473889 Sec/Block/Lot: 139.-3-43
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
6/5/2018 pursuant to which Building Permit No. 42756 dated 6/5/2018
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:
RECONNECT EXISTING 100 AMP ELECTRIC SERVICE
The certificate is issued to McShane,Karen
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 42756 06-06-2018
PLUMBERS CERTIFICATION DATED
Authorized Signature
OF SOU��o�
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Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
CAR
P.O.Box 1179 , ® �Q roger.richert(-town.Southold.ny.us
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Karen McShane
Address: 240 Freeman Avenue city.Mattituck st: New York zip: 11952
Budding Permit#: 42756 Section: 139 Block. 3 Lot: 43
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: HOME OWNER DBA: License No:
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 100A Heat Duplec Recpt Ceding Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel 100A 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 100A Switches Twist Lock Exit Fixtures TVSS
Other Equipment: Existing 100A Service, OK to Reconnect.
Notes:
Inspector Signature: �� Date: June 6, 2018
0-Cert Electrical Compliance Form.xls
TOWN OF SOUTHOLD
o
�� BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
o . 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#: 42756 Date: 6/5/2018
Permission is hereby granted to:
McShane, Karen
240 Freeman Ave
Mattituck, NY 11952
To: turn electric service on
At premises located at:
240 Freeman Ave, Mattituck
SCTM # 473889
Sec/Block/Lot# 139.-3-43
Pursuant to application dated 6/5/2018 and approved by the Building Inspector.
To expire on 12/5/2019.
Fees:
ELECTRIC $85.00
Total: $85.00
tt
Bt ing Inspector
�o�NOE SO�IyO�
# TOWN OF SOUTHOLD BUILDING DEPT.
courm, 765-1802
INSPECTION
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[ ] FOUNDATION 1ST [ ] ROUGH PLBG. ��
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
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DATE 5 INSPECTOR
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�OAFFBUILDING DEPARTMENT- Electrical Inspector
C
TOWN OF SOUTHOLD
Town Hall Annex - 54375 Main Road - PO Box 1179
o • Southold, New York 11971-0959
plr Telephone (631) 765-1802 - FAX (631) 765-9502
1 roper.riche rt(cDtown.southold.ny.us -
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED-BY..-- Date:-- — - -
Company Name:
Name:
License No.: email:
Address:
Phone No.:
JOB SITE INFORMATION: (All Information Required)
Name: }lj pke �\0-1�'J r
Address: CIL10 Freepe'cw -- Rc.s.'�
Cross Street: 1c,\<VNC".j 4%�v (N
Phone No.: 1031 (evS -7 a.X
BIdg.Permit#: LA1-15- email: _\)6/kF' e #N,0L p ( M
Tax Map District: 1000 Section: 1'3 q Block: Lot:
BRIEF DESCRIPTION OF WORK (Please Print Clearly)
--V-6 hArN w1'\AJ1J h1GPV-',.e
Circle All That Apply:
Is job ready for inspection?: ES NO Rough In Final
Do you need a Temp Certificate?: YES NO Issued On
Temp Information: (All information required)
Service Size 1 P 3 Ph Size: l b A # Meters Old Meter#
New Service - Fire Reconnect-'FIoQd Reconnect Service Reconnecte Underground - Overh ad
# Underground Laterals 1 2 H Frame Pole Work done on Service? Y N
Additionat Information:
PAYMENT DUE WITH APPLICATION
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Request for Inspection FormAs