HomeMy WebLinkAbout43254-Z C*UM
Town of Southold 12/7/2018
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40087 Date: 12/7/2018
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 2860 Skunk Ln, Cutchogue
SCTM#: 473889 Sec/Block/Lot: 97.-8-10
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
11/28/2018 pursuant to which Building Permit No. 43254 dated 11/28/2018
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:
ELECTRICAL SURVEY
The certificate is issued to Mann,William&Cynthia
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 43254 12-05-2018
PLUMBERS CERTIFICATION DATED
Authorized Si re
Jt TOWN OF SOUTHOLD
BUILDING DEPARTMENT
a TOWN CLERK'S OFFICE
10 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#: 43254 Date: 11/28/2018
Permission is hereby granted to:
Mann, William & Cynthia
2860 Skunk Ln
Cutchogue, NY 11935
To: electrical survey
At premises located at:
2860 Skunk Ln, Cutchogue
SCTM # 473889
Sec/Block/Lot# 97.-8-10
Pursuant to application dated 11/28/2018 and approved by the Building Inspector.
To expire on 5/29/2020.
Fees:
ELECTRIC $120.00
Total: $120.00
spector
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Town Hall Annex Telephone(631)765-1802
54375 Main Road y Fax(631)765-9502
P.O.Box 1179 G Q
Southold,NY 11971-0959
• io roger.richert(aD-town.southold.ny.us
OOUNTY,�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To William Mann
Address. 2860 Skunk Ln City- Cutchogue St: New York Zip 11935
Building Permit#- 43254 Section: 97 Block: 8 Lot: 10
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: AS BUILT DBA. License No
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service Only
Commerical Outdoor X 1 st Floor X Pool
New Renovation 2nd Floor Hot Tub
Addition Survey X 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 overhead service, 1-single recpticle for fire place.
Notes:
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Inspector Signature: Date: December 5 2018
81-Cert Electrical Compliance Form.xls
�pffOt,t BUILDING DEPARTMENT-Electrical Inspector
TOWN OF SOUTHOLD
= Town Hall Annex - 54375 Main Road - PO Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1802 - FAX(631) 765-9502
roper.richert(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:
Address: e
Cross Street: `T" s
Ze
Phone No.: '7 171
Bldg.Permit#: email: 'S4 rGGv' -ce-yr,
Tax Map District: 1000 Section: Block: 18 Lot::
BRIEF DESCRIPTION OF WORK(Please Print Clearly) Z--
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Circle All That Apply:
Is job ready for inspection?: ES NO Rough In Final
Do you need a Temp Certificate?: YES/ �O Issued On
Temp Information: (All information required)
Service Size,:?co,q,.,/&b 3 Ph Size: 2!?� _A #Meters__ Old Meter#
New Service- Fire Reconnect- Flood Reconnect-Service Reconnected -Underground Overhead
# Underground Laterals 1 2 H Frame Pole Work done on Service? Y lv
Additional Information
PAYMENT DUE WITH APPLICATION
82-Request for Inspection FormAs r ec'C1
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