HomeMy WebLinkAbout43271-Z Town of Southold 12/7/2018
Jul. P.O.Box 1179
53095 Main Rd
Southold, New York 11971
CERTIFICATE OF OCCUPANCY
No: 40089 Date: 12/7/2018
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 9025 Route 25, Mattituck
SCTM#: 473889 Sec/Block/Lot: 122.-6-22.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
12/4/2018 pursuant to which Building Permit No. 43271 dated 12/4/2018
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:
RE-CONNECT EXISTING 100 AMP ELECTRICAL SERVICE
The certificate is issued to 9025 Main Road LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 43271 11-30-2018
PLUMBERS CERTIFICATION DATED
Authorized Signat e
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
§ 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#: 43271 Date: 12/4/2018
Permission is hereby granted to:
9025 Main Road LLC
10095 Main Rd Unit 4
Mattituck, NY 11952
To: electrical inspection of hot box as per PSEG
At premises located at:
9025 Route 25, Mattituck
SCTM #473889
Sec/Block/Lot# 122.-6-22.1
Pursuant to application dated 12/4/2018 and approved by the Building Inspector.
To expire on 6/4/2020.
Fees:
ELECTRIC $125.00
Total: $125.00
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Town Hall Annex Telephone(631)765-1802
54375 Main Road N Fax(631)765-9502
P.O.Box 1179 �o roger.riche rt(7town.south old.ny.us
Southold,NY 11971-0959 '01
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To. 9025 Main Road LLC
Address. 9025 Rt 25 City- Mattituck St: New York Zip. 11952
Building Permit#- 43271 Section. 122 Block: 6 Lot: 22.1
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor- DBA. Sabat Electric License No- 4204-ME
SITE DETAILS
Office Use Only
Residential Indoor Basement Service Only X
Commerical X Outdoor X 1 st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph 100a Heat Duplec Recpt Ceiling 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: RE-connect existing 100a service
Notes:
Inspector Signature: Date: November 30 2018
81-Cert Electrical Compliance Form.xls
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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
roger.richert(cD-town.southold.ny.us
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: 0 A K-Vc- SA 6�' Date: /f. 2 o . 1 8
Company Name: S'sA aT cl c -rR( L
Name:
License No.: Z D 61 E email: S A P,a T&t-(:-FLTJ-t - G M A LL- C
Address: �-b A i L A 0 f M 4--irrT-Lt C 14 t4
Phone No.: Co 3 l -`7-7 L(; 1:-4 a
JOB SITE INFORMATION: (AN information Required)
Name: . CAP -r L- t a
Address: 2 MA 1 b A 1b girl -TT1-r C-1c 1 LC 5--,Z-
Cross Street: 'FA LT6 rz '
Phone No.: A-
Bldg.Permit#: a,7 t email:
Tax Map District: 1000 Section: �— Block:—Z,o Lot: a
BRIEF DESCRIPTION OF WORK(Plea5e Print Cleari SA 'F�"r'�'
1,i s Pe'crr o 4 o� r-
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Circle All That Apply:
Is job ready for inspection?: E / NO Rough In
Do you need a Temp Certificate?: ES NO Issued On-A s
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p Information: (All information required)
Service Size 1 Ph 3 Ph Size: P A #Meters Old Meter#
New Service-Fire Reconnect- Flood Reconnect-Service Reconnect �- ��veflwad
#Underground Laterals 1 2 H Frame Pole Work done on Service? Y N
Additional Information:
AAi � ���1/ c7 CLC- .
3 -7- - S"
PAYMENI WITHAPP
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82-R est for Inspection Form As
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