HomeMy WebLinkAbout36678-Z ®�SUFFpt�.cOG Town of Southold Annex 9/27/2011
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CERTIFICATE OF OCCUPANCY
No: 35235 Date: 9/27/2011
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 39765 CR 48, Southold,
SCTM#: 473889 See/Block/Lot: 59.-9-30.1
Subdivision: Filed Map No. . Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
9/9/2011 pursuant to which Building Permit No. 36678 dated 9/9/2011
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:
New Electrical Service
The certificate is issued to Surozenski, David
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 36678 9/2/11
PLUMBERS CERTIFICATION DATED
Authorized Signature
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Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 �o roger.riche rt(ab_town.southo Id.ny.us
Southold,NY 11971-0959
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: David Syrozenski
Address: 39765 North Rd, Rt 48 City: Southold St: NY Zip: 11971
Building Permit#: ` �� Section: �� Block: Lot: 1
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Pumillo Electric License No: 2300-me
SITE DETAILS
Office Use Only
Residential X Indoor Basement Service Only X
Commerical Outdoor X 1st 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 A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks
Disconnect 100a Switches Toast Lock Exit Fixtures TVSS
Other Equipment: 100a overhead service (out side only)
Notes:
Inspector Signature: Date: Sept 2 2011
81-Cert Electrical Compliance Form
o�suFFGjjt TOWN OF SOUTHOLD
BUILDING DEPARTMENT
y 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#: 36678 Date: 9/9/2011
Permission is hereby granted to:
Surozenski, David
39765 CR 48
Southold, NY 11971
To: New Electrical Service
At premises located at:
39765 CR 48, Southold
SCTM # 473889
Sec/Block/Lot# 59.-9-30.1
Pursuant to application dated 9/9/2011 and approved by the Building Inspector.
To expire on 3/10/2013.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector