HomeMy WebLinkAbout36752-Z tf'�sUFFp[,� Town of Southold Annex 10/18/2011
3�� cOay 54375 Main Road
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 35244 Date: 10/18/2011
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 875 Pike St, Mattituck,
SCTM#: 473889 Sec/Block/Lot: 140.-2-24
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
10/13/2011 pursuant to which Building Permit No. 36752 dated 10/13/2011
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:
Electric Service upgrade
The certificate is issued to Keogh,Frances Margaret
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 36752 10/14/2011
PLUMBERS CERTIFICATION DATED
Authorized Signature
pf SO!/r�olo
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 �Q roger.richerto__town.southold.ny.us
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Frances Keogh
Address: 875 Pike St City: Mattituck St: NY Zip: 11952
Building Permit#: Section: Block: Lot:
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: C-Cat Co License No: 953-me
SITE DETAILS
Office Use Only
Residential X Indoor X Basement X Service Only X
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 Fixtures Time Clocks
Disconnect 200a Switches Twist Lock Exit Fixtures TVSS
Other Equipment: service up grade to 200a overhead
Notes:
Inspector Signature: Date: Oct 14 2011
81-Cert Electrical Compliance Form
TOWN OF SOUTHOLD
cay� BUILDING DEPARTMENT
y TOWN CLERK'S OFFICE
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 #: 36752 Date: 10/13/2011
Permission is hereby granted to:
Keogh, Frances Margaret
875 Pike St
PO BOX 646
Mattituck, NY' 11952
To: Service upgrade
At premises located at:
875 Pike St, Mattituck
SCTM # 473889
Sec/Block/Lot# 140.-2-24
Pursuant to application dated 10/13/2011 and approved by the Building Inspector.
To expire on 4/13/2013.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
SOUryO
Telephone `2
(631)765-180
Town Hall Annex
54375 Main Road (631)765- 50
roger richert(a��own.sout�iofd.ny.us
P.O.Box 1179
Southold,NY 11971-0959 O
BUILDING DEPARTMENT
TOWN OF SOUTHOI D
APPLICATION FOR ELECTRICAL INSPECTION
FREQUESTED BY: ! J Date:any Name: ' }-
Name:
License No.:
Address: „ 6 J� Z-
Phone No.: 3 - Ct B- 87(o't
JOBSITE INFORMATION: (*Indicates required information)
*Name: _ 9y i(�.t� IE N
*Address: 75 E1 S i
*Cross Street: LOJC' (A
*Phone No.: gac,z,
Permit No.:
Tax Map District: 1000 Section: Block: � Lot:
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
c
(Please Circle All That Apply)
*Is job ready for inspection: YES NO Rough In Final
.*Do you need a Temp Certificate: YES NO
Temp Information (If needed)
*Service Size: 1 Phase 313hase 100 150 200 300 350 400 Other
*New Service: Re-connect Underground Number of Meters hange of Se r ' =verhea�>
Additional Information: PAYMENT DUE WITH APPLICATION
82-Request for Inspection Form