HomeMy WebLinkAbout36750-Z �UffOl,fc Town of Southold Annex 11/10/2011
54375 Main Road
y ' Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 35282 Date: 11/10/2011
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 445 Walnut Pl, Mattituck,
SCTM#: 473889 Sec/Block/Lot: 142.-1-16.2
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore tiled in this officed dated
10/13/2011 pursuant to which Building Permit No. 36750 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:
Outside Electrical Service Repair.
The certificate is issued to Dohm Jr,Walter&Dohm,Kinta
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 36750 10/28/11
PLUMBERS CERTIFICATION DATED ?
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Authorized Signature
SO!/jyolo
Town Hall Annex Telephone(631)765-1802
54375 Main Road cn Fax(631)765-9502
P.O.Box 1179 G Q
Southold,New York 11971-0959 '� roper.riche rt(Q)town.southold.ny.us
ly UNTY,
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Walter Dohm
Address: (445)265 Walnut Place. City: Mattituck St: NY Zip: 11952
Building Permit#: So Section: 142 Block: 1 Lot: 16.2
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: MD Electric Inc License No: 4925-e
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 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 Fixture Time Clocks
Disconnect Switches Twist Lock HExit Fixtures TVSS R
Other Equipment: service repair-out side only-to existing 150a overhead service
Notes:
Inspector Signature: Lim Date: Oct 28 2011
81-Cert Electrical Compliance Form
TOWN OF SOUTHOLD
�guFFO(,�co
moo aye BUILDING DEPARTMENT
s 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#: 36750 Date: 10/13/2011
Permission is hereby granted to:
Dohm Jr, Walter & Dohm, Kinta
PO BOX 977
Mattituck, NY 11952
To: Outside Electrical Service Repair
At premises located at:
445 Walnut PI, Mattituck
SCTM # 473889
Sec/Block/Lot# 142.-1-16.2
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
i
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54375 Maio Road Tekohone(63D 7&3-1808
P O.Box 1179 r0aer.RdlBrt[sstoWn south us
Sout LOK NY 119714"
BVIDr I Nc 3DEPART 47M
TOWN OF SOUTHOLD
APPLICATION OR ELECTRICAL IIVSp�eT10N
REQUESTED SY: M,�,(2.V- Sk-J Date: o( f t
ILI
Company Name: N& fi INC,
Name: .
icense Na.:
Address: I e
Phone No.:
JOBStTE INFORMATION: *indicates.required information) .
*Address: ���� 7-6 WA IA-r- IiPG� i U
*Cross Street: G
�C, o<
*Phone No..
Permit No.:
Tax Map District: 1006 Sectfan: . (may Wtock: �
Lot. (o,v.
*BRIEF DESCRIPTION OF WORD(Please i'tint Ctasrly)
(P hme Circle Alt That Apply)
*Is.job ready for inspection: *00"Do you need a Temp C®rtifica�ta; Rough In Find'
Temp lnformadon eeded)
*Service Slze. 1 Phasa. Whase 'f00 't50 200 30tT a'�a 400 other
*New Service: Re-connect Underround Num er o€Meters Change of SeM Overhead
Additional Information: PAYMENT DUE WI`Ij APPLICATIO
G /4 # 5ti0ti866 L :96 .04-0L-80