HomeMy WebLinkAbout37008-Z S�pF0� Town of Southold Annex 2/24/2012
P.O.Box 1179
3 54375 Main Road
C* $'
i Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 35455 Date: 2/24/2012
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1100 Hyatt Rd, Southold,
SCTM#: 473889 Sec/Block/Lot: 50.4-10
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
2/24/2012 pursuant to which Building Permit No. 37008 dated 2/24/2012
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:
underground electric service.
The certificate is issued to Kemeny,Mary
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 37008 2/22/12
PLUMBERS CERTIFICATION DATED
Authorized Signature
�gOFF0.4 TOWN OF SOUTHOLD
moo 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 #: 37008 Date: 2/24/2012
Permission is hereby granted to:
Kemeny, Mary
36 Perry St
New York, NY 10014
To: underground electric service.
At premises located at:
1100 Hyatt Rd, Southold
SCTM # 473889
Sec/Block/Lot# 50.-1-10
Pursuant to application dated 2/24/2012 and approved by the Building Inspector.
To expire on 8/25/2013.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
OF SOUryol
Town Hall Annex ~ Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 117 �� roger.richert
Southold,NY 11971-0959 (c-town.Southold.ny.us
�`
c4UNT'1,� '
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Mart Margaret Kemeny
Address: 1100 Hyatt Rd City: Southold St: NY Zip: 11971
Building Permit#: J -7 o o,�s Section: 50 Block: 1 Lot: 10
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Custom Lighting of Suffolk License No: 38893-me
SITE DETAILS
Office Use Only
Residential X Indoor Basement Service Only
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: 200a underground service
Notes:
Inspector Signature: Date: Feb 22 2012
— 0
81-Cert Electrical Compliance Form.xls
VS
Town Hall Annex l J�f Telephone(63I)765-1802
54375 Main Road N ,a (631)76 �5Q
P.O.Box 1179 G Q roger.richertCa7'iownsou 6
2 ny us
Southold,NY 11971-0959
laur'm;��' .
I
BUIMING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
IN
EQUESTED BY: Date:
J t
ompany Name: t
ame:
License No.: J
Address: •
uct<_ NUJI 11,
Phone No.: {p 3 ( (p
JO'BSITE INFORMATION: (Indicates required information)
*Name: -
*Address: ( ( -
*Cross Street: btu � p
*Phone No.:
Permit No.:
Tax-Map District: 1000 Section: 0. Block: Lot:
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
000 Aim
(Please Circle All That Apply) (
*Is job ready for inspection: E / NO Rough Inj Final
*Do-you need a Temp Certificate: / NO .t ` �77 lo7a 3 off'
Temp Information(if needed) -RD c(or-ask ppfio rl I I w e ,Aje.-t-
*Service Size: Phas 3Phase 100 150 (a 300 350 400 Other
*New Service: e-connec Undergroun)d Number of Meters Range of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
LL
82=Request for lnspection Form
k k A+ 1EIM n