HomeMy WebLinkAbout37322-Z c,�1FFOl,f Town of Southold Annex 6/28/2012
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54375 Main Road
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CERTIFICATE OF OCCUPANCY
No: 35786 Date: 6/28/2012
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 735 Westphalia Rd,Mattituck,
SCTM#: 473889 Sec/Block/Lot: 141.-3-21
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
6/25/2012 pursuant to which Building Permit No. 37322 dated 6/25/2012
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:
electric service upgrade
The certificate is issued to MARJAM 50 LLC
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 37322 06/25/2012
PLUMBERS CERTIFICATION DATED
Authorized Signature
o�SUFFn�Kco TOWN OF SOUTHOLD
�a ay 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#: 37322 Date: 6/25/2012
Permission is hereby granted to:
MARJAM 50 LLC
c/o Mitchell Kahn
125 Jericho Tpke
Jericho, NY 11753
To: Service Upgrade
At premises located at:
735 Westphalia Rd, Mattituck
SCTM # 473889
Sec/Block/Lot# 141.-3-21
Pursuant to application dated 6/25/2012 and approved by the Building Inspector.
To expire on 12/25/2013.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
SO�ryolo
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
aQ.P roger.richert(aD-town.southold.ny.us
Southold,NY 11971-0959
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Mariam(residence)
Address: 735 Westphalia Rd 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: . License No:
SITE DETAILS
Office Use Only
Residential X Indoor X Basement 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: 200a Overhead service
Notes:
Inspector Signature: Date: June 25 2012
81-Cert Electrical Compliance Form.xls
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Town Hall Annex Telephone(631)765-1802
54375 Main Road ra�oxw1)s 765 50g
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P.O.Box 1179 rocier.riche 0d.ny.us
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUMOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: �Ay�. Date: (�
Company Name:
ame: -
License No.: 5 —
Address:
Phone No.: L
J.OBSITE-INFORMATION: (*Indicates required information)
*Name: _ 1
*Address.
*Cross Street: .i- If R
*Phone No.:
Permit No..
Tax Map District:, 1000 Section: k Lk Block: Lot:
*BRIEF DESCRIPtION OF WORK(Please Print Clearly) S
Please Circle All That Apply)
*Is job ready for inspection: YE NO Rough In final
*Do you need a'Temp Certificate: YES
Temp Information (If needed)
*Service Size: P�Pls� '37 150 00 300 350 400 Other
*New Service: nnec n Ue Number of Meters Change of Servi verhea
Additional-inform JUN 2 2 2012 AYMENT DUE WITH APPLICATION
BLDG.DEPT.
T01NN
82-Request forinspection Form