HomeMy WebLinkAbout37047-Z s� f' Town of Southold Annex
ti��OgUFFaI� 9/4/2012
P.O.Box 1179
54375 Main Road
d1 2
oy • � 4j� Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 35930 Date: 9/4/2012
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 3245 Camp Mineola Rd, Mattituck,
SCTM#: 473889 See/Block/Lot: 123.-6-12.2
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
3/7/2012 pursuant to which Building Permit No. 37047 dated 3/7/2012
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:
new electric service
The certificate is issued to Browne,Mona
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 37047 08/30/2012
PLUMBERS CERTIFICATION DATED
Authorized Signature
" TOWN OF SOUTHOLD
`og11FFD(,rCo'�iy
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#: 37047 Date: 3/7/2012
Permission is hereby granted to:
Anne Hommel, Estate
C/O Patricia Ann Wenerowicz
152 Stillbrook Trl
Enterprise, FL 32725
To: new electric service
At premises located at:
3245 Camp Mineola Rd, Mattituck
SCTM # 473889
Sec/Block/Lot# 123.-6-12.2
Pursuant to application dated 3/7/2012 and approved by the Building Inspector.
To expire on 9/6/2013.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
�o��pF SO(/lyol
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 Q roger.riche rt(cD-town.southo Id.ny.us
COMM
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION'
Issued To: Mona Browne
Address: 3245 Camp Mineola Rd City: Mattituck St: NY Zip: 11952
Building Permit#: Section: 123 Block: 6 Lot: 12.2
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Hubbard Electric License No: 4709-me
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 underground service
Notes:
Inspector Signature: Date: Aug 30 2012
81-Cert Electrical Compliance Form.xls
OF SOpryolo
col • �Q
1 �
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION ..,
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING/STRAPPING [ ] FINAL
[ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ELECTRICAL (FINAL)
REMARKS:
DATE' INSPECTOR7 '
Town Halt Annex � � Telephone(681)765-1802
5W5 Mam Road
P.O.Box 1179 �► rouerrichertOi+m saliod.nvus
Southold,NY 11971-0959 � � .
BURDINC DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELEG RICAL INSPECTION
REQUESTED BY: � J� Date:
Company Name: J L
Name:
License No.: Q tNl 1=
Address: 4LA0 b a
hone No.: (fJ3) - `7�Z 7 �d 0 CP -Gl 7e -
JOBSITE INFORMATION: (*Indicates required information)
*Name: O i-\G, C0
*Address:
*Cross Street
`Phone No.: a
Permit No.:
Tax-Map District 1000 • Section: Block: Lot
*BRIEF DESCRIPTION OF WORK(Please Print Cleariy)
(Please Circle AN That Apply)
Is job ready for inspection: YES/ NO Rough In Final
*Do-you need a Temp Certificate: YES I NO
Temp Informadon of needed) .
*Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other
*New Service: Re-connect Underground Number of Meters Change of SepA3e Overhead
Additional Information: PAYMENT DUE WITH APP_ UCATION
B24tewest for Inspection Form I 1