HomeMy WebLinkAbout37417-Z �osjj OFE G Town of Southold Annex 9/21/2012
y� P.O.Box 1179
N 54375 Main Road
�" • �,``� Southold,New York 11971
A u
CERTIFICATE OF OCCUPANCY
No: 35964 Date: 9/21/2012
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1900 Pine Tree Rd, Cutchogue,
SCTM#: 473889 Sec/Block/Lot: 98.4-17.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
8/2/2012 pursuant to which Building Permit No. 37417 dated 8/2/2012
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:
200 AMP Electrical Service
The certificate is issued to Kosmynka,Martin&Kosmynka,Christine
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 37417 9/18/12
PLUMBERS CERTIFICATION DATED
Authorized Signature
o�safFnt�co TOWN OF SOUTHOLD
BUILDING DEPARTMENT
CA 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#: 37417 Date: 8/2/2012
Permission is hereby granted to:
Kosmynka, Martin & Kosmynka, Christine
1985 Pine Tree Rd
Cutchogue, NY 11935
To: 200 AMP Electrical Service
At premises located at:
1900 Pine Tree Rd, Cutchogue
SCTM # 473889
Sec/Block/Lot# 98.-1-17.1 .-
Pursuant to application dated 8/2/2012 and approved by the Building Inspector.
To expire on 2/1/2014.
Fees:
ELECTRIC $85.00
Total: $85.00 -
Building Inspector _ _... .-
pF SO(/lyol
Town Hall Annex ~ Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 N
Southold,NY 11971-0959 @ roger.richert(aD-town.southold.ny.us
COUAM
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: North Fork Self Storage
Address: 1900 Pine Tree Rd City: Cutchogue St: NY Zip: 11935
Building Permit#: Section: 98 Block: 1 Lot: 17.1
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: G&S Electric License No: 578-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 200a 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 100 Switches Twist Lock Exit Fixtures TVSS
Other Equipment: 200a underground service (h frame)
Notes:
Inspector Signature: ,cti Date: Sept 18 2012
81-Cert Electrical Compliance Form.xls
,*pE S01/jyo
l0
Town Hall Annex Telephone(631)765-1802
54375 Main Road m�:ax(631)765- 5)2,
P.O.Box,1179 ,n rocler.richert(cy_town.sout�io ny.us
Southold,NY 11971-0959 SO
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: Date: a
Company Name: 4f S ( f_C�_ CQL. aenJ ,
Name:
License No.: Je5
Address: , C3 , c S o c..D AJ ? 1
Phone No.: ,3 ,r toy l
JOBSITE INFORMATION: ('Indicates required information) �` �
*Name: te-7 624c- 1f6L-f 1-7-OrLA6E
*Address: /jOo Z,6021 -7-12,C—,E _ AJ
*Cross Street: p C.L Al
*Phone No.: Z 3 y c2L 177
Permit No.: --
Tax Map District: 1000 Section: Block:—�— Lot: -7
*BRIEF DESCRIPTION .OF WORK (Please Print Clearly)
(Please Circle All That Apply)
*Is job ready for inspection: SNO
NO - . Rough In Final
*Do you need a Temp Certificate:
Temp Information (If needed)
*Service Size: 1 Phase 3Phase 100 150 20 300 350 400 Other
*New Service Re-connect ergro d Number of Meters / Change of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
82-Request for Inspection Form