HomeMy WebLinkAbout37564-Z gGFp�,fC Town of Southold Annex 10/16/2012
=off °may P.O.Box 1179
y 54375 Main Road
oy �g Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 36003 Date: 10/16/2012
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 3405 Grand Ave,Mattituck,
SCTM#: 473889 Sec/Block/Lot: 107.4-8.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
10/9/2012 pursuant to which Building Permit No. 37564 dated 10/9/2012
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 Galdri,Alberta&Walsh,Brendan
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 37564 10/15/2012
PLUMBERS CERTIFICATION DATED
Authorized Signature
�Eot,r
TOWN OF SOUTHOLD
o�SUF �o
�� oy BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
oy . 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#: 37564 Date: 10/9/2012
Permission is hereby granted to:
Galdri, Alberta &Walsh, Brendan
3405 Grand Ave
Mattituck, NY 11952
To: 200 Amp Electrical Service
At premises located at:
3405 Grand Ave, Mattituck
SCTM # 473889
Sec/Block/Lot# 107.-1-8.1
Pursuant to application dated 10/9/2012 and approved by the Building Inspector.
To expire on 4/10/2014.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
*pG SO!/Tyolo
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 G • �4W roger.richert(a7town.southold.ny.us
Southold,NY 1 1 97 1-0959
o�yCoU ,�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Brendon Walsh
Address: 3405 Grand Ava City: Mattituck St: NY Zip: 11952
Building Permit#: 3�S� Section: Block: Lot:
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL.ELECTRIC CODE
Contractor: DBA: C-Cat CO License No: 953-me
SITE DETAILS
Office Use Only
Residential X Indoor X Basement X 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: Oct 15 2012
81-Cert Electrical Compliance Form.xls
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Town Halt Annex vc �gg�� 22 54375 Main Road y r Che IO �1SOuttlltl
P.O.Box 1179 G • @ O_
. Southold,NY 11971-0959 �CO �
12
BLDG.DEPT.
TOWN OF SOUTHOLD
BUIWING DEPARTMENT'
TOWN OF SOUM01M
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: Date: d .�
Company Name:
- -
___.--Matftiuck,.N:Y --
License No.:
r
Address:
Phone No.: Cl p qq P 3 -71
JOBSITE INFORMATION: (*Indicates required information)
*Name:
*Address: 3405- C-Y.Aao - 64/tr , /VtAVInIC&
*Cross Street .
*Phone No.: 117c
Permit No.-
Tax Map District: 1000 Section: Block: Lot
*BRIEF DESCRIPTION OF WORK(Please Print Clearly)
S 1 Lc,d- CtAwj3 r e-
(Please Circle All That Apply)
*Is job ready for inspection: YES! NO Rough In Final
*Do you need a Temp Certificate: % NO
Temp Infommadon(if needed) '
*Service Size: ,as,� V atp E 150 20 300 350 400 Other
*New Service: ll�� n eUrgro Number of Meters ange of Ser Overhead
Additional Inform OCT - 9 2012 YMENT DUE WITH APPLICATION
BLDG. DEPT.
i4
82-Request for Inspection Form