HomeMy WebLinkAbout37643-Z SU FF pl�.c Town of Southold Annex 12/17/2012
P.O.Box 1179
z 54375 Main Road
co
4;1 Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 36087 Date: 12/17/2012
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 290 Oak St, Mattituck,
SCTM#: 473889 Sec/Block/Lot: 141.4-16.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
11/26/2012 pursuant to which Building Permit No. 37643 dated 11/26/2012
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:
overhead electric service.
The certificate is issued to Zawasky, John&Zawasky,Dorothy
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 37643 12/13/12
PLUMBERS CERTIFICATION DATED
Authorized Signature
5� TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
o . g 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#: 37643 Date: 11/26/2012
Permission is hereby granted to:
Zawasky, John &Zawasky, Dorothy
4790 Aston Gardens Way
Naples, FL 34109
To: Electric Service Change
At premises located at:
290 Oak St, Mattituck
SCTM # 473889
Sec/Block/Lot# 141.-1-16.1
Pursuant to application dated 11/26/2012 and approved by the Building Inspector.
To expire on 5/28/2014.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
SO!/r�ol
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 roger.richert( -town.southold.ny.us
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: John Zawasky
Address: 290 Oak St City: Mattituck St: NY Zip: 11952
Building Permit#: 37643 Section: 141 Block: 1 Lot: 16.1
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: EECO Electric Corp License No: 2816-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 100a Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel 100a 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 100a Switches Twist Lock Exit Fixtures TVSS
Other Equipment: 100a overhead service
Notes:
Inspector Signature: Date: Dec 13 2012
81-Cert Electrical Compliance Form.xis
Town Hall Annex Telephone(631)765-1802
54375 Main Road
P.O.Box 1179 rager.richertk ' soutl9io1 ny us
Southold,NY 11971-0959
- Bua DING DEPARTMENT
TOWN OF SOUTHOLD
APP.LICATION FOR ELECTRICAL INSPECTION
REQUESTED BY:
Av �s . ... . Date:....
-- L lq t2
Company Name: ,. Coy . ,, .. .. _. .. . . i..
Name: 1 ► r rn�L
License No.: 191(p.
M �-
Address: � �tq�'8
Phone No.: -1(05 55 y
JOBSITE INFORMATION: (*Indicates required information)
*Name: 2-Awas k
*Address: 2-N) �. n qSZ.
*Cross Street:
`Phone No.: Zalg I 19 ►
Permit No.:
Tax-Map District: - 1000 e' ion: Block: Lot.
*BRIEF DESCRIPTION OF WORK(Please Print Clearly)
(Please Circle All That Apply)
Is job ready for inspection: YES./00 Rough In Final
*Do-you need a Temp Certificate: YES NO
Temp InformationnPh
ed)
`Service Size: 3Phase 100 150 200 300 Mo 400 Oflmr
*New Service: Re-connect Underground Numbe Meters Cange of Servi verhead
Additional Information: PAYME I 'DUE WITH APP TION
Z24tequest for Inspection Form