HomeMy WebLinkAbout38347-Z �%4EE04co Town of Southold Annex 12/10/2013
O aye P.O.Box 1179
54375 Main Road
a • -t Southold,New York 11971
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CERTIFICATE OF OCCUPANCY
No: 36649 Date: 12/10/2013
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 5275 CR 48, Mattituck,
SCTM#: 473889 See/Block/Lot: 140.4-11
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
1/l/1900 pursuant to which Building Permit No. 38347 dated 9/20/2013
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:
UNDERGROUND ELECTRIC SERVICE
The certificate is issued to Martin,Rita
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 38347 12-02-2013
PLUMBERS CERTIFICATION DATED
Authorized Signature
�o�Sii�Fnt�-�v TOWN OF SOUTHOLD
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#: 38347 Date: 9/20/2013
Permission is hereby granted to:
Martin, Rita
3406 SE Glacier Ter
Hobe Sound, FL 33455
To: underground electric service
At premises located at:
5275 CR 48, Mattituck
SCTM # 473889
Sec/Block/Lot# 140.-1-11
Pursuant to application dated 1/1/1900 and approved by the Building Inspector.
To expire on 3/22/2015.
Fees:
ELECTRIC $85.00
Total: $85.00
�uiilding Inspector
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Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.sox 1179 roger.richert(a)_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: Rita Martin
Address: 35 Maiden Ln (5275 CR 48) City: Mattituck St: NY Zip: 11952
Building Permit#: 38347 Section: 140 Block: 1 Lot: 11
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 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 2-10 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 2-10 Switches Twist Lock Exit Fixtures TVSS
Other Equipment: 200a underground service with 2 meters, 2-100a disconnects
Notes:
Inspector Signature: Date: Dec 2 2013
81-Cert Electrical Compliance Form.xls
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Town Hall Annex Telephone(631)765-1802
54375 Main Road
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�roperrichewP.O.Box 1179 uodny.us
Southold,NY 11971-0959 Q • �O
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: bf" Date:
Company Name:
Name:
License No.:
Address: 116. 7
Phone No.:
JOBSITE INFORMATION: (*Indicates required information)
*Name: �aJ5_ C O.Wl ' 44 ,
*Address: 35 w �_No `
*Cross Street: CANA1A!A 'F&Ake— '46
*Phone No.: 631. 7(1 . 5401
Permit No.: 2Z2� Q.
Tax Map District: 1000 Section: q Block: — Lot: —
*BRIEF DESCRIPTION OF WORK (Please Print Clearly) ` -GMbJE ws_-Y nC4
PN u VL 'ro Se j
(Please Circle All That Apply)
*Is job ready for inspection: YE NO Rough In Final
*Do you need a Temp Certificate: YES / NO
Temp Information (If needed)
*Service Size:. has 3Phase 100 150 200 300 350 400 Other
*New Service: Re-connect Underground Number of Meters Change of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
82-Request for Inspection Form �
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