HomeMy WebLinkAbout37124-Z �o�SyFp Loco Town of Southold Annex 4/16/2012
aye P.O.Box 1179
N 54375 Main Road
oy �1!1�j Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 35538 Date: 4/16/2012
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 9945 Route 25, Mattituck,
SCTM#: 473889 Sec/Block/Lot: 142.4-27
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
4/9/2012 pursuant to which Building Permit No. 37124 dated 4/9/2012
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:
outside dedicated electric circuit.
The certificate is issued to GAN A Properties-Deer Inc
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 37124 4/9/12
PLUMBERS CERTIFICATION DATED
Authorized Signature
L' TOWN OF SOUTHOLD
gUfFO4����
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#: 37124 Date: 4/9/2012
Permission is hereby granted to:
GAMA Properties-Deer Inc
320 Front Pond Rd
Old Brookville, NY 11545
To: outside dedicated electric circuit.
At premises located at:
9945 Route 25, Mattituck
SCTM # 473889
Sec/Block/Lot# 142.-1-27
Pursuant to application dated 4/9/2012 and approved by the Building Inspector.
To expire on 10/9/2013.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
pF SO(/jyolo
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 e roger.richert(a)-town.southold.ny.us
Southold,NY 11971-0959
'rOUNT`I,�ct1�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: 7-Eleven
Address: 9945 Main Rd City: Mattituck St: NY Zip: 11952
Building Permit#: 3�7 1.14 Section: 142 Block: 1 Lot: 27
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Statewide Elec License No: 35491-me
SITE DETAILS
Office Use Only
Residential Indoor X Basement Service Only
Commerical X Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph 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 Fixtures Time Clocks
Disconnect Switches Twist Lock Exit Fixtures TVSS
Other Equipment: install dedicated line to outside DVD vending machine, to include out side disconn
Notes:
Inspector Signature: Date: April 9 2012
81-Cert Electrical Compliance Form.xls
• o��a�So��Q _
543754375 Maus Road own Hal!Annex Trlephone(631)765.1802
P.O.Box,1179 ro er ri&e wn sou19o95.n .us
Southold,NY 11971.0959 !
A A
BUtonvr,DEPARTMENT
TOWN of So OLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: _ Date: '�C�,rG'1
Company Name: =\ 'tr i G
Name:
License No.: 3fL4cil - N L
Address: GL1 C_
Phone No....
JOBSITE INFORMATION., (1nd:icates required information)
*Name:..
*address:
*Cross Street:
Permit No.
Tax-Map.District 1000 Section: Block: lot; '
*BRIEF;DIESCRiPTIt3N OF WORK(Please Print Clearly)
MeaseZircle All That Apply) -
*Is job ready for inspection: YES/ hough In Final
*Do-.you need a Temp Certificate: YES fN0
Temp Information(If needed)
*Seimce Size: i Phase 3Phase 100 150 200 300 350 400 Other
NpW,Service: Re-connect Underground---Number of Mete 1 v d.
.Additional information: PAYME T DUE H
n.
Tr n
B24Requed for Inspection Form '� BLDG.DE PT.
TOWN OF SOUTHOLD
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