HomeMy WebLinkAbout43289-Z ����S�FFQt'fcoGy Town of Southold 12/23/2018
P.O.Box 1179
CO
.C* : 53095 Main Rd
o4 # Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40137 Date: 12/24/2018
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 9245 Route 25, East Marion
SCTM#: 473889 Sec/Block/Lot: 31.-3-11.31
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
12/7/2018 pursuant to which Building Permit No. 43289 dated 12/7/2018
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:
electric for sign.
The certificate is issued to East Marion Fire District
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 43289 12/22/2018
PLUMBERS CERTIFICATION DATED
Authorized Signature
o��vFfai,r�o• TOWN OF SOUTHOLD
�� oy BUILDING DEPARTMENT
y TOWN CLERK'S OFFICE
oy_. o� 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#: 43289 Date: 12/7/2018
Permission is hereby granted to:
East Marion Fire District
PO BOX 131
East Marion, NY 11939
To: Electric for Sign
At premises located at:
9245 Route 25, East Marion
SCTM # 473889
Sec/Block/Lot# 31.-3-11.31
Pursuant to application dated 12/7/2018 and approved by the Building Inspector.
To expire on 6/7/2020.
Fees:
Total: $0.00
spector
pF SO!/T�®!
Town Hall Annex Telephone(631)765-1802
54375 Main Road CAR Fax(631)765-9502
P.O.Box 1179 Q
Southold,NY 11971-0959 .co • �o roger.richerti D-town.southold.ny.us
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To East Marion Fire District
Address: 9245 Rt 25 City: East Marion St: New York Zip: 11939
Building Permit#. 43289 Section: 31 Block. 3 Lot 11.31
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Nick Kersner Electric License No: 42972-ME
SITE DETAILS
Office Use Only
Residential Indoor X Basement X 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 Ceding 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 rl Switches 2 Twist Lock ri Exit Fixtures TVSS
Other Equipment: Install 2-20a circuits to manufactured front yard sign
Notes-
Inspector Signature: Date: December 112018
81-Cert Electrical Compliance Form.xls
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BUILDING DEPARTMENT-Electric I� D��
TOWN OF SOUTHOLD
Town Hall Annex - 54375 Main Road - B 179
Southold, New York 11971-0959 - 7 2018
Telephone (631) 765-1802 - FAX(631) 765-9502
DE PT.
roaer.richert& .town.soUthold.by.us�R,
-TOVN OF SOUTHO
APPLICATION FOR ELECTRICAL INSPECTION„
REQUESTED BY: 3rf;,�6 �oW Date:; 121-102,19-
Company
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Company Name: c—-� -Ida
Name: . /c e
License No.: _ �Z 97Z-�u-� email: !L
Address: 3fo 6 -
Phone No.: 1�2-3
JOB SITE INFORMATION: (All Information Required)
Name:
Address:
Cross Street:
Phone No.: --
BIdg.Permit#: �� email:
]Tax Map District: 1000 Section: 3 J Block: 3
BRIEF DESCRIPTION OF WORK(Please Print Clearly)
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Circle AII That Apply:
Is job ready for inspection?: YE / N Rough In :F:inal
Do you need a Temp Certificate?: YES N Issued On ,
;Temp Information: (All information required)
Service'Size .1 Ph 3 Ph Size: A #Meters _ Old Meter#
New Service- Fire Reconnect- Flood Reconnect- Service Reconnected - Underground -Overhead
#Underground Laterals 1 2 H Frame Pole Work done on Service?.
Additional Inform do cxAle.7 �c r e x
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WDA/Lea PAYMENT DUE WITH APPLICATION
82-Request for Inspection FormAs
BUILDING DEPARTMENT-Electric l-
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' TOWN OF SOUTHOLD DD
Town Hall Annex- 54375 Main Road
- 7 2018
Southold, New York 11971-0959
Telephone (631) 765-1802 - FAX(631) 765-9502
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TO WN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION ,
REQUESTED BY: 3ra'16 r _ Date:;
Company Name: o.� - P` _
Name: -
License No.: -
Atidress: mitts
Phone No.: -'
JOB SITE INFORMATION: (All Information Required)
Name: --
Address: 92¢� _Q•.� /lea - -
Cross Street: !
Phone No.:
BIdg.Permit#: . __ �. - email --- -
Tax Ma District: 1000 Section: ,31 Block:
BRIEF DESCRIPTION OF WORK(Please Print Clearly) l ss � e <<7' 'C.
Circle All That Apply:
Is job ready for inspection?: YE / NO, Rough InFi�a )
Do you need a Temp Certificate?: YESN Issued On , _
Temp Information: (All information required)
S&Wce Size 1 Ph 3 Ph Size: A #Meters Old Meter# -1/1*
New Service- Fire Reconnect- Flood Reconnect- Service Reconnected - Underground -Overhead
#--Underground Laterals 1 2 H Frame Pole Work done on Service? YN -
Ad`diti aI Inform io�
lea se�.�a �• ems// 2�6' f�77� - �/
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PAYMENT DUE WITH APPLI .A`IION
82-Request for Inspection FormAs