HomeMy WebLinkAbout43471-Z L-A=f- '
��o�guFfOl�C Town of Southold 3/4/2019
a P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40247 Date: 3/4/2019
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1640 Sterling Rd, Cutchogue
SCTM#: 473889 Sec/Block/Lot: 104.4-15
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
2/13/2019 pursuant to which Building Permit No. 43471 dated 2/13/2019
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:
electrical survey.
The certificate is issued to Gallagher,Daniel&Jennifer
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 43471 2/7/2019
PLUMBERS CERTIFICATION DATED
Authorized Signature
o�S� eoc�co TOWN OF SOUTHOLD
�� ay BUILDING DEPARTMENT
y z 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#: 43471 Date: 2/13/2019
Permission is hereby granted to:
Gallagher, Daniel
500 E 85th St#14H
New York, NY 10028
To: Electric
At premises located at:
1640 Sterling Rd, Cutchogue
SCTM # 473889
Sec/Block/Lot# 104.-4-15
Pursuant to application dated 2/13/2019 and approved by the Building Inspector.
To expire on 8/14/2020.
Fees:
ELECTRIC $85.00
Total: $85.00
B nspector
®F SOU��®l
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 ® �o roger.riche rtaa town.south old.ny.us
Southold,NY 11971-0959
C®Uf19�,�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To Daniel Gallagher
Address: 1640 Sterling Rd City: Cutchogue St. New York Zip: 11935
Building Permit#: 43471 Section: 104 Block: 4 Lot: 15
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: AS BUILT DBA: License No:
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service Only X
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey X Attic Garage
INVENTORY
Service 1 ph 200a Heat Duplec Recpt Ceding 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 FixturesTime Clocks
Disconnect 200a Switches Twist Lock rl Exit Fixtures TVSS
Other Equipment: "AS BUILT" "ELECTRICAL SURVEY" "NO VISUAL DEFECTS"
Notes. OK to re-connect existing 200a electrical service
Inspector Signature: V-,eDate: February 7 2019
81-Cert Electrical Compliance Form.xls
q SOUIyo�
# TOWN OF SOUTHOLD BUILDING DEPT.
°`ycourm,� 765-1802
INSPECTION
[ ] FOUNDATION 1ST ( ] ROUGH PLRG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
( ] CODE VIOLATION [ ] CAULKING
REMARKS:
A�
DATE INSPECTOR �Z
r
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BUILDING DEPARTMENT-Electrical Inspector
_ TOWN OF SOUTHOLD
�T r, Z'^ 7vibwn Hall Annex - 54375 Main Road - PO Box 1179
`'��0� ®'g�® Southold, New York 11971-0959
Telephone (631) 765-1802 - FAX (631) 765-9502
roger.richertcbtown:southold.ny.us
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: Date:
Company Name:
Name:
License No.: email:
Address:
Phone No.:
JOB SITE INFORMATION: (All Information Required)
Name: 0iqm ez- %Z-L-Iq6
Address: U2 L12L-/N ,*-,f o C 07-CH6 AA
Cross Street: l
Phone No.: - ri r "
Bldg.Permit#: email: ��'`r�EZ L Z�
Tax Map District: 1000 Section: Block: Lot:
BRIEF DESCRIPTION OF WORK(Please Print Clearly)
Circle All That Apply:
Is job ready for inspection?: E / NO Rough In Final
Do you need a Temp Certificate?: (YES/ NO 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
1#-Underground Laterals 1 2 H Frame Pole Work done on Service? Y N
Additional Information:
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PAYMENT DUE WITH APPLICATION
J\
B2-Request for Inspection Formals �� ��