HomeMy WebLinkAbout43646-Z ��q.�S�FFUIKCIO, Town of Southold 4/15/2019
P.O.Box 1179
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53095 Main Rd
�yfj�1 �ap� Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40317 Date: 4/15/2019
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 255 Sixth St, Laurel
SCTM#: 473889 Sec/Block/Lot: 126.-7-2
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
4/12/2019 pursuant to which Building Permit No. 43646 dated 4/12/2019
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 of"as built" service.
The certificate is issued to Kraebel Ahlers,Karen
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 43646 4/2/2019
PLUMBERS CERTIFICATION DATED
Authorized Signat e
SSUTOWN OF SOUTHOLD
hyo coat' BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
o s, 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#: 43646 Date: 4/12/2019
Permission is hereby granted to:
Kraebel Ahlers, Karen
255 6th St
Laurel, NY 11948
To: electrical survey of "as built" service.
At premises located at:
255 Sixth St, Laurel
SCTM # 473889
Sec/Block/Lot# 126.-7-2
Pursuant to application dated 4/12/2019 and approved by the Building Inspector.
To expire on 10/11/2020.
Fees:
t
ELECTRIC $90.00
Total: $90.00
Building Inspector
SO!/T�®l
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 � �
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Southold,NY 11971-0959 c®U '�,��`
BUII_DING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To- Karen Kraebel Ahlers
Address: 255 Sixth St City: Laurel St: New York Zip: 11948
Budding Permit#: 43646 Section- 126 Block: 7 Lot: 2
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Ftractor:7AS 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 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 Fixture Time Clocks
Disconnect 100a Switches Twist Lock Exit Fixtures TVSS
Other Equipment: "AS BUILT" "ELECTRICAL SURVEY" "NO VISUAL DEFECTS"
Notes: 100a overhead service
Inspector Signature: T"' Date: April 2 2019
81-Cert Electrical Compliance Form.xls
ho�aOF 50UT�O�
* # TOWN OF SOUTHOLD BUILDING DEPT.
765-1602
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
7
[ ] 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:
DATE INSPECTOR
FF�Xc UILDING DEPARTMENT- Electrical Inspector
TOWN OF SOUTHOLD
va
T Hall Annex - 54375 Main Road - PO Box 1179
2 5 2019 Southold, New York 11971-0959
�0 Telephone (631) 765-1802 - FAX (631) 765-9502
Y � � roger richertna town.southoid.ny.us
AOL&YA ION FOR ELECTRICAL INSPECTION
REQUESTED BY: f Date:
Company Name: I I
Name:
License No.: email:
Address:
Phone No.:
JOB SITE INFORMATION: (All Information Required)
Name: -
Address: �- S
Cross Street: 41-
Phone No.:
Bldg.Permit#: `���a email:
Lot:
Tax Map District: 1000 Section:
Block:
BRIEF DESCRIPTION OF WORK (Please Print Clearly)
C
Circle All That Apply=
YES 1 NO Rough In Fina(
Is job ready for inspection?.:
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
# Underground Laterals 1 2 H Frame Pole Work done on Service? Y N
Additional information:
PAYMENT DUE WITH APPLICATION
82-Request for Inspection Form As P 11
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