HomeMy WebLinkAbout43565-Z FfQd/ccoG� Town of Southold 4/18/2019
P.O.Box 1179
a -
�'' 53095 Main Rd
o4% � Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40337 Date: 4/18/2019
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 2390 The Long Way, East Marion
SCTM#: 473889 Sec/Block/Lot: 30.-2-122
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
3/18/2019 pursuant to which Building Permit No. 43565 dated 3/18/2019
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 SAFETY INSPECTION FOR PSEG
The certificate is issued to US Bank Trust NA
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 43565 03-29-2019
PLUMBERS CERTIFICATION DATED
Authorized Signature
o�SUFFotX�oG TOWN OF SOUTHOLD
BUILDING DEPARTMENT
W TOWN CLERK'S OFFICE
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#: 43565 Date: 3/18/2019
Permission is hereby granted to:
US Bank Trust NA
13801 Wireless Way
Oklahoma City, OK 73134
To: Electrical Inpsection for PSEG
At premises located at:
2390 The Long Way, East Marion
SCTM # 473889
Sec/Block/Lot# 30.-2-122
Pursuant to application dated 3/18/2019 and approved by the Building Inspector.
To expire on 9/16/2020.
Fees:
ELECTRIC $85.00
Total: $85.00
Build Inspector
pF SO�jj�,®l
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 ;4% �® _roger.richert(aD-town.Southold.nV.us
2�C®U01
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: US Bank Trust
Address: 2390 The`Long Way City. East Marion St: New York Zip: 11939
Building Permit#, 43565 Section. 30 Block- 2 Lot- 122
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
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 Fixtures Time Clocks
Disconnect 200a Switches Twist Lock Exit Fixtures 11 TVSS
Other Equipment. Safety inspection of residence per PSEG Long Island, OK to re-connect existing
200a service
Notes.
"AS BUILT" "ELECTRICAL SURVEY" "NO VISUAL DEFECTS"
Inspector Signature: - =_ --- Date: March 29 2019
81-Cert Electrical Compliance Form.xls
D
4ING DEPARTMENT-Electrical Inspector
MAR 18 2019 TOWN OF SOUTHOLD
Town Hall Annex-54375 Main Road-PO Box 1179
Southold, New York 11971-0959
TOWN OF SOUZ`iA, ephone (631-) 765-1802 - FAX(631) 765-9502
roger.6her1@town.,soUtho1d.1'y-qs
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: ;� C,YA.Ut� / Date: 2 1
Company Name: y
Name:
License No.: email:
Address:
Phone No.: t "3A
JOB SITE INFO � TION; (All lnfdrmabon,Required)
Name: - - Ck
Address: _ o S-Z'
Cross Street:
Phone No.:,
BIdg-Pennit-#. email:,
Tax Map pistrict: 1600 ' Section: Block; Lot:1
BRIT F QESGRIPTION OF WOW(Please P.dilfCleady)
Circle Aff Thiat Apply:
Is job ready forinspectron?: Q1 NO RoLigh In Finan
Do.yQu need a TernP C*lifirate?: YES/NO Issued On
tion required)
e: A #Meters+��Did Meter#
riect'-:Service Reconnected-Underground-Overhead
e- 'Pole Work:dong on Service? Y N
DUE WITH APPLICATION
1