HomeMy WebLinkAbout43613-Z �o��11EfOl,�earn Town of Southold 4/18/2019
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P.O.Box 1179
co 53095 Main Rd
Pyo! o�� Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40335 Date: 4/18/2019
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 2480 Minnehaha Blvd, Southold
SCTM#: 473889 Sec/Block/Lot: 87.-3-57
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore Sled in this office dated
4/4/2019 pursuant to which Building Permit No. 43613 dated 4/4/2019
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:
UNDERGROUD ELECTRIC SERVICE TO SHED
The certificate is issued to Osler, Scott&Julia
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 43613 04-10-2019
PLUMBERS CERTIFICATION DATED
Authorized Signature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
y 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#: 43613 Date: 4/4/2019
Permission is hereby granted to:
Osler, Scott & Julia
2335 Minnehaha Blvd
Southold, NY 11971
To: installation of 100a underground electric service.
At premises located at:
2480 Minnehaha Blvd, Southold
SCTM # 473889
Sec/Block/Lot# 87.-3-57
Pursuant to application dated 4/4/2019 and approved by the Building Inspector.
To expire on 10/3/2020.
Fees:
ELECTRIC $85.00
Total: $85.00
Buildi
so
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 �� r_oger.richert(c�town.southold.ny.us
Southold,NY 11971-0959 �®
BLTELDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Osler
Address: 2480 Minnehaha Blvd City: Southold St: New York Zip. 11971
Budding Permit#: 43613 Section 87 Block 3 Lot, 57
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor, DBA: Daniel Wilcenski Electric License No: 4723-ME
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 Attic Garage
INVENTORY
Service 1 ph 100a Heat Duplec Recpt Ceding 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 Fixtures Time Clocks
Disconnect 100a Switches Twist Lock Exit Fixtures TVSS
Other Equipment: 100a underground service to shed
Notes*
Inspector Signature: -____'� Date: April 10 2019
81-Cert Electrical Compliance Form As
OE SOUTyo6
# TOWN OF SOUTHOLD BUILDING DEPT.
couHr+ 765-1802
INSPECTION ,,
FOUNDATION 1ST [ ] ROUGH PLBG. p
[ ] 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:
zooms
DATE !� INSPECTORl-7(fPa'-lFZ2
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F014-�o BUILDING DEPARTMENT- Electrical Inspector
ay TOWN OF SOUTHOLD
Town Hall Annex - 54375 Main Road - PO Box 1179
�y,�O• ��o�� Southold, New York 11971-0959
Telephone (631) 765-1802 - FAX (631) 765-9502
roger.richert(cDtown.southold.ny.us
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY:`-,-Dr,— Date: 3 - i 2- - / 9
Company Name: QJ ev, s k• ee-t-ri C-
Name:
License No.: L4-7 2 3- m email:
Address: i- o . 30 Sou-r'L, ti l J t / 1
Phone No.: 31- 2-3 - (o )_ J'
JOB SITE INFORMATION: (All Information Required)
Name: z:s-u I`A- 0
Address: Aq F O yh, h,9 e-4/4-.A.4- -17lvc) 5'6 L-t-/e /J i-/ //47-7/
Cross Street: ►,n , r .� t, �,,� I„J .
Phone No.: 1 _ 3 . 6 2 P
Bldg.Permit#: q?-4n ` email: '-1/ �
Tax Map District: 1000 Section: S Block: `3 Lot:
BRIEF DESCRIPTION OF WORK(Please Print Clearly) , s 4-4 //,--) -Tti C-, -�
G .q ✓h c��c- o n S-el
Circle All That Apply:
Is job ready for inspection?: YE / NO Rough In in
Do you need a Temp Certificate?: 'ES'� NO Issued On
Temp Information: (All information required)
Service Size 1 P 3 Ph Size: JQ ° A #Meters l Old Meter#
New Service- Fire Reconnect- Flood Reconnect- Service Reconnected Undergroun Overhead
#Underground Laterals 1 2H Frame Pole Work done on Service? �D N
Additional Information:
PAYMENT DUE WITH APPLICATION
82-Request for Inspection Form.)ds � 1 `"