HomeMy WebLinkAbout43738-Z ��o�g11fF04�OGy Town of Southold 5/18/2019
3 P.O.Box 1179
o
C' 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40392 Date: 5/20/2019
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1945 Nokomis Rd, Southold
SCTM#: 473889 Sec/Block/Lot: 78.-3-37
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
5/14/2019 pursuant to which Building Permit No. 43738 dated 5/14/2019
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:
"as built"electrical survey.
The certificate is issued to Dawson,Todd
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 43738 5/16/2019
PLUMBERS CERTIFICATION DATED
Of J—Isnaz��z
Authorized Signature
TOWN OF SOUTHOLD
aa�gUfFU1,¢�,GG BUILDING DEPARTMENT
TOWN CLERKS 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#: 43738 Date: 5/14/2019
Permission is hereby granted to: r
Dawson, Todd
1945 Nokomis Rd
Southold, NY 11971
To: Electric Survey for PSEG
At premises located at:
1945 Nokomis Rd, Southold
SCTM # 473889
Sec/Block/Lot# 78.-3-37
Pursuant to application dated 5/14/2019 and approved by the Building Inspector.
To expire on 11/12/2020.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
so
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 ® �� roger.riche rt((-town.south old.ny.us
Southold,NY 11971-0959c®U '���
BUILDING DEPARTMENT
TOWN OF SOUTHOI.D
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To* Dawson
Address: 1945 Nokomas Rd City: Southold St- New York Zip: 11971
Building Permit#: 43738 Section 7$ Block- 3 Lot. 37
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 Surrey X Attic Garage
INVENTORY
Service 1 ph 200a Heat Duplec Recpt Ceiling 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 Fixture Time Clocks
Disconnect 200a Switches Twist Lock Exit Fixtures �] TVSS
Other Equipment, "AS BUILT" "ELECTRICAL SURVEY" "NO VISUAL DEFECTS"
Notes* OK to re-connect existing 200a overhead service
s_
Inspector Signature: - Date: May 16 2019
81-Cert Electrical Compliance Form.xis
OF SOUTyO�
# # TOWN OF SOUTHOLD BUILDING DEPT.
Own 765-1802
INSPECTION ,,
37
3�
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] 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:
�r�cw-
DATE INSPECTOR"'Of f
*pF SO(/Tyol
0
Town Hall Annex 1 [ Jxq Telephone(631)765-1802
54375 Main Road v, ,axx,(631)765- 5Q$
P.O.Box 1179 G� Q r0gerAchert(C�1own.SOUt�OIhy us
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD -
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED°BY: F ��-�j�� Date: '��
Company Name: >-
Name:
License No.:
Address: j�j S Gtr ULA
Phone No.:
JOBSITE INFORMATION: (*Indicates required information)
*Name: A? � /0;
V' I
*Address: �
*Cross Street: 1I1"ew
*Phone No.: �
Permit No.:
Tax Map District: 10001 Section: Block:— Lot:
*BRIEF DESCRIPTION OF WORK(Please Print Clearly)
(Please Circle All That Apply)
*Is job ready for inspection: §YES
! O R in Fina
AY- 1 4 2019
*Do-you need a Temp Certificate: / NO
Temp Information (if needed)
'Service Size: 1 Phase 3Phase 100 150 200 300 V"o 4000UT Other
'New Service: Re-connect Underground Number of Meters Change of Service Overh d
kdditional Information: PAYMENT DUE WITH APPLICATION
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YKyp
82-Request for Inspection Form
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