HomeMy WebLinkAbout43802-Z sU FF �l�cd�y Town of Southold 7/19/2019
M1 P.O.Box 1179
coo
x 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40515 Date: 7/19/2019
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 735 Park Way, Southold
SCTM#: 473889 Sec/Block/Lot: 70.41-14
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
5/28/2019 pursuant to which Building Permit No. 43802 dated 5/28/2019
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:
200a overhead electrical service.
The certificate is issued to Wienclaw,Theodore&Rita
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 43802 6/12/2019
PLUMBERS CERTIFICATION DATED
uthorized Signature
�gUFFD(�-coG
TOWN OF SOUTHOLD
moo y 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#: 43802 Date: 5/28/2019
Permission is hereby granted to:
Wienclaw, Theodore & Rita
12 Lamberson St
Valley Stream, NY 11580
To: new 200a overhead electrical service
At premises located at:
735 Park Way, Southold
SCTM #473889
Sec/Block/Lot# 70.-11-14
Pursuant to application dated 5/28/2019 and approved by the Building Inspector.
To expire on 11/26/2020.
Fees:
ELECTRIC $85.00
Total: $85.00
Bui n ector
pF SO(�j�®l
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 ® �Q roger.richertCaD-town.southold.ny.us
Southold,NY 11971-0959 C®U '�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Theodore Wienclaw
Address: 735 Park Way city,Southold st: New York zip: 11971
Building Permit#: 43802 Section: 70 Block: 11 Lot: 14
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Wilcenski Electric License No: 4723-ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement X Service Only
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey 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 FixtureTime Clocks
Disconnect 200A Switches Twist Lock Exit Fixtures 9 TVSS
Other Equipment- 200A Overhead Service
Notes:
Inspector Signature: Date: June 12, 2019
If
0-Cert Electrical Compliance Formas
UVV
fpl,�c BUILDING DEPARTMENT-Electrical Inspector
TOWN OF SOUTHOLD
Town Hall Annex - 54375 Main Road - PO Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1802 - FAX(631) 765-9502
roger.richerttown.southold.ny.us
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: ���ti I,U�l.ctk SKS Date: S- a�'
Company Name: i Lcr V�
Name:
License No.: q'7 .2 3 - wt F., email: r K; r(e�►.r�y! vo
Address: jq. o j3 v,, S q o--rA I °� ` I q 7 7
Phone No.: (031 - 6 S ZP6
JOB SITE INFORMATION: (All Information Required)
Name: 'T <i1�2✓
Address: 3 5 All-IL w.12
Cross Street:
Phone No.:
BIdg.Permit#: email:_
Tax Map District: 1000 Section: rl Block: Lot:
BRIEF DESCRIPTION OF WORK(Please Print Clearly)
Circle All That Apply:
Is job`ready for inspection?: *NO
NO Rough In Final
Do you need a Temp Certificate?: Issued On
t
nformation: (Ail information required)'ze 3 Ph Size: Zo,0 A #Meters_�_ Old Meter#
rvi - Fire Reconnect- Flood Reconnect- Service Reconnected -Underground Overhead
ground Laterals 1 2 H Frame Pole Work done on Service? Y N, ,
Additional Information:
PAYMENT DUE WITH APPLICATION
82-Request for Inspection Foran ids �I