HomeMy WebLinkAbout43896-Z g�yffOl C Town of Southold
7/21/2019
o� P.O.Box 1179
r 53095 Main Rd
'ao� `} Southold,New York 11971
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CERTIFICATE OF OCCUPANCY
No: 40532 Date: 7/21/2019
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 215 Northfield Ln, Southold
SCTM#: 473889 Sec/Block/Lot: 71.4-24
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
6/21/2019 pursuant to which Building Permit No. 43896 dated 6/21/2019
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 electric service and panel replacement.
The certificate is issued to Carbonara,John&Julie
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 43896 6/25/2019
PLUMBERS CERTIFICATION DATED
Authorized Signature
zaU-tp- TOWN OF SOUTHOLD
Fcot,r�& BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
vii a
"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#: 43896 Date: 6/21/2019
Permission is hereby granted to:
Carbonara, John
74 Smith St
Glen Head, NY 11545
To: Electric Service
At premises located at:
215 Northfield Ln, Southold
SCTM # 473889
Sec/Block/Lot# 71.-1-24
Pursuant to application dated 6/21/2019 and approved by the Building Inspector.
To expire on 12/20/2020.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspec or
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 G Q
® �® roper.riche rtatown.south old.ny.us
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: John Carbonara
Address: 215 Northfield Ln City: Southold St: New York Zip: 11971
Building Permit# 43896 Section 71 Block: 1 Lot: 24
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Brian Brooks Electric License No: 3613-E
SITE DETAILS
Office Use Only
Residential X Indoor X Basement X Service Only X
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Surrey 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 Fixtures Time Clocks
Disconnect 200a Switches Twist Lock Exit Fixtures 11 TVSS
Other Equipment: Replace 200a service panel
Notes:'
Inspector Signature: Date: June 25 2019
81-Cert Electrical Compliance Form.xls
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TOWN OF SOUTHOLD BUILDING DEPT.
Co - 765-1802 .
INSPECTION-
FOUNDATION
1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ]
FRAMING /STRAPPING [ ] FINAL
[ ]
FIREPLACE & CHIMNEY [ ] ,,FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) Jg�'J ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
DATE L Z INSPECTOR Q•
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BUIL I DEPARTMENT- Electrical Inspector
JUN 2 1 2019 """ TOWN OF SOUTHOLD
Town Hall Annex - 54375 Main Road - PO Box 1179
`� Southold, New York 11971-0959
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�tilO?� aOtt?�e (631) 765-1802 - FAX (631) 765-9502
roger.richertP-town.southold.ny.us
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: 2 Date: ; ly
Jri�ln �lro®�S
Company Name: �rl r-A n
Name: ����
License No.: t 3 email:
Address: PIS Env yank Aoq tt� '
Phone No.:
JOB SITE INFORMATION: (All Information Required)
Name: c j' �' �v��re--
Address:
Cross Street: tiSvl Cry.
Phone No.: d$, - (Da -5�
Bldg.Permit#: � �P email:
Tax Map District: 1000 Section: / Block: Lot:
BRIEF DESCRIPTION OF WORK(Please Print Clearly)
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1 .
1 Circle All That Apply:
Is job ready for inspection?: YE / NO Rough In Final
i
Do you need a Temp Certificate?: YES /0 Issued On I
Temp Information: (All information required)
Service Size 1 P 1 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: R&_.0lact °" �>a �� ' `�
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PAYMENT DUE WITH APPLICATION
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82-Request for Inspection Form.xls
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