HomeMy WebLinkAbout43918-Z �O�SUFF04 CAG., Town of Southold 7/29/2019
3 P.O. Box 1179
o -
d' 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40562 Date: 7/29/2019
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 930 Park Way, Southold
SCTM#: 473889 Sec/Block/Lot: 70.40-42
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
6/28/2019 pursuant to which Building Permit No. 43918 dated 6/28/2019
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:
ELECTRIC SERVICE UPGRADE
The certificate is issued to Hayes,John&Jean
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 43918 07-29-2019
PLUMBERS CERTIFICATION DATED
Authorized Signature
Wit. `a TOWN OF SOUTHOLD
BUILDING DEPARTMENT
y TOWN CLERK'S OFFICE
oy • 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#: 43918 Date: 6/28/2019
Permission is hereby granted to:
Hayes, John
930 Park Way
Southold, NY 11971
To: Upgrade to electric service
At premises located at:
930 Park Way, Southold
SCTM # 473889
Sec/Block/Lot# 70.-10-42
Pursuant to application dated 6/28/2019 and approved by the Building Inspector.
To expire on 12/27/2020.
Fees:
ELECTRIC $85.00
Total: $85.00
Bui i ector
®��pF SO(/r�®l
Town Hall Annex ® Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 • �®� sean.devlin(a--)town.southold.ny.us
l�c®UNTI,�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: John Hayes
Address: 930 Park Way city:Southold st: NY zip: 11971
Building Permit#: 4391$ section: 70 Block. 10 Lot: 42
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
contractor: DBA: Daniel Wilcenski Electrical License No: 4723-ME
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 Survey X Attic Garage
INVENTORY
Service 1 ph X 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 Switches Twist Lock Exit Fixtures TVSS
Other Equipment: 42 Circuit panel, 2 Ground rods, Coldwater ground.
Notes
Inspector Signature: Date: July 29, 2019
S.Devlin-Cert Electrical Compliance Form.xls
13 C3 l
SOF SO�Ty (
# TOWN OF SOUTHOLD BUILDING DEPT.
°ycourm��' 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) [ ELECTRICAL (FINAL) l
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
DATE INSPECTOR
��1ff01 BUILDING DEPARTMENT-Electrical Inspector
TOWN OF SOUTHOLD
Town Hall Annex- 54375 Main Road - PO Box 1179
�y • � Southold, New York 11971-0959
Telephone (631) 765-1802 - FAX(631) 765-9502
roaer.richertO.town.southold.ny.us
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: Gj t c ��C is Date:^ (P . 7-7 -
Company
7 .Company Name: vr►
Name:
License No.: 2-'�_M email: w%k cc,s\Ci q:1 e,-*n c,,
Address:
Phone No.: (�3 ) , Z G • G ZS'�
JOB SITE INFORMATION: (Ail Information Required)
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Name: :n-0 1-% R V �-�
Address: o r IL ►e4,2 S u v B l
Cross Street:
Phone No.: G U
Bldg.Permit M email:
Tax Map District: 1000 Section: Block: Lot:
BRIEF DESCRIPTION OF WORK(Please Print Clearly)
Circle All That Apply:
Is job ready for inspection?: YES NO Rough In ina!
Do you need a Temp Certificate?: YES 1 NO Issued On.
Temp Information: (All information required)
Service Size 6h 3 Ph Size: ZD D 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
Addi
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U V1
JUN 2 8 2019 DMENT DUE WITH APPLICATION
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