HomeMy WebLinkAbout43916-Z oPo�O'UFFQI'fC�?, Town of Southold
G 8/15/2019
g y P.O.Box 1179
53095 Main Rd
to Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40622 Date: 8/15/2019
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 37430 CR 48,Peconic
SCTM#: 473889 Sec/Block/Lot: 69.4-9.1
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. 43916 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:
electrical survey and 100a overhead electric service.
The certificate is issued to Sepenoski Jr, John
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 43916 7/16/2019
PLUMBERS CERTIFICATION DATED
ut o ' e Signature
�ooSaFfoa TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S 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#: 43916 Date: 6/28/2019
Permission is hereby granted to:
Sepenoski Jr, John
PO BOX 120
Peconic, NY 11958
To: Electrical Survey
At premises located at:
37430 CR 48, Peconic
SCTM # 473889
Sec/Block/Lot# 69.4-9.1
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
Building Inspector
®�*oF SO(/l�ol
Town Hall Annex ~ ® Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 v'
Southold,NY 11971-0959 • aOQ roger.riche rt(c-town.south old.ny.us
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To* john Sepenoski
Address: 37430 Rt 48 City: Peconic St: New York Zip: 11958
Building Permit#• 43916 Section. 69 Block 4 Lot: 9.1
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 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 100a Heat Duplec Recpt Ceiling 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- "AS BUILT" "ELECTRICAL SURVEY" "NO VISUAL DEFECTS"
Notes: 100a overhead service
Inspector Signature: Date: July 16 2019
81-Cert Electrical Compliance Form.xls
OF SOUIyo�
# TOWN OF SOUTHOLD BUILDING DEPT. Q
courm, 765-1802 Q(/�
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INSPECTION --
I
FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2ND [ ] INSULATION
C�
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
�Icc
DATE 14 INSPECTOR< �
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BUILDING DEPARTMENT- Electrical Inspector
TOWN OF SOUTHOLD
- x1179
�l � n Hall Annex - 54375 Main Road PO Bo
1 2019 Southold, New York 11971-0959
Telephone (631) 765-1802 - FAX (631) 765-9502
r
roger.richert@town.southold.nV.us
Ta�' 50,
AP KATION FOR ELECTRICAL INSPECTION
J n Date: G—
REQUESTED BY:
Company Name:
Name:
email:
License No.:
Address:
Phone No.:
JOB SITE INFORMATION: (All Information Required) �
Name: �� �` C5�uG Ar-,d f
Address: 3 W 3 a z
Cross Street:
Phone No.: 6` 31—
B[dg.Permit ,� p„ email:
Tax Map District: - `1000 Section: cL� -3 ,FF-9 Block:
BRIEF DESCRIPTION OF WORK(Please Print Clearly) /�� Cts Fav-fl —
1� V
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Circle All That Apply: �na
Is job ready for inspection?: E 1 NO Rough In
Do you need a Temp Certificate?: [ N Issued On
Temp Informations
information required)
Service Size
T Ph 3 Ph Size: = # Meters. Old Meter#
=NewService> Fire Reconnect- Flood Reconnect- Service Reconnected - Underground -Overhead
# Underground Laterals 1 2 H Frame Pole Work done on Service? Y N
Additional information' Ar AF
PAYMENT DUE WITH APPLICATION
82-Request for 1nspec(y0n Focm.x(s