HomeMy WebLinkAbout44113-Z ����SUFfQI,fC Town of Southold 9/19/2019
g P.O.Box 1179
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Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40708 Date: 9/19/2019
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 44335 Route 25, Southold
SCTM#: 473889 Sec/Block/Lot: 75.-2-1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
8/30/2019 pursuant to which Building Permit No. 44113 dated 8/30/2019
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" 150a electric service panel, electric for washer and dryer and romex wiring_
The certificate is issued to Bauer,Jacqueline
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 44113 9/3/2019
PLUMBERS CERTIFICATION DATED
Authorized Signature
zV
FOL/re y TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
oy . SOUTHOLD, NY
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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#: 44113 Date: 8/30/2019
Permission is hereby granted to:
Bauer, Jacqueline
PO BOX 1084
Southold, NY 11971
To: as bit" 150a electric service panel, electric for washer and dryer-and rornex wiring.
At premises located at: S�-
44335 Route 25, Southold
SCTM # 473889
Sec/Block/Lot# 75.-2-1
Pursuant to application dated 8/30/2019 and approved by the Building Inspector.
To expire on 2/28/2021.
Fees:
ELECTRIC $180.00
Total: $180.00
Building Inspector
®�*pF SO(/ry®l
Town Hall Annex ~ O Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 G sea n.devlin(a)-town.Southold.ny.us
Southold,NY 11971-0959 �O
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: Jacqueline Bauer
Address. 44335 Route 25 City Southold St: NY zip: 11971
Building Permit#: 44113 Section. 75 Block. 2 Lot. 1
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor. DBA: AS BUILT License No:
SITE DETAILS
Office Use Only
Residential X Indoor X Basement X Service Only
Commerical Outdoor X 1st Floor X Pool
New Renovation 2nd Floor Hot Tub
Addition Survey X Attic Garage
INVENTORY
Service 1 ph X Heat Duplec Recpt 2 Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt 1 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 1 Emergency Fixtures Time Clocks
Disconnect Switches Twist Lock Exit Fixtures Combo SD/CO
Other Equipment ground rod and Coldwater ground
Notes "AS BUILT" "NO VISUAL DEFECTS"
Inspector Signature: Date: September 3, 2019
S.Devlin-Cert Electrical Compliance Form As
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# # TOWN OF SOUTHOLD BUILDING DEPT.
`ycourm, 765-1802
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) kA ELECTRICAL (FINAL) 5&iQvlC�
[ ] CODE VIOLATION [/ ] CAULKING
REMARKS:
:9WA,L. iL�CisTIZ! ► IUS� GT7DA1 r U�
DATE I Aa/ 1 INSPECTOR
I0C ,
NO— �
Of fat 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.richerl(abtown.southold.nVms
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: Date: 3 o 19
Company Name:
'Name:
License No.: email:
Address:
Phone No.:
JOB SITE INFORMATION: (All Information Required)
ID C MCE
Address: _ L - 3 3"S All A-1 dv 7ZZ AD P,-r- 2 5- SPU-R- L-',)
Cross Street: v ec og cc, L-P►J G
Phone No.: 571(0 —J-,-,L -77 L-Bs(,:c
Bldg.Permit#: L"{- ! I'j email:
Tax Map District: 1000- Section: `1 Block: oti Lot:
BRIEF DESCRIPTION .OF WORK (Please Print Clearly) I�vt.�k ✓ � �,`�cRfe
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Circle All That Apply:
Is job ready for inspection?: - YES NO Rough In, Final
Do you need a Temp Certificate?: YES / NO Issued On
Temp Information: (All information required)
Service Size 1 Ph 3 Ph Size: 17D A # Meters Old•Meter#
New Service - Fire Reconnect- Flood Reconnect- Service Reconnected - Underground - Overhead
J# Underground Laterals 1 2 H Frame Pole Work done on Service? Y N
Additional Information: ti�.a w+Q . �- edl PRf%
PAYMENT DUE WITH APPLICATION
Request for Inspection Form.xls VD
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