HomeMy WebLinkAbout45076-Z 'UL"
p�0 coG , Town of Southold 9/27/2020
P.O.Box 1179
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P 53095 Main Rd
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,rj0� app �? Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 41472 Date: 9/27/2020
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 875 S Harbor Rd, Southold
SCTM#: 473889 See/Block/Lot: 75.4-5
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
8/6/2020 pursuant to which Building Permit No. 45076 dated 8/6/2020
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"electric for existing accessory shed.
The certificate is issued to Lehr,Beverly
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 45076 9/15/2020
PLUMBERS CERTIFICATION DATED
Autho n'z'e'ZrSignature
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o�SUFFe�, o TOWN OF SOUTHOLD
BUILDING DEPARTMENT
H TOWN CLERK'S OFFICE
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y�o ao� 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)
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Permit#: 45076 I Date: 8/6/2020
Permission is hereby granted to:
Lehr, Beverly
PO BOX 85;1
Southold, NY 11971
To: Existing electrilc in shed
At premises located at:
875 S Harbor Rd, Southold
I
SCTM # 473889
1
Sec/Block/Lot# 75.4-5
Pursuant to applications dated 8/6/2020 and approved by the Building Inspector.
To expire on 2/5/2022.
Fees:
ELECTRIC $180.00
Total: $180.00
BuildQ Inspector
so
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
COW,
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: Beverly Lehr
Address: 875 S Harbor Rd city:Southold st: NY zip: 11971
Budding Permit#: 45076 Section: 75 Block: 4 Lot: 5
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 Service
Commerical Outdoor X 1st Floor X Pool
New Renovation 2nd Floor Hot Tub
Addition Survey X Attic Shed X
INVENTORY
Service 1 ph Heat Duplec Recpt 6 Ceding Fixtures 4 Bath Exhaust Fan
Service 3 ph Hot Water GFCI Recpt 2 Wall Fixtures Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures CO2 Detectors
Sub Panel X A/C Blower Range Recpt Ceiling Fan Combo Smoke/CO
Transformer UC Lights Dryer Recpt Emergency Fixture Time Clocks
Disconnect Switches 2 4'LED Exit Fixtures Pump
Other Equipment-
Notes* AS BUILT, NO VISUAL DEFECTS" Sub Panel and Wiring in Shed
Inspector Signature: Date: September 15, 2020
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S Devlin-Cert Electrical Compliance Form.xls
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* # TOWN OF SOUTHOLD BUILDING DEPT.
cou765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2ND [ ] INSULATIOWCAULKING r
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION , [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) kX ELECTRICAL (FINAL)
[ ] CODE VIOLATION [� PRE C/O
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REMARKS:
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DATE INSPECTOR
�oso 45074, 7s S k,4 all', l p�
# # TOWN OF SOUTHOLD BUILDING DEPT.
p`y�ourm ' 765-1802
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
-[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING/STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [A ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O Tre Cid
REMARKS:
VNAL, 9 CAL- /A/IMMA/
DATE 1S INSPECTOR
�O� �apE 50UTy�
# # TOWN OF SOUTHOLD BUILDING DEPT.
`yco 765-1802
- INSPECTION
[ ] FOUNDATION 1 ST [XROPLBG.
FOUNDATION 2ND [ TION/CAULKING
FRAMING /STRAPPING [
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY'INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
Okl by—.-
DATE
INSPECTOR
FO 1 BUILDING DEPARTMENT- Electrical Inspector
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TOWN OF SOUTHOLD
27 2020 Town Hall Annex - 54375 Main Road - PO Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1802 - FAX (631) 765-9502
d i' 'l• ! �t' t� Ccr�.southoldtownny;gov
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APPLICATION FOR ELECTRICAL INSPECTION ;
ELECTRICIAN INFORMATION (All information Required) Date:
Company Name: .r-- ' n
Name:
License No.: email:
Address:
Phone No.:
JOB SITE INFORMATION (All Information Required)
Name:
Address;x-75 So,r,�l� ur1„�
Cross Street:
Phone No.:
BIdg.Permit #: email; cAO�-�.sOc�sC��►u�rx,o, or�
Tax Map District: 1000 Section: `7S Block: Lot: S
BRIEF DESCRIPTION OF WORK (Please Print Clearly) µrj
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Circle All That Apply:
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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: 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:
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PAYMENT DUE WITH APPLICATION _ k
Request for Inspection Fornn,xls l V
l z BUILDING DEPARTMENT- Electrical Inspector
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TOWN OF SOUTHOLD
c 2 7 2020 Town Hall Annex - 54375 Main Road - PO Box 1179
Southold, New York 11971-0959
rVNG DEPT. Telephone (631) 765-1802 - FAX (631) 765-9502
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APPLICATION FOR ELECTRICAL INSPECTION _
TION (All Information Required) Date: �1-a' p�
� SAN I N FORMA _
ame:
ame: email:
No-:
fess:
ti .LN0.: ;
"ORMA, ION (AII Information Required)
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email:" QaA Section: `7S Block: Lot: S
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WORK (Please Print Cle6rl-y) . . �.�
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Circle All That =-
Is job ready fogy ii1 y= ' YES / NO. Roue In Fina)-A
Do you need a T §s::, YES / NO Issued On
Temp-Informath"' rrnatipn required)
Service Si_ tze: A # Meters Old Meter# `
- New Service - Fire'sLL "connect - Service Reconnected - Underground - Overhead.,
. # Underground Late e -Pole Work done on Service? Y -N -
Additional Informaf _
T 1D.UE WITH APPLICATION
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Request for Inspection Form:
PERMIT# Address:
Switches
Outlets
GFI's
Surface
Sconces
H H's
UC Lts
Fans Fridge HW
Exhaust Oven Dryer
Smokes DW Service
Carbon Micro Generator
Combo Cooktop Transfer
AC AH Mini
Special: l
Comments*
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