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Home My WebLink About46520-Z �o�OSUFFa1KcoGy Town of Southold 3/21/2023 a P.O.Box 1179 o - �' 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 42287 Date: 8/26/2021 THIS CERTIFIES that the building ELECTRICAL Location of Property: 360 Bayview Dr.,East Marion SCTM#: 473889 Sec/Block/Lot: 37.4-1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 7/1/2021 pursuant to which Building Permit No. 46520 dated 7/1/2021 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 overhead electric service. The certificate is issued to Goleb Paul&Diane Revoc Trust of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 46520 7/1/2021 PLUMBERS CERTIFICATION DATED Authorized ignature TOWN OF SOUTHOLD BUILDING DEPARTMENT C, x TOWN CLERK'S OFFICE wo . 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#: 46520 Date: 7/1/2021 Permission is hereby granted to: Goleb Paul C Revoc Trust 203 Tschiffely Square Rd Gaithersburg, MD 20878 To: 200A Overhead electric service. At premises located at: 360 Bayview Dr., East Marion SCTM #473889 Sec/Block/Lot# 37.4-1 Pursuant to application dated 7/1/2021 and approved by the Building Inspector. To expire on 12/31/2022. Fees: ELECTRIC $85.00 Total: $85.00 ctor i so Town Hall Annex ® Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 ® sean.devlinCcD-town.southold.ny.us Southold,NY 11971-0959 .� a Own BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Goleb Paul C Revoc Trust Address: 360 Bayview Dr city:East Marion st: NY zip: 11939 Building Permit#: 46520 Section 37 Block- 4 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 X Commerical Outdoor X 1 st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey X Attic Garage INVENTORY Service 1 ph X Heat Duplec Recpt Ceiling Fixtures Bath Exhaust Fan Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors Main Panel 200A A/C Condenser Single Recpt Recessed Fixtures CO2 Detectors Sub Panel A/C Blower Range Recpt Ceiling Fan Combo Smoke/CO Transformer UC Lights Dryer Recpt Emergency Fixtures Time Clocks Disconnect Switches 4'LED Exit Fixtures Pump Other Equipment- Notes: quipmentNotes: " AS BUILT NO VISUAL DEFECTS " Service Inspector Signature: Date: July 1, 2021 S.Devlin-Cert Electrical Compliance Form rD o�'S'ffoUr BUILDING DEPARTMENT-Electrical Inspector y i TOWN OF SOUTHOLD oy�41 _V Town Hall Annex-54375 Main Road-PO Box 1179-Southol;d, NY 11971-0959 Telephone (631) 765-1802-FAX(631) 765-950 Temporary Certificate # 2 Date 2021 Customer Name Electrician Name Address AdMi&Af1hone 7.?j;-0 e-mail e-mail -L Phone License# 2—D Mf, Size -2,O ' A Phase Overhead Underground #of Meters Remarks /�� A 1'.0 1 V #of Underground Laterals 1 2 New "H" Frame or Pole H P Fire Reconnect Was work done on Service? Y/N Flood Reconnect Old Meter# Service Reconnected Application for electrical service equipment is on file with the town of Southold.On the applicant's notification that this installation is complete,the town will conduct a premises inspection of the service equipment. This verification is valid for 90 days from the date above. Authorized by r Suf � BUILDING DEPARTMENT-Electrical Inspector r��d ' G•y��t'� TOWN OF SOUTHOLD C= 2 5 2021 Town Hall Annex- 54375 Main Road - PO Box 1179 •- "T,�, Southold, New York 11971-0959 VNC DF.V1° lephone (631) 765-1802 - FAX (631) 765-9502 rogerr(aD-southoldtownnv.gov — sea nd@southoldtownnv.aov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: Company Name: Name: License No.: email: Phone No: ❑I request an email copy of Certificate of Compliance Address.: JOB SITE INFORMATION (All Information Required) Name: Pa,w( 4- 131a*tz (,o lt,6o Address: Soo 6a v�ejA) 'by, Cross Street: C.e.�-Ay Phone No.: 3,0% F(p Bldg.Permit#: 4� 5 Do email:Tax-Map District: 1000 Section: Block: LJ Lot: BRIEF DESCRIPTION OF WORK (Please Print Clearly) �rrl,u- J-Lg9 Check All That Apply: Is job ready for inspection?: ❑YES [D1G0 ❑Rough In [—]Final Do you need a Temp Certificate?: [VfYES ❑NO Issued On Temp Information: (All information required) Service Size ❑1_Ph ❑3 Ph Size: �-()O A # Meters Old Meter# ❑New Service ❑ Service Reconnect ❑ Underground Overhead #Underground Laterals-r-11 2 ❑H Frame Opole Work done on Service? ❑Y ❑N Additional Information: PAYMENT DUE WITH APPLICATION 00 -Illy -Illy coq Electrical Inspection Form 2020.xlsx