HomeMy WebLinkAbout46835-Z s�SUFFoc`��,
�0�0 1pGy Town of Southold 10/9/2021
P.O.Box 1179
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yfj0 ao�} Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 46835 Date: 10/9/2021
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1185 Minnehaha Blvd., Southold
SCTM#: 473889 See/Block/Lot: 87.-3-21
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
9/16/2021 pursuant to which Building Permit No. 46835 dated 9/16/2021
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:
200 amp electric service.
The certificate is issued to Martin,Albin&Kathie
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 46835 9/28/2021
PLUMBERS CERTIFICATION DATED
4
Authorized Signature
�o�suFFoc,��oTOWN OF SOUTHOLD
ay BUILDING DEPARTMENT
y x TOWN CLERK'S OFFICE
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#: 46835 Date: 9/16/2021
Permission is hereby granted to:
Martin, Albin
61 Euclid Ave
Massapequa, NY 11758
To: 200A electric service upgrade.
At premises located at: ,
1185 Minnehaha Blvd., Southold
SCTM #473889
Sec/Block/Lot# 87.-3-21
Pursuant to application dated 9/16/2021 and approved by the Building Inspector.
To expire on 3/18/2023.
Fees:
ELECTRIC $85.00
Total: $85.00
Bui ing Inspector
Town Hall Annex -,Y;° Telephone(631)765-1802
54375 Main Road
P.O.Box 1179 t sean.deviin(cciltown.southold.ny.us
Southold,NY 11971-0959 :.
COU
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: Albin Martin
Address: 1185 Minnehaha Blvd city Southold st: NY zip: 11971
Building Permit#: 46835 Section: 87 Block 3 Lot 21
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Only Solutions Electric License No- 59161 ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service X
Commerical Outdoor X 1 st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey 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 200A Switches 4'LED Exit Fixtures 11 Pump
Other Equipment: Meter Main Disconnect 200A, 200A Panel 40 Circuit/ 11 Used
Notes: New Service
Inspector Signature: Date: September 28, 2021
S Devlin-Cert Electrical Compliance Form
laf S0(/lyo� 1 Al [MV 4-ItA-
TOWN OF SO THOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND - - [ ] INSULATION/CAULKING
[ ] FRAMING/STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ Y] FIRE-SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION =
[ ] ELECTRICAL (ROUGH) kb ELECTRICAL (FINAL)
[ ] CODE VIOLATION ] PRE C/O
REMARKS:
fj� /v 3T v
DATE q, INSPECTOR
V�
S„, BUILDING DEPARTMENT- Electrical Inspector
TOWN OF SOUTHOLD
o -,I own Hall Annex- 54375 Main Road - PO Box 1179
Southold, New York 11971-0959
V 5011- Telephone (631) 765-1802 - FAX (631) 765-9502
D rogerr(cD-southoldtownny.gov - sea nd(aD-southoldtownny.aov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date:
Company Name: b7JL4 S1J1_ilJ71�rNS
Name: AVOYL:-w RVI A
License No.: email: ��,ny s��.. 9�.zs 17L
Phone
® yyyt�,� a,n,
Phone No: -di request an email copy of Certificate of Compliance
Address.: 1 �O /Vo L 1byLz-vV C�L�T L��1a3 N`1 11�Zo
JOB SITE INFORMATION (All Information Required)
Name: AL M:AA:T-r-J
Address: 11..8�s' Lb N\1 -1
Cross Street: 01 XS
PhoneNo.:
BIdg.Permit#: , 3rj email:
m
Tax Map District: 1000 Section: g 17 Block: 3 Lot: a
BRIEF DESCRIPTION OF WORK (Please Print Clearly) `3--�'4 �}��p S`�QJ�(L C)1
14
Check All That Apply:
Is job ready for inspection?: [ YES ❑NO ❑Rough In Final
Do you need a Temp Certificate?: ❑YES FjNO Issued On
Temp Information: (All information required)
Service Size ❑1 Ph ❑3 Ph Size: A # Meters Old Meter#
❑New Service ❑ Service Reconnect ❑ Underground []Overhead
# Underground Laterals ❑1 ❑2 ❑H Frame ❑Pole Work done on Service? ❑Y ❑N
Additional Information: >
PAYMENT DUE WITH APPLICATION
.o VY-
Electrical Inspection Form 2020.xlsx V
PERMIT# Address:
Switches
Outlets
G F I's
Surface
Sconces
H H's
UC Lt"s
Fans x ukzu_ „ _,- Tridge, _. ..,_ 'HW r..
Exhaust Oven W/D
_Smokes .�.��..`�,. _•_J_, *- _ + ,..�__ },DW ;.. MiniV
- �� t_,_.
Carbon ... r = , : "Micro'" ,__, r Generafor,-
Combo_ _ ..__ . _; _ ...,, __ 'Cooktop -. ,.-- ._. W r Transfer
AC AH Hood Service
Amps ' ' Have ,-Used`
Special: "2 aw
,
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