HomeMy WebLinkAbout47012-Z `tS11FFO� ,t Town of Southold
�4o11/13/2021
a P.O.Box 1179
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53095 Main Rd
�y�j01 �oo� Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 42531 Date: 11/13/2021
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1540 Smith Dr S, Southold
SCTM#: 473889 Sec/Block/Lot: 76.-3-5
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
1/1/1900 pursuant to which Building Permit No. 47012 dated 10/21/2021
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 underground electrical service.
The certificate is issued to Kustek,Paul&Joan
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 47012 10/21/2021
PLUMBERS CERTIFICATION DATED
Authorized Signature
TOWN OF SOUTHOLD
yy BUILDING DEPARTMENT
H 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#: 47012 Date: 10/21/2021
Permission is hereby granted to:
Kustek, Paul
743 Flowerdale Dr
Seaford, NY 11783
To: underground upgrade of 100 am service to 200 am service and new 200 am
g pg p p p panel.
At premises located at:
1540 Smith Dr S, Southold
SCTM # 473889
Sec/Block/Lot# 76.-3-5
Pursuant to application dated 1/1/1900 and approved by the Building Inspector.
To expire on 4/22/2023.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
rg so
Town Hall Annex ® Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 roger.richert(aD-town.south old.ny.us
Southold,NY 11971-0959 �° a
COU
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To, Paul Kustek
Address: 1540 Smith Dr S. City: Southold St: New York Zip: 11971
Budding Permit#. 47012 Section 76 Block 3 Lot. 5
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: REP Electric License No: 46288-ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service Only X
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph 200a Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel 200a A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks
Disconnect 200a Switches Twist Lock Exit Fixtures TVSS
Other Equipment Service up grade to 200a underground
Notes
Inspector Signature: Date: October 21 2021
81-Cert Electrical Compliance Form As
t
BUILDING DEPARTMENT-Electrical Inspector
�- TO4f'ttN OF SOUTHOLD
own Hall Annex - 54375 Main Road - PO Box 1179
Southold, New York 11971-0959
' \ 1� relephone (631) 755-1802 - FAX (631) 765-9502
ro er.richerta(,,touvn.southold.ny.us
4
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: RE--. O- �� I . Dater 2-2,3112,C l
Company Name: G '
Name:
License No.: v � email:-- �1�C 7� '�' <f- L � ,
Address: 17 fr��_! � s --
Phone No. 631 767 &t5i&
JOB SITE INFORMATION: (All Inforrnation Required)
Name:
Address: L U -f
Cross Street: M/'b X) 13A y Ut eu-1
Phone No.: C,,!T f 76- 7 60L!'_ - -
BIdg.Permit#: `"�- CS l�- �.. email: 2 I FCS r G I C lV\a►L
Tax Map District: 1000 Section: Block: Lot-
.5
BRIEF DESCRIPTION OF WORT{(Please Print Clearly)
Circle Ail That Apply: lv�� 2-o ° it-we
I'pe Y
Is job ready for inspection?: ° ES NCS Rough Infinal
Do you need a Temp Certificate?: YES ! Issued On
Temp Information". (All information required)
N
Service Size 1 P 3 Ph Size: 00_A #Nle.ters 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:
Il '
PAYMENT DUE WITH APPLI-CATION
OCT 2 12021
�a_a
BUILDING DEPT. -
82-FTAVJ9tQ'Fr V i{ xm As l00
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