HomeMy WebLinkAbout47943-Z �o�g�FFOi Town of Southold 6/22/2022
a y� P.O.Box 1179
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53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 47875 Date: 6%22/2022
THIS CERTIFIES that the building ELECTRICAL
Location of Properly: 3720 S Harbor Rd, Southold
SCTM#: 473889 Sec/Block/Lot: 75.-8-2
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
6/9/2022 pursuant to which Building Permit No. 47943 dated 6/9/2022
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:
electric for ceiling fans. mini-split system removed)
The certificate is issued to Creecy, Susan&Ors.
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 47943 6/16/2022
PLUMBERS CERTIFICATION DATED
AS
Authorized Signature
�o�SUfF TOWN OF SOUTHOLD
ay BUILDING DEPARTMENT
x TOWN CLERK'S OFFICE
oy • o��%� SOUTHOLD, NY
s
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#: 47943 Date: 6/9/2022
Permission is hereby granted to:
Creecy, Susan
515 Park View Dr
Eldridge, IA 52748
To: Removing mini-split and ceiling fans
I
At premises located at:
3720 S Harbor Rd, Southold
SCTM #473889
Sec/Block/Lot# 75.-8-2
Pursuant to application dated 6/9/2022 and approved by the Building Inspector.
To expire on 12/9/2023.
Fees:
ELECTRIC $90.00
Total: $90.00
Building Inspector
o��OF SO(/r�ol
� o
Town Hall Annex Telephone(631)765-1802
54375 Main Road
P.O.Box 1179 �Q sean.devlinl.town.southold.ny.us
Southold,NY 11971-0959 QIyCOMM�,��`
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: Susan Creecy
Address: 3720 S Harbor Rd city:Southold st: NY zip: 11971
Building Permit#: 47943 Section: 75 Block: $ Lot: 2
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 1 st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey X Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt 1 Ceiling Fixtures Bath Exhaust Fan
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures CO2 Detectors
Sub Panel A/C Blower Range Recpt Ceiling Fan 2 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 " Removed Mini Split &Added Two Fans
Inspector Signature: Date: June 16, 2022
S.Devlin-Cert Electrical Compliance Form
/ oy�0hp `'l l 13 7 U vlJ fid
OE SOUL
* * TOWN OF SOUTHOLD BUILDING DEPT.
i!_� Ar•
coum, 631-765-1802
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) V ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O [ ] RE TAL /
REMARKS:
DATE INSPECTOR
c�uFF6 BUILDING DEPARTMENT- Electrical Inspector
TOWN OF SOUTHOLD
�� �� v v„ Town Hall Annex - 54375 Main Road - PO Box 1179
k%, ® � ovvN o�SCS 1 Pr�oL�' Southold, New York 11971-0959
Telephone (631) 765-1802 - FAX (631) 765-9502
rogerrRsoutholdtownny.gov - sea ndgsoutholdtownny.gov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All information Required) Date: (� 2 0 2 Z
Company Name:
Electrician's Name:
License No.: Elec. email:
Elec. Phone No: ❑I request an email copy of Certificate of Compliance
Elec. Address.:
JOB SITE INFORMATION (All Information Required)
Name: -5L--e- C-- �eL v
Address:
Cross Street:
Phone No.: j 72 G
Bldg.Permit#: - 5 email:
Tax Map District: 1000 Section: s Block: Lot:
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please... nt GIearly) 1
.220
Squa ' -Footage:
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[-11 PhF—]3 Ph Size: A # Meters Old Meter#
El New Service❑Fire Reconnect❑Flood Reconnect❑Service Reconnect[:]Underground❑Overhead
# Underground Laterals 1 2 H Frame Pole Work done on Service? Y N
Additional Information:
PAYMENT DUE WITH APPLICATION
(9 �q
PERMIT# Address:
Switches
Outlets
G FI's
Surface
Sconces
H H's
UC Lts
Fans H Fridge HW
Exhaust Oven Dryer
Smokes DW Service
Carbon Micro Generator
Combo Cooktop Transfer
AC AH
Mini
Special:
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