HomeMy WebLinkAbout35470-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-34271
Date: 04/14/10
THIS CERTIFIES that the tmilding ELECTRIC FOR BARN
Location of Property: 2050 MAIN RD L~UREL
(HOUSE NO.) (STREET) (HAMLET)
County Tax ~ap No. 473889 Section 125 Block 3 Lot 2.3
Subdivision Filed Map No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 12, 2010 pursuant to which
Building Permit No. 35470-Z dated APRIL 14, 2010
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 EXISTING BARN AS APPLIED FOR.
The certificate is issued to GIAN M MANGIERI
(OWNER)
of the aforesaid building.
SI~FFOLK COUNTY DEP~T~E~T OF HEALTH APPROV~J~ N/A
RT.~¢Li-KIC3~L U~TIFIf3%TH NO. 35470 04/12/10
PL~Ei~S U~TIFICATION DA'£~D N/A
Rev. 1/81
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUII/)ING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 35470 Z Date APRIL 14, 2010
Permission is hereby granted to:
GIA~ M MANGIERI
PO BOX 368
LAUREL,NY 11948
for :
ELECTRIC FOR EXISTING BARN AS APPLIED FOR.
at premises located at 2050 MAIN RD
County Tax Map No. 473889 Section 125
pursuant to application dated APRIL
Building Inspector to expire on OCTOBER
LAUREL
Block 0003 Lot No. 002.003
12, 2010 and approved by the
14, 2011.
Fee $ 125.00
horized Signature
ORIGINAL
Rev. 5/8/02
Towll Hall Annex
51375 Main Road
P.O. Box 1179
Soufl~old, NY l 1 .ti71-095g
Telephone (631) 76.5-18(Y2
l;:u~ ((531) 765-9502
ro.qer, richertC, town. so uthold.ny, us
BI ilLDING I)EPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
ssued To: Gian Mangieri
Address: 2050 Main Rd. City: Laurel St: NY Zip: 11948
Building Permit#: ~-{'"'~ Section: /~.~ Block: '~ Lot: ~,~)
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: James Murray DBA: Express Elec License No: 3653
SITE DETAILS
Office Use Only
Residential ~ Indoor ~ Basement ~
Commerical Outdoor 1st Floor
New Renovation 2nd Floor
Addition Survey Attic
INVENTORY
Servicelph ~ Heat ~ DuplecRecpt ~ Ceiling Fixtures ~s~.
Service 3 ph Hot Water GFCI Recpt Wall Fixtures
Main Panel NC Condenser Single Recpt Recessed Fixtures
Sub Panel NC Blower Range Recpt Fluorescent Fixture ~
Transformer Appliances Dryer Recpt Emergency Fixture
Disconnect Switches Twist Lock Exit Fixtures L_
Other Equipment:
GarageHotPoolService Tub Only
HID Fixtures
Smoke Detectors
CO Detectors
Pumps
Time Clocks
TVSS
1-50a welder recpticle, 16 ft track lighting
Inspector Signature:
Date: t~a_tt-- 14 - 7~fo
81-Cert Electrical Compliance Form
Towi~- Hall Annex
54375 Main Road
P.O. Box 1179
Southold, NY 11971-0959
Telephone (631) 765-1802
· _...V~ (631) 765-9502
roqer.r cnen~wgown.southord.ny.us
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
Company Name:
Name:
License No.:
Address:
Phone No.:
REQUESTED BY:
'j
Date: L~//'~//20 [iD
JOBSITE INFORMATION: (*Indicates required information)
*Address: _.._~"-f-~
*Cross Street: / ' ~
*Phone No.:
Permit No.:
Block:
Tax Map District: 1000 Section: I ~5
*BRIEF DESCRIPTION OF WORK (Please Print Cleady)
(Please Circle All That Apply)
*Is job ready for inspection:
*Do you need a Temp Certificate:
Temp Information (If neededl
*Service Size: 1 Phase
*New Service: Re-connect
Additional Information:
Y~ES) NO
YES / NO
Rough In
3Phase 100 150 200 300 350 400 Other
Underground Number of Meters Change of Service Overhead
PAYMENT DUE WITH APPLICATION
82-Request for Inspection Form
Town Hall Annex
54375 Main Road
P.O. Box 1179
Soulhold, NY 11971-0959
Telephone (631) 765-1802
Fax (631) 765-9502
ro,qer.dchert~town.southold.ny.us
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Gian Mangied
Address: 2050 Main Rd. City: Laurel St: NY Zip: 11948
3uilding Permit #: '~..~L~'"'~O Section: ~,,~ Block: ..~ Lot: c~,
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
3ontractor: James Murray DBA: Express Elec License No: 3653
SITE DETAILS
Residential
Commedcal
New
Addition
Service 1 ph
Service 3 ph
Main Panel
Sub Panel
Transformer
Disconnect
Other Equipment:
Office Use Only
Indoor ~ Basement ~ Service Only ~
Outdoor I st Floor Pool
Renovation 2nd Floor Hot Tub
Survey Attic Garage
INVENTORY
Hot Water GFCI Recpt
NC Condenser Single Recpt
NC Blower Range Recpt
Appliances Dryer Recpt
Switches Twist Lock
Ceiling Fixtures [~ HID Fixtures
Wall Fixtures ~ Smoke Detectors
Recessed Fixtures ~ CO Detectors
Fluorescent Fixture ~ Pumps
Emergency Fixture~_.~ Time Clocks
Exit Fixtures ~ TVSS
1-50a welder recpficle, 16 ft track lighting
Notes:
Inspector Signature:
81-Cert Electdcel Compliance Form
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or
topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead.
5. Commemial building, industrial building, inultiple residences and similar buildings and installations, a certificate
of Code Compliance from architect or engineer responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses:
1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic
features.
2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is
denied, the Building Inspector shall state the reasons therefor in writing to the applicant.
C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00,
Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Building- $100.00
3. Copy of Certificate of Occupancy- $.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
New Construction:
Location of Property:
House No.
Owner or Owners of Property: ~ 'l (k FX
Suftblk County Tax Map No 1000, Section
Subdivision
Old or Pre-existing Building:
Permit No. '~D~-D q "-}0 Date of Permit.
Street
loek
Filed Map.
Applicant:
(check one)
Hamlet
Lot
Lot:
Health Dept. Approval:
Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate:
Fee Submitted: $ ~x)'~
(check one)
Applicant Signature