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Home My WebLink About35507-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34328 Date: 05/05/10 THIS u~aTIFIE$ that the building ELECTRIC Location of Property: 755 CEDAR DR SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map NO. 473889 Section 78 Block 7 Lot 39 subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 30, 2010 pursuant to which Building Permit No. 35507-Z dated APRIL 30, 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 UPGRADE TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to RUTH L PECK of the aforesaid building. ( OWNER ) SuFMOI~KCOI~TYDBP~/{77~TOF~ALTH~I~RO~-AL N/A ~CT~ICAL c~TIFICATH NO. 35507 04/29/10 PLD~ERS ~KTIFICATION DA'i'~.~ N/A Authorized Signature Rev. 1/81 Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 Telephone (631) 765-1802 · (631) 76 5 ro,qer, r chert~,t~w((n so6u~-1~5o(~(~.ny.us BUILDING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: ~ iJ{]~ ICeS ~[ Date: ~7/'-~ f.-/o Company Name: ~-~.~../~¢../~'(C~.r'/t~' ~[c¢..~-~v,.,~( ~-~--~-~-f-~-~ '~-~c. Name: License No.: Address: Phone No.: JOBSITE INFORMATION: (*Indicates required information) *Name:'~/' *Address: *Cross Street: *Phone No.: Permit No.: ~j~ Tax Map District: 1000 Block: 7 Lot:,~ *BRIEF DESCRIPTION OF ~D~RK (Please Print Clearly) (Please Circle All That Apply) *Is job ready for inspection: *Do you need a Temp Certificate: Temp Information (If needed] *Service Size: 1 Phase *New Service: Re-connect Additional Information: NO Rough In ~ 3Phase 100 150 (~ 300 350 400 Other Underground Number of Meters Change of Service ~'~ PAYMENT DUE WITH APPLICATION 82*Request for Inspection Form Town llall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 Tclcphonc ((331) 763-1802 Fax (631) 763-9502 rofler, richert~town.southold.ny.us BUILDIN(; 1)EPAI/TMI~;NT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION ssued To: Virgina Dietrich Address: 755 Cedar Lane City: Southold St: NY Zip: 11971 3uilding Permit #: '~O'~ Section:'~ Block: "~ Lot: "~ WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: Wilcenski Elec DBA: License No: 4723 SITE DETAILS Office Use Only Residential ~ Indoor ~ Basement ~ Service Only ~ Commerical Outdoor 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 3 ph Hot Water GFCI Recpt Main Panel NC Condenser Single Recpt Sub Panel A/C Blower Range Recpt Transformer Appliances Dryer Recpt Disconnect Switches Twist Lock Other Equipment: 200a over head service Ceiling Fixtures [~ HID Fixtures Wall Fixtures ~ Smoke Detectors Recessed Fixtures ~ CO Detectors Fluorescent Fixture ~ Pumps Emergency Fixtures~ Time Clocks Exit Fixtures ~ TVSS Notes: Inspector Signature: Date: April 29 2010 81-Cert Electrical Compliance Form FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 35507 Z Date APRIL 30, 2010 Permission is hereby granted to: VIRGINIA DIETRICH 755 CEDAR DRIVE SOUTHOLD,NY 11971 for : ELECTRIC UPGP~ADE TO AN EXISTING ONE FAMILY DWELLING. at premises located at County Tax Map No. 473889 Section 078 pursuant to application dated APRIL Building Inspector to expire on OCTOBER 755 CEDAR DR SOUTHOLD Block 0007 Lot NO. 039 30, 2010 and approved by the 30, 2011. Fee $ 85.00 / Authorized Signature ORIGINAL Rev. 5/8/02 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. 35507 Z Date APRIL 30, 2010 Permission is hereby granted to: VIRGINIA.DIETRICH 755 CEDAR DRIVE SOUTHOLD,NY 11971 for : ELECTRIC UPGP~ADE TO AN EXISTING ONE FAMILY DWELLING. at premises located at County Tax Map No. 473889 Section 078 pursuant to application dated APRIL Building Inspector to expire on OCTOBER 755 CEDAR DR SOUTHOLD Block 0007 Lot No. 039 30, 2010 and approved by the 30, 2011. Fee $ 85.00 ~~uthor~[gnature COPY Rev. 5/8/02 Form No. 6 TOW'N 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. Commercial building, industrial building, multiple 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, stroets, 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 dcnic& thc 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: Old or Pre-existing Building: ocationof?roperty: House- o. -- Street Owner or Owners ofProperty: (~-~.~'x /~- ]Q~-~C~ Suffolk County Tax Map No 1000, Section '-'~ ~ Block (check one) Hamlet Subdivision Permit No.'~- ~ Health Dept. Approval: Date of Permit. Filed Map. Applicant: Underwriters Approval: Lot: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ d P'~ Final Certificate: (check one) ApPlicant Signature