HomeMy WebLinkAbout35570-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-34540 Date: 09/03/10
THIS CERTIFIES that the building UNDERGROUND ELECTRIC
Location of Property: 3155 PINE NECK RD SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 70 Block 6 Lot 19
Subdivision Filed Map NO. __ Lot NO. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 19, 2010 pursuant to which
Building Per~it NO. 35570-Z dated MAY 19, 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 UNDERGROUND ELECTRIC AS APPLIED FOR.
The certificate is issued to CHARLES C & PENNY P BURNHAM
(OWNER)
of the aforesaid building.
SUFFOLK COI~T~fDEPART~TrOFHEALTHAPPROVAL N/A
ELBt-rKICAL c~KTIFICATE NO. 35570 09/03/10
PLI~ERS CERTIFICATION DA'rKO N/A
Authorized Signature
Rev. 1/81
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
(THIS
BUILDING PERMIT
PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 35570 Z
Date MAY 19, 2010
Permission is hereby granted to:
CHARLES C BURNHAM
PO BOX 65
SOUTHOLD,NY 11971
for :
UNDERGROUND ELECTRIC SERVICE AS APPLIED FOR.
at premises located at 3155 PINE NECK RD SOUTHOLD
County Ta3~ Map No. 473889 Section 070 Block 0006 Lot No. 019
pursuant to application dated MAY 19, 2010 and approved by the
Building Inspector to expire on NOVEMBER 19, 2011.
Fee $ 85.00
AuthOrized Signature
ORIGINAL
Rev. 5/8/02
Town ttall Ampex
54375 Main Road
P.O. Box 1179
Tclcphonc (631) 765-1802
Lcx (631) 765-g502
ro.qer, richert~town.southold, ny. us
BUIIJ)ING I)EI)ARTMENT
TOWN OF $OUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Charles Burnham
Address: 3155 Pine Neck Rd City: Southold St: NY Zip: 11971
Building Permit #: Section: 70 Block: 6 Lot: 19
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Bright Side Electric License No: 3681-e
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
Servicelph ~ Heat ~ DuplecRecpt ~
Service 3 ph Hot Water GFCI Recpt
Main Panel NC Condenser Single Recpt
Sub Panel NC Biower Range Recpt
Transformer Appliances D~,er Recpt
Disconnect Switches Twist Lock
Other Equipment: 200a under 9round service
Ceiling Fixtures ~ HID Fixtures
Wall Fixtures I I Smoke Detectors
Recessed Fixtures~ CO Detectors
Fluorescent Fixture [~ Pumps
Emergency Fixture~._~ Time Clocks
Exit Fixtures [~ TVSS
Notes:
Inspector Signature:
Date: Aug 23 2010
81-Cert Electrical Compliance Form
05-13-10;13'.25 ;
Tom ~
~75 Mai.
P.O. Box 1179
Sou~d, ~ 11971~959
REQUESTED BY:
Company Name:
Name:
License No.:
Address:
Phone No.:
3310259
roger.~
BUILDING DKPARTM:KNT
"I'O~N O1~ SOUTHOI~
APPLICATION FOR ELECTRICAL INSPECTION
BLDG. DEPI',
TOWN OF SOUTHOLO --
eS - 53% ,x?6 ...............
JOBSITE INFORMATION: (*lndiates mquir~ info~ation)
*Address:
*Cross Street:
*Phone No.:
Permit No.:
Tax Map District: 1000 Section: '7 0 Block:
Lot:,
*BRIEF DESCRIPTION OF WORK (Please Print Cleady)
(Please Circle All That Apply)
*Is job ready for inspection:
*Do you need a Temp Cert~cate:
YES / I~
(~SO
Temp Informatlon~]
*Service Size: L~Phase_~ 3Ph.sa 100 150 G
*New Se~/ice: Re-connect ~..~deraround~ Number of Meters
Additional Information:
Rough In Final
300 350 400 Other
Change of Service Overhead
PAYMENT DUE WITH APPLICATION
82-Request~rlnspectionFown