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Home My WebLink About35765-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34500 Date: 08/11/10 11{IS c~TIFIES that the building ELECTRIC SERVICE UPGRADE Location of Property: 955 NORTH PARISH DR SOUTHOLD (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 71 Block 1 subdivision Filed Map No. Lot No. __ Lot 10 (HAMLET) conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 11, 2010 pursuant to which Building Pern~t No. 35765-Z dated AUGUST 11, 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 SERVICE UPGRADE AS APPLIED FOR. The certificate is issued to DAVID E & CHRISTINE R CZERNIECKI ( OWNER ) of the aforesaid building. S~FFOLKCO~YDEPART~TOF~EALT~APPRO~-AL N/A Er.Rt-rKICAL CERTIFICATE NO. 35765 08/11/10 PL~ CERTIFICATION Da'r~ N/A ~ Authorize~ Signature Rev. 1/81 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. 35765 Z Date AUGUST 11, 2010 Permission is hereby granted to: DAVID & CHRITINE CZERNIECKI 42 OAK PLACE BERNARDSVILLE,NY 07924 for : ELECTRIC SERVICE UPGRADE AS APPLIED FOR. at premises located at County Tax Map No. 473889 Section 071 Block pursuant to application dated AUGUST 11, 2010 Building Inspector to expire on FEBRUARY 11, 955 NORTH PARISH DR SOUTHOLD 0001 Lot No. 010 and approved by the 2012. Fee $ 85.00 ~uthorized Signature ORIGINAL Rev. 5/8/02 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled ia by typewriter or ink and submitted to the Building Department with the following: ,4. For new building or new use: ' 1. Final survey of property with accurate location of all buildings, pwperty lines, streets, and unusual natural or topographic features. 2. Final Appr°val from Health Dept. of water supply and sewerage-disposal (S.9 form). 3. Approval o f electrical iastallation fi'om Board of Fire Under~vriters. :.4' Sworn statement from.plumber c0ttifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commer°ial buildiag iadustrial building, muitiple residences and Similar buildings and iastallations, a Certifieate of Code Complian~ from architect or engineer responsible for the building. '6. Submit Planning Board Approval o f'6ompleted site plan requirements. B..For exlstingbuildings.(prior to April 9, 1957) non-eanforming uses~ or buildings nnd "pre.existing" land uses: 1. Accurate survey of Property showing all property lines, strects, buildiag 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. Certifieate 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. Certifieate of O~cupancy on Pre~existing Building - $100.00 3. Copy of Certifieate of Occupancy - $.25 4. Updated Certificate ofOceapancy - $50.00 5. Temporary Certifieate of Occupancy - Residential $15.00, Commercial $15.00 Date. INlew Construction: Old or Pm-existing Building: (check one) onofPro .. : (5< · . House No. Street Hamlet OWneror'OwnersofProperty:. Vi ~- qL ~Syr-l~ {/~ ~>~-~:~r~/~, · suffolk CoUnty Tax Map No 1000, Section Subdivision Permit No. ~D ~ ~7.~'- 'Date'0fPermit. Block. [ Lot Filed Map.... Lot: Applicant: Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ N% Underwriters Approval:, Final Certificate: (check one) ApPlicant Signature Town ttall Annex 31375 Main Road P.O. Box 1179 Soulhold, NY 11971-0959 Telei)honc (631) 76,5-1802 Fax (631) 765-9302 roger r chert~,town.southold.ny, us BI 7IL1)ING 1)EPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION ssued To: David Czerniecki ~ddress: 955 North Parish Dr. City: Southold St: NY Zip: 11971 3uildingPermit#: Section: q I B,oek: [ Lot: lb WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE ,3ontractor: DBA: East Bay Electric License No: 43662-me 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 1st Floor Pool Renovation 2nd Floor Hot Tub Survey Attic Garage INVENTORY Hot Water GFCl Recpt NC Condenser Single Recpt NC Blower Range Recpt Appliances Dryer Recpt Switches Twist Lock Ceiling Fixtures ~ Wall Fixtures ~.~ Recessed Fixtures ~.~ ; ~:rr;:~l;;t F~ix tXtu;rees~ Exit Fixtures L HID Fixtures Smoke Detectors CO Detectors Pumps Time Clocks TVSS Notes: service up grade only, change meter pan, main panel, and sub panel Inspector Signature: Date: Aug 11 2010 81 -Ced Electrical Compliance Form TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] RRE RESISTANT O0#STR~ ~].FIRE RESISTAFn' PENETRATION [ ] ELECTRICAL (ROUGH) ~:I.~ECTRICAL (FINAL) REMARKS: DATE INSPECTORShiP__ Town Hall Annex 54375 M~n Road P.O. Bor 1179 Southold, NY 11971-0959 Telephone (63t) 765-1802 ro~er.richertCa~o (~.~oTu~q~.n¥.u~ · . Bun.r~ING DEPARTMENT ' TOWN OF 8OUTHOLn APPLICATION FOR ELECTRICAL INSPECTION Date: ~ ~'/3'--/]0 JOBSITE INFORMATION: *Name: *Address: *Cross Street: *Phone No.: (*Indicates required information) Permit No.: Tax Map District: t000 Section: '-'7 I Block: *BRIEF DESCRIPTION OF WORK (Please Print Clearly) (Please Circle All That.~ply) *Is.job ready for inspection: .*Do you need a Temp Certificate: Lot: / 0 Temp.lnformation (If needed}. *Service SiZe: 1 Phase 3Phase 100 *New Service: Re-connect Underground Additional InfOrmation: 82-Request for InspectiOn Form ~NO YES/~) 350 150 ~ 300 Final Number of Meters Change of Service PAYMENT DUE WITH APPLICATIOI~ Rough In 400 Other