HomeMy WebLinkAbout35635-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-34578 Rte: 09/24/10
THIS c~KTIFIES tkuat the buildin§ ELECTRIC SERVICE CHANGE
Location of Property: 5830 INDIAN NECK LA PECONIC
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 98 Block 5 Lot 16
Subdivision Filed Map No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 11, 2010 pursuant to which
Building Permit No. 35635-Z dated JUNE 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 UPGRADE ELECTRIC SERVICE FOR AN EXISTING BUILDING.
· ~ne certificate is issued to SEAGYAN CLUB INC
(OWNER)
of the aforesaid building.
SUFPI~I~( C~DI~qTYDEPAR~TOFf~ALTHAPPRO%KAL N/A
BLECLrKIC2%L CTERTIFICATH NO. 35635 09/01/10
PLIERS CERTIFICATION DA'i'~43 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
COMPLETION OF THE WORK AUTHORIZED)
FULL
PERMIT NO. 35635 Z
Date JUNE 11, 2010
Permission is hereby granted to:
for :
ELECTRIC SERVICE CHANGE
SEAGYAN CLUB INC
PO BOX 208
SOUTHOLD,NY 11971
FOR AN EXISTING BUILDING AS APPLIED FOR.
at premises located at 5830 INDIAN NECK LA PECONIC
County Tax Map No. 473889 Section 098 Block 0005 Lot No. 016
pursuant to application dated JUNE 11, 2010 and approved by the
Building Inspector to e~ire on DECEMBER 11, 2011.
Fee $ 85.00
AutHorized Signature
ORIGINAL
Rev. 5/8/02
Town Hail Annex
54375 Main Road
P.O. Box 1179
Southold, NY 11971-0959
Telephone (631) 765-1802
Fax (631) 765-9502
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
sued To: Seagyan Club
~,ddress: 5830 Indian Neck La City: Peconic St: NY Zip: 11958
3uilding Permit#: "~(~1"~" Section: 98 Block: 5 Lot: 1~
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
3ontractor: Stephen Albertson DBA: License No: 3494-me
SITE DETAILS
Residential ~ Indoor
Commedcal Outdoor
New Renovation
Addition Survey
Office Use Only
Basement ~ Service Only [~
1st Floor Pool
2nd Floor Hot Tub
Attic Garage
NVENTORY
Service 3 ph Hot Water GFCI Recpt
Main Panel NC Condenser Single Recpt
Sub Panel NC Blower Range Recpt
Transformer Appliances Dryer Recpt
Disconnect Swffches Twist Lock
Other Equipment:
Ceiling Fixtures R HID Fixtures
Wall Fixtures I I Smoke Detectors
Recessed Fixtures~ CO Detectors
Fluorescent Fixture ~.~ Pumps
Emergency Fixtures!~ Time Clocks
Exit Fixtures L._J TVSS
Notes: upgrade service, 100a overhead service
Inspector Signature:
Date: Sept I 2010
81-Cert Electhcal Compliance Form
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, NY 119714)959
Telephone (631) 765-1802
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY:
Company Name:
Name:
License No.:
Phone No.:
JOBSITE INFORMATION: ' (*Indicates required information)
*Name: --~----OLC.. ~ ~ ~--~_u~
*Address: ~;- ~'(")' ~-~ ~ ('"UL~ ~.~ I ~)~ ('~"~-~' ~ ~/~ ~'
*Cross Street:
*Phone No.:
Permit No.: "~ ~-~ -~_~'-
TaxaapDistdct: 1000 Section: ~[ ~ Block: ~ Lot:
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
(Please Circle All That Apply)
*Is job ready for inspection: ~'~-~ NO
*Do you need a Temp Certificate: NO R0 - '~E C ~E ~' -
Temp Information (If needed)
*Service Size: ~ 3Phase
*New Service: Re-connect Underground Number of Meters ~Cllan_~e'of ~~'~ead'
Additional Information: PAYMENT DUE WITH APPLICATION
82-Request for Inspection Form