HomeMy WebLinkAbout35963-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Mall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-34686 Date: 11/17/10
THIS C~KTIFIES that the building ELECTRIC SERVICE
Location of Property: 2000 NASSAU POINT RD CUTCHOGUE
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 104 Block 10 Lot 11
subdivision Filed ~p NO. Lot NO.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 21, 2010 purs-mmt to which
Building Permit NO. 35963-Z dated OCTOBER 21, 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 SERVICE AS APPLIED FOR.
The certificate is issued to KENNETH SEIFERTH
( OWNER )
of the aforesaid building.
SUFFOLK COI~TYDEPARTME~FTOF ~EALTHAP~ROVAL N/A
Rr~-£RICAL c~KTIFICATE NO. 35963 11/17/10
PLD~ERS CERTIFICATION DA'£~D N/A
~Au~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. 35963 Z
Date OCTOBER 21, 2010
Permission is hereby granted to:
KENNETH SEIFERTH
GARDEN CITY,NY 11530
for :
UNDERGROUND ELECTRIC SERVICE AS APPLIED FOR.
at premises located at
County Tax Map No. 473889 Section 104
pursuant to application dated OCTOBER
Building Inspector to expire on APRIL
2000 NASSAU POINT RD
CUTCHOGUE
Block 0010 Lot No. 011
21, 2010 and approved by the
21, 2012.
Fee $ 85.00
Authorized Signature
ORIGINAL
Rev. 5/8/02
Town 1 lall Aiiiicx
5~375 Main Road
P.O. Box 117!)
Southoh[, NY 115)71-0959
Tclcphonc (63 I) 76. kl 802
Fax (631) 765-9502
ro.qer, r chert~town.southold.ny.us
B[ IILI)ING I)IqPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Ken Seiferth
Address: 2000 Nassau Point Rd City: Southold St: NY Zip: 11971
3uildingPermit#:-'~,5o~L.¢~) Section: \[~))..~ Block: ~.[~) Lot: Il
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
3ontractor: DBA: BJ Electric License No: 2670-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
Service 1 ph 11100aI Heat
Service 3 ph ~ Hot Water
Main Panel NC Condenser
Sub Panel NC Blower
Transformer Appliances
Disconnect Switches
Other Equipment:
INVENTORY
GFCl Recpt
Single Recpt
Range Recpt
Dryer Recpt
Twist Lock
100a underground service
Ceiling Fixtures ~r--lJ~ HID Fixtures
Wall Fixtures I I Smoke Detectors
Recessed Fixturesl I CO Detectors
Fluorescent Fixture Pumps
Emergency Fixture Time Clocks
Exit Fixtures [~ TVSS
Notes:
Inspector Signature:
Date: Nov 17 2010
81-Cert Electrical Compliance Form
Town H~I Annex
54375 Main Road
P.O. Box 1179
Southold, NY 11971-0959
Telephone (631) 765-1802
ax (631) 7
ro.~er richertC~own.so~.n¥.us
IREQUESTED BY:
Company Name:
Name:
License No.:
BUILDING DEPARTMENT
TOWN OF $OUTHOLn
APPLICATION FOR ELECTRICAL INSPECTION
Date:
*Name:
*Address:
*Cress Street:
*Phone No.:
Address:
JOBSITE INFORMATION: (*lndi~tes required information)
Tax Map District:
1000 Section: / ~,~ Block: ] ¢-~ Lot:
*BRIEF DESCRIPTION OF WORK (Please Pdnt Clearly)
I
(Please Circle All That Apply)
*Is job ready for inspection:
*Do you need a Temp Certificate:
Temp Information (If needed}
*Service Size: ~ ~ 150 200
*New Service: Re-connect~Underground~ Number of Meters
Additional Information:
Rough In
300 350 400
Change of Service
PAYMENT DUE WITH APPLICATION
Final
Other
Overhead
82~Request for Inspection Form