Loading...
HomeMy WebLinkAbout36078-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34768 Date: 12/28/10 THIS CERTIFIES that the building ELECTRIC SERVICE CHANGE Location of Property: HEDGE ST FISHERS ISLAND (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 10 Block 7 Lot 27.9 subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 7, 2010 pursuant to which Building Permit No. 36078-Z dated DECEMBER 7, 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 OVERHEAD ELECTRIC SERVICE AS APPLIED FOR. The certificate is issued to GILBERT S & TRACEY W HANSE (OWNER) of the aforesaid building. SUFFOLK CO~NTYDEPART~T OF }~ALTHAPPROVAL N/A EI~t-rKICAL C~TIFICATH NO. 36078 12/16/10 PLUb~ERS C~KTIFICATION DA'r~u3 N/A Authorized Signature Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEP~TMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 36078 Z Date DECEMBER 7, 2010 Permission is hereby granted to: GILBERT S & TRACEY W KANSE 9 TIBURON LANE MALVERNE,PA 19355 for : ELECTRIC SERVICE CHANGE AS APPLIED FOR. at premises located at County Tax Map No. 473889 Section 010 pursuant to application dated DECEMBER Building Inspector to expire on JUNE HEDGE ST FISHERS ISLAND Block 0007 Lot No. 027.009 7, 2010 and approved by the 7, 2012. Fee $ 85.00 Authorized 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 in by typewriter or ink and submitted to the Building Department with the folloWing: A. For new building or new use: 1. Final survey °f pr°perry with aceurate 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 ofeleetrinal 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. $. 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 PI.arming Board Approval of completed site plan requirements. B; Fo[ existing buildings (prior to April 9, 1957) non_conforming uses, or buildings and .pre_existing,, land uses: I. Accuiate survey 0f pr0perty showing all property lines, streets, 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 denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy ~ New dwelling $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00, Switmning pool $50.00, Accessory building $50.00, Additions to accessory building $$0.00, 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, Comlnercial $1S.00 New Construction: Location of Property: Old or Pre-existing Building: House No. co OwnerorOwners0fmroperty:. ~--wi / ~w_~%~ .- Suffolk County Tax Map No 1000, Section Subdi~iSioa~..4v k~'~ c'~ permit No.. ~k.~©q ~ Date of Permit. Health Dept. Approval: Planning Board Approval: (check one) Street Filed Map. Applicant: Underwriters Approval: Hamlet Request for: Temporary Certificate Fee Submitted: $ ~x) (5~ Final Certificate: (check one) Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 Telephone (631 ) 765-1802 Fax (631) 765-9502 ro.qer, richert~.town southo d ny us BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION ssued To: Gil Hanse ~,ddress: 395 Hedge St City: Fishers Island St: NY Zip: 639¢ 3uilding Permit #: 36078 Section: 1 0 Block: 7 Lot: 27..c WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE 3ontractor: DBA: BD Electric License No: 35821-me SITE DETAILS Residential Commerical 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 Fool Renovation 2nd Floor Hot Tub Survey Attic Garage INVENTORY Hot Water GFCI Recpt NC Condenser Single Recpt NC Blower Range Recpt Appliances Dryer Recpt Switches Twist Lock Ceiling Fixtures [~ HID Fixtures Wall Fixtures J.~ Smoke Detectors Recessed Fixtures [~ CO Detectors Fluorescent Fixture [~ Pumps Emergency Fixtures[~ Time Clocks Exit Fixtures ~ TVSS Notes: change service from overhead to underground Inspector Signature: Date: Dec 16 2010 81-Cer[ Electrical Compliance Form Tram Ila[{ Anncx 5,1375 Mzin Road ILO. Box 1 I79 $oudm]d, NY 11971-0959 BUILDING DEPARTMENT TO%tN OF $OUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: 3ompany Name: Name: License No.: Address: Phone No.: JOBSITE INFORMATION: (*indicates required information) *Name: *Address: *Cross Street: *Phone No.: ~3r-¢, ~¢¢8 .-'~0¢/j5~ Permit No.: ~'~(.,,o~"] ~; Tax Map District: 1000 Section: Block: *BRIEF DESCRIPTION OF WORK (Please Print Clearly) (Please Circle All That Apply) *Is job ready for inspection: ~ NO Rough In (~inal% *Do you need a Temp Certifica[e: ~ NO Temp Information (I/~.~,~d} Size: ~Ph~/~3Phase 100 150 ~~300 350 400 Other *New Service: Re-connect ('Underground") Number of Meters ("Chan~e ot'~ Overhead Additional Information: PAYMENT DUE WiTH APPLICATION 82-Request for ,nspection Fo~ ~ ~ .~