HomeMy WebLinkAbout36281-ZTown of Southold Annex
54375 Main Road
Southold, New York 11971
4/18/2011
CERTIFICATE OF OCCUPANCY
No: 34903
Date: 4/18/2011
THIS CERTIFIES that the building
Location of Property:
SCTM #: 473889
Subdivision:
ELECTRICAL
195 Clark Rd, Southold
Sec/Block/Lot: 51.-3-24
Filed Map No.
conforms substantially to the Application for Building Permit heretofore
1/1/1900 pursuant to which Building Permit No. 36281 dated 4/11/2011
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:
Lot No.
filed in this officed dated
Electric service repair due to fire damage.
The certificate is issued to
Thomson, Jay & Thomson, Mary
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
36281 4/11/11
Authorized Signature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, NY
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit #: 36281
Permission is hereby granted to:
Thomson, Jay & Thomson, Mary
PO BOX 467
Greenport, NY 11944
Date: 4/11/2011
To:
Electric service repair due to fire damage.
At premises located at:
195 Clark Rd
SCTM # 473889
Sec/Block/Lot # 51 .-3-24
Pursuant to application dated
To expire on 10/10/2012.
Fees:
1/1/1900
and approved by the Building Inspector.
ELECTRIC
Total:
$85.00
$85.00
Building Inspector
Town Hall Annex
54375 Main Road
P.O. Box I 179
Southold, New York I 1971-0959
Telephone (631 ) 765 1802
Fax (631) 765-9502
ro.qer, richert~town southold.ny.us
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
ssued To: Jay Thomson
Address: 195 Clark Road City: Southold St: NY Zip: 11971
3uilding Permit#: ,"~.~ ~),.~ I Section: 51 Block: 3 Lot: 2z
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
3ontractor: DBA: Roslak Electric License No: 3677-me
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
Service 3 ph
Main Panel
Sub Panel
Transformer
Disconnect
Other Equipment:
Heat
Hot Water
NC Condenser
NC Blower
Appliances
Switches
repair
INVENTORY
GFCI Recpt
Single Recpt
Range Recpt
Dryer Recpt
Twist Lock
Ceiling Fixtures ~
RWe~=~le ~ is~ ~ r; i; t u r e s [~
Fluorescent Fixture ~.~
Emergency Fixtures~
Exit Fixtures L
HID Fixtures
Smoke Detectors
CO Detectors
Pumps
Time Clocks
TVSS
of existing 100a overhead service, replace meter pan and feeders from
weather head to meter pan
Notes:
Inspector Signature:
Date: April 11 2011
81-Cert Electrical Compliance Form
BUILDING DEPARTMENT
APPLICATION FOR,ELECTRICAL INSPECTION
License No.:
~,ddress:
JOE[SITE INFORMATfON: (*tndicates required information)
Ta~ ~ ~ 1GOO ..... Section: ~, ~, Block: ..~ Lot:
*BRIEF DE,.RCRIP?ION OF WORK (.l.,~e Print Clearly) ~/-~. ~~
(Please Clinic All That Apply)
you r~eed ~ Temp Certt~cate:
YES ~
Temp Inl~n~at~on Ill ~
*,~l~Jce SJT..e; I Phase 3Phase 100
*New Service: Re-com~ect Underground
· /
150 200 300 350 400 Other
Number of Meters Change of SenSe Overhead