HomeMy WebLinkAbout36294-ZTown of Southold Annex
54375 Main Road
Southold, New York 11971
4/6/2011
CERTIFICATE OF OCCUPANCY
No: 34887
Date: 4/4/2011
THIS CERTIFIES that the building
Location of Property:
SCTM #: 473889
Subdivision:
ELECTRICAL
520 Shore Dr, Southold, NY 11971,
Sec/Block/Lot: 80.-1-49.1
Filed Map No.
conforms substantially to the Application for Builffmg Permit heretofore
4/4/2011 pursuant to which Building Permit No.
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
36294 dated 4/4/2011
electric service upgrade & generator as applied for.
The certificate is issued to
Pearsall, Douglas & Pearsall, Benita
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIHCATE NO.
PLUMBERS CERTIFICATION DATED
36294 3/30/11
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 #: 36294
Permission is hereby granted to:
Pearsall, Douglas & Pearsall, Benita
1725 Oak Dr
Southold, NY 11971
Date: 414/2011
To:
electric service upgrade & generator as applied for.
At premises located at:
520 Shore Dr, Southold, NY 11971
SCTM # 473889
Sec/Block/Lot # 80.-1-49.1
Pursuant to application dated
To expire on 10/3/2012.
Fees:
4/4/2011
and approved by the Building Inspector.
ELECTRIC
Total:
$90.00
$90.00
Building Inspector
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, NY I 1971-0959
Telephone (631 ) 765-1802
Fax (63 I) 765-9502
ro.qer, richert~town.southo d ny us
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: D & B Pearsall
Address: 1725 Oak Dr City: Southold St: NY Zip: 11971
Building Permit #: Section: Block: Lot:
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: QC Electric License No: 3823-e
SITE DETAILS
office Use Only
Residential ~ Indoor ~ Basement ~ Service Only [~
Commerical Outdoor 1 st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 3 ph Hot Water GFCI Recpt
Main Panel NC Condenser Single Recpt
Sub Panel A/C Blower Range Recpt
Transformer Appliances Dryer Recpt
Disconnect Switches Twist Lock
Other Equipment:
switch
Notes:
Ceiling Fixtures ~ HID Fixtures
Wall Fixtures I I Smoke Detectors
Recessed Fixtures[~ CO Detectors
Fluorescent Fixture ~.~ Pumps
Emergency Fixtures~ Time Clocks
Exit Fixtures [~ TVSS
upgrade 200a service equipment, install 20 kw generator with automatic transfer
Inspector Signature:
Date: March 30 2011
81-Cert 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
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANI' PENETRATION
[ ] ELECTRICAL (ROUGH) ~ELECTRICAL (FINAL)
, \
REMARKS:
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, NY 11971-0959
Telephone (631) 765-1802
ax (631) 7 5
BUILDING DEPARTM~
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY:
Company Name:
Name:
License No.:
Date:
Address: /t ~ ,5(',,c ~/~'
Phone No.: Z~' ~gq ~ ~/~
JOBSITE INFORMATION: (*Indicates required information)
*Name: ~~ ~ ~~ ~
*Address: /~ ~D/~ ~.~ ~~
*Cross Street: ~/?~:~ ~Z ~ ~', ~ [ ~.
*Phone No.: ~(~._ /~c( ' ~~
Pe~it No.:
Tax Map District: 1000 Section: ~O
*BRIEF DESCRIPTION OF WORK (Please Pdnt Cleady)
· (Please Circle All That Apply)
*Is job ready for inspection:
*Do you need a Temp Certificate:
Temp Information (If needed]
*Service Size: 1 Phase
*New Service: Re-connect
Additional Information:
3Phase
YES / NO
~ES t NO
Rough In Final
100 C g) 300 350 400
Underground Number of Meters Change of Service
PAYMENT DUE WITH APPLICATION
t t
82.Request for Inspec~on Form