HomeMy WebLinkAbout36493-ZTown of Southold Annex
54375 Main Road
Southold, New York 11971
6/20/2011
CERTIFICATE OF OCCUPANCY
No: 35005
Date: 6/20/201 l
THIS CERTIFIES that the building
Location of Property:
SCTM #: 473889
Subdivision:
ELECTRICAL
62253 CR 48, Greenport,
Sec/Block/Lot: 40.-1-4
Filed Map No.
conforms substantially to the Application for Building Permit heretofore
6/20/2011 pursuant to which Building Permit No. 36493
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
dated 6/20/2011
underground electric service upgrade.
The certificate is issued to
Grzesik, Stefan & Grzesik, Norma
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
36493 6/17/11
~uthorized Signatur~
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 #: 36493
Date: 6/2012011
Permission is hereby granted to:
Grzesik, Stefan & Grzesik, Norma
62253 CR 48
Greenport, NY 11944
To:
underground electric service upgrade.
At premises located at:
62253 CR 48, Greenport
SCTM # 473889
Sec/Block/Lot # 40..1.4
Pursuant to application dated
To expire on 1211912012.
Fees:
6/20/2011
and approved by the Building Inspector.
ELECTRIC
Total:
$85.00
$85.00
Building Inspector
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631 ) 765-1802
Fax (63 I) 765-9502
rofler, richert~town.southold.n¥.us
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
ssued To: Stephen Grzesil
~ddress: 62253 Rt 48 City: Greenport St: NY Zip: 1194,~
3uilding Permit #: '~, 14 Oj ~.) Section: ,J"j 0 Block: / Lot: L~
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
3ontractor: service only DBA: License No:
SITE DETAILS
Office Use Only
Residential ~~] Indoor ~ Basement ~ Se~iceOnly ~
Corn medcal Outdoor 1st 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 Pane[ NC Blower Range Recpt
Transformer Appliances Dryer Recpt
Disconnect Switches Twist Lock
Other Equipment: 100a underground service upgrade
Ceiling Fixtures ~1 HID Fixtures
Wall Fixtures ~ Smoke Detectors
Recessed Fixture! I I CO Detectors
Fluorescent Fixture[~ Pumps
Emergency Fixturesl.~ Time Clocks
Exit Fixtures L__l TVSS
Notes:
Inspector Signature:
Date: June 17 2011
81-Cert Electrical Compliance Form
INSPECTION
[ ] FOUNDATION 1ST
[ ] FOUNDATION 2ND
[ ] FRAMING / STRAPPING
[ ] FIREPLACE & CHIMNEY
ROUGH PLBG.
INSULATION
FINAL
FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [~ELECTRICAL (FINAL)
REMARKS:
DATE
I NSPECTORC~~-
Town Hall Annex Telephone (68I) 765-1809
54375 Main Road
P.O. Box 1179 roger, richertdt~w(~n !s) o7 u~gcJ(~.ny, us
Southold, NY 11971-0959
SOUT OLn
~ APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY:
Company Name:
Date:
Name:
License No.:
Address:
No.:
JOBSITE INFORMATION:
*Name:
*Address:
*Cross Street:
*Phone No.:
Permit No.:
(*Indicates required information)
77-
Tax Map District: 1000 Section:
*BRIEF DESCRIPTION OF WORK (Plea_se Pdnt Cleady)
Block: Lot:
(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:
YES / NO Rough In
YES / NO
Final
3Phase~ 150 200 300 350 400 Other
Change of Service Overhead
U~Number of Meters
PAYMENT DUE WITH APPLICATION
82-Request for Inspection Form