HomeMy WebLinkAbout36716-ZTown of Southold Annex
54375 Main Road
Southold, New York 11971
CERTIFICATE OF OCCUPANCY
9/27/2011
No: 35238
Date:
9/16/2011
THIS CERTIFIES that the building
Location of Property:
SCTM #: 473889
Subdivision:
ELECTRICAL
650 Old Shipyard Rd, Southold,
Sec/Block/Lot: 64.-2-44
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
9/27/2011 pursuant to which Building Permit No. 36716 dated 9/27/2011
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:
overhead electric service upgrade
The certificate is issued to
Salup, Mami & Rubin, Stephanie
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
36716 9/16/11
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 #: 36716
Permission is hereby granted to:
To:
Date: 9/27/2011
Salup, Marni & Rubin, Stephanie
403 W 21st St
New York, NY 10011
overhead electric service upgrade
At premises located at:
650 Old Shipyard Rd, Southold
SCTM # 473889
Sec/Block/Lot # 64.-2-44
Pursuant to application dated
To expire on 3/28/2013.
Fees:
9/27/2011
and approved by the Building Inspector.
ELECTRIC
Total:
$85.00
$85.0O
Building Inspector
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, NY 11971-0959
Telephone (631 ) 765-1802
Fax (631 ) 765-9502
rofler, richert~town.southold.nv.us
BUILDING DEPARTMENT
TOWN OF' SOUTItOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
ssued To: Salup/Rubin
~,ddress: 650 Old Shipyard La City: Southold St: NY Zip: 11971
Permit#: "~ ~'-'~ I ~ ~ Section: 64 Block: 2 Lot: 44
3uilding
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
3ontractor: as built DBA: License No:
SITE DETAILS
Residential ~ Indoor
Commerical Outdoor
New Renovation
Addition Survey
Service 1 ph ~ Heat
Service 3 ph ~ Hot Water
Main Panel NC Condenser
Sub Panel NC Blower
Transformer Appliances
Disconnect Switches
Other Equipment: 200a overhead service upgrade
Office Use Only
[~ Basement ~] Service Only ~
1st Floor Pool
2nd Floor Hot Tub
Attic Garage
INVENTORY
~ DuplecRecpt ~ Ceiling Fixtures ~ HID Fixtures ~b__J~
GFCI Recpt Wall Fixtures U Smoke Detectors
Single Recpt Recessed Fixtures CO Detectors
Range Recpt Fluorescent Fixture Pumps
Dryer Recpt Emergency Fixture Time Clocks
Twist Lock Exit Fixtures II TVSS
Notes:
Inspector Signature:
Date: Sept 16 2011
81-Cert Electrical Compliance Form
Town Hall Annex Telephone (631) 765-1802
· (631) 765~ 50
5',37,~ Ma~ Road ro.qer nchert~,,i~wn soui~oi~d ny.us
P.O. Box 1179 '
Southold, NY 11971-0959
-- ~ TOWN OF $OUTHOLD ~ 1 ~ 4
/~~~AT[ON FOR ELECTRICAL INSPECTION ~-~/.~_> ~
REQUESTED BY:
Date:
Company Name:
Name:
License No.:
Address:
Phone No.:
JOBSITE INFORMATION: (*Indicates required information)
'Name: ,~R (-3. / ~z~,/.~
*Address: ~,~3 ~fl-4% ~ & (~o ?¢'/¢7_~) L~
*Cross Street:
*Phone No.:
Permit No.: ~~ ,~?c~.~ ~ /2j~.~)
Tax Map District: 1000 Section: /or-J~ t Block:
*BRIEF DESCRIPTION OF WORK (Please Pdnt Cleady)
Lot:
(Please Circle All That Apply)
*Is job ready for inspection:
*Do you need a Temp Certificate:
YES / NO Rough In
YES / NO
Final
Temp Information (1~]
*Service Size: (,~P~,~ 3Phase 100 150(2.~) 300 350 40,,~__D_~__.~,r
*New Service: R~:connect Underground Number o~eters Change of Servic(e' Overhead
PAYMENT DUE WITH APPLICATION----_..
Additio"hal Information.~,, /'
82-Request for Ingpection Form