HomeMy WebLinkAbout36864-ZTown of Southold Annex
54375 Main Road
Southold, New York 11971
CERTIFICATE OF OCCUPANCY
12/28/2011
No: 35369
Date: 12/28/2011
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 38640 Route 25, Orient,
SCTM #: 473889
Sec/Block/Lot: 15.-8-31.3
Subdivision: Filed Map No.
conforms substantially to the Application for Building Permit heretofore
! 2/7/201 l pursuant to which Building Permit No.
Lot No.
filed hi this officed dated
36864 dated 12/7/2011
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:
electric service change to underground
The certificate is issued to
Orestuk, Frederick & Orestuk, Marguerite
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
36864 12/09/2011
~Au~re
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, NY 11971-0959
Telephone (631) 765-1802
Fax (631) 765-9502
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
ssued To: Frederick R Orestuk Sr
~,ddress: 38640 Main Rd City: Orient St: NY Zip: 11957
]uilding Permit #: ',~ ~ (~:::~ q Section: J5 Block: ~ Lot: r,.~ l, 3
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
~,ontractor: DBA: Shore Electric License No: 46594-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
INVENTORY
Servicelph ~ Heat ~ DuplecRecpt ~
Service 3 ph Hot Water GFCI Recpt
Main Panel NC Condenser Single Recpt
Sub Panel NC Blower Range Recpt
Transformer Appliances Dh/er Recpt
Disconnect Switches Twist Lock
Other Equipment:
Ceiling Fixtures
Wall Fixtures
Recessed Fixtures
Fluorescent Fixture
Emergency Fixtures
Exit Fixtures
change overhead service to 150a underground service
HID Fixtures
Smoke Detectors
CO Detectors
Pumps
Time Clocks
TVSS
Inspector Signature:
Date: Dec 9 2011
81-Cert Electrical Compliance Form
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 #: 36864
Date:
12/7/2011
Permission is hereby granted to:
Orestuk, Frederick & Orestuk, Marguerite
38640 Route 25
Orient, NY 11957
To~
electric service change to underground
At premises located at:
38640 Route 25, Orient
SCTM # 473889
Sec/Block/Lot # 15.-8-31.3
Pursuant to application dated
To expire on 6/7/2013.
Fees:
12/7/2011
and approved by the Building Inspector.
Total:
$0.00
uilding Inspector
Town Hall Annex
54375 Main Road
P.O. Box 1179
&:)ua]old, NY 11971-0959
Telephone (631) 765-1802
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TOWN OF $O[/THOLD
.APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY:
Company Name:
Name:
License No.: '
Address:
Date:
Phone No.: ' - (DZ 4-
JOBSITE INFORMATION: (*Indicates required information)
*Name: ~Z~.T3~=.~_i°c_ V.,_ ~"~,., (~-.~__~'ST'~
*Address:
*Cross Street:
Block: ~ Lot:
*Phone No.:
Permit No.:
Tax Map District: 1000 Section: J_..%
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
(Please Circle All That Apply)
*Is job ready for inspectiOn:
*Do you need a Tamp Certificate:
'~¥ES-'/NO Rough In Final
YES / NO
Temp Information (If. needed) _
*Service Size: 1 Phase 3Phase 100 ~ 200 300 350 400 Other
*New Service: Re~'~-~ ,Underground~ ~Number of Meters Change of Service Overhead
Additional Informatio~ ...... PAYMENT DUE WITH APPLICATION
82~Request for Inspection Form