HomeMy WebLinkAbout37059-ZTown of Southold Annex
P.O. Box 1179
54375 Main Road
Southold, New York 11971
CERTIFICATE OF OCCUPANCY
3/12/2012
No: 35486
Date: 3/12/2012
THIS CERTIFIES that the building
Location of Property:
SCTM #: 473889
Subdivision:
ELECTRICAL
1115 Main Bayview Rd, Southold,
Sec/Block/Lot: 70.-8-2
Filed Map No.
conforms substantially to the Application for Building Permit heretofore
3/12/2012 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
37059 dated 3/12/2012
Electrical Upgrade
The certificate is issued to
Custer Institute
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
37059 03/07/2012
Authortzed 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 #: 37059
Permission is hereby granted to:
Custer Institute
PO BOX 1204
Southold, NY 11971
Date: 3/1212012
To:
Electrical Upgrade
At premises located at:
1115 Main Bayview Rd, Southold
SCTM # 473889
Sec/Block/Lot # 70.-8-2
Pursuant to application dated
To expire on 9/1112013.
Fees:
3/1212012
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 11971-0959
Telephone (631 ) 765~ 1802
Fax (631) 765-9502
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BUILDING DEPARTMENT
TOWN O1* SOUTI-IOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
issued To: Custer Institute Inc
Address: 1115 Main Bayview Road City: Southold St: NY Zip: 11971
Building Permit #: Section: 70 Block: 8 Lot:
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: License No:
SITE DETAILS
Office Use Only
Commerical Outdoor 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Su~ey Attic Garage
INVENTORY
Servicelph ~ Heat ~ DuplecRecpt ~
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:
Ceiling Fixtures ~ HID Fixtures
Wall Fixtures ~ Smoke Detectors
Recessed Fixtures ~ CO Detectors
Fluorescent Fixture ~ Pumps
Emergency Fixtures~ Time Clocks
Exit Fixtures ~ TVSS
electrical alterations to existing building, 1 sub panel and 4 recpticles in telescope
room
Notes:
Inspector Signature: '"~~
Date: March 7 2012
81-Cert Electrical Compliance Form.xls
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BE~LnING DEPARTMENT
TOWN OF $OUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY:
Company Name:
Name:
License No.:
Address: -~5 ~/ 7~,~"f.-~ .~6-'-~_
Phone No.: /~/- ~ - 5 ~'2 ~
JOBSITE INFORMATION: (*Indicates required information)
*Address: ///~ ~/~ ~ r~' ~
*Cross Street: ~/PC ~¢ ~ /~
*Phone No.: ~?/_ ~,ff~
Pe~it No.:
Tax Map District: 1000 Section: ~/ Block:
Lot:_ .5.~
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
*Is job ready for inspection: ~ NO Rough In / ,. :: '~~ .
-2
*Do you need a Temp Certificate:
Temp Information (If needed]
*Service Size: 1 Phase 3Phase
*New Service:
300
Change of Service
PAYMENT DUE WITH APPLICATION
350 400 Other
Overhead
100 150 200
Re-connect Underground Number of Meters
Additional Information:
82-Request [or Inspection Form