HomeMy WebLinkAbout37074-ZTown of Southold Annex
P.O. Box 1179
54375 Main Road
Southold, New York 11971
3/28/2012
CERTIFICATE OF OCCUPANCY
No: 35515
Date:
3/28/2012
THIS CERTIFIES that the building
Location of Property:
SCTM #: 473889
Subdivision:
ELECTRICAL
325 Sigsbec Rd, Laurel,
Sec/Block/Lot: 143.-2-7
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
3/19/2012 pursuant to which Building Permit No. 37074 dated 3/19/2012
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:
storm damage repair to outside portion of 100a overhead scxvice.
The certificate is issued to
Biegler, Jean
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
37074 3/26/12
Authorized 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 #: 37074
Date: 3/1912012
Permission is hereby granted to:
Biegler, Jean
180 Horton Ave
ValleyStream, NY 11580
To:
Storm Damage Repair to outside 100 Amp Service
At premises located at:
325 Sigsbee Rd, Laurel
SCTM # 473889
Sec/Block/Lot # 143.-2-7
Pursuant to application dated
To expireon 9/18/2013.
Fees:
3/19/2012
and approved by the Building Inspector.
ELECTRIC
Total:
$85.00
$85.00
Building Inspector
Town Hall Annex
54375 Main Road
P.O. Box I 179
Southold, NY 11971-0959
Telephone(631)765-1802
Fax(631)765-9502
mqer. richert~,,town southo d ny us
BUILDING DEPARTMENT
TOWN OFSOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Biegler
Address: 325 Sigsbee Rd City: Mattituck St: NY Zip: 11952
Building Permit #: '~ '~ ~ ~ Section: 143 Block: 2 Lot:
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: All Ways Electric Corp License No: 764-e
SITE DETAILS
Office Use Only
Residential ~ Indoor ~ Basement ~ Service Only ~
Corn medcal Outdoor 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 3 ph Hot Water GFCl Recpt
Main Panel NC Condenser Single Recpt
Sub Panel NC Blower Range Recpt
Transformer Appliances Dr~er Recpt
Disconnect Switches Twist Lock
Other Equipment:
Ceiling Fixtures ~R[~ HID Fixtures
Wall Fixtures I I Smoke Detectors
Recessed Fixtures CO Detectors
Fluorescent Fixtun~ Pumps
Emergency Fixture Time Clocks
Exit Fixtures I I TVSS
storm damage repair to outside portion of 100a overhead service
Notes:
Inspector Signature:
Date: March 26 2012
81-Cert Electrical Compliance Form.xls
07-30-10; Ii: 27
Town H~)I Annex
54,3?5 Main Road
P,O. Box 1179
Sou&old, NY 11971-0959
66{L479
Tclcphoac (631) 765-1802
631) 76& .50
# 1 /
BUILDING DEPAR'L'MENT
TOWN OF $OUTHOLD
APPLIGATION FOR ELEGTRIGAL INSPEGTION
REQUESTED BY:
Name:
Name:
Date:
Address:
Phone No.:
*Name:
*Address:
*Cross Street:
*Phone No.:
JOBSITE INFORMATION: (*Indicates required information)
Permit No.:
Tax Map District: 1000 Section: j~, Block: ~2, Lot: '7
*BRIEF DESCRIPTION OF WORK (Please Print Cleady) S~J~_.__.~_~-~_..
.... ·
(Please Circle All That Apply)
*Is job ready for inspection:
'Do you need a Temp Certificate:
Temp Information I~e~d}
*Service Size: {.~ Ph~!
*New Service: Re-connect
Additional Information:
NO
NO
Rough In
3Phase d~00~J 150 200 300
Underground Number of Meters Chan!
PAYMENT DUE WITH AP
82~equcst for Inspection Form
350 400 Other
BLDG OEPl.
lOWr~ OF SOt ~HOLD