HomeMy WebLinkAbout37136-ZTown of Southold Annex
P.O. Box 1179
54375 Main Road
Southold, New York 11971
6/7/2012
CERTIFICATE OF OCCUPANCY
No: 35741 Date: 6/7/2012
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 900 Gardiners Ln, Southold,
SCTM #: 473889 Sec/Block/Lot: 70.-8-7
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
4/12/2012 pursuant to which Building Permit No. 37136 dated 4/12/2012
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:
overhead electric service.
The certificate is issued to
Kristyensen, Eric & Kristyensen, Annmarie
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
37136 4/13/12
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 #: 37136
Permission is hereby granted to:
Kdstyensen, Eric & Kristyensen, Annmarie
186 Meridian Rd
Levittown, NY 11756
To:
overhead service.
Date: 4/12/2012
At premises located at:
900 Gardiners Ln, Southold
SCTM # 473889
Sec/Block/Lot # 70.-8-7
Pursuant to application dated
To expire on 10/12/2013.
Fees:
4/12/2012 and approved bythe Building Inspector.
ELECTRIC
Total:
$85.00
$85.00
Building InspeCtor
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, NY 11971 0959
Telephone (631 ) 765-1802
Fax (631) 765-9502
ro.qer, richert~town.southo d ny us
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Kdstyensen
Address: 900 Gardiners Lane City: Southold St: NY Zip: 11971
Building Permit #: ~"~ ~ ~'~(,~c~ Section: Block: Lot:
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Double-Pole Electric LicenseNo: 3913-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
Service 3 ph Hot Water GFCI Recpt
Main Panel A/C Condenser Single Recpt
Sub Panel NC Blower Range Recpt
Transformer Appliances Dryer Recpt
Disconnect Switches Twist Lock
Other Equipment: 200a overhead service
Ceiling Fixtures I ~ HID Fixtures
Wall Fixtures I I Smoke Detectors
Recessed Fixtures[~ CO Detectors
Fluorescent Fixtur~] Pumps
Emergency Fixture Time Crocks
Exit Fixtures I I TVSS
Notes:
Inspector Signature:
Date: April 13 2012
81-Cert Electrical Compliance Form.xls
~ ~q ~OwN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ]FOUNDATION 1ST
[ ]FOUNDATION 2ND
[ ]FRAMING / STRAPPING
[ ]FIREPLACE & CHIMNEY
[ ]FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ROUGH PLBG.
[ ] INSULATION
[ ] FINAL
[ ] FIRE SAFETY INSPECTION
ELECTRICAL (ROUGH) ~LECTRICAL (FINAL)
REMARKS:
DATE
INSPECTOR~-~~
Town of $outhold
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold NY 11971-0959
COPY
Telephone (631) 765-1802
Fax (631) 765-9502
roger, richert(~town.southold.ny.us
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
RE(~UESTED BY:
COf4PANY NAME:
NAME:
LZCENSE NUt4BER
ADDRESS
PHONE #
DATE: APRZL 10, 2012
DOUBLE-POLE ELECTRTC INC
STEVE NEGRT
3913-t-tE
P.O. BOX 130
361-6440
NESCONSET NY 11767
CELL # 672-0241
3OBSITE ZNFORf4ATTON
NAME:
ADDRESS:
CROSS STREET:
PHONE NUMBER:
PERMZT NUMBER:
TAX MAP DZSTRZCT:
BRZEF DESCRZPTZON OF WORK:
Zs job ready for inspection:
Do you need a Temp Certificate:
TEMP ZNFORMATTON (if needed)
Service Size
New Service
Additional Znformation
MR, & MRS. KRZSTYENSEN
900 GARDINERS LANE
SOUTHOLD NY 11971
CELL # (516) 520-0912 ~ ANN-MARIE
Section: "/O Block: ~ Lot: ~/
SERVZCE UP-GRADE
APRZL 13, 2012
PLEASE FAX TEMP ~ 361-6442
200 AMP
YES
SERV?CE 1'S OVERHEAD