HomeMy WebLinkAbout37280-ZTown of Southold Annex
P.O. Box 1179
54375 Main Road
Southold, New York 11971
CERTIFICATE OF OCCUPANCY
6/7/2012
No: 35743
Date:
6/7/2012
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 145 Wood Ln, Greenport,
SCTM #: 473889 Sec/Block/Lot: 43.-4-26
Subdivision: Filed Map No.
conforms substantially to the Application for Building Permit heretofore
6/6/2012 pursuant to which Building Permit No.
Lot No.
filed in this officed dated
37280 dated 6/6/2012
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
Hickson Jr, William & Hickson, Eileen
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
37280 4/4/12
~a~~ture
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 #: 37280
Permission is hereby granted to:
Hickson Jr, William & Hickson, Eileen
4 Lincoln PI
Port Washington, NY 110503221
To:
overhead electric service.
Date: 6/6/2012
At premises located at:
145 Wood Ln, Greenport
SCTM # 473889
Sec/Block/Lot # 43.-4-26
Pursuant to application dated 6/6/2012
To expire on 12/6/2013.
Fees:
and approved by the Building Inspector.
ELECTRIC $85.00
Total: $85.00
Building Inspector
Town Hall Annex
54375 Main Road
P.O. Box I 179
Southold. NY 11971 0959
Telephone (631) 765-1802
Fax (63 I) 765-9502
ro.qer, richert@town southold.n¥.us
Issued To: Kevin Hickson
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Address: 70 Wood Lane
City: Greenport St: NY Zip: 11944
Building Permit #:
Section: l--{---~ Block: L~ Lot: ~:'~>
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Daniel Wilcenski Elec License No: 4723-me
SITE DETAILS
office Use 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 A/C Blower Range Recpt
Transformer Appliances Dr~er Recpt
Disconnect Switches Twist Lock
Other Equipment: install new 100a overhead service
Ceiling Fixtures ~
Wall Fixtures ~.
Recessed Fixtures ~.~
FE ImU ~;;:Cn;;t F~ ix;tu;rees~
Exit Fixtures L
HID Fixtures
Smoke Detectors
CO Detectors
Pumps
Time Clocks
TVSS
Notes:
Inspector Signature:
Date: April 4 2012
81-Cerl Electrical Compliance Form.xls
Town Haft Annex
54375 Main Road
P.O. Box 1179
Southold, NY 11971-0959
Telephone (631) 765-1809
rocler, rich e r tdt~w(6r13/s) o7 u6~(~(~, n y. u.~
BUILDING DEPARTMENT
TOWN OF $OUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY:
Company Name:
Name:
License No.:
Address:
Phone No.:
JOBSITE INFORMATION: (*Indicates required information)
*Name:
*Address:
*Cross Street:
*Phone No.:
Permit No.:
Tax Map District: 1000 Section: Block: Lot:
*BRIEF DESCRIPTION OF WORK (Please Print Cleady)
(Please Circle All That Apply)
*Is job ready for inspection:
*Do you need a Temp Certificate:
Y~NO
Temp Information (If needed]
3Phase
Re-connect
*Service Size:
*New Service:
Additional Information:
Underground
Rough In
1~ 150 200 300 350 400 Other
Number
Change of Service
of
Meters
PAYMENT DUE WITH APPLICATION
82-Request for Inspection Form