HomeMy WebLinkAbout37557-ZTown of Southold Annex
P.O. Box 1179
54375 Main Road
Southold, New York 11971
10/10/2012
CERTIFICATE OF OCCUPANCY
No: 35994 Date: 10/10/2012
Location of Property:
SCTM #: 473889
Subdivision:
THIS CERTIFIES that the building ELECTRICAL
1040 Nokomis Rd, Southold,
Sec/Block/Lot: 78.-3-16
Filed Map No.
conforms substantially to the Application for Building Permit heretofore
10/4/2012 pursuant to which Building Permit No.
Lot No.
filed in this officed dated
37557 dated 10/4/2012
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:
replace electric wiring
The certificate is issued to
Harbin, Andrew
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
37557
10/09/2012
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 #: 37557
Permission is hereby granted to:
Harbin, Andrew
1040 Nokomis Rd
Southold, NY 11971
Date: 10/4/2012
To;
replace electric wiring
At premises located at:
1040 Nokomis Rd, Southold
SCTM # 473889
Sec/Block/Lot # 78.-3-16
Pursuant to application dated
To expire on 4/5/2014.
Fees:
10/4/2012
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 I 1971-0959
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
ssued To: Andy Harbin
Address: 1040 Nokomis Rd City: Southold St: NY Zip: 11971
3uilding Permit #: Section: 78 Block: 3 Lot: 1~
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
3ontractor: DBA: REP Electric License No: 46288-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 NC Condenser Single Recpt
Sub Panel NC Blower Range Recpt
Transformer Appliances Dryer Recpt
Disconnect Switches Twist Lock
Other Equipment:
Ceiling Fixtures~J~~ HID Fixtures
Wall Fixtures II Smoke Detectors
Recessed Fixtures CO Detectors
Fluorescent Fixtur Pumps
Emergency Fixture~ Time Clocks
Exit Fixtures I I TVSS
remove aluminum wire and replace with copper, including oil furnace, 2-circuts
Notes:
Inspector Signature:
Date: Oct 9 2012
81-Cert Electrical Compliance Form.xls
'~ ~ TOWN OF SOUTHOLD BUILDING DEPT.
~/~..//TOWN 765-1802
INSPECTION
FOUNDATION 1ST
FOUNDATION 2ND
FRAMING/STRAPPING
FIREPLACE & CHIMNEY
[ ] ROUGH PLBG.
[ ] INSULATION
[ ] FINAL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ~LECTRICAL (FINAL)
REMARKS:
DATE
INSPECTOR~~~______
Town H~/I Annex
~375 ~ Road
P.O. Box 1179
Soulhold, NY 119714)959
Telephone (631) 765-1802
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TOWN 017 SOUTFIOLD
,APPLICATION FOR ELECTRICAL INSPECTION
Company Name:
IName:
License No.:
Address:
]Phone No.:
JOBSITE INFORMATION: (*Indicates required information)
Pe~it No.: /
Tax Map District: 1~00 Section:~ ~ Block: ~ Lot: ] ~
*BRIEF DESCRIPTION OF WORK (Please Pdnt Clearly)
(Please Circle All ~hat Apply) '
*Is ~b ready for inspe~ On: ~O Rough In Final
*~-~u n~ a T~p Cedifi~te: YES / NO
Temp Information (If-needed)
*Service Size: 1 Phase 3Phase 100
~New Service: Re-connect Underground
Addit~ra~ Information:
824~equ~t io~ Inspection Form
150 200 300 350 400
Number of Meters Change of Service
.PAYMENT DUO, WITH APPLICATION
Other
Overhead