HomeMy WebLinkAbout37540-ZTown of Southold Annex
P.O. Box 1179
54375 Main Road
Southold, New York 11971
10/18/2012
CERTIFICATE OF OCCUPANCY
No: 36015 Date: 10/18/2012
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 995 Henrys Ln, Peconic,
SCTM #: 473889 Sec/Block/Lot: 74.-1-14
Subdivision: Filed Map No.
conforms substantially to the Application for Building Permit heretofore
9/24/2012 pursuant to which Building Permit No.
was issued, and conforms to all of thc requirements of the applicable provisions of the law. The occupancy for
which this certificate is issued is:
Lot No.
filed in this officed dated
37540 dated 9/24/2012
200 Amp Electric Overhead Service
The certificate is issued to
Viola, George
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
37540
10/17/12
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 #: 37540
Date: 9/24/2012
Permission is hereby granted to:
Viola, George
995 Henrys Ln
PO BOX 216
Peconic, NY 11958
To:
200 Amp Electric Overhead Service
At premises located at:
995 Henrys Ln, Peconic
SCTM # 473889
Sec/Block/Lot # 74.-1-14
Pursuant to application dated
To expire on 3/2612014.
Fees:
9124/2012
and approved by the 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 (63 ! ) 765-1802
Fax (63 l) 765-9502
roger, richert~.town.southold.ny, us
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: George Viola
Address: 995 Henry's Lane City: Peconic St: NY Zip: 11958
Building Permit #: ~Se'~ ~L~ 1~ Section: Block: Lot:
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: BJ Electric License No: 2670-me
SITE DETAILS
Office Use Only
Residential [~ Indoor [~ Basement [~ Service Only
Commerical Outdoor 1 st 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
Wall Fixtures
Recessed Fixtures
Fluorescent Fixture
Emergency Fixtures~
Exit Fixtures ~
200a overhead service, to include main panel and sub panel
HID Fixtures
Smoke Detectors
CO Detectors
Pumps
Time Clocks
TVSS
Notes:
Inspector Signature:
Date: Oct 17 2012
81-Cert Electrical Compliance Form.xls
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, NY 11971-0959
Telephone (63t) 765-1802
· _ .._.Fax (631) 765:~)50,2,
ro.cler.ncnert(,~town.soutno~a.ny.~us
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY:
Company Name:
Name:
Date:
License No.:
Address:
Phone No.: ~"/~'
JOBSITE INFORMATION:
*Name:
*Address:
*Cross Street:
*Phone No.:
Permit No.:
Tax Map District:
(*Indicates required information)
1000 Section:
Block:
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
Lot:
(Please Circle All That Apply) ~ ./ ) --
*Is job ready for inspection:-- '" '"'-'__ --~ / f~d,//t~v-~
NO
*Do you need a Temp Certificate/" ~/NO
Temp Information (If neededJ
*Service Size: ~ 3Phase 100 150 ~
*New Service: Re-connect Underground Number of Meters
Additional Information:
Rough In
300 350 400
Change of Service
PAYMENT DUE WITH APPLICATION
Final
Other
Overhead
82-Request for Inspection Form