HomeMy WebLinkAbout37522-ZTown of Southold Annex
P.O. Box 1179
54375 Main Road
Southold, New York 11971
12/11/2012
CERTIFICATE OF OCCUPANCY
No: 36081
Date: 12/11/2012
THIS CERTIFIES that the building
Location of Property:
SCTM ti: 473889
Subdivision:
ELECTRICAL
195 Youngs Ave, Southold,
Sec/Block/Lot: 61.-4-38.1
Filed Map No.
conforms substantially to the Application for Building Permit heretofore
9/18/2012 pursuant to which Building Permit No.
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:
electric for existing nonhabitable accessory garage.
Lot No.
filed in this officed dated
37522 dated 9/18/2012
The certificate is issued to
Fredriksson, Jim & Fredriksson, Elaine
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIHCATION DATED
37522 12/10/12
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 #: 37522
Permission is hereby granted to:
Fredriksson, Jim & Fredriksson, Elaine
Date: 9/18/2012
PO BOX 1906
Southold, NY 11971
To:
Electric for existing garage
At premises located at:
195 Youngs Ave, Southold
SCTM # 473889
Sec/Block/Lot # 61.-4-38.1
Pursuant to application dated
To expire on 3/20/2014.
Fees:
9/18/2012
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 11971-0959
Telephone (631) 765-1802
Fax (63 I) 765-9502
ro.qer, richert~,town.southold, ny. us
BUILDING DEPARTMENT
TOWN OF SOUTI-IOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: E & J Fredriksson
Address: 195 Youngs Ave City: Southold St: NY Zip: 11971
Building Permit#: "~'~ ~'"<~..~._ Section: ~ [( Block: Lc Lot: ~ ~, /
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: home owner DBA: License No:
SITE DETAILS
Office Use Only
Residential ~ Indoor ~ Basement ~ Service Only
Commedcal Outdoor 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Servicelph ~ Heat ~ DuplecRecpt ~
Service 3 ph Hot Water GFCI Recpt
Main Panel NC Condenser Single Recpt
Sub Panel A/C Blower Range Recpt
Transformer Appliances Dryer Recpt
Disconnect Switches Twist Lock
Other Equipment;
Ceiling Fixtures
Wall Fixtures
Recessed Fixtures
Fluorescent Fixture ~.~
Emergency Fixturesl~
Exit Fixtures
HID Fixtures
Smoke Detectors
CO Detectors
Pumps
Time Clocks
TVSS
"DETACHED GARAGE", 2-special 20a recpticles, 2-specisl 30a recpticles
Notes:
Inspector Signature:
Date: Dec 10 2012
81-Cert Electrical Compliance Form.xls
765-1802
INSPECTION
[ ] FOUNDATION 1ST
[ ]FOUNDATION 2ND
[ ]FRAMING / STRAPPING
[ ]FIREPLACE & CHIMNEY
[ ] ROUGH PLBG.
[]INSULATION
[ ] FINAL (~. t
I 1 F,R,: SAFm',.SP':CT,ON
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATI~ON~j
~t~JhELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS:
DATE ~ INSPECTOR~ ~
INSPECTION
[ ] FOUNDATION 1ST
[ ] FOUNDATION 2ND
[ ] FRAMING / STRAPPING
[ ] FIREPLACE & CHIMNEY
ROUGH PLBG.
INSULATION
FINAL
FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION ~FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL)
REMARKS:
DATE iNSPECTOR .~ ~~ ---~
Town Hall Annex
54375 Main Road
P.O. Box I. l, 79
Southold, NY 11971-0959
Telephone (631) 76,5-1802
ro.qer r chert ('~,~o$3nl.)s~6dj~l~d. ny. us
BUILDING DEPARTMENT
TOWN OF $OUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY:
Company Name:
Date:
Name:
License No.:
Phone No.:
JOBSITE INFORMATION: (*Indicates required information)
*Name:
*Address:
*Cross Street:
*Phone No.:
1000 Section:
Permit No.:
Tax Map District:
*BRIEF DESCRIPTION OF WORK (Please Print Cleady)
Block: L/L Lot:
(Please Circle All That Apply)
*Is job ready for inspection:
*Do you need a Temp Certificate:
Temp Information (If needed]
*Service Size: 1 Phase
*New Service: Re-connect
Additional Information:
YES / NO
YES / NO
Rough In,
Final
3Phase 100 150 200 300 350 400 Other
Underground Number of Meters Change of Service Overhead
PAYMENT DUE WITH APPLICATION
82-Request for Inspect,ion Form