HomeMy WebLinkAbout37676-ZTown of Southold Annex
P.O. Box 1179
54375 Main Road
Southold, New York 11971
CERTIFICATE OF OCCUPANCY
12/14/2012
No: 36084 Date: 12/14/2012
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 135 Birch Ave, Southold,
SCTM #: 473889 Sec/Block/Lot: 77.-1-21
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
12/10/2012 pursuant to which Building Permit No. 37676 dated 12/10/2012
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
Beaton, Harry
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
37676 12/11/12
Authorized Signature
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold. NY 11971 0959
Telephonc (631) 765-1802
Fax (631) 765-9502
ro.qer, richertC, town.southold.ny.us
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
ssued To: Harry Beaton
~,ddress: 135 Birch Ave City: Southold St: NY Zip: 11971
3uilding Permit #: ~'~ ~'"7 (¥¢ Section: Block: Lot:
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
3ontractor: DBA: melsan Electric Inc LicenseNo: 4934-me
SITE DETAILS
Office Use Only
Residential ~ Indoor ~ Basement ~ Service Only ~
Corn medcal 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: 200a overhead service
Ceiling Fixtures ]~ HID Fixtures
Wall Fixtures ~ Smoke Detectors
Recessed Fixtures ],~ CO Detectors
Fluorescent Fixture ~.~ Pumps
Emergency Fixturel__~ Time Clocks
Exit Fixtures ~ TVSS
Notes:
Inspector Signature:
Date: Dec 11 2012
81-Cert Electrical Compliance Form.xls
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 #: 37676
Date: 12/10/2012
Permission is hereby granted to:
Beaton, Harry
73 Sunflower Ridge Rd
So Setauket, NY 11720
To:
New Electrical Service
At premises located at:
135 Birch Ave, Southold
SCTM # 473889
Sec/Block/Lot # 77.-1-21
Pursuant to application dated
To expire on 6/11/2014.
Fees:
12110/2012
and approved by the Building Inspector.
ELECTRIC $85.00
Total: $85.00
Town Nd Annex
54375 M~n Road
P.O. Box ! 179
Southold, NY 11971-09.59
Telephone (631) 7~-1802
BU~ ,DING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY:
Company Name:
Name:
License No.:
Address:
Phone No.:
JOBSITE INFORMATION: (*Indicates required information)
*Name:
*Address: ' i~ ~"~;~
*Cross Street:
*Phone No.:
Pe~it No.:
Tax*Map DistH~: 1000 Section: Block: Lot:
*BRIEF DESCRIPTION OF WORK (Please Pdnt Clearly) ~1~, _q 2-~ ~
· (Please Circle All That Apply}
*Is job ready for inspection:
*Do.you need a Temp Certificate:
Temp Information I~ed]
*Service Size: ~ 3Phase
*New Service: Re-connect
Additienal Information:
82=Request for Inspection Form
(~)/NO
YES / NO
Rough In Final
lO0
Underground
DEC 1 0 2012 ?L_~/
150 ~ 300 350 ,400 Other
Number of Meters ~ Overhead
:' WITH APPLICATION