HomeMy WebLinkAbout37594-ZTown of Southold Annex
P.O. Box 1179
54375 Main Road
Southold, New York 11971
3/5/2013
CERTIFICATE OF OCCUPANCY
No: 36156
Date: 2/28/2013
THIS CERTIFIES that the building
Location of Property:
SCTM #: 473889
Subdivision:
ELECTRICAL
820 S Smith Dr, Southold,
Sec/Block/Lot: 76.-3-21.3
Filed Map No.
conforms substantially to the Application for Building Permit heretofore
10/23/2012 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:
Lot No.
filed in this officed dated
37594 dated 10/23/2012
New Underground Electrical Service
The certificate is issued to
Daniel & Nancy Melhado
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
37594 2/28/13
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 #: 37594
Permission is hereby granted to:
O'Neill, Louise
Date: 10/23/2012
55075 Main Rd
Southold, NY 11971
To:
New Underground Electrical Service
At premises located at:
820 S Smith Dr, Southold
SCTM # 473889
Sec/Block/Lot # 76.-3-21.3
Pursuant to application dated
To expire on 4/24/2014.
Fees:
10/23/2012
and approved by the Building Inspector.
ELECTRIC
Total:
$85.00
$85.00
Building I~spector
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, NY I 1971-0959
Telephone (631 ) 765-1802
Fax (63 I) 765-9502
ro,qer, richert~,town.southolfl.ny.us
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
ssued To: Dan Melhado
~,ddress: 820 Smith Drive South City: Southold St: NY Zip: 11971
Building Permit #: "~'""~ ~ q L.){ Section: Block: Lot:
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
;ontractor: DBA: Bdan Brooks Electrical Inc LicenseNo: 3613-e
SITE DETAILS
Office Use Only
Residential ~ Indoor ~ Basement ~ Service Only ~
Corn medcal Outdoor I st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 3 ph Hot Water GFCl Recpt
Main Panel NC Condenser Single Recpt
Sub Panel NC Blower Range Recpt
Transformer Appliances Dryer Recpt
Disconnect Sw~tches Twist Lock
Other Equipment: 200a underground service
Ceiling Fixtures [~ HID Fixtures
Wall Fixtures [~ Smoke Detectors
Recessed Fixtures [~ CO Detectom
Fluorescent Fixture [~ Pumps
Emergency Fixtures[~ Time Clocks
Exit Fixtures [~ TVSS
Notes:
Inspector Signature:
Date: Feb 28 2013
81-Cert Electrical Compliance Form.xls
To,,~. H~ Annex
54375 ~ Road
P.O. Box 1179
$outhoM, NY 11971..0959
REQUESTED BY:
Company Name:
Name:
License No.:
Address:
Phone No.:
Tel
ro.qer.richert(~
BUn ~EqG DF, PARTMENT
TOWN OF SOUTEIOI.13
APPLICATION FOR ELECTRICAL INSPECTION
BL~G DEPI'.
TOWN OF SOUTHOLD
JOBSITE INFORMATION:
*Name:
*Address:
*Cross Street:
*Phone No.:
Permit No.:
Tax.Map District:
(*Indicates required information)
1000 Section: Block: Lot:
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
(Please Circle All That Apply)
*Is job ready for inspection:
*Do. you nc~c.d a Temp Certificate:
/NO Rough In
/ NO
Temp Information (If. needed]
*Service Size: ~ 3Phase 100 150 ~
*New Service: Re-connect ~ Number of Meters
Additienal Information:
Final
300 350 400 Other
Change of Service Overhead
PAYMENT DUE WITH APPLICATION
824~,quest for Inspection Form