HomeMy WebLinkAbout38067-ZTown of Southold Annex
P.O. Box 1179
54375 Main Road
Southold, New York 11971
6/7/2013
CERTIFICATE OF OCCUPANCY
No: 36286
Date:
6/7/2013
Location of Property:
SCTM #: 473889
Subdivision:
THIS CERTIHES that the building ELECTRICAL
1375 Ackerly Pd Ln, Southold,
Sec/Block/Lot: 69.-5 -7.1
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
5/31/2013 pursuant to which Building Permit No. 38067 dated 5/31/2013
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 Electrical Service
The certificate is issued to
Glenn, Brian
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
38067 06-03-2013
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 #: 38067
Permission is hereby granted to:
Glenn, Bdan
PO BOX 329
Southold, NY 11971
Date: 5/31/2013
Toz
New Overhead Electrical Service
At premises located at:
1375 Ackerly Pd Ln, Southold
SCTM # 473889
Sec/Block/Lot # 69.-5-7.1
Pursuant to application dated 5/31/2013
To expire on 11/30/2014.
Fees:
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
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Telephone (631) 765-1802
Fax (631) 765-9502
ro.qer.richertC~,town,southold.ny.us
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Brian S Glenn
Address: 1375 Ackedy Pond Ln City: Southold St: NY Zip: 11971
5uilding Permit #: 38067 Section: 69 Block: 5 Lot: 7.1
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Parks Electric License No: 4458-me
SITE DETAILS
Office Use Only
Resideatial : Indoor ~ Basement : Ser~iceOnly :
Commerical Outdoor 1st Floor Pool
New Renovati(Ta 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 3 ph Ho~ 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: 400a overhead service, 2-200a disconnects (on H frame)
Ceiling Fixtures
RWe~al: isxt6~ r F ieSxt u r es
Exit Fixtures
HID Fixtures
Smoke Detectors
CO Detectors
Pumps
Time Clocks
TVSS
Inspector Signature:
Date: June 3 2013
Electrical Certificate.xls
Town Hgl A~x
P.O. B~ 1179
,Saellb~d, ~ 1
Tdepix2ee (631) 765,*18~
BUILDING DEPAglMEHT
TOWN OF 80UT~OLD
APPLICATION FOR ELECTRICAL INSPECTION
*Name:
*Cross Street:
*Phone No.:
Permit Ne,:
JOBSITE INFORMATION:, (*Indicates required information)
Tax. Map District: 1000 Section: ~; Block: ,~ Lo~. '7, [
*BRIEF, DESCRIPTION OF WORK (Please Print Clemty) I ~/
(Flame ¢~rde Aa That
Job reedy for Jflspecaon:
*Doyou hoed a Temp Ce~i;l,::ste:
NO Rough In Rnal
NO
Temp Infonnation (If. needed)
'Service Size: ~ 3Phase 100 150 200 300 350 ~_ Olher
~ Re-oormect Undeegr°und Number of Me{em..].
Change of Sen~3e ~ l
Addltlenai InformalJon:
82,4~equeet f~3r Jnspe~lkm Foa~
PAYMENT DUE WITH APPI, JCATION ~ ,'~