HomeMy WebLinkAbout38172-Z r'~~~* Towu of Southold Annex
8/29/2013
,.t ~ P.O. Box 1179
~ 54375 Main Road
~ Southold, New York 11971
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CERTIFICATE OF OCCUPANCY
No: 36475 Date: 8/29/2013
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1265 Terry Ln, Orient,
SCTM 473889 SecBlock/Lot: 14.-3-1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
7/15/2013 pursuant to which Building Permit No. 38172 dated 7/15/2013
-
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:
electric meter pan
The certificate is issued to Rose, John & Others
-
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 38172 8/27/13
PLUMBERS CERTIFICATION DATED
- -
uthorized Signature
`w~~~ ~ ~ TOWN OF SOUTHOLD
BUILDING DEPARTMENT
a TOWN CLERK'S OFFICE
~'a~~;`' SOUTHOLD, NY
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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 38172 Date: 7/15/2013
Permission is hereby granted to:
Rose, John & Duffy, Margaret
-
2 Scotts Cv
Setauket, NY 11733
To: Replace 200 amp Meter
At premises located at:
1265 Terry Ln, Orient
SCTM # 473889
Sec/Block/Lot # 14.-3-1
Pursuant to application dated 7/15/2013 and approved by the Building Inspector.
To expire on 1/14/2015.
Fees:
ELECTRIC $85.00
Total $85.00
Building Inspector
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Town Hall Annex yy Telephone (631) 765-1802
54375 Main Road T ~ Fax (631) 765-9502
P.O. Box ll79 ~
soutnota, NY 1 t97t-ogs9 ~ • ~o roger.richert(c~town.southold.nv.us
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: J Rose
Address: 1265 Terry Ln City: Orient St: NY Zip: 11957
Building Permit 38172 Section: 14 Block: 3 Lot: 1
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: License No:
SITE DETAILS
Offce Use Only
Residential X Indoor Basement Service Only X
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks
Disconnect Switches Twist Lock Exit Fixtures TVSS
otner Egnipment: 200a underground service-replace meter pan only
Notes:
Inspector Signature: Date: Aug 27 2013
81-Cert Electrical Compliance Form.xls
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TOWN OF SOUTHOI.D
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: ~
Company Name: Date: -f~
1=3
Name: -!Y' ~ C_'° r
License No.: 2-l 8 ~ -,-y-, -
Address: 2~
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e No.: w~ r - -7loS- 55
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JOBSITE fNFORMATION: (*Indicates required information)
'Name: ----_.~~.n h ~os2
*Addraess: , ,
*Cross Street: 1--ta ~ r, ~ I l --i
'Phone No.: (o r _ 8 -1 `f' - 3 8 ~ ~
Permit No.:
Tax Map District: 1000 Section:
i Block: Lot: -L_
'BRIEF DESCRIPTION OF WORK (Please Print Clearly) !
t~.2 1 ~c 2 ~ C7 A,_„, M Q~.G i
I
(Please Circle Ail That AAPIY)
*Is job ready for inspection:
YE / NO Rough in Final
"Do you need a Temp CertiNcate: YES NO
Temp Information (If
I
•SeMce Size: 1 Pha 3Phase 100 !50 200 ~
*NeW Service: Re-c:onnecC ~~f~ ~ ~ 350 .400 Other
~Jro Number l Meters Change of Service Overhead ~
Additional Information: PAYME~DUE WITii APPLICATION
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