HomeMy WebLinkAbout37880-Z Town of Southold Annex 9/4/2013
~ P.O. Box 1179
~ 54375 Main Road
i~~p~ Southold, New York 11971
CERTIFICATE OF OCCUPANCY
No: 36484 Date: 9/4/2013
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1370 N Sea Dr, Orient,
SCTM 473889 Sec/Block/Lot: 15.-3-36.3
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this ofiiced dated
3/22/2013 pursuant to which Building Permit No. 37880 dated 3/22/2013
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:
CHANGE TO 200 AMP OVERHEAD ELECTRICAL SERVICE
The Certificate is issued to Baum, John & Baum, Doris
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 37880 08-26-2013
PLUMBERS CERTIFICATION DATED
-7
- -
Authorized Signature
,~~`"~r
~ TOWN OF SOUTHOLD
v~,~ BUILDING DEPARTMENT
~ ~ TOWN CLERK'S OFFICE
'+s®~`' SOUTHOLD, NY
r... ip
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 37880 Date: 3/2212013
Permission is hereby granted to:
Baum, John 8~ Baum, Doris
61 Woodland Dr
Brightwaters, NY 11718
To: Change 200 amp Overhead Service
At premises located at:
1370 N Sea Dr, Orient
SCTM # 473889
Sec/Block/Lot # 15: 3-36.3
Pursuant to application dated _ 3/22/2013_ and approved by the Building Inspector.
To expire on 9/21/2014.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
~o~~pf
SO~,
Town Hall Annex Telephone (631) 765-1802
54375 Main Road ~ ~ Fax (631) 765-9502
P.o. sox I t79 roger. richert(a)town.southold.ny.us
Southold, NY 1 1 97 1-0959 ~
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Giordano (Baum)
Address: 1370 North Sea Dr City: Orient St: NY Zip: 11957
Building Permit 37880 Section: 1j Block: 3 Lot: 36.3
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
contractor: DBA: Double R Contracting Inc License No: 4027-e
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service Only X
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph 200a Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel 200a 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 200a Switches Twist Lock Exit Fixtures TVSS
Other Equipment: 200a Overhead S2fVICe
Notes:
Inspector Signature: Date: Aug 26 2013
81-Cert Electrical Compliance Form.xls
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Tam Hall Annez # ~ Telephone (631) 765-1802
54375 Main Road . _Fax (631) 7659502 ~ I'
- P.O. Box 1179 ' ~ roper.riche Own SO O nV US,
Southold, NY 11971-0959 ~ ~ ~n ~
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TOWN OF SOUTHOLD ~ ~ ~ ~ ~ 'I
APPLICATION FOR ELECTRICAL INSPECTION f~`"
i'?~~
REQUESTED BY: G/eH ~
~6~rr=S Date: _ -~3 i
Company Name: o ~H ~ ~ ~ ~c i
Name: ~
e~
License No.: d ~
Address: 6 ~
JOBSITE INFORMATION: (*Indicates required information) i
*Name: Ors cevt~ _ 3_Hhn-t Doris ~aurYl
*Address: /!JB/~av~ (7n~o~ r w' ora ~C.~ g5--J
*Cross Street: ~ y ~c~-y,l it
`Phone No.. S/6 - ff /3 `-/C>
Permit No.:
Tax Map District: 1000 Section: I S' Block: Lot: (o
*BRIEF DESCRIPTION OF WORK (Please Print Clearly) ~I(aa~~ a D~W~r
lXct Je~C~I c ~ ; ~Dy°crl >;a` t~
I
(Please Circle All That Apply)
*Is job ready for inspection: YES ~ Rough In Final
*Do you need a Temp Certificate: YES / NO
Temp Ir>fonmatlon (If n eded)
*Service Size: 1 Phase 3Phase 100 150 20~ 300 350 400 Other
*New Service: Re-conned Underground Number of Meters Change of Servi Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
g5. - , .
82-Request for Inspection Form L ~ 05
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