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Town of Southold Annex 10/25/2013
P.O. Box 1179
54375 Main Road
{7 Southold, New York 11971
CERTIFICATE OF OCCUPANCY
No: 36582 Date: 10/25/2013
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 295 Bayview Ave, Greenport,
SCTM 473889 Sec/Block/Lot: 52.-5-26
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
10/10/2013 pursuant to which Building Permit No. 38405 dated 10/10/2013
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 electric service.
The certificate is issued to Santacroce, John
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 38405 10/22/13
PLUMBERS CERTIFICATION DATED
Authorized Signature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
® TOWN CLERK'S OFFICE
m¢ 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 38405 Date: 10/10/2013
Permission is hereby granted to:
Santacroce, John
9331 Avenel Ln
Port Lucie, FL 34986
To: overhead electric service
At premises located at:
295 Bayview Ave, Greenport
SCTM #473889
Sec/Block/Lot # 52.-5-26
Pursuant to application dated 10/10/2013 and approved by the Building Inspector.
To expire on 4/11/2015.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
Town Hall Annex ~~~yy Telephone (631) 765-1802
54375 Main Road T Fax (631) 765-9502
P sox 117
Southold, , NY 11 971-0959 roper. riche rt()town.southold.nv.us
Cow M11,
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: John Santacroce
Address: 295 Bayview Ave City: Greenport St: NY Zip: 11944
Building Permit 38405 Section: 52 Block: 5 Lot: 26
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
contractor: DBA: Jim Sage Electric License No: 3635-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 100a Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel 100a 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 100a Switches Twist Lock Exit Fixtures TVSS
Other Equipment: 100a overhead service
Notes:
Inspector Signature: Date: Oct 22 2013
V
81-Cert Electrical Compliance Form.xls
TOWN of SOUTHOLD
OFFICE OF BUILDING INSPECTOR
8 412 6 Town Hall Annex
Receipt No. Southold, New York 11971
Date iu-10-l3
Received of (Y) ` G n
11^P /100Dollars
For D
Fee for Fee for
Fee for Fee for Fee for Certificate Electrical
? Sign ? Flood Development Pmt. ? Building Permit ? of Occupancy Inspection
? Cash
Check
Building Department
OF SO~jyolo
Town Hall Annex Telephone (631) 7651802
54375 Main Road 66~~..gg QQgg
P.O. Box 1179 roger.richert t01NnN'OU .0 nV us
Southold, NY I1971-0959
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY. J Gvv, Date: L ~a
Company Name: /mar
Name:
License No.:
Address: L 6a. I
Phone No.:
JOBSITE INFORMATION: (*Indicates required information)
*Name:
*Address:
*Cross Street:
*Phone No.:
Permit No.: !
Tax Map District: 1000 Section: _ Block: Lot:
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
Sfc.D~1~ 4 ~,vn~s
(Please Circle All That Apply)
*is job ready for inspection: / NO Rough In Final
*Do you need a Temp Certificate: NO
Temp Information (If needed)
*Service Size: 1 Phase 3Phase 100 150 300 350
*New Service: Re-connect Underground Number of Meters Change of Servi40Overh
Additional Information: PAYMENT DUE WITH APPLICATION
\-A A
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82-\equest for Inspection Form