HomeMy WebLinkAbout38785-Z f' Town of Southold Annex 4/23/2014
P.O. Box 1179
54375 Main Road
Southold, New York 11971
CERTIFICATE OF OCCUPANCY
No: 36870 Date: 4/23/2014
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1245 Jackson St, New Suffolk,
SCTM#: 473889 Sec/Block/Lot: 117.-9-10
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
4/17/2014 pursuant to which Building Permit No. 38785 dated 4/17/2014
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:
200 AMP ELECTRIC SERVICE
The certificate is issued to Tovar,Gabriela
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 38785 04-22-2014
PLUMBERS CERTIFICATION DATED
Authorized Signature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
'a 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#: 38785 Date: 4/17/2014
Permission is hereby granted to:
Tovar, Gabriela
1245 Jackson St
New Suffolk, NY 11956
To: Electric Service
At premises located at:
1245 Jackson St, New Suffolk
SCTM #473889
Sec/Block/Lot# 117.-9-10
Pursuant to application dated 4/17/2014 and approved by the Building Inspector.
To expire on 10/17/2015.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
pF SO�lyOlo
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O. Box 1179 G roger.riche rt((2-)-town-Southold.ny.us
Southold,NY 11971-0959
Own
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Tovar
Address: 1245 Jackson St City: New Suffolk St: NY Zip: 11956
Building Permit#: 38785 Section: 117 Block: 9 Lot: 10
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Glens Electric License No: 4770-me
SITE DETAILS
Office Use Only
Residential X Indoor Basement Service Only X
Commerical Outdoor 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 Fixtures Time Clocks
Disconnect 200, Switches Twist Lock Exit Fixtures TVSS
Other Equipment: 200a overhead service
Notes:
Inspector Signature: / Date: April 22 2014
81-Cent Electrical Compliance Form.xls
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54375 Main Road j "`�`
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P.O.Box 1179 G @ roe iown Sou�h0lp.n .0
Southold,NY 11971-0959 ��` �� APR 16 2014 #
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: Date:
Company Name: G�iV S
Name:
License No.:
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Address: o ( j
Phone No.:
JOBSITE INFORMATION: (*Indicates required information)
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*Name:
*Address: SAS= -11-3A 1 272 ,2-2-2— . Oki
*Cross Street:
*Phone No.:
7-
Permit No.:
Tax-Map District: 1000 Section: Block:_=�— Lot:
*BRIEF DESCRIPTION OF WORK(Please Print Clearly)
(Please Circle All That Apply)
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*Is job ready for inspection: k O Rough In Final
*Do-you need a Temp Certificate: YE O i
Temp Information If eded)
*Service Size: Q!ha3s 3Phase 100 150 20 300 350 . 400 Other
*New Service: Re-connect Underground Number of Meters Change of Service Overhea '
Additional Information: PAYMENT DUE WITH APPLICATION
G, 7
82=Request for Inspection Form ` -
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