HomeMy WebLinkAbout38823-Z ,I Town of Southold Annex 6/2/2014
P.O.Box 1179
54375 Main Road
e3 Southold, New York 11971
;!�77 flo,
CERTIFICATE OF OCCUPANCY
No: 36947 Date: 6/2/2014
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 2355 Main Bayview Rd, Southold,
SCTM#: 473889 Sec/Block/Lot: 78.4-10.23
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
4/25/2014 pursuant to which Building Permit No. 38823 dated 4/28/2014
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 Underground Electric Service
The certificate is issued to Old Town Farm LLC The
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 38823 05-29-2014
PLUMBERS CERTIFICATION DATED
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#: 38823 Date: 4/28/2014
Permission is hereby granted to:
Old Town Farm LLC The
7930 Indian Neck Ln
PO BOX 1
Peconic, NY 11958
To: 200 Amp Underground Electric Service
At premises located at:
2355 Main Bayview Rd, Southold
SCTM # 473889 _
Sec/Block/Lot# 78.-1-10.23
Pursuant to application dated 4/25/2014 and approved by the Building Inspector.
To expire on 10/28/2015.
Fees:
ELECTRIC $125.00
Total: $125.00
Building Inspector
*oF so�ryOlo
Town Hall Annex Telephone(631)765-1802
54375 Main Road cn Fax(631)765-9502
P.O.Box 1179 iQ roger.riche rt(aD_town.southoId.ny.us
Southold,NY 11971-0959 Q
&4UNTY,�c�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Old Town Farm LLC (Ed Dart)
Address: 2355 Main Bayview Rd City: Southold St: NY Zip: 11871
Building Permit#: 38823 Section: 7$ Block: 1 Lot: 10.23
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: BJ Electric License No: 2670-me
SITE DETAILS
Office Use Only
Residential Indoor Basement Service Only X
Commerical X Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph 200a Heat Duplec Recpt 1 Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt 1 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 1
Disconnect 200a Switches 11 Twist Lock Exit Fixtures TVSS
Other Equipment: 200a underground service, 1-motor control
Notes:
Inspector Signature: -� Date: May 29 2014
81-Cert Electrical Compliance Form.xls
,�o opo
Town Hall Annex
54375 Main Road Telephone(631)7651802
P.O.Box 1179 G ax(631)765grA
Southold,M'11971-0959 r �Q ro er.riChert IOWn.SOuthO .n .us
BUIIDTNG DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: ��ee "e,
Company Name: Date:
Name: '
License No.-
Address:
Phone No.: % S'!J O 577 GJ
JOBSITE IN RAT10NInd.icat
*Name; eequi a inform on
� ")161-
*Address:
*Cross Street:
,�/,e�c J' f¢ /i G'0
*Phone No.: -/-21c z.,/ �9
Permit No.:
amu/ d OGE vt s
Tax Map District: 1000 Section:
---- IP
11IL6, Block: Lot: c)
*BRIEF DESCRIPTION OF WORK(Please Print Clearly)
2110
(Please Circle All That Apply)
*Is job ready for inspection:
YE NO Rough In Final
*00-you need a Temp Certificate:
YES NO(:
Temp Information(If.needed)
`Service SI 1 Phase 3Phase 100 150 200 300 350
*New Servi r 400 Other
Cn9 Number of Meters Change of Service Overhead
\�
-----=- i ead
Additional! tion:
PAYMENT DUE WITH APPLICATION \�
APR z 1
jr
82=RegUesllOf IRSp O
U
V