HomeMy WebLinkAbout38790-Z ,r Town of Southold Annex 7/14/2014
P.O. Box 1179
54375 Main Road
W, Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 37020 Date: 7/14/2014
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 565 Sound Ave, Peconic,
SCTM#: 473889 Sec/Block/Lot: 67.-2-1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
4/18/2014 pursuant to which Building Permit No. 38790 dated 4/18/2014
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:
RELOCATE 200 AMP OVERHEAD ELECTRICAL SERVICE
The certificate is issued to Zimmer,Roxanne
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 38790 07-10-2014
PLUMBERS CERTIFICATION DATED
Authorized Signature
TOWN OF SOUTHOLD
S, BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
4 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#: 38790 Date: 4/18/2014
Permission is hereby granted to:
Zimmer, Roxanne
27 Sylvia St
Glen Head, NY 115451226
To: relocating 200a electric service
At premises located at:
565 Sound Ave, Peconic
SCTM # 473889
Sec/Block/Lot# 67.-2-1
Pursuant to application dated 4/18/2014 and approved by the Building Inspector.
To expire on 10/18/2015.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
pF SO(/r�,ol
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Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 A roger.richert(Cb-town.Southold.ny.us
Southold,NY 11971-0959
OWN%
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Roxanne Zimmer
Address: 565 Sound Ave City: Peconic St: NY Zip: 11958
Building Permit#: 38790 Section: 67 Block: 2 Lot: 1
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Pumillo Electric License No: 2300-me
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 Fixtures Time Clocks
Disconnect 200a Switches Twist Lock Exit Fixtures TVSS
Other Equipment: relocate 200a overhead electrical service
Notes:
Inspector Signature: Date: July 10 2014
81-Cert Electrical Compliance Form.xls
Town Ha!!Annex � � ly - � r
54875 Main Road
P.O.Box 1179 oWidd.ny.us
&mthoK NY 11971-0959 APR 16 20)4
•
BURDINCDEPARTl1 EW PH-Ji N-PT.
TOWN OF SOUMOLD
APPLICATION FOR ELECTRICAL, INSPECTION
REQUESTED BY: :J Z 1) Z ( Wit Date:
Company Name: UPPI, Lco 6�ZCz� 7✓e/c.
Name: y U r'
License No.. a 3 (0 M E-
Address: x �-
Phone No.: ��'/ en X06
JOBSITE INFORMATION: (*Indicates required information)
*Name: a Ov/V , 6'h
*Address: �P) /ice
*Cross Street:
*Phone No.: Z.
Permit No.:
Tax-Map District: 1000 Section: Block: Lot:
*BRIEF DESCRIPTION OF WORK(Please Print Clearly) Jct r r G
(Please Circle AN That Apply)
*19 job ready for bion: *YES
Rough In Flnal
Vo-you need a Temp Certficate: NO
Temp information(Ifa 11
*Servim Size: 1 Phase Whase 100 150 6�) 300 360 400 Other
*New Service: Re-aorrnec� Undergmund Number of bleters Change of ft-4 Overhead
AddltIwW Information: PAYMENT QUE WITH APPUCATION
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82=RegUest for Inspection Form t