HomeMy WebLinkAbout39029-Z Town of Southold Annex 7/21/2014
y�iFOl P.O.Box 1179
54375 Main Road
W, Southold, New York 11971
CERTIFICATE OF OCCUPANCY
No: 37034 Date: 7/21/2014
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1295 Island View Ln, Greenport,
SCTM#: 473889 Sec/Block/Lot: 57.-2-16
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
7/15/2014 pursuant to which Building Permit No. 39029 dated 7/15/2014
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:
ELECTRIC SERVICE CHANGE TO 200 AMP SERVICE
The certificate is issued to Mangus, Gary&Meyers,Miriam
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 39029 07-16-2014
PLUMBERS CERTIFICATION DATED
7!i��
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#: 39029 Date: 7/15/2014
Permission is hereby granted to:
Mangus, Gary & Meyers, Miriam _
121 Sterling PI 4-13
Brooklyn, NY 11217
To: Electric Service Change
At premises located at:
1295 Island View Ln, Greenport
SCTM # 473889
Sec/Block/Lot# 57.-2-16
Pursuant to application dated 7/15/2014 and approved by the Building Inspector.
To expire on 1/14/2016.
Fees:
ELECTRIC $85.00
Total: $85.00
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Building Inspector
o�*OF SO�TyQI
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Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 0 roger.riche rt(CD-town.southoId.ny.us
Southold,NY 11971-0959 Q
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Gary Mangus
Address: 1295 Island View Ln City: Greenport St: NY Zip: 11944
Building Permit#: 29029 Section: 57 Block: 2 Lot: 16
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Daniel Wilcenski Elec License No: 4723-me
SITE DETAILS
Office Use Only
Residential X Indoor 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 FixtureSIA Time Clocks
Disconnect 200a Switches Twist Lock F1 Exit Fixtures TVSS
Other Equipment: 200a overhead Service
Notes:
Inspector Signature: Date: July 16 2014
81-Cert Electrical Compliance Form.xls
S, lyo
Town Hall Annex Telephone(631)7f�51802
54375 Main Road pax �1).7.g Q-�1,
P.O.Box 1179 rocer.richertd-ro (r�i.SO[lir101lJ nY us
Southold,NY 11971.0959 1.
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: pate: v�
Company Name: ct, t1t_� C� ��c 7 CQ T
Name: \4
License No.: _ V�
Address: C> \,q S
Phone No.: 3
JOBSITE INFORMATION: (*Indicates required information) ?
*Name: T S
'"Address: v,.
*Cross Street: L� t� f ,.., � v�. �'.�'•,,,.—'. �
1
*Phone No.: �o r.��.r � _ �-3 � (� 2-
Permit No.: i.
Tax-Map District: 1000Section:__ Block: Lot:
*BRIEF DESCRIPTION OF WORK(Please Print Clearly)
I
(Please Circle All That Apply)
*Is job ready for inspection: NO Rough In anal
*Do-you need a Temp Certificate:
. YES NO �
Temp Information(if needed)
*Service Size: 1 Pha 3Phase 100 15020 300 350 400 Other .
*New Service: Re-connect Underground Number o e#ers hange of Se Overh
Additional f :ifion: PAYMENT DUE WITH AP LICATIO
8241equest for liii a ion Form I