HomeMy WebLinkAbout38986-Z p Town of Southold Annex 8/11/2014
P.O.Box 1179
54375 Main Road
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 37084 Date: 8/11/2014
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1300 Minnehaha Blvd, Southold,
SCTM#: 473889 Sec/Block/Lot: 87.-2-11
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
6/24/2014 pursuant to which Building Permit No. 38986 dated 6/24/2014
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 UPGRADE TO 200 AMP
The certificate is issued to Cheska,John&Cheska,Kathy
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 38986 07-29-2014
PLUMBERS CERTIFICATION DATED
Authorized Signature
_ TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
'$ }s SOUTHOLD, NY
1 1y�1
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#: 38986 Date: 6/24/2014
Permission is hereby granted to:
Cheska, John & Cheska, Kathy
1300 Minnehaha Blvd
Southold, NY 11971
To: Upgrade Electrical Service to 200 Amps
At premises located at:
1300 Minnehaha Blvd, Southold
SCTM # 473889
Sec/Block/Lot# 87.-2-11
Pursuant to application dated 6/24/2014 and approved by the Building Inspector.
To expire on 12/24/2015.
Fees:
ELECTRIC $95.00
Total: $95.00
Building Inspector
*pF SO�ryol.
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 roger.richert((�town.southold.ny.us
Southold,NY 11971-0959
COUNTY,Nc�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Cheska
Address: 1300 Minnehaha Blvd City: Southold St: NY Zip: 11971
Building Permit#: 38986 Section: $7 Block: 2 Lot: 11
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Brian Brooks Electrical Inc License No: 3613-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 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: 200a overhead service
Notes:
Inspector Signature: Date: July 29 2014
81-Cert Electrical Compliance Form.xls
o���F SOUr�,o
Town Hall Annex l L Telephone(631))7865-1802
54375 Main Road y roger.rlChertEiOW 1.SOUthO1 .nY.U&
P.O.Box 1179
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: S Date: 6 193 L
Company Name: .
Name: � .
License No.:
Address: eo Bo IND I V h
Phone No.: - —ILA it ce{d , a 3
JOBSITE INFORMATION: (*Indicates required information)
*Name: u �►e
"Address:
*Cross Street: p
*Phone No.:
Permit No.:
Tax-Map District: 1000 Section: Block: Lot:
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
(Please Circle All That Apply)
*Is job ready for inspection: YES t& Rough In Final
*Do you need a Temp Certificate: (YW/ NO
Temp Information(if needed)
*Service Size: ase 3Phase 100 150 20 300 350 400 Other
*New Service: Re-connect Underground Number of Metersge a ervlc
Additional Information: PAYMENT DUE WITH APPLICATION
�6
8241equest for Inspection Form