HomeMy WebLinkAbout39017-Z Town of Southold Annex 9/10/2014
' P.O.Box 1179
6
54375 Main Road
v . Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 37141 Date: 9/10/2014
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 540 Takaposha Rd, Southold,
SCTM#: 473889 Sec/Block/Lot: 87.-6-9
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
7/9/2014 pursuant to which Building Permit No. 39017 dated 7/9/2014
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:
200a overhead electric service.
The certificate is issued to Panella Ralph &Panella Elaine Rev Tr
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 39017 8/25/2014
PLUMBERS CERTIFICATION DATED
Aut orized 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#: 39017 Date: 7/9/2014
Permission is hereby granted to:
Panella Ralph L Revoc Trt & Panella Elaine B Revoc Trt
PO BOX 1643
Southold, NY 11971
To: Electric Service
At premises located at:
540 Takaposha Rd, Southold
SCTM # 473889
Sec/Block/Lot# 87.-6-9
Pursuant to application dated 7/9/2014 and approved by the Building Inspector.
To expire on 1/8/2016.
Fees:
ELECTRIC $85.00
Total: $85.00
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Building nspector
OF SOUjyQI
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Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 117
Southold,NY 11971-0959 Q roger.richert(a-town-so uthold.ny.us
Q �
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Ralph Panella
Address: 540 Takaposha City: Southold St: NY Zip: 11971
Building Permit#: 39017 Section: $7 Block: 6 Lot: 9
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Brooks Electric License No:
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 Fixture Time Clocks
Disconnect 200a Switches Twist Lock Exit Fixtures TVSS
Other Equipment: 200a Overhead service
Notes:
Inspector Signature: n Date: Aug 25 2014
81-Cert Electrical Compliance Form.xls
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Town Hall Annex 1 41 Telephone(631)765-1802
54375 Main RoadCAR ro er.riche o n s
P.O.Box 1179 ' Q
Southold,i+1Y 11971-0959 i }
J 2014
BUMDING DEPARTMI'1V'I'
Town OF SOUTHOLD D�PT.
APPLICATION FOR ELECTRICAL INSPECTI T0t'in'' `' ° T''0f D
REQUESTED BY: �. �nS Date: Il.!
Company Name:
Name:
License No.:
Address:
JDativ-10 Of 1&35
Phone No.: oZ
5—
JOBSITE INFORMATION: (*Indicates required information)
*Name: Qn.ne-,11QL
*Address:
*Cross Street:
*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/dSkj�- Rough In Final
*Do you need a Temp Certificate: CYEV NO
Temp Information(If needed)
*Service Size: Phas 3Phase 100 150 (M:) 300 350 400 Other
*New Service: Re-connect Underground Number of Meters Change of Senn r ea
Additional Information: PAYMENT DUE WITH APPLICATIONfl
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A
82-Request for Inspection Form