HomeMy WebLinkAbout38224-Z Town of Southold Annex
11/3/2014
P.O.Box 1179
54375 Main Road
Southold,New York 11971
t
CERTIFICATE OF OCCUPANCY
No: 37250 Date: 11/3/2014
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1375 Bray Ave., Laurel,
SCTM#: 473889 Sec/Block/Lot: 126.-8-6
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
7/31/2013 pursuant to which Building Permit No. 38224 dated 7/31/2013
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
The certificate is issued to Sweeney,Michael&Sweeney,Nancy
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 38224 10-22-2014
PLUMBERS CERTIFICATION DATED
Authorized Signature
TOWN OF SOUTHOLD
�} Fnt,r Ar}N BUILDING DEPARTMENT
Vic
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#: 38224 Date: 7/31/2013
Permission is hereby granted to:
Sweeney, Michael & Sweeney, Nancy
1375 Bray Ave
Laurel, NY 11948
To: electric service
At premises located at:
1375 Bray Ave., Laurel
SCTM # 473889
Sec/Block/Lot# 126.-8-6
Pursuant to application dated 7/31/2013 and approved by the Building Inspector.
To expire on 1/30/2015.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
pF SO(/Tyol
0
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 CA roger.richert(d)-town.southold.ny.us
Southold,NY 11971-0959 Q
�yCOUNTY,Nc�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Mike Sweeney
Address: 1375 Bray Ave City: Laurel St: NY Zip: 11948
Building Permit#: 38224 Section: 126 Block: 8 Lot: 6
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Glen's Electric License No: 4770-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 100a Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel 100a A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency FixtureTime Clocks
Disconnect 100a Switches Twist Lock 11 Exit Fixtures S11 TVSS
Other Equipment: temp construction service, 100a OH removed after re-building of house
Notes:
Inspector Signature: Date: Oct 22 2014
81-Cert Electrical Compliance Form.xls
i
o��OF SO�jlyo
Town Hall Annex Telephone(631)765-1802 is
54375 Main Road s�9 02
P.O.Box 1179 roQer.richert #ow%southoltl ny us
Southold,NY 11971-0959 `
I
1IP11� I
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION '
REQUESTED BY: Dale:
Company Name: —
i
Name: SLEiv 'U� o.&s ..
License No.:
I
Address:
I
Phone No.: _ v
JOBSITE INFORMATION: (*Indicates required information)
*Name:
*Address:
i
*Cross Street:
E' o
i
`Phone No.:
Permit No.:
Tax-Map District: 1000 Section: Block: Lot:
*BRIEF DESCRIPTION OF WORK(Please Print Clearly)
E-
l`/ -w oyez227-= 4AI42
E X��SZtdl•c •�•cry �'
Y d
(Please Circle Ali That Apply)
*Is job ready for inspection: �`1 NO Rough In Final
*Do you need a Temp Certificate: NO i
Temp lnformati7,,(Ino ded)
*Service Size: Phase 3Phase 100 150 200 300 350 400 Other
New Service: e-connect Underground Number of Meters Change of Service Overhead '
Additional Information: PAYMENT DUE WITH APPLICATION
D� /3, 2— 3 - 5$4
82=Request for Inspection Form G ��
.<T
0