HomeMy WebLinkAbout39100-Z �yFOi,tr Town of Southold Annex 11/3/2014
P.O.Box 1179
54375 Main Road
"3 Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 37252 Date: 11/3/2014
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1085 West Ln, Southold,
SCTM#: 473889 Sec/Block/Lot: 88.-6-8
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
8/11/2014 pursuant to which Building Permit No. 39100 dated 8/11/2014
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:
100A INSIDE ELECTRIC SERVICE UPGRADE
The certificate is issued to Thompson, Leslie
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 39100 37252
PLUMBERS CERTIFICATION DATED
Authorized Signature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
'a 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 #: 39100 Date: 8/11/2014
Permission is hereby granted to:
Thompson, Leslie
119 Harvard Ave
Staten Island, NY 10301
To: replace 100a electric service inside only.
At premises located at:
1085 West Ln, Southold
SCTM # 473889
Sec/Block/Lot# 88.-6-8
Pursuant to application dated 8/11/2014 and approved by the Building Inspector.
To expire on 2/10/2016.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
y _ TOWN CLERK'S OFFICE
y • ' ' SOUTHOLD, NY
. �Ypl � dao .
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 #: 39100 Date: 8/11/2014
Permission is hereby granted to:
Thompson, Leslie
119 Harvard Ave
Staten Island, NY 10301
To: replace 100a electric service inside only.
At premises located at:
1085 West Ln, Southold
SCTM # 473889
Sec/Block/Lot# 88.-6-8
Pursuant to application dated 8/11/2014 and approved by the Building Inspector.
To expire on 2/10/2016.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
,of SOV&
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.sox u79 o roger.riche rt(aD-town.southoId.ny.us
Southold,NY 11971-0959 N10�7
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Leslie Thompson
Address: 1085 West La City: Southold St: NY Zip: 11971
Building Permit#: 39101 Section: $$ Block: 6 Lot: 8
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 X Basement X Service Only X
Commerical Outdoor 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel 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 Switches Twist Lock Exit Fixtures TVSS
Other Equipment: up grade 100a service, (interior only) 100a main panel, and 100a sub panel
Notes:
Inspector Signature: Date: Oct 22 2014
81-Cert Electrical Compliance Form.xls
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Town Hall Annex Telephone(631)765-1842
54375 Main Roady (631)765- 5Q2
P.O.Box 1179 Q roaer.richert fown.soutf9i0IICtl] nV us
Southold,NY 11971-0959
�OUOil
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: Date:
Company Name:
Name:
i
License No.:
Address:
Phone No.: . ��
JOBSITE INFORMATION: (*Indicates required information)
i
*Name:
*Address: � S'� F><c>i.t2 A) //!2 7/
*Cross Street: T—
*Phone No.:
Permit No.:
Tax-Map District: 1000 Section: $ Block:�` Lot:
*BRIEF DESCRIPTION OF WORK(Please Print Clearly) U 1 {
(Please Circle All That Apply)
*Is job ready for inspection: YE % NO. Rough In Fina
*Do.you need a Temp YES NO
Certificate:
. /
Temp Information(If ne ed) 7e/y ti'e;-, �
*Service Size: Phase 3Phase '300 150 200 300 350 . 400 Other I .
*New Service: e-connect Underground Number of Meters Change of Service Overhead
i
Additional Information: _PAYMENT DUE WITH APPLICATION
PC 7-► N
82=Request for Inspection Form
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