HomeMy WebLinkAbout39323-Z * Town of Southold Annex
}y FF04 11/12/2014
P.O.Box 1179
54375 Main Road
4
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 37268 Date: 11/12/2014
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 510 Clark Rd, Southold,
SCTM#: 473889 Sec/Block/Lot: 135.-2-4
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
10/28/2014 pursuant to which Building Permit No. 39323 dated 10/28/2014
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 Blim,Thomas&Sonneborn, Susan
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 39323 10/29/2014
PLUMBERS CERTIFICATION DATED
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#: 39323 Date: 10/28/2014
Permission is hereby granted to:
Blim, Thomas & Sonneborn, Susan
128 Gordonhurst Ave
Montclair, NJ 07043
To: 200 Amp Electric Service Change
At premises located at:
510 Clark Rd, Southold
SCTM #473889
Sec/Block/Lot# 135.-2-4
Pursuant to application dated 10/28/2014 and approved by the Building Inspector.
To expire on 4/28/2016.
Fees:
ELECTRIC $100.00
Total: $100.00
Building Inspector
SO(/rypl
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Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 �, io roger.riche rt(aD-town-so uthold.ny.us
Southold,NY 11971-0959 'QIyCOUN�'�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Tom Blim
Address: 510 Clark Rd City: Southold St: NY Zip: 11971
Building Permit#: 39323 Section: 135 Block: 2 Lot: 4
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: East County Electric Inc License No: 1005-e
SITE DETAILS
Office Use Only
Residential X Indoor Basement Service Only X
Commerical Outdoor 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: Date: Oct 29 2014
81-Cert Electrical Compliance Form.xls
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Town Hall Annex ad Telephone(631)765-1802
SP.O.Main
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Southold,NY 11971059 �y� � .
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BUILDING DFPARTZb1 ENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
- REQUESTED BY: t I C r' 'C�s ZC6 L
Date: !0 7-97:Z i
Company Name:
Name:
License No.:
Address: 23co (Ste-nn, cl. OU Q
Phone No.
i
JOBSITE INFORMATION: (*Indicates required information)
i
*Name:
*Address:
r ov
*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: S NO Rough In Final
*Do-you need a Temp Certificate: YES NO
Temp Information(If needed)
*Service Size: Phase 3Phase 100 150 tOO 300 350 400 Other
*New Service: e-connect Underground Number umber of Meters Change of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
s
82-Request for Inspection Form
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