HomeMy WebLinkAbout39369-Z FBI 'Yy Town of Southold Annex 11/18/2014
P.O.Box 1179
54375 Main Road
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 37279 Date: 11/18/2014
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 475 Pipes Neck Rd, Greenport,
SCTM#: 473889 Sec/Block/Lot: 53.-1-6.3
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
11/18/2014 pursuant to which Building Permit No. 39369 dated 11/18/2014
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:
"as built"electric for accessory barn.
The certificate is issued to Pekunka,Michael&Marczewski, Barbara
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 39369 10/29/2014
PLUMBERS CERTIFICATION DATED
Authorized Signature
TOWN OF SOUTHOLD
ogt1FF0�,� rtr}4 BUILDING DEPARTMENT
SYa�'��'
TOWN CLERK'S OFFICE
�y • {;_ 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#: 39369 Date: 11/18/2014
Permission is hereby granted to:
Pekunka, Michael & Marczewski, Barbara
475 Pipes Neck Rd
Greenport, NY 11944
To: as built" electric for accessory barn.
At premises located at:
475 Pipes Neck Rd, Greenport
SCTM # 473889
Sec/Block/Lot# 53.-1-6.3
Pursuant to application dated 11/18/2014 and approved by the Building Inspector.
To expire on 5/19/2016.
Fees:
ELECTRIC $90.00
Total: $90.00
Building Inspector
O��OF SO(/Tyol
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Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 �,, roger.riche rt(@-town.southoId.ny.us
Southold,NY 11971-0959 Q
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Pekunka
Address: 475 Pipes Neck Rd City: Greenport St: NY Zip: 11944
Building Permit#: -5 9 Section: 53 Block: 1 Lot: 6.3
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: AS BUILT DBA: License No:
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service Only
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage X
INVENTORY
Service 1 ph Heat Duplec Recpt 3 Ceiling Fixtures 2 HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures 1 Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel 1 A/C Blower Range Recpt Fluorescent Fixture 1 Pumps
Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks
�]
Disconnect Switches F2 Twist Lock Exit Fixtures TVSS
Other Equipment: AS BUILT----BARN----ELECTRICAL SURVEY----NO VISUAL DEFECTS----
Notes:
Inspector Signature: Date: Oct 29 2014
81-Cert Electrical Compliance Form.xls
OF SOUIyo
il
'SCO N 1 UNf'1,
TOWN OF SOUTHOLD BUILDING DEPT. �j r
�. 765-1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLUMBING
[ ] FOUNDATION 2ND [ ] INSULATION
[ ]
FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
DATE �� `� INSPECTOR
SO(/l�ol
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Town Hall Annex Telephone(631)765-1802
54375 Main Road N � (631)765-9g502
P.O.Box 1179 Q roger.richert(cr_fxwn.southo d ny us
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: Date:
Company Name:
Name:
License No.:
Address:
Phone No.:
JOBSITE INFORMATION: (*Indicates required- information)
*Name:
A// ,
*Address: e l
*Cross Street: ,2—5
*Phone No.: _
Permit No.: 3(,
Tax Map District: 1000 Section: Block: Lot:
*BRIEF DESCRIPTJON OF WORK(Please Print Clearly)
(Please Circle All That Apply)
*Is job ready for inspection: YES / NO Rough In Final
*Do you need a Temp Certificate: YES / NO
Temp Information (If needed) 1�
Service Size: 1 Phase 3Phase 100 150 200 300 350 400/
YV
'New Service: Re-connect Underground Number of Meters Change of Service ,%l Ove a
Ndditional Information: PAYMENT DUE WITH APPLICATIO `
82-Request for Inspection Form