HomeMy WebLinkAbout39769-ZTown of Southold 5/27/2015
P.O. Box 1179
53095 Main Rd
Southold, New York 11971
CERTIFICATE OF OCCUPANCY
No: 37577 Date: 5/27/2015
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 815 Old Shipyard Rd, Southold
SCTM #: 473889 Sec/Block/Lot: 64.-5-19
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
5/14/2015 pursuant to which Building Permit No. 39769 dated 5/14/2015
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 FOR "AS BUILT" GARAGE AND GENERATOR
The certificate is issued to Martin, John
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
39769
05-20-2015
Authorized Signature
gt1FFOt4-TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
o . 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 #: 39769 Date: 5/14/2015
Permission is hereby granted to:
Martin, John
815 Old Shipyard Ln
PO BOX 680
NY 11971
To: Electric in garage and generator
At premises located at:
815 Old Shipyard Rd, Southold
SCTM # 473889 .
Sec/Block/Lot # 64.-5-19
Pursuant to application dated
To expire on 11./12/2016.
Fees:
5/14/2015
and approved by the Building Inspector.
ELECTRIC $175.00
Total: $175.00
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, NY 11971-0959
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Telephone (631) 765-1802
Fax(631)765-9502
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CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: John Martin
Address: 815 Old Shipyard Lane City: Southold St: New York Zip: 11971
Building Permit #: 39769 Section: 64 Block: 5' Lot: 19
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
Commerical Outdoor X 1st Floor
New Renovation 2nd Floor
Addition Survey Attic
INVENTORY
Service Only
Pool
Hot Tub
Garage X
Service 1 ph
Heat
Duplec Recpt
Ceiling Fixtures
HID Fixtures
Service 3 ph
Hot Water
GFCI Recpt
7
Wall Fixtures
Smoke Detectors
Main Panel
A/C Condenser
Single Recpt
Recessed Fixtures
CO Detectors
Sub Panel
A/C Blower
Range Recpt
Fluorescent Fixture
5
Pumps
Transformer
Appliances
Dryer Recpt
Emergency Fixtures
Time Clocks
Disconnect
Switches
4
Twist Lock
Exit Fixtures 1d
TVSS
El
Other Equipment:
2_ Garage Door Openers,
30 KW Generator with 100A Transfer Switch
Notes:
Inspector Signature: Date: May 20, 2015
Electrical 81 Compliance Form.xls
Of SOUTyo�
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLEIG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH)Lei
ELECTRICAL (FINAL)
REMARKS:
DATE 7�ff � INSPECTOR
Town Hall Annex
54375 Main road
P.O. Box 1179
Southold, NY 11971-0959
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Telephone (631) 765-1802
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BUIMING DEPAAR`IMEENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: Date:
Company Name:
Name- C j�k C1
License No.:
Address -
Phone No.:
JOBSITE INFORMATION: (*Indicates required information)
*Name: rl &14X_' ANA.
*Address: <Z(,5r cr)i70 !;'X z S7 d -.'v
*Cross Street: 9;Idd-1-9 tt A -
£Phone No.: f// 1 �I �7/� 5° 3 i° 4a C .. i 3' C'p`l1 6 1-4 ff' x`215
Permit No..
Tax -Map District: 1000 Section: Block: S Lot:
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
(Please Circle All That Apply)
*Is job ready for inspection: YE / NO Rough In Final
*Do- you need a Temp Certificate: YES / No
Temp Information (If needed)
*Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other
*New Service: Re -connect Underground Number of Meters Change of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
.82 -Request for Inspection Form