HomeMy WebLinkAbout39900-ZNo: 37675
Town of Southold
P.O. Box 1179
53095 Main Rd
Southold, New York 11971
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 580 Gin Ln, Southold
7/23/2015
Date: 7/23/2015
SCTM #: 473889 Sec/Block/Lot: 88.-3-8.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
6/25/2015 pursuant to which Building Permit No. 39900 dated 6/25/2015
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:
200A OVERHEAD ELECTRIC SERVICE
The certificate is issued to Wells, Arthur & Wells, Rose
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
39900 07-08-2015
Authorized Signature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
ca TOWN CLERK'S OFFICE
. o 4V 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 #: 39900
Permission is hereby granted to:
Wells, Arthur & Wells, Rose
700 Mease Plz Apt 347
Dunedin. FL 346986624
To: Electric Service
At premises located at:
580 Gin Ln, Southold
SCTM # 473889
Sec/Block/Lot # 88.-3-8.1
Date: 6/25/2015
Pursuant to application dated 6/25/2015 and approved by the Building Inspector.
To expire on 12/24/2016.
Fees:
ELECTRIC $85.00
$85.00
Building Inspector
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, NY 11971-0959
1 1 � '•' 1.
Telephone (631) 765-1802
Fax (631) 765-9502
roper.richert(a_town.southold.ny.us
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Arthur Wells
Address: 580 Gin Lane City: Southold St: New York Zip: 11971
Building Permit #: 39900 Section: 88 Block: 3 Lot: 8.1
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Ladernann Electric License No: 4141-E
SITE DETAILS
Office Use Only
Residential X Indoor Basement X Service Only X
Commerical Outdoor X 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 A1C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel AIC Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks
Disconnect 200A Switches 11 Twist Lock Exit Fixtures TVSS
Other Equipment: 200A OVERHEAD SERVICE
Notes:
Inspector Signature: Date: July 8, 2015
Electrical 81 Compliance Form.xls
SOO
Town Hall Annex
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�r, i r, , �rcl E17 P1, 'T BUILDING DEPARTMENT
jl'� TOWN OF SOUTHOIJ)
M.'
eeu TION FOR ELECTRICAL IN
REQUESTED BY.
Company Name:
Name:
License No.: 41 j-,
Address: _46 z)—
JPhone No.:. 7'714_ –,717 At
Telephone (631) 765-1802
—765 -15.
ro g e r. riche rt (d_re0xw'6n'!s) OUf& 0 ny.us
Date: /_ -I �-_
JOBSITE WFORMATION: (Indicates required information)
*Name: _A%.- - A' w 0
*Address:
*Cross Street:
*Phone No.: CA I'AJ
Permit No.:
Tax Map District: 1000 Section:__ Block:
Lot: iFi I
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
(Please Circle All That Apply)
*Is job ready for inspection:
*®o you need a Temp Certificate: Y
3YESNO Rough In Final
� NO
Temp Information (if needed)
*Service Size: /-1Th_a_s_� 3Phase 100 150 ( ' 300 350 400 Other
*New Service: Re -connect Underground Number of Meters hange of Servi Overhead
Additional Information: PAYMENT DUE WITHAPPLICATION
STT /
82 -Request,
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