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Town of Southold 9/17/2015
1 �� P.O.Box 1179
53095 Main Rd
et,fj�� $ Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 37783 Date: 9/17/2015
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 4075 PARADISE POINT RD SOUTHOLD
SCTM#: 473889 Sec/Block/Lot: 81.-1-10.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
1/20/2011 pursuant to which Building Permit No. 36144 dated 1/20/2011
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 POLE SERVICE
The certificate is issued to STEVEN T&ANDREA KOLYER
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ,
ELECTRICAL CERTIFICATE NO. 36144 09-16-2015
PLUMBERS CERTIFICATION DATED .
ti
Authorized Signature
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 36144 Z Date JANUARY 20, 2011
Permission is hereby granted to:
STEVEN T & ANDREA KOLYER
24 GRAMERCY PARK S APT 3E
NEW YORK,NY 10003
for :
ELECTRIC SERVICE POLE AS APPLIED FOR.
at premises located at 4075 PARADISE POINT RD SOUTHOLD
County Tax Map No. 473889 Section 081 Block 0001 Lot No. 010 . 001
pursuant to application dated JANUARY 20, 2011 and approved by the
Building Inspector to expire on JULY 20, 2012 .
Fee $ 90 . 00
Authorized Signature
ORIGINAL
Rev. 5/8/02
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 36144 Z Date JANUARY 20, 2011
Permission is hereby granted to:
STEVEN T & ANDREA KOLYER
24 GRAMERCY PARK S APT 3E
NEW YORK,NY 10003
for :
ELECTRIC SERVICE POLE AS APPLIED FOR.
at premises located at 4075 PARADISE POINT RD SOUTHOLD
County Tax Map No. 473889 Section 081 Block 0001 Lot No. 010 . 001
pursuant to application dated JANUARY 20, 2011 and approved by the
Building Inspector to expire on JULY 20, 2012 .
Fee $ 90 . 00
(aL
Authorized Signature
COPY
Rev. 5/8/02
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Town Hall Annex �� ® : Telephone(631)765-1802
54375 Main Road ; Fax(631)765-9502
P.O.Box 1179 % co__ i
roger.richertRtown.southold.ny.us
Southold,NY 11971-0959 . �` �® e
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To. Kolyer
Address: 4075 Paradise Point Road City: Southold St: New York Zip: 11971
Building Permit#. 36144 Section: 81 Block: 1 Lot: 10.1
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Goodale Electric License No: 783-E
SITE DETAILS
Office Use Only
Residential X Indoor Basement Service Only
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 NC Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel NC Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks
Disconnect 200A Switches Twist Lock Exit Fixtures TVSS
Other Equipment: 200A Overhead Pole Service With 2-20A Circuit Panel
Notes:
Inspector Signature: Date: September 16, 2015
Electrical 81 Compliance Form.xls
,
Town Hall Annex ;1:1;.("fgtiitl Telephone(631)765-1802
54375 Main Roady ( 1)7rg��l'O..Box1179 �\ GQ��S roger.richert((�own.southo .nv.us
- .Southold,NY 11971-0959 ; Q0 ������
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BUILDING DEPARTMENT -
- TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
- REQUESTED BY: p6,60 �� / Date: /r-- / —/f,
Company Name: d iaA-14._ r2C
, .
Name:
License No.: g
Address: 1) v 6 o 1 /To ' , .A--T�e (11 i f c5,,
Phone No.:
JOBSITE INFORMATION: (*Indicates required information)
*Name:• •'Teta VS /24 ii C%z-V-,
*Address: 'O AA/1i 5A P.,p. ' i' Oc/17Q
• *Cross Street: Mti,2`l./ ,4 it,�ir , )
*Phone No.: _S . -iy/ 59-2 3S-
Permit No.: . `.. e.11i-- ,
Tax Map District: 1000 Section: . 2 \ Block: i Lot: kb
*BRIEF DESCRIPTION OF WORK(Please Print Clearly) •
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Vt.'17`(--/ (J?( dxr - R/x- /,Frs r,r' Poc-e �:vc •
(Please Circle Alt That Apply)
*Is.job ready for inspection: ES / NO Rough In 6.16-,-,-;a0
Do you need a Temp Certificate: s?,I NO •
/4114/ .
Temp'information If needed) • p �`
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*Service Size: 1 P ase 3Phase 100 150 200 300 350 400 Other
*New Service: •Re-connect Underground Number of Meters Change of Serviceverhea. -/
Additional Information: PAYMENT DUE WITH APPLICATION . V
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