HomeMy WebLinkAbout40376-Z r '
Town of Southold 1/14/2016
co
i P.O.Box 1179
' 53095 Main Rd
01,,E Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38046 Date: 1/14/2016
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1220 Third St,New Suffolk
SCTM#: 473889 Sec/Block/Lot: 117.-7-15
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretoforefiled in this office dated
12/29/2015 pursuant to which Building Permit No. 40376 - dated 12/29/2015
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:
REPLACE 200 AMP METER PAN AND OVERHEAD ELECTRIC SERVICE
The certificate is issued to Burkhardt,Agnes
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 40376 01-12-2016
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#: 40376 Date: 12/29/2015
Permission is hereby granted to:
Burkhardt, Agnes
1220 Third St
PO BOX 97
New Suffolk, NY 11956
To: Replace 200 Amp Meter and New Overhead Electric Service
At premises located at:
1220 Third St, New Suffolk
SCTM # 473889
Sec/Block/Lot# 117.-7-15
Pursuant to application dated 12/29/2015 and approved by the Building Inspector.
To expire on 6/29/2017.
Fees:
ELECTRIC $85.00
Total: $85.00 '
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Town Hall Annex t� ti0 l0 : Telephone(631)765-1802
54375 Main Road i 411 illZ Fax(631)765-9502
P.O.Box 1179 : G Q
Southold,NY 11971-0959 = Ol •
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To. Burkhardt
Address: 1220 Third Street City: New Suffolk St: New York Zip: 11956
Building Permit#. 40376 Section: 117 Block. 7 Lot: 15
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor DBA: Brian Brooks Electrical, Inc License No. 3613-E
SITE DETAILS
Office Use Only
Residential X Indoor Basement Service Only X
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph 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 Switches Twist Lock Exit Fixtures TVSS
Other Equipment: Replace 200A Meter Pan and Install New Service Entrance Conductors in PVC Pipe
Notes:
.7Inspector Signature: — Date: January 12, 2016
Electrical 81 Compliance Form.xls
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'''''' UlH ': BUILDING DEPARTMENT
f f TOWN OF SOUTHOLD
1 Town Hall Annex•54375 Main Road•P0:Box 1179•Southold,NY 11971-0959
Telephone(631)765-1802•Fax(63;C65-9502
765-9502
DatZq ,20(S
Number of Meters / Temporaary/Certificate
Size '0 Phase 4() 0743
Overhead,, Underground ❑
New Service ❑ Change of Service ❑ Reconnect Existing Service ❑
Location /1W .3 19) C17 A/ SAA
Issued to IS u. ak1 ii-L- t
Installed by
g-1 iesio d 4�--Lic.# —5 et,/ "Lt—
Reference
Application for electrical service equipment is on file with the Town of Southold.On applicant's notification
that this installation is complete,the town will conduct a premises inspection of the service equipment.
This v '' tion is vv.�'� rom the above date.
Authorized by��
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Town Hall Annex - iiiiI Telephone(631)765-1802
54375 Main Road • (631)76 �5Q2
f ' P.O.Boxh179� G Q ii roger.richert {a'o`wn.10 O1lUa.ny.us
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DEC 292015
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
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BLDG nFPI •
Tom or SOUf�o 0APPLI'ATION FOR ELECTRICAL INSPECTION
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REQUESTED BY: Tx. ?)/,0014.6Date: a�ComIanY
company Name:e ` io�ln 16roo y_s t-c caf i Tivx �.
- Name: Bow Brooms
License No.: 3 6I3-E
Address: ?Cl 1240x 1COt , CutfnOgt , we (%
Phone No.: JJ
JOBSITE INFORMATION: (*Indicates required information)
*Name: PhArN&S 801-K 1 a-I -
Address: ,4 i, ;I.2sa.O 3"a S -,f�)Pi -x1 5u4 I14
*Cross Street: 0 rCtflatrdi re.;A-
*Phone No.: I– apl _ 7.51 - 33oa
Permit No.:
Tax Map District: 1000 Section: I,( 1 Block: . 1 Lot: 1 S
*BRIEF DESCRIPTION OF WORK (Please Print Clearly) llaCectO
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I ' -a- ►Otic !v 4 Ir - •1 , e _ . .. It ' "1 rrcw, '- ,, in L ;n
n',
(Please Circle All That Apply)
*Is job ready for inspection: C2.NO Rough In Final
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*Do.you need a Temp Certificate: OW/ NO
Temp Information(If needed) 1
*Service Size: 1 Phase-3Phase 100 150 i 201 300 350 400 Other
*New Service: Re-connect Underground Number of Meters Change of Servi - Overhead
Additional Information: PAYMENT DUE WITH APPLICATION c6
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,� IT ' IA/ (J51\c 1\t/0
82 request for spection Form /, t9)
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