HomeMy WebLinkAbout40400-Z �; S�FFOI,�e® - Town of Southold 2/3/2016
tom i P.O.Box 1179
cf„t m 53095 Main Rd
p , Southold,New York 11971
0110 � .0
CERTIFICATE OF OCCUPANCY
No: 38080 Date: 2/3/2016
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 380 Washington Ave, Greenport
SCTM#: 473889 Sec/Block/Lot: 41.-1-39
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
1/11/2016 pursuant to which Building Permit No. 40400 dated 1/12/2016
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 FOR 2 STORAGE SHEDS AND ELECTRICAL SURVEY
The certificate is issued to Stepnoski, Jean
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 40400 01-20-2016
PLUMBERS CERTIFICATION DATED
*.?--el,"---V:E?
Authorized Signature
5 TOWN OF SOUTHOLD
X04° BUILDING DEPARTMENT
t d s TOWN CLERK'S OFFICE
v� o� SOUTHOLD, NY
DI * l'eP
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#: 40400 Date: 1/12/2016
Permission is hereby granted to:
Stepnoski, Jean
PO BOX 993
Southold, NY 11971
To: Electric Service
At premises located at:
380 Washington Ave, Greenport
SCTM # 473889
Sec/Block/Lot# 41.-1-39
Pursuant to application dated 1/11/2016 and approved by the Building Inspector.
To expire on 7/13/2017.
Fees:
ELECTRIC $90.00
Total: $90.00
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Building pector ---
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��,o%OF SOUTH®
Town Hall Annex �, �® l® : Telephone(631)765-1802
54375 Main Road t iill 1111 t Fax(631)765-9502
P.O.Box 1179 : co* ic' ��
Southold,NY 11971 0959 O aQ��1, roger.richert(a�town.southold.ny.us
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Stepnoski
Address: 380 (28)Washington Avenue City: Greenport St: New York Zip: 11944
Building Permit#. 40430&40400 Section. 41 Block: 1 Lot: 39
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Dan Wilcenski Electrical License No: 4723-ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement X Service Only
Commencal Outdoor X 1st Floor X Pool
New Renovation 2nd Floor X Hot Tub
Addition Survey X Attic Garage
INVENTORY
Service 1 ph 200A Heat OIL Duplec Recpt 39 Ceiling Fixtures 18 HID Fixtures
Service 3 ph Hot Water GFCI Recpt 8 Wall Fixtures 8 Smoke Detectors
Main Panel 200A NC Condenser Single Recpt Recessed Fixtures 13 CO Detectors
Sub Panel A/C Blower Range Recpt 20A Fluorescent Fixture Pumps
Transformer Appliances DW Dryer Recpt Emergency Fixtures Time Clocks
Disconnect 200A Switches 21 Twist Lock Exit Fixtures TVSS
Other Equipment: Certificate Includes 2 - Storage Sheds.
Notes: "Electrical Survey"-"As Built" "No Visual Defects", 2-Exhaust Fans
Vi.Inspector Signature: Date: January 20, 2016
Electrical 81 Compliance Form.xls
•
Town Hall Annex Telephone(631)765-1802
54375 Main Road % c0� ; (631)765950
P.O.Box 1179 ; G � , roper.richet���own.soufC�ot�.nY.us
Southold,NY 11971-0959 O oi
�yCOUITIV` '
,
BUILDING DEPARTMENT
' TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
- :REQUESTED BY: Dan Wilcenski Date: 1/11/2016 `_ \.
Name: Dan Wilcenski Electrical Contracting
Company
•
Name: Dan Wilcenski _
License No.: 4723-me
Address: PO Box 319,Southold,NY 11971
' Phone No.:
631-765-2864
JOBSITE INFORMATION: (*Indicates required information)
*Name:
Stepnoski
- *Address: 28 Washington Ave, Greenport NY 11944
`Cross Street: Main Street
*Phone No.: 631-765-5815
Permit No.:
Tax-Map District: 1000 • Section:- 41 - Block: 1 Lot: 39 yy
*BRIEF DESCRIPTION OF WORK(Please Print Clearly) Install new 200 Amp Service on •
pre-existing structure,shed wiring and change services E (c ( :_ ,156 -e --; (.A f ``
(Please Circle M That Apply)
*Is job ready for inspection:
A----41,O Rough In Final
*Do you need a Temp Certificate: _ NO
Temp Information(If-neezted '
*Service Size: 1 Phase 3Phase 100 151---C212_)300 --350----.---4 0 Other
*New Service: e-connect Underground Number of Mete Change of Service O erhead
Additional Information: PAYMENT DUE WIT ?PLIC"A N
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82=Request for Inspection Form � U
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