HomeMy WebLinkAbout40505-Z ` SU ¢ '�C
f� dG� Town of Southold 4/28/2016
to P.O.Box 1179
c" 53095 Main Rd
410 00 Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38273 Date: 4/28/2016
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 625 Glenn Rd.,Southold
SCTM#: 473889 Sec/Block/Lot: 78.-2-8
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
3/3/2016 pursuant to which Building Permit No. 40505 dated 3/3/2016
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 WIRING OF BATHROOM AND OUTSIDE LIGHTING
The certificate is issued to Quinn,Robert
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 40505 03-31-16
PLUMBERS CERTIFICATION DATED
Authorized Signature
,.s�FFo".,If TOWN OF SOUTHOLD
;'o`� �O� BUILDING DEPARTMENT
V' TOWN CLERK'S OFFICE
}o' s ar SOUTHOLD, NY
.,,7491 * �ao�,'
... 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#: 40505 Date: 3/3/2016
Permission is hereby granted to:
Quinn, Robert
17 Jamaica Ave
Plainview, NY 118033419
To: Residential Inspection to include Bath/ Outside Lighting ,
At premises located at:
625 Glenn Rd.,Southold
SCTM # 473889
Sec/Block/Lot# 78.-2-8
Pursuant to application dated 3/3/2016 and approved by the Building Inspector.
To expire on 9/2/2017.
Fees:
ELECTRIC $90.00
Total: $90.00
Building Inspector
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Town Hall Annex �� ~o l® : Telephone(631)765-1802 .
54375 Main Road % ilig illi ; Fax(631)765-9502
P.O.Box 1179a
Southold,NY 11971-0959 ,-'mac% 4Zb���` roper.richert(a�town.southold.ny.us
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To. Quinn
Address: 625 Glenn Road City: Southold St: New York Zip: 11971
Building Permit#: 40505 Section: 78 Block: 2 Lot: 8
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Daniel Wilcenski License No: 4723-ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service Only
Commerical Outdoor X 1st Floor X Pool
New Renovation X 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt Ceiling Fixtures 1 HID Fixtures
Service 3 ph Hot Water GFCI Recpt 2 Wall Fixtures 1 Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures 4 CO Detectors
Sub Panel NC Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks
Disconnect Switches 5 Twist Lock Exit Fixtures TVSS
Other Equipment 1- Exhaust Fan
Notes:
' 21Inspector Signature: Date: March 31, 2016
Electrical 81 Compliance Form.xls
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TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLUMBING
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) k] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
Af tom- a
DATE - /( (//‘‘ INSPECTO —
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Town Hail Annex * * Telephone(631)765-1802
54375 Main Road (631)7fi 5
P.O.Box 1179 ; •44.41
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Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
- REQUESTED BY: b c IA/ / Date: 3-3_
Company Name: n". s)C. I e . ��-
Name: ic
License No.: 7 Z-3 _ !M F
Address: P. b • � so -i4.-IJ //f2/
"Phone No.: • ?/ _ ? 4 5- - ) cy
JOBSITE INFORMATION: (*Indicates required information)
*Name: u -
*Address: (o 9 4-e-va. i20. ,p r'c� / -� w //S'7/
*Cross Street L A-/ 101 e_4.Ov . (20,
*Phone No.: `3J _ -2.7 c - (., 'Lc f- . . c •
Permit No.: - � ,�.. •
Tax.Map District: 1000 Section: Block: Lot:
*BRIEF DESCRIP ION OF WORK(Please Print Clearly)
- Vv "k kr--- •
(Please Circle All That Apply)
*Is job ready for inspection: NO Rough In Final
Do you need a Temp Certificate: YES slop
nformation(If needed) •
: ; Lt
Service ize: Pha3`f 100 150 200 00 350 400 Other
New Service: Undergroun r of Meters Change ice Overhe�
Additional Information: PAYMENT DUE WITH APPLICATION
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.22- Request for rpspection Form (� -