HomeMy WebLinkAbout40848-Z Town of Southold 9/28/2016
P.O.Box 1179
ca 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38545 Date: 9/28/2016
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 695 Howard Ave,Mattituck
SCTM#: 473889 Sec/Block/Lot: 113.-9-3
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
7/21/2016 pursuant to which Building Permit No. 40848 dated 7/15/2016
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 DOCK, INCLUDING LIGHTS AND SWITCHES
The certificate is issued to Eshelman,Thomas
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 40848 07-21-2016
PLUMBERS CERTIFICATION DATED
Authorized Signature
Sv�Fat c TOWN OF SOUTHOLD
. pG BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
o� • 04 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#: 40848 Date: 7/15/2016
Permission is hereby granted to:
Eshelman, Thomas
2203 Delancey PI
Philadelphia, PA 19103
To: Electric on dock
At premises located at:
695 Howard Ave, Mattituck
SCTM # 473889
Sec/Block/Lot# 113.-9-3
Pursuant to application dated 7/21/2016 and approved by the Building Inspector.
To expire on 1/20/2018.
Fees:
ELECTRIC $90.00
Total: $90.00
uil nspector
pF SO�jr�®�
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 ® �� roper.riche rt&town.southoId.ny.us
Southold,NY 11971-0959 Q
COUNTY,N
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Tom Eshelman
Address: 695 Howard Avenue City: Mattituck St: New York Zip: 11952
Building Permit#: 40848 Section 113 Block. 9 Lot. 3
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: License No:
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 Heat Duplec Recpt Ceding Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks
Disconnect El Switches 2 Twist Lock 1-30 Exit Fixtures TVSS
11 11
Other Equipment: Supply Electric Power To Dock. To Include; 14 -Deck Lights, 2 - Switches,
1 -GFCI Receptacle, 1 -Twist Lock Receptacle,1 -Post Light
Notes:
Inspector Signature: 7Date: September 14, 2016
00Electdcal 81 Compliance Form.xls
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OF SOUTy�Io
- !'YUOUNi'1,
TOWN OF SOUTHOLD BUILDING DEPT.,
765-1802
INSPECTION "
[ ] FOUNDATION 1ST [ ] ROUGH PLUMBING
[ ] FOUNDATION 2ND [ ] INSULATION
[ ]
FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE A CHIMNEY [ ]'FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) J ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
v
f
J
DATE ql1f` /C' INSPECTOR c
f4f so
Tomn Ha Annex
54375 Main Road (631)11
.So�-tA5
FORso'! 015.n .us
P.O.Box 1179 DD
SouthoK NY 11971-0959 COU JUL 2016
BUILDING DEPARTMEMP NUMDINGDEPT.
TOWN OF SOLD TOWN OFSOUTHOLD
APPLICATION FOR ELEqTRI CAL INSPECTION
VREQUESTED BY: Date:
' T r
Company Name-
Name: 7�tbc I
License No.: _38%q3 !LAE
Address: "-Vo �y MOS
Phone No.:
JOBSITE INFORMATION: (*Indicates required information)
*Name:
"Address: )0
*Cross Street:
*Phone No.:
Piarmit No.:
1'"ax Map District: 15'056 Block: Lot:
*BRIEF DESCRIPTION OF WORK(Please Print Clearly)
VL 0_0
dxN x w,
(P.Bease Circle AJI That Apply) 60 C-r-
ls job ready for inspection: YE Rough Irr" Final
:M
*Do you need a Temp Certificate: YF
Temp Information (if needed) -
*Service Size: I Phase 3Phase 100 150 200 300 350 400 Other
*lNew Service: Re-connect Underground Nu-nbero';deters Change of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
82-Request for Inspection Form