HomeMy WebLinkAbout40949-Z %,aff 'r Town of Southold 9/28/2016
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P.O.Box 1179
v' 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38543 Date: 9/28/2016
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 675 Hill Rd, Southold
SCTM#: 473889 See/Block/Lot: 70.4-28
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
8/31/2016 pursuant to which Building Permit No. 40949 dated 8/31/2016
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:
200A UNDERGROUND ELECTRIC SERVICE FOR CONSTRUCTION
The certificate is issued to GFH Homes LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 40949 09-21-2016
PLUMBERS CERTIFICATION DATED
Authorized Signature
o•ASUa��oTOWN OF SOUTHOLD
BUILDING DEPARTMENT
ti a TOWN CLERK'S OFFICE
-1 • o� 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#: 40949 Date: 8/31/2016
Permission is hereby granted to:
GFH Homes LLC
7675 Cox Ln
PO BOX 932
Cutchogue, NY 11935
To: Electric Service
At premises located at:
675 Hill Rd, Southold
SCTM # 473889
Sec/Block/Lot# 70.-4-28
Pursuant to application dated 8/31/2016 and approved by the Building Inspector.
To expire on 3/2/2018.
Fees:
ELECTRIC $85.00
Total: $85.00
Buildin ctor
pF SOUj�®l
Town Hall Annex Telephone(631)765-1802
54375 Main Road N �e Fax(631)765-9502
P.O.Box 1179 • �� roger.richertl'aD_town.southold.ny.us
Southold,NY 11971-0959
lyC®UNTI,��
BUELDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Heidtmann(GFH Homes LLC)
Address: 675 Hill Road City: Southold St: New York Zip: 11971
Building Permit#: 40949 Section: 70 Block: 4 Lot: 28
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: G&S Electric License No: 578-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 Surrey Attic Garage
INVENTORY
Service 1 ph 200A Heat Duplec Recpt Ceiling 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 2-20 Switches Twist Lock Exit Fixtures TVSS
Other Equipment 200A Underground Service with Temporary Construction Panel and Receptacles.
Notes:
Inspector Signature: Date: September 21, 2016
0-81-Cert Electrical Compliance Form.xls
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Toxin Hall Annex
54375 Main Road
P.O.Box 1179 G� • roci-er.r own.sou off.n .uoD
Southold,NY 11971-0959 '�
��yCOU�{N AUG 3 1 2016
BUILDING DEPARTMENT BUILDING DEPT.
TOWN OF SOUTHOLD TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: Date: �,1G
Company Name:
Name:
License No.: ?
Address: /-?,Oy& C;)I J _A�eb v cA
Phone No.: CP ctzC IC-6 6
JOBSITE INFORMATION: (*Indicates required information)
*Name: ��,<'•►� ���� i h7r4 1�ny.
*Address: ,� ?.�' i�c- /1�,An Soy�ln•�
*Cross Street: (,J,ES, 4
*Phone No.: 72 V, ;7e;/.FV
Permit No.:
Tax-Map District: 1000 Section:- 7 00 . Block:-__0 Lot:
*BRIEF DESCRIPTION OF WORK(Please Print Clearly)
(Please Circle All That Apply)
*Is job ready for inspection: YES NO Rough In Final
*Do-you need a Temp Certificate: YES NO
Temp Information (If needed)
'Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other
'New Service: Re-connect<1nderground Number of Meters /Change of Service Overhead
4dditional Information: PAYMENT DUE WITH APPLICATION
82-Request for Inspection Form AoL- w