HomeMy WebLinkAbout40939-Z ��O�gllfrfOdk�pG� Town of Southold 10/14/2016
. P.O.Box 1179
C3
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38587 Date: 10/14/2016
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 270 Dogwood Ln, East Marion
SCTM#: 473889 Sec/Block/Lot: 38.-5-4
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
8/29/2016 pursuant to which Building Permit No. 40939 dated 8/29/2016
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 overhead electric service.
The certificate is issued to Ulich George F Test Trt&Eleanor
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 40939 9/21/2016
PLUMBERS CERTIFICATION DATED
Authorized Signature
f FOL eco TOWN OF SOUTHOLD
BUILDING DEPARTMENT
y TOWN CLERK'S OFFICE
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#:' 40939 Date: 8/29/2016
Permission is hereby granted to:
Ulich George F Test Trt & Eleanor
PO BOX 19
East Marion, NY 119390019
To: 200a overhead electric service.
At premises located at:
270 Dogwood Ln, East Marion
SCTM # 473889
Sec/Block/Lot# 38.-5-4
Pursuant to application dated 8/29/2016 and approved by the Building Inspector.
To expire on 2/28/2018.
Fees:
ELECTRIC $85.00
Total: $85.00
Buil ictor
pf SOUTH®l
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 ® a� roger.riche rt(-town.southoId.ny.us
Southold,NY 11971-0959
COUNVI
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Ulich
Address: 270 Dogwood Lane City: East Marion St: New York Zip: 11939
Building Permit#: 40939 Section. 38 Block 5 Lot: 4
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: C-Cat Company License No: 953-ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service Only X
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage X
INVENTORY
Service 1 ph 200A Heat Duplec Recpt 1 Ceding Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures Smoke Detectors
Main Panel 200 A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency FixturesTime Clocks
Disconnect 200 Switches Twist Lock Exit Fixtures TVSS
H H
Other Equipment: 200A Overhead Service Change
Notes
Inspector Signature: Date: September 21, 2016
0-81-Cert Electrical Compliance Form.xls
SOUlyOlo
coum,
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLEIG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ] ELECTRICAL (FINAL)
REMARKS:
DATE INSPECTOR i
- Town HaII Aix T (631)763.1802
54375 Main Road 1)763�pgg
P.O Boa 1179 1 mer nd1e �.1sOU[hOdll.rlV.
SOUdtOW NY 1197149M
BUMDINGDEPARTIUNT
• TOWN OF SOU MOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY- D, elk Cl
Date:
Z2l
Company Name:
License No.:
ddress:
Phone No.:
JOBSITE INFORMATION: (Indic atm required nforinafion)
*Name.- Q\%C. \ -
*Addrew a La
*Cr+oss Street
*Phone No.:
Pemnit No.: O�I
Tax Map Distrix low S`echon: ; Blodc L�
*BRIEF DESCRIPTION OF WORK(Please Print Clearly)
(Pleaes Circle All That Apply)
*is job r+eadytorhmpection: YES/ NO Rough in Final
*Do you need a Temp Certificate: YES/ NO
Temp frrbnrratlon ff
eNice Size: 1 Phase 313ha,se 100 150 300 350 400 Other
*Ne�ev�S M' hw1h:
nr� Undergnaund Number of Mens a of Ser vice Overhead
Adi�ibio"nai~ItPAYMENT DUE WITH AP UC-A ON
.�,VOCWn FOM
�1