HomeMy WebLinkAbout41055-Z �UFFQL,�c�G Town of Southold 10/20/2016
P.O.Box 1179
o 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38606 Date: 10/20/2016
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 3720 S Harbor Rd, Southold
SCTM#: 473889 Sec/Block/Lot: 75.-8-2
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
10/4/2016 pursuant to which Building Permit No. 41055 dated 10/4/2016
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:
RE-WIRE ELECTRIC IN COTTAGE
The certificate is issued to March Margaret M Liv Trt
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 41056 10-11-2016
PLUMBERS CERTIFICATION DATED
Authorized Signature
1
pypgUFFQdc® TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
o • SOUTHOLD, NY
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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#: 41055 Date: 10/4/2016
Permission is hereby granted to:
March Margaret M Liv Trt
515 Park View Dr
Park View, IA 52748
To: new electric in cottage
At premises located at:
3720 S Harbor Rd, Southold
SCTM # 473889
Sec/Block/Lot# 75.-8-2
Pursuant to application dated 10/4/2016 and approved by the Building Inspector.
To expire on 4/5/2018.
Fees:
ELECTRIC $90.00
Total: $90.00
Bui nspector
OF SOU��®C
� o
Town Hall Annex Telephone(631)765-1802
54375 Main Road N Fax(631)765-9502
P.O.Box 1179 • roger.riche rt( -town.southoId.ny.us
Southold,NY 11971-0959
l�coum,�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: March (Creecy)
Address: 3720 South Harbor Road City: Southold St: New York Zip: 11971
Budding Permit#- 41055 Section: 75 Block: 8 Lot: 2
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: "HOME OWNER" DBA: License No:
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service Only
Commerical Outdoor 1st Floor X Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt 14 Ceiling Fixtures 1 HID Fixtures
Service 3 ph Hot Water GFCI Recpt 4 Wall Fixtures 1 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 FixturesTime Clocks
Disconnect Switches 2 Twist Lock Exit Fixtures TVSS
Other Equipment: Re-wire Summer Cottage
Notes:
Inspector Signature: Date: October 11, 2016
0-81-Cert Electrical Compliance Form.xls
l ESO(/lyolo
I �cOUNi`I N
TOWN OF SOUTHOLD BUILDING DEPT.
768-1802
INSPECTION,
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL)
REMARKS:
DATE �� �� INSPECTO
oC
OF SO�jyo!
Town Hall Annex JI
54375 Main Road Telephone(631)7651802
F,ax(631)765-g5Q2
P.O.Box 1179 G Q roger d hert _IOwnsouth0l`fl.nV.uS
Southold,NY 11971-09590 !
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: Creecv
. Date: / 0.62/,/6
j
Company Name: ,.--
Name: Q�
License No.:
Address: ,�� C21 , ^
Phone No.: 22 G coo
JOBSITE INFORMATION: (*Indicates required information)
i
*Name: , ----
*Address: ?
*Cross Street:
*Phone No.: S�7 �� 2,k6
Permit No.:
Tax Map District: 1000 Section:^] Block: _ Lot:
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
(Please Circle All That Apply)
*Is job ready for inspection: )
YES/ NO Rough in Final I
*Do you need a Temp Certificate: YES/ NO -
Temp Information(if needed) '
f
*Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other
*New Service: Re-connect Underground Number of Meters Change of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
C/o
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on L j
82-Request for Inspection Form h-�'G'39 J
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