HomeMy WebLinkAbout37543-Z ��O�gUFFOt�CpG�� Town of Southold 12/8/2016
P.O.Box 1179
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Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38698 Date: 12/8/2016
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 50 Indian Neck Ln,Peconic
SCTM#: 473889 See/Block/Lot: 86.-4-1.3
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
9/25/2012 pursuant to which Building Permit No. 37543 dated 9/25/2012
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:
NEW POLE FOR ELECTRIC METER ONLY(NO INTERIOR WORK)
The certificate is issued to Nodelman Family Trust
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 37543 12-06-2016
PLUMBERS CERTIFICATION DATED
Authorized Signature
so
Town Hall Annex Telephone(631)765-1802
54375 Main Road 'Ir ArFax(631)765-9502
P.O.Box 1179 roger.riche rt(aD-town.southold.ny.us
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Robert Nodelman
Address: 50 Indian Neck Lane City: Peconic St: New York Zip: 11958
Budding Permit#: 37543 Section: 86 Block: 4 Lot: 1.3
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Goodale Electrical License No: 783-E
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 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 Switches Twist Lock Exit Fixtures 11 TVSS
Other Equipment: Install Class 7 Pole for New Meter for Existing Under Ground Service.
No Interior Work Done.
Notes:
Inspector Signature: Date: December 6, 2016
0-Cert Electrical Compliance Form.xls
�SUFFn�x TOWN OF SOUTHOLD
BUILDING DEPARTMENT
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 #: 37543 Date: 9/25/2012
Permission is hereby granted to:
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163-Marcus-Ave G.t l2 A c�
New Hyde Park, NY 11040 10
To: install new pole for meter
At premises located at:
50 Indian Neck Ln, Peconic
SCTM # 473889
Sec/Block/Lot# 86.-4-1.3
Pursuant to application dated 9/25/2012 and approved by the Building Inspector.
To expire on 3/27/2014.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
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Town Hall Annex 1 ( Telephone(631)765-1802
54375 Main Road Q2
P.O.Box 1179 roaer.ClCheft(JoWn SOU Old ny U$
Southold,NY 11971-0959
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1 B� ' BUILDING DEPARTM EN r
N �� TOWN OF SOUTHOLD
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PkPP ATION FOR ELECTRICAL INSPECTION
REQUESTED BY: d dp Date: _ a
Company Name: c ,
Name:
License No.:
Address:
Phone No.. �— 7
JOBSITE INFORMATION: (*Indicates required information) 03)
*Name: � 7 ���Lr-'" 0314 .
*Address:
*Cross Street: ��,� /��C �
*Phone No.: 5-
Permit No.: I
Tax-Map District: 1000 Section:�_ Block: Lot:
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
-(Please Circle All That Apply)
*Is job ready for inspection: YE / NO bough In
*Do-you need a Temp Certificate: / NO
Temp Information (If needed}
*Service Size: 1 a 3Phase 100 200 300 350 400 Other
*New Service: 1 connect Underground Number of Meters Change of Service Overhead
Additions nformation: PAYMENT DUE WITH APPLICATION
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-Request for Inspection Form °'�'