HomeMy WebLinkAbout41262-Z F04C0� Town of Southold 1/23/2017
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38786 Date: 1/23/2017
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 50 Daly Ln, Southold
SCTM#: 473889 See/Block/Lot: 66.-1-20
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
12/30/2016 pursuant to which Building Permit No. 41262 dated 12/30/2016
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:
REWIRE ELECTRIC IN KITCHEN
The certificate is issued to Argentina,Gene
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 41262 01-05-2017
PLUMBERS CERTIFICATION DATED
Authorized Signature
p�gUFFncK�oTOWN 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#: 41262 Date: 12/30/2016
Permission is hereby granted to:
- Argentina, Gene
15 Westward Ln
Pelham Manor, NY 108032427
To: Rewire Kitchen
At premises located at:
50 Daly Ln, Southold
SCTM # 473889
Sec/Block/Lot# 66.-1-20
Pursuant to application dated 12/30/2016 and approved by the Building Inspector.
To expire on 7/1/2018.
Fees:
ELECTRIC $90.00
Total: $90.00
Buil g In pector
aso
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Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 �Q roger.riche rt(aD-town.southold.ny.us
Southold,NY 11971-0959 Q
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Argentina
Address: 50 Daly Lane City: Southold St: New York Zip: 11971
Building Permit#: 41262 Section: 66 Block: 1 Lot: 20
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Off Shore Electric License No: 36664-ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service Only
Commerical Outdoor 1st Floor X Pool
New Renovation X 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt 2 Ceding Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt 3 Wall Fixtures Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures 11 CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer AppliancesDryer Recpt Emergency Fixtures Time Clocks
DW
Disconnect Switches 2 Twist Lock Exit Fixtures TVSS
Other Equipment: Kitchen; Gas Cook Top, 50A Oven, 1- Exhaust Fan
Notes:
Inspector Signature: Date: January 5, 2017
0-Cert Electrical Compliance Form.xls
OF SOUlyOlo
coum
TOWN OF SOUTHOLD' BUILDING DEPT.
765-1602
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLRG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ] ELECTRICAL (FINAL)
REMARKS:
DATE �� INSPECTOR
*pF SO(/l�Ql
_ o _
Town Hall Arinex ] - el— — 8
54375 Main Road N []�
P.O.Box 1179 G • �Q r0 er.ric �+` D
Southold,NY 11971-0959 'Q
OOUNTI,� DEC 3 0 2016
BUILDING DEPARTMENT BUILDING DEPT.
TOWN OF SOUTHOLD TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: Cti:;Ae l f o— AhxkAel W'. Inc . Date: 12-1.9'6
Company Name: �hd✓e c, �c_.
Name: a4'e'l
License No.: (o _ .e
Address: l-dv 119149
Phone No.:
JOBSITE INFORMATION: (*Indicates required information)
*Name:
*Address: v /-� 0ba Lw
*Cross Street: Sc)dho i�#
*Phone No.: 4-6 C.0, -
Permit No.: p�
Tax Map District: 1000 ction: Block: Lot:
TO—
*BRIEF DES RIPTION OF ORK (Please Print Clearly)
P,fJifB�c 0p
(Please Circle All That Apply)
*Is job ready for inspection: E NO Rough In inal
$p
*Do you need a Temp Certificate. YES / NO
Temp Information (If needed)
*Service Size: 1 Phase 3Phase100r 150 200 300 350 400 Other
*New Service: Re-connect Underground Number of Meters Change of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
i
82-Request for Inspection Form / \ �' ®