HomeMy WebLinkAbout41282-Z �o�SUFFOI,fc�G� Town of Southold 2/13/2017
0
P.O.Box 1179
o 53095 Main Rd
o4, Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38825 Date: 2/13/2017
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 2850 Pine Neck Rd, Southold
SCTM#: 473889 Sec/Block/Lot: 70.-10-4
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
1/11/2017 pursuant to which Building Permit No. 41282 dated 1/11/2017
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 BATHROOM
The certificate is issued to Andruski,Nathan
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 41282 01-25-2017
PLUMBERS CERTIFICATION DATED
Authorized Signature
SOFEnttTOWN OF SOUTHOLD
coG BUILDING DEPARTMENT
C2, TOWN CLERK'S OFFICE
o . Z SOUTHOLD, NY
0
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#: 41282 Date: 1/11/2017
Permission is hereby granted to:
Andruski, Nathan
PO BOX 1227
Southold, NY 11971
To: Re-Wire Bathroom
At premises located at:
2850 Pine Neck Rd, Southold
SCTM #473889
Sec/Block/Lot# 70.-10-4
Pursuant to application dated 1/11/2017 and approved by the Building Inspector.
To expire on 7/13/2018.
Fees:
ELECTRIC $90.00
Total: $90.00
i ng Inspector
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Town Hall Annex Telephone(631)765-1802
54375 Mam Road Fax(631)765-9502
P.O.Box 1179 G Q
Southold,NY 11971-0959 ®lCot
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To. Andruski
Address: 2850 Pine Neck Road City: Southold St: New York Zip: 11971
Building Permit#: 41282 Section: 70 Block: 10 Lot: 4
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Hy Point Electric License No: 39698-ME
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 Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt 1 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 SNntches P3 Twist Lock Exit Fixtures TVSS
Other Equipment: 1- Exhaust Fan
Notes: Bathroom"
Inspector Signature: Date: January 25, 2017
0-Cert Electrical Compliance Form.xls
Of SO�TyOIo
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cOUNi'I
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 , �� INSPECTORj` "
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Town Hall Annex 4 Telepho (631)765-1802
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thold,NY 1197I-0959 D Ql
JAN 1 1 2017 � �
BUILDING DEPARTMENT
BUILDING DEPT. TOWN OF SOUTHOLD {
TOWN of sfUrmU ION FOR ELECTRICAL INSPECTION
REQUESTED BY: L. d VaV-J . /A L-t-� Date:jpj 1 l 1 +
Company Name: Powv F-Lc?at c- c, m ena
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Name:
License No.: 3
Address: K�
Phone No.: 3 -s s3- a-6
JOBSITE INFORMATION: (*Indicates required information)
*Name: ,,
*Address: � CD �� �- 6�e�� �� -<�'Z" Q„�►
*Cross Street:
t
*Phone No.: �3 - I -(o 14- (0 -
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
*Do,you need a Temp Certificate: YES I NO
Temp Information(it needed)
*Service Size: 1 Phase 313hase 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
BMequest for Inspection Form
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