HomeMy WebLinkAbout41306-Z o�OgUFFOI,�C�G Town of Southold 4/6/2017
g P.O.Box 1179
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oy _ 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38889 Date: 4/6/2017
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1415 Harbor Ln, Cutchogue
SCTM#: 473889 Sec/Block/Lot: 97.-6-10
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
1/23/2017 pursuant to which Building Permit No. 41306 dated 1/23/2017
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:
200A UNDERGROUND ELECTRIC SERVICE
The certificate is issued to Klodnicki,Eric&Jennifer
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 41306 03-29-2017
PLUMBERS CERTIFICATION DATED
Authorized Signature
s� �lk TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
�y 0 04 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#: 41306 Date: 1/23/2017
Permission is hereby granted to:
Klodnicki, Eric & Jennifer
660 Jacquelyn Rd
Washington, NJ 07676
To: 300a underground electric service
At premises located at:
1415 Harbor Ln, Cutchogue
SCTM # 473889
Sec/Block/Lot# 97.-6-10
Pursuant to application dated 1/23/2017 and approved by the Building Inspector.
To expire on 7/25/2018.
Fees:
ELECTRIC $85.00
Total: $85.00
Buildin s or
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Town Hall Annex Telephone(631)765-1802
54375 Main Road cis Fax(631)765-9502
P.O.Box 1179 ® �Q roger.richert(a-Dtown.southoId.ny.us
Southold,NY 11971-0959
®l�coumi
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To Klodnicki
Address: 1415 Harbor Lane City: Cutchogue St: New York Zip: 11935
Building Permit# 41306 Section: 97 Block: 6 Lot 10
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Rocky Point Electric License No: 32664-ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service Only X
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph 200A Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel 200A A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks
Disconnect 200A Switches Twist Lock Exit Fixtures TVSS El
Other Equipment: 200A UNDERGROUND SERVICE
Notes:
Inspector Signature: _Q Date: March 29, 2017
0-Cert Electrical Compliance Form.xis
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TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLEIG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL)
REMARKS:
a,4j
DATE INSPECTOR
Jan. 17.2017 07 :10 PM PAGE. 1/ 1
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Toon Hall Mitac Telephone(631)765.1809
54374 Main Road
Y.O.Em 1179
sauhokl.NY 11971.0959
��IIIrI, -
BvffiDING DEPAMMENT
TOWN OF SOUTHOLD
� I�9A.TION EM E,LECTR1!PAL I-N$—PECTII N
REQUESTED BY.- �,Ci�' ,
Date: 1-11-1"7
�
Company Name:
Name:
License No.: - 6,q /-Vze
Phone No.: fd I `q r
JOBSITE INFORMATION: (*indicates required information)
*Name:
*Address: / fig" /4'
'Crass Street:
*Phone No.: i
Permit No.:
Tax•Msp District: 1000 Section: Block: Lot:
*BRIEF DESCRIPTION OF WORK(Please Print Clearly)
+(Rorie Circle All That Apply)
*Is job ready for inspectlon: YES N4 Rough In Final
*Do you news a Temp Certificate: NO
Temp Information(If needed)
*SQMW Size: 1 Phase 313hase 100 ISO 200 300 390 400 other
"New$ervlce: lie-connect llrt�umber of Meters /Change of Servioe Ov$rhead
al info�rr� o .
PAYMENT MIF WITH&pL CATION
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