HomeMy WebLinkAbout41403-Z �0�0511FF0��y�pG Town of Southold 4/6/2017
P.O.Box 1179
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53095 Main Rd
oy�j®� �o� Southold,New York 11971
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CERTIFICATE OF OCCUPANCY
No: 38890 Date: 4/6/2017
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 905 Smith Dr N., Southold
SCTM#: 473889 Sec/Block/Lot: 76.4-16
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
3/8/2017 pursuant to which Building Permit No. 41403 dated 3/8/2017
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:
ELECTRIC UP-GRADE IN KITCHEN
The certificate is issued to Germuth,Gerard
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 41403 04-04-2017
PLUMBERS CERTIFICATION DATED
Authorized Signature
sncK TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
oy • 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#: 41403 Date: 3/8/2017
Permission is hereby granted to:
Germuth, Gerard
155 W Creek Rd
Southold, NY 11971
To: Electrical permit to bring kitchen up to code.
At premises located at:
905 Smith Dr N., Southold
SCTM # 473889
Sec/Block/Lot# 76.-1-16
Pursuant to application dated 3/8/2017 and approved by the Building Inspector.
To expire on 9/7/2018.
Fees:
ELECTRIC $90.00
Total: $90.00
Building Inspector
pF SOUPy®l®
Town Hall Annex Telephone(631)765-1802
54375 Main Road y Fax(631)765-9502
P.O.Box 1179 �Q roger.rich ert(-town.southoId.ny.us
Southold,NY 11971-0959 Q
�yC®UNTY,�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Germuth
Address: 905 Smith Drive North City: Southold St: New York Zip: 11971
Building Permit#: 41403 Section: 76 Block- 1 Lot: 16
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: SAFE License No: 4324-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 4 Ceiling Fixtures 1 HID Fixtures
Service 3 ph Hot Water GFCI Recpt 2 Wall Fixtures Smoke Detectors
Main Panel A/C Condenser Single Recpt 1 Recessed Fixtures 1 CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency FixtureTime Clocks
Disconnect Switches 2 Twist Lock Exit Fixtures TVSS
Other Equipment: Kitchen Up-Grades
Notes:
Inspector Signature: Date: April 4, 2017
0-Cert Electrical Compliance Form.xls
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pE SOUTyolo
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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:
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DATE INSPECTOR 8�-�
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Town Hall Annex 4 Telephone(631)765-1802 j
54375 Main Road cn (6315-g5
P.O.Box 1179 • O roger.riche t(CA006 s)o76UM0 tl.nV.us ,
Southold,NY 11971-0959. Q i
B€n DING DEPARTMENT �
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION•
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REQUESTED BY- Date: 3
Company Name: "5Varo✓ PE_R,2CIAA-L[,C-'G°77;"e;e, meq.- 6%
Name- Sic.✓
License No.: �3L y.•� E
Address: p,c,v-e- e✓P s A
Phone No.. 3/- SIP 7 A Y&7 a c ia31 —5 of S
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JOBSITE INFORMATION: (*Indicates required information)
*Name:
*Address: � ��I
*Cross Street: i pQ,Ve-1oA ¢h
i+c A 0 SS 'T€Rk 24c 4�
*Phone No.: 3/ ? _ 5-Y®
Permit No.:
Tax-Map District: 1000 Section: Block: - Lot: /
*BRIEF DESCRIPTION OF WORK(Please Print Clearly) g"t
(Please Circle All That Apply)
*Is job ready for inspection: YE NO augh Final
YES!(O
*Do-you need a Temp Certificate:
Temp Information(If-needed)
*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
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82-bequest for Inspection Form
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