HomeMy WebLinkAbout41474-Z Ira,. Town of Southold 5/9/2017
P.O.Box 1179
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yljbl �ao� Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38934 Date: 5/9/2017
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 4001 Wells Rd, Peconic
SCTM#: 473889 Sec/Block/Lot: 86.-1-9.4
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
3/29/2017 pursuant to which Building Permit No. 41474 dated 3/29/2017
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:
REPAIR 200A UNDERGROUND ELECTRIC SERVICE
The certificate is issued to Johnson Leung Family Trust
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 41474 02-02-2017
PLUMBERS CERTIFICATION DATED
Authorized Signature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
py, . 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#: 41474 Date: 3/29/2017
Permission is hereby granted to:
Johnson Leung Family Trust
304 W 115th St Apt 7A
New York, NY 10026
To: repair 220a underground feed wire.
At premises located at:
4001 Wells Rd, Peconic
SCTM # 473889
Sec/Block/Lot# 86.-1-9.4
Pursuant to application dated 3/29/2017 and approved by the Building Inspector.
To expire on 9/28/2018.
Fees:
EL RIC $85.00
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$85.00
Building Inspector
OF SO!/T�ol
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Town Hall Annex Telephone(631)765-1802
54375 Main Road N � Fax(631)765-9502
P.O.Box 1179 �Q roper.richert(a-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: Johnson Leung Family Trust
Address: 4001 Wells Road City: Peconic St: New York Zip: 11958
Building Permit#: 41474 Section: 86 Block: 1 Lot: 9.4
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: BJ Electric License No: 2670-ME
SITE DETAILS
Office Use Only
Residential X Indoor Basement Service Only X
Commerical Outdoor X 1st Floor 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 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 FixtureTime Clocks
Disconnect Switches Twist Lock Exit Fixtures TVSS El
Other Equipment: Repair 200A Under Ground Service Lateral (Splice)
Notes:
Inspector Signature: Date: May 2, 2017
0-Cert Electrical Compliance Form.xls
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Town Hall Annex 41 4 Telephone(631)765-1802
54375 Main Road • 0 ,,aaxx(631)765-gg5i
P.O.Box 1179 G Q rogenrichert Lown outhOQ2 nV us
Southold,NY 11971-0959
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY-
Date: zm
Company Name: �Le'e
Name:
License No.:
Address:
Phone No.:
JOBSITE INFORMATION: (*Indicates required information,) _
*Name: AL164 -TAn t)
*Address:
*Cross Street: f
*Phone No.:
Permit No.:
Tax-Map District: 1000 Section: Block:' Lot:
*BRIEF DESCRIPTION OF WORK(Please Print Clearly)
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(Please Circle All That Apply)
*Is lob ready for inspection: C�O Rough in final
*Do you need a Temp Certificate:
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Temp Information (if needed) Ir ,,, i
*Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other I
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*New Service: Re-connect Underground Number of Meters Change of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
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