HomeMy WebLinkAbout41408-Z �O�sUFFnc,��pG Town of Southold 5/25/2017
P.O.Box 1179
0
CA 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38970 Date: 5/25/2017
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 30697 CR 48,Peconic
SCTM#: 473889 Sec/Block/Lot: 73.4-4.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
3/9/2017 pursuant to which Building Permit No. 41408 dated 3/9/2017
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:
200 AMP UNDERGROUND ELECTRIC SERVICE
The certificate is issued to Gober,Robert
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 41408 04-05-2017
PLUMBERS CERTIFICATION DATED
Authorized Signature
o�SU Kco TOWN OF SOUTHOLD
h� aye BUILDING DEPARTMENT
y TOWN CLERK'S OFFICE
oy • 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#: 41408 Date: 3/9/2017
Permission is hereby granted to:
Gober, Robert
216 W 20th St
New York, NY 10011
To: Underground electric service
At premises located at:
30697 CR 48, Peconic
SCTM # 473889 -
Sec/Block/Lot# 73.4-4.1
Pursuant.to application dated 3/9/2017 and approved by the Building Inspector.
To expire on 9/8/2018.
Fees:
ELECTRIC $85.00
Total: $85.00
BuiIdinspe r
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 ® roger.rich ert(aD-town.southold.ny.us
Southold,NY 11971-0959 ®��c®U '��
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Robert Gober
Address: 30697 CR 48 City: Peconic St: New York Zip: 11958
Building Permit#- 41408 Section: 73 Block: 4 Lot. 4.1
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Paul Burns Electric License No: 3897-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 200A Heat Duplec Recpt Ceding Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt 1 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 ri Twist Lock Exit Fixtures TVSS
Other Equipment: 200A UNDERGROUND SERVICE.
Notes:
Inspector Signature: Date: April 5, 2017
0-Cert Electrical Compliance Form.xls
Mrs
Town Hall Annex Telephone(681)765-1802
54375 Main Road
P.O.Box 1179 r0-endC S
Sou@iold,NY 11971-0959 `��01 D
MAR - 9 2017
WADING DEPARTMENT
TOWN O»SOUTHOLD BUILDINGDEPT.
TOWN OF SOUTHHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: 2Date: 3 q
Company Name: t s.
Name: 2 r
License No.:
Address:
Phone No.: Q-365' —r-1_23
JOBSITE INFORMATION: (*Indicates required information)
*Name: 26 ,-I-Gob�r.
*Address: 6g Q? crf4 Led zcan cd 12 ej y 8
*Cross Street:
*Phone No.:
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: ! NO Rough In Fi
*Do.you need a Temp Certificate: YES NO
Temp InformatiorIP—ha
eeded)
*Service Size: 3P 100 X150 20 300 350 400 Other
*New Service: Re-connect ndergro Number of Meters Change of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
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