HomeMy WebLinkAbout41803-Z ofFOL'ir G Town of Southold 7/26/2017
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~� P.O.Box 1179
.o` + 53095 Main Rd
4:A§ ao�' Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39077 Date: 7/26/2017
THIS CERTIFIES that the building ELECTRICAL
Location of Property: Cedar Ln, East Marion
SCTM#: 473889 Sec/Block/Lot: 31.-6-28.6
Subdivision: bled Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
4/24/2017 pursuant to which Building Permit No. 41803 dated 7/11/2017
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:
100A Electric Sub Panel and 6 GFCI Receptacles in Field Lot
The certificate is issued to Rozenbaum, Susan
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 41803 05-24-2017
PLUMBERS CERTIFICATION DATED
Authorize Signat e
�v RIC TOWN OF SOUTHOLD
�p�� BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
co
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#: 41803 Date: 7/11/2017
Permission is hereby granted to:
Rozenbaum, Susan
100 Greenway Ter
Forest Hills, NY 11375
To: new subpanel with 3 20a outlet circuits - 4/0 AL. underground feeders
At premises located at:
Cedar Ln, East Marion
SCTM # 473889
Sec/Block/Lot# 31.-6-28.6
Pursuant to application dated 4/24/2017 and approved by the Building Inspector.
To expire on 1/10/2019.
Fees:
ELECTRIC $125.00
T $125.00
may,
Building Inspector
pF SOU��®l
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Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 G roger.richert(@-town.southo1d.ny.us
Southold,NY 11971-0959 '®ly® �q
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Rozenbaum (Lavender By the Bay Inc.)
Address: Cedar Lane City: East Marion St: New York Zip: 11939
Budding Permit#: 41803 Section. 31 Block: 6 Lot: 28.6
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Doroski Electric License No: 2941-E
SITE DETAILS
Office Use Only
Residential Indoor Basement Service Only
Commerical X Outdoor X 1st Floor Pool
New X Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt Ceding Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt 6 Wall Fixtures Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel 100A A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks
Disconnect 100A Switches F1 Twist Lock Exit Fixtures TVSS
Other Equipment 100A Sub Panel on "H" Frame, 6- GFCI Receptacles in Field Lot.
Notes:
Inspector Signature: Date: May 24, 2017
0-Cert Electrical Compliance FormAs
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Af'PLICATION FOR ELECTRICAL INSPECTION
k-EQUESTE D BY: elrt'c�':5�'�'i� -�-e �•� C}are:
Company Name:
Name:
License No.: � .� ;.
Address-
Phone-No.:.
ddress:
Phone•No. CL\v- C." °3„1 = `7 O 17— a . -7 3 + '7S`Z
JOBS(TE INFORMATION: dicafes required information)
*
f+3ame: L a� -c C. b
Address_ 6 �A�® �l `�1 � _
`Cross Street:
*Phone No.:
Permit No.: H i 8D3
Tax-Map District: 1000 Section: "� � � Block: �� Logi a
*dPJtF;DESCRIPTION OF W RK(ReaSe print Clearly) � %J �
'MCA �p
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(Please Circle All That,Apply) i
*Is job ready for Inspection: YES/ NO. Rough In Sinai
*0o-you need a Temp Certlftcate: YES I NO
Temp information (it-needed)
*Service Size: 9 Phase 3phase, 100 150 200 300 350 400 Other
'New Service: Re-connect Underground Number of Meters Change of Service Overhead
Additional Information: PAYMEt4T DUE Wilms APf,'LJCATI0N '
82-r egvo�,t for tnspecUon Porm. i
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