HomeMy WebLinkAbout41682-Z o�guFFOt,��OG Town of Southold 8/2/2017
P.O.Box 1179
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o • g 53095 Main Rd
y�rQl �ao� Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39094 Date: 8/2/2017
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 43900 Route 25,Peconic
SCTM#: 473889 Sec/Block/Lot: 75.-6-5
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
5/30/2017 pursuant to which Building Permit No. 41682 dated 5/30/2017
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 OVERHEAD ELECTRIC SERVICE
The certificate is issued to Stankewicz,Veronica&Ors.
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 39094 07/12/2017
PLUMBERS CERTIFICATION DATED
Authorized Signature
o�SUFFol,r�oTOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
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#: 41682 Date: 5/30/2017
Permission is hereby granted to:
Stankewicz, Veronica & Ors.
PO BOX 88
Southold, NY 11971
To: 200a overhead electric service.
At premises located at:
43900 Route 25, Peconic
SCTM # 473889
Sec/Block/Lot# 75.-6-5
Pursuant to application dated 5/30/2017 and approved by the Building Inspector.
To expire on 11/29/2018.
Fees:
ELECTRIC $85.00
Total: $85.00
1
Building Inspector
OF SOU��®l
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
CP
P.O.Box 1179 , • aQ roger.riche rt(cDtown.southoId.ny.us
Southold,NY 11971-0959 Q
l�c®UNN,�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To. Stankewicz
Address: 43900 Route 25 city:Peconic st: New York zip: 11958
Building Permit#: 41682 Section: 75 Block: 6 Lot: 5
Contractor: DBA: Roslak Electric License No: 3677-ME
SITE DETAILS
Office Use Only
Residential X Indoor Basement Service Only
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
Other Equipment: 200A OVERHEAD SERVICE
Notes:
Inspector Signature: Date: July 12, 2017
0-Cert Electrical Compliance Form.xls
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SOUTyolo
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION ,
[ ] FOUNDATION 1ST [ ] ROUGH'PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIREAESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ol ELECTRICAL (FINAL)
REMARKS:
DATE 2 INSPECTOR `
o¢soy
Town Hall Annex O
Telephone(631)765-1862 i
54375 Main Road (631)765- 5�2
P.O.Box 1179 • ro er.richert 'o`wn.sout�i0 f.n .us i
Southold,NY 11971-0959
BUILDING DEPARTMENT ;
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTEIJ BY.'
Rp .S L,4 V Date: .��� t7
Company.Name: r,
Name: t
License No..
Address: �(l, f
Phone No.: /� 'ice L71 I
JOBSITE INFORMATION:• (*Indicates required information)
*Name: VMb A)yC_ melC E 1- , s
"Address: &r
*Cross Street: 2 D I '-
*Phone No.: ��✓�'�7�
Permit No..
Tax Map District: 1000
Section:-77-5- _ Block:� Lot: t
i
*BRIEF DESCRIPTION OF WORK(Please Print Clearly) -
{Please,•Circle AI! That'Apply}
*Is'job ready for inspection:' NO : Rough In Final .
*Do you need a Temp Certificate; ES/ NO
Temp Information'(If needed) ,
E
*Service Size: hase 3Phase 100 150 'K 300 350 '400 Other
*New Service: Re-connect Underground Number of Meters hange of Servic Overhea
E
Additional Information: PAYMENT DUE WITH APPLICATION
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BUILDING DEBT.
TOWN OF SOUTHOLD