HomeMy WebLinkAbout36683-Z S�FEnI�.. TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
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#: 36683 Date: 9/12/2011
Permission is hereby granted to:
Mill Creek Partners LLC
C/O Goggins & Palumbo
13235 Main Rd
Mattituck, NY 11952
To: Temporary Service Riser
At premises located at:
64300 Route 25, Greenport
SCTM # 473889
Sec/Block/Lot# 56.-7-2
Pursuant to application dated 9/12/2011 and approved by the Building Inspector.
To expire on 3/13/2013.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
SOUr�®lo
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O Box 1179 � ® Sx.-- roger.richert(cb-town.southoId.ny.us
Southold,NY 11971-0959
4l' VUUNTY,I
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To, Mill Creek Partners
Address: 64300 Main Rd-Rt 25 City: Southold St: NY Zip: 11971
Budding Permit#: 2)(A,23 Section. U Block: -I Lot: a
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: G&S Electric License No. 578-e
SITE DETAILS
Office Use Only
Residential Indoor Basement Service Only X
Commerical X Outdoor X 1st Floor Pool
New 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 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 Fixtures Time Clocks
Disconnect Switches Twist Lock F1 Exit Fixtures 11 TVSS
Other Equipment: Temporary service riser to existing 3 phase 200a service
Notes:
Inspector Signature: Date: Sept 23 2011
14
81-Cert Electrical Compliance Form
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Town Hall Annex J�[ Telephone(631) 765-1802
54375 Main Road ax(631)765- 5 2
@ roger.richertCa)town.sout o d.ny.us
P.O.Box 1179
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Southold,NY 11971-0959 O
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: Date:
Company Name:
Name: 0F�2V-4-caL(_�D
License No.: 5 8 — rL
Address: 0 . R o x -)-t S" Sm u�,o t✓� /'U- 1 La 7-z
Phone No.: 9 / — 6.S'
JOBSITE INFORMATION: (Indicates required information)
*Name: /L-L— Ql--- / 141.l''fl�
*Address: 6010 � !v✓
*Cross Street: N,r-- — i 0 GO c-,D S/?/ H S
*Phone No.: Z3 ;r '7
Permit No.: _ S c T-l"
Tax Map District: 1000 Section: l Block: Lot:
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
OZ 62l 4� P�.A �Y S4�W1
Ar—
(Please Circle All That Apply)
*Is job ready for inspection: ES / NO Rough In Final
*Do you need a Temp Certificate: YE / NO
Temp Information (If needed)
*Service Size: 1 PhasePhase ' 100 150 � 300 350 400 Other
*New Service: Re-connect Underground Number of Meters Change of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
( � S1/ vim"'
82-Request for Inspection Form