HomeMy WebLinkAbout42154-Z SUFFa6i�c Town of Southold
5/10/2018
P.O.Box 1179
0
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39636 Date: 5/10/2018
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1425 Jacobs Ln, Southold
SCTM#: 473889 Sec/Block/Lot: 79.-6-4.4
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
11/17/2017 pursuant to which Building Permit No. 42154 dated 11/17/2017
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 Mohr, Christopher&Gianfrancesco, S
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 42154 04-24-2018
PLUMBERS CERTIFICATION DATED
OM
Authorized Signature
TOWN 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#: 42154 Date: 11/17/2017
Permission is hereby granted to:
Mohr, Christopher
1425 Jacobs Ln
Southold, NY 11971
To: Electric Service
At premises located at:
1425 Jacobs Ln, Southold
SCTM # 473889
Sec/Block/Lot# 79.-6-4.4
Pursuant to application dated 11/17/2017 and approved by the Building Inspector.
To expire on 5/19/2019.
Fees:
ELECTRIC $85.00
Total: $85.00
B nspector
SO!/��®l
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 c Q roger.richertQ—town.southoId.ny.us
Southold,NY 11971-0959Q
�ycOUNT`1,��
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Christopher Mohr
Address: 1425 Jacobs Lane City Southold st: New York zip: 11971
Building Permit#: 42154 Section: 79 Block: 6 Lot: 4.4
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: RJ Corazzini License No: 33419-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 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
Other Equipment: 200A Underground Service
Notes: Move Existing Electric Meter to be Code Compliant.
r
Inspector Signature: Date: April 24, 2018
0-Cert Electrical Compliance FormAs
tio��pf SO�lyDlo
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Toxin Hall Annex JR l Telephone(631)765-1842
54375 Main Road
P.O.Box 1179 G, Q roaer.richert(a town sAT95�d ny us
Southold,NX 1197I-0959 �O r� I
BUILDING DEPARTMENT ` N 0 V 2017
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
TLI_F I C)YrL
REQUESTED BY- Date: zz_
Company Name: C Z,^ — G l ,
Name: o o is z-z,
License No.: `9, _
Address: ZO //,c
Phone No.: _ -75 1
JOBSITE INFORMATION: (*Indicates required
yormation)
*Name:
*Address:
*Cross Street:
*Phone No.:
Permit No.: I
Tax-Map District: 4000 Section:��_ Block:, Lot:
"BRIEF DESCRIPTION OF WORK(Please Print Clearly)
(Please Circle All That Apply)
i
*Is job ready for inspection: YES/ NO Rough In Fina!
*Do you need a Temp Certificate: Y NO SS u la $�' 5 1-- 6_o`er) rl
Temp Information(if nee d)
*Service Size: Phase Whase 100 150 20 300 350 400 Other
*New Service: - nnec ndergrou Number of Meters Change of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION t 0
i
\ Q
82=Request for Inspection Form