HomeMy WebLinkAbout41071-Z �,tlFFOI,fC' Town of Southold
4/24/2018
a�, y P.O.Box 1179
53095 Main Rd
�'yljQlaOt Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39613 Date: 4/24/2018
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 3245 Delmar Dr, Laurel
SCTM#: 473889 See/Block/Lot: 125.4-7
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
10/12/2016 pursuant to which Building Permit No. 41071 dated 10/12/2016
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 UPGRADE
The certificate is issued to Peconic Land Trust
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 41071 03/28/2018
PLUMBERS CERTIFICATION DATED
uthorized Signature
4�SUFFo�,r�oTOWN OF SOUTHOLD
BUILDING DEPARTMENT
y TOWN CLERK'S OFFICE
oy, • 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#: 41071 Date: 10/12/2016
Permission is hereby granted to:
Hubbard, Anne
1 Stoueleigh Plz 5K
Bronxville, NY 10708
To: Electric Service
At premises located at:
3245 Delmar Dr, Laurel
SCTM # 473889
Sec/Block/Lot# 125.4-7
Pursuant to application dated 10/12/2016 and approved by the Building Inspector.
To expire on 4/13/2018.
Fees:
ELECTRIC $85.00
Total: $85.00
Bui nspector
Ursa
Town Hall Annex Telephone(631)765-1802
54375 Main Road c� Fax(631)765-9502
P.O.Box 1179 ® �� roger.richertQ-town.southold.ny.us
Southold,NY 11971-0959
C®UhVTd,�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To. Peconic Land Trust (Hubbard)
Address: 3245 Delmar Drive city,Laurel st: New York zip: 11948
Building Permit#: 41071 Section: 125 Block: 4 Lot 7
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Brian Brooks Electric License No: 3613-E
SITE DETAILS
Office Use Only
Residential X Indoor X 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 Ceding 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 Over Head Service Up Grade.
Notes:
Inspector Signature: Za �''-- Date: March 28, 2018
0-Cert Electrical Compliance Form As
SO4Ury��
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courm,
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TOWN OF SOUTHOLD BUILDING DEPT.
755-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLEIG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL)
REMARKS:
Z
DATE 3 � INSPECTOR
f i
i
Of SO�jl,�o`
Town Hall Annex Telephone(631)765-1802
54375 Main Road c/+ m�ax(631)765-gg5
P.O.Box 1179 G @ roger.riChert(C Rax us
Southold,NY 11971-0959
BUILDING DEPARTMENT ;
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: PI -�- �®
. GBK IG /�Glnd �r,�� Date:
Company Name: r� I.
Name:
License No.: 36 ! E
Address: P -
Phone No.: (431 ) 32. )S'
JOBSITE INFORMATION: (*Indicates required info ation)
*Name: �iG c®n a G t� T✓� �J I
*Address: Z, j
*Cross Street:
`Phone No.: — O ;
Permit No.: Y� Q
Tax-Map District: 1000 Section: Block: Lot:
*BRIEF DESCRIPTION OF WORK(Please Print Clearly) S�Q/.�l1GG
(Please Circle All That Apply)
*Is job ready for inspection: YES!(p Rough In Final
*Do-you need a Temp Certificate: YE ! NO
Temp Information if needed)
*Service Size: 1 Phase) 3Phase 100 ` 150 200 300 350 400 Other I -
*New Service: Re-gonnect Underground"-2Wmber f Meters ange o�Servi�cqO�verhead
!
Additional Information: PAYMENT DU WITH APPLICATION
mou I Jf VVI 0 — n4
82-Request for inspection Form