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42563-Z
Q�Qgt1EFO`,y�COG Town of Southold 6/8/2018 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39699 Date: 6/8/2018 THIS CERTIFIES that the building ELECTRICAL Location of Property: 6130 Great Peconic Bay Blvd, Laurel SCTM#: 473889 Sec/Block/Lot: 128.-2-6 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 4/12/2018 pursuant to which Building Permit No. 42563 dated 4/12/2018 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: 300 AMP ELECTRIC SERVICE The certificate is issued to Froehlich,William&Anne of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 42563 08-08-2018 PLUMBERS CERTIFICATION DATED Authorized Signature s�FF��K 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#: 42563 Date: 4/12/2018 Permission is hereby granted to: Froehlich, William 6130 Peconic Bay Blvd Laurel, NY 11948 To: 300 AMP Electric Service At premises located at: 6130 Great Peconic Bay Blvd, Laurel SCTM # 473889 Sec/Block/Lot# 128.-2-6 Pursuant to application dated 4/12/2018 and approved by the Building Inspector. To expire on 10/12/2019. Fees: ELECTRIC $85.00 Total: $85.00 Building ector I , pF SOUTyo� * # TOWN OF SOUTHOLD BUILDING DEPT. Comm a 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: DATE INSPECTOR rot o BUILDING DEPARTMENT-Electrical 1® � TOWN OF SOUTHOLD —ca Town Hall Annex - 54375 Main Road - Bogp"7P 3 2010 •_ �� Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 76 - 502 . ; . ..__t roger.richert@,,town.southold.nY. ' AWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTEDBY: Date: Company Name: � U Name: License No.: g Ila 45- () email: `7(0( C G�toa> ©A. Address: Phone No:: S"((p �2 3 �31 c6 C JOB SITE INFORMATION: (All Information Required) Name: (� (� L aokl 'r�0eV-A k en Address: RvA Liv ri?'.l N Ug`A Cross Street: (� Phone No.: 0s139 BIdg.Permit#: email: Tax Map District: 1000 Section: = Block: - Lot: BRIEF DESCRIPTION OF WORK(Please Print Clearly) 3co CSlt�C✓,�' .� �S'�.s'�-�'� t�c t1 �1 JAS Circle All That Apply: Is job ready for inspection?: YES / NO Rough In Final Do you need a Temp Certificate?: ES/ NO Issued On Temp Information: (All information required) Service Size u 3 Ph Size: . S) Q a A #Meters _ Old Meter# New Service - Fire Reconnect- Flood Reconnect-Service Reconnected Under roup - Overhead #Underground Laterals 2 F e Pole Work done on Service? Y N. Additional Information: PAYMENT DUE WITH APPLICATION 82-Request for Inspection Form As V S