HomeMy WebLinkAbout42739-Z �O�g,AfFQttCp1A Town of Southold 6/14/2015
P.O.Box 1179
0
a' 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39708 Date: 6/14/2018
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 4170 Indian Neck Ln, Southold
SCTM#: 473889 Sec/Block/Lot: 98.4-27.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
5/31/2018 pursuant to which Building Permit No. 42739 dated 5/31/2018
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:
ELECTRIC FOR DOCK
The certificate is issued to 4170 Indian Neck Ln Hldgs
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 42739 06-07-2018
PLUMBERS CERTIFICATION DATED
Authorized Signature
o�SU ��,co TOWN OF SOUTHOLD
BUILDING DEPARTMENT
y TOWN CLERK'S OFFICE
o . SOUTHOLD, NY
y�01 � dap!
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#: 42739 Date: 5/31/2018
Permission is hereby granted to:
4170 Indian Neck Ln Hldgs
c/o O'Shea Marcincuk & Bruyn
250 North Sea Rd
Southampton, NY 11968
To: Electric for Dock
At premises located at:
4170 Indian Neck Ln, Southold
SCTM #473889
Sec/Block/Lot# 98.-1-27.1
Pursuant to application dated 5/31/2018 and approved by the Building Inspector.
To expire on 11/30/2019.
Fees:
ELECTRIC $90.00
Total: $90.00
AV
B nspector
�o't'®F SO(/j�®l
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 G
Southold,NY 11971-0959 •� • yo roger.rich ertO-)town.Southold.ny.us
r. couno,
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: 4170 Indian Neck Lane Holdings
Address: 4170 Indian Neck Lane city,Southold st: New York zip: 11971
Building Permit#: 42739 Section: 98 Block: 1 Lot: 27.1
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Platinum East Electric License No: 34091-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 X Attic Garage -
INVENTORY
Service 1 ph Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel 50A A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks
Disconnect Switches Twist Lock F1 Exit Fixtures TVSS
Other Equipment: "AS BUILT" - "ELECTRICAL SURVEY" - "NO VISUAL DEFECTS"
Notes: "Electric Power to Dock Lighting" 1- Well Pump
4- Dock Lights, 2- Dock Receptacles.
Inspector Signature: SZ&a__DDate: June 7, 2018
0-Cert Electrical Compliance FormAs
ING DEPARTMENT- Electrical Inspector
TOWN OF SOUTHOLD
~ � wn � II Annex - 54375 Main Road - PO Box 1179
- 2fi�
o • Southold, New York 11971-0959
p� BUILDING telephone (631) 765-1802 - FAX (631) 765-9502
l ' TOWN OF SOUTTHOLD roger.richertCcDtown.southold.ny.us
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: �E:1-01 Date:
Company Name: F
Name: ICcI'i-1+
License No.: ME email: pla 11 eksi
Address: ` D r4 SquTgOLQ
Phone No.: 623 f - - y
JOB SITE INFORMATION: (All Information Required)
Name: iv /L, Al .r- u C
Address: y A.10( tie �AJ OL/7VOL
Cross Street:
Phone No.: _ S--
Bldg.Permit#: _ a email:
Tax Map District: 1000 Section: _ _ , Block: 1 Lot: o� l
BRIEF DESCRIPTION OF WORK (P ease Print Clearly)
C (LQ �,�,�-� tt0
Circle All That Apply:
Is job ready for inspection?: Y / NO Rough In F"
Do you need a Temp Certificate?: YES / NO Issued On
Temp Information: (All information required)
Service Size 1 Ph 3 Ph Size: A # Meters Old Meter#
New Service - Fire Reconnect- Flood Reconnect-Service Reconnected - Underground -Overhead
# Underground Laterals 1 2 _ H Frame Pole Work done on Service? Y N
Additional Information:
PAYMENT DUE WITH APPLICATION
ra� CP
Request for Inspection FormAs * \ x ix