HomeMy WebLinkAbout42826-Z ®�pSIfF t' td� Town of Southold 7/12/2015
P.O.Box 1179
0
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39763 Date: 7/12/2018
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 29215 Route 25, Orient
SCTM#: 473889 Sec/Block/Lot: 13.-2-9
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
6/28/2018 pursuant to which Building Permit No. 42826 dated 6/28/2018
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 SERVICE REPAIR TO BARN
The certificate is issued to Kurman,Lee&Wood,Elaine G
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 42826 07-05-2018
PLUMBERS CERTIFICATION DATED
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#: 42826 Date: 6/28/2018
Permission is hereby granted to:
Kurman, Lee
940 Park Ave #213
New York, NY 10028
To: Electric Service to barn
At premises located at:
29215 Route 25, Orient
SCTM # 473889
Sec/Block/Lot# 13.-2-9
Pursuant to application dated 6/28/2018 and approved by the Building Inspector.
To expire on 12/28/2019.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
SO(/r�®l
Town Hall Annex Telephone(631)765-1802
54375 Main Road N Fax(631)765-9502
P.O.Box 1179 ® �� roger.richerta—town.southold.ny.us
Southold,NY 11971-0959
COUnlT`6,��
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Wood (Kurman)
Address: 29215 Route 25 city.Orient st: New York zip: 11957
Budding Permit#: 4.2826 Section: 13 Block: 2 Lot: 9
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Hildebrandt Electric License No: 38496-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 Barn
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 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 Switches Twist Lock Exit Fixtures TVSS
Other Equipment: New Overhead Portion of Existing 200A Service Due to Tree Damage Repair.
Notes:
Inspector Signature: Date: July 5, 2018
0-Cert Electrical Compliance Form.xls
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ILDING DEPARTMENT- Electrical Inspector
�O JUN 2 S 2018 TOWN OF SOUTHOLD
_ Town Hall Annex- 54375 Main Road - PO Box 1179
o . ,DI1QiGDEPT- Southold, New York 11971-0959
y �lp� OF SOephone (631) 765-1802 - FAX (631) 765-9502
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roger.riche rtccDi town.south old.ny.us
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: " WpY V" Date: g -a-F,j►g` - -
Company Name: ,�, �B ,-V-r C_
Name: 14-i a 6 ��
License No.: 21K% Man email: h ; I eLecs-"e
Address: aa. v'1e-,_ R-0• Vo r&vdLD OU-Y.
Phone No.: G3 I -- ->�6 - J07 7
JOB SITE INFORMATION: (All Information Required)
Name: 0-c.4�r� wooer
Address: ri -IZQ rz-re � *- H '�
Cross Street: lmmaw P-D ,
Phone No.:
Bldg.Permit#: email:
Fax Map District: 1000 Section: ) Block: �11 Lot:
1
BRIEF DESCRIPTION OF WORK (Please Print Clearly)
�-Era 2 SFtEv A cry To 6 RN 1criocu-ca ?
ircle All That Apply:
Is job ready for inspection?: YE NO Rough In Final
Do you need a Temp Certificate?: E / NO Issued On
Temp Information: (All information required)
Service Size (OP
3 Ph Size: _a-c)O AA # Meters 1 Old Meter#
New Service - Fire Reconnect- Flood Reconnect - ervice Reconnec - Underground - Overhead
# Underground Laterals 1 2 H Frame P01 Work done on Service? ® N
Additional Information:
PAYMENT DUE WITH APPLICATION
,1. n <A\
Request for Inspection ForniAs
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