HomeMy WebLinkAbout42318-Z ��o�gLlEF0j/( Town of Southold 7/23/2018
o P.O.Box 1179
d' 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39789 Date: 7/23/2018
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 41705 Route 25,Peconic
SCTM#: 473889 Sec/Block/Lot: 75.-5-11
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
1/23/2018 pursuant to which Building Permit No. 42318 dated 1/23/2018
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:
200 AMP OVERHEAD ELECTRICAL SERVICE
The certificate is issued to Grimes,Eugene&Mary Ellen
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 42318 07-13-2018
PLUMBERS CERTIFICATION DATED
Authorized Signature
o�saFFn��coTOWN 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#: 42318 Date: 1/23/2018
Permission is hereby granted to:
Grimes, Eugene
41705 Route 25
PO BOX 503
Peconic, NY 11958
To: 200 Amp Electric Service
At premises located at:
41705 Route 25, Peconic
SCTM # 473889
Sec/Block/Lot# 75.-5-11
Pursuant to application dated 1/23/2018 and approved by the Building Inspector.
To expire on 7/25/2019.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
pF SO!/�y®l®
Town Hall Annex Telephone(631)765-1802
54375 Main Road y Fax(631)765-9502
P.O.Box 1179 G ® �o roger.richert(D_town.southold.ny.us
Southold,NY 11971-0959 '®
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Eugene Grimes
Address: 41705 Route 25 city,Peconic st: New York zip: 11958
Building Permit#: 42318 Section: 75 Block. 5 Lot: 11
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Goodale Electric License No: 783-E
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service Only
Commerical Outdoor X 1st Floor X 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 Overhead Service
Notes:
Inspector Signature: Date: July 13, 2018
0-Cert Electrical Compliance Form.xls
OF SOUIyO�
# TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG. Z
[ ] 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
�1
�Of SOUT
., -
Town Hall Annex ho " 631)765-1802
54375 Main Road
P.O_Box 1179 G roger.riche :S o
Southold,NY 11971-0959 rap
JAN 232010
BUILDING DEPARTNUN'T
TOWN OF SOUTHOLDF'``�'~°'i' c; �°�•
APPLICATION FOR ELECTRICAL INSPECTION OWN OFS®ur]IOLD
REQ JESTED BY: k Date:
Coml any Name: � - �(�
Y Nam- -- _ - - --- - - -- - = - --_ ----- --- __ -- .
Licen a No.:
Addr s: �— • �
Phon No.: 3.c -
JOB ITE INFORMATION: (*Indicates required information)
*Nam v v
*Add s:
*Cros Street:
*Pho No.. -2 3
Perm No..
Tax p District: 1000 Se ion:. `j 5 Block: 5 Lot:
*BRIE' DESCRIPTION OF WORK(Please Print Clearly)
(Plea a Circle All That Apply)
*Is jo ready for inspection: YES / NO - Rough In Final
*Do yu need a Temp Certificate: YES / NO
Temp nformation(if needed)
*Servi a Size: 1 Phase 313hase 100 150 200 300 350 400 they
*New ervice: Re-connect nderground Number of Meters Change of Service Overhead
Additi nform tion. - PAYMENT DUE WITH APPLICATION
1
82-R mu for Inspection Form
1