HomeMy WebLinkAbout42971-Z S0 4COG. Town of Southold 8/29/2018
o -
P.O.Box 1179
co 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39873 Date: 8/29/201'8
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1010 Hiawathas Path, Southold
SCTM#: 473889 Sec/Block/Lot: 78.-3-50.2
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
8/27/2018 pursuant to which Building Permit No. 42971 dated 8/27/2018
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 ELECTRIC SERVICE UPGRADE
The certificate is issued to Kollen Joseph H Iry Trt
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 42971 08-28-2018
PLUMBERS CERTIFICATION DATED
Authorized Signature
pF SOUjy�l
0
Town Hall Annex Telephone(631)765-1802
54375 Main Road N Fax(631)765-9502
P.O.Box 1179 G Q
Southold,NY 11971-0959 �`y� dao roger.richert(cD_town.Southold.ny.us
4UNTY,
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Joseph Kollen
Address: 1010 Hiawathas Path City: Southold St: New York Zip: 11971
Building Permit* 42971 Section: 78 Block. 3 Lot: 50.2
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Custom Lighting of Suffolk License No: 38893-ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service Only X
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph 200a Heat Duplec Recpt Ceiling 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 upgrade
Notes:
Inspector Signature: l Date: August 28 2018
81-Cert Electrical Compliance Form.xls
V-4= TOWN OF SOUTHOLD
BUILDING DEPARTMENT
y 2 TOWN CLERK'S OFFICE
oy �' SOUTHOLD, NY
dol � Sao
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#: 42971 Date: 8/27/2018
Permission is hereby granted to:
Kollen Joseph H Iry Trt
1010 Hiawathas Path
Southold, NY 11971
To: 200A Overhead Service Upgrade
At premises located at:
1010 Hiawathas Path, Southold
SCTM #473889
Sec/Block/Lot# 78.-3-50.2
Pursuant to application dated 8/27/2018 and approved by the Building Inspector.
To expire on 2/26/2020.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
OF SOUIyo�
# TOWN OF SOUTHOLD BUILDING DEPT.
`ycouNr+, 765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
DATE IN t
SPECTORC
D C ��C
BUILDING DEPARTMENT- Electrical s ctoAUG 2 ., 201$ `
' TOWN OF SOUTHOLD
W' Town Hall Annex - 54375 Main Road - PO B DEW.
Southold, New York 11971-095 o��., rhe
jf7"d
`fid' j ,9 n D
Telephone (631) 765-1802 - FAX (631) 765-9502
rocler:richert d-)town:southold.ny.us
" APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY• _ Date-
Company Name: - p m i
Name: 'Ren
License No.: gCt 3 email:
Address: y �lGl
Phone No.: R
JOB SITE INFORMATION: (Ali Information Required)
Name:
Address: 0101, L y 10)
Cross Street:
Phone No.:
Bldg.Permit#: email:
Tax Map District: 1000 Section: Block: Lot: '
BRI F DESCRIPTION OF WORK(Please Print Clearly)
O r U a
Circle All That Apply:
Is job ready for inspection?: �NO Rough In Final
Do you need a Temp Certificate?: YES NO Issued On
Temp Information: (Ail information required)
Service Size 1 Ph 3 Ph Size: #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
82-Request for Inspection Formals `�