HomeMy WebLinkAbout42710-Z �sUfFO4Nle. Town of Southold 9/18/2018
=oo Gyp P.O.Box 1179
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• 53095 Main Rd
4% �a T Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39904 Date: 9/18/2018
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 2030 Kerwin Blvd, Greenport
SCTM#: 473889 Sec/Block/Lot: 53.4-44.6
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
5/22/2018 pursuant to which Building Permit No. 42710 dated 5/22/2018
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:
RE-LOCATE ELECTRIC METER PAN
The certificate is issued to Gayson John J Jr PRT
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 42710 09-12-2018
PLUMBERS CERTIFICATION DATED
Authorized Signature
�S�FFnc� TOWN OF SOUTHOLD
�a coGy BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, NY
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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#: 42710 Date: 5/22/2018
Permission is hereby granted to:
Gayson John J Jr PRT
334 Mineola Blvd
Mineola, NY 11501
To: relocation of 200a meter pan
At premises located at:
2030 Kerwin Blvd, Greenport
SCTM #473889
Sec/Block/Lot# 53.-4-44.6
Pursuant to application dated 5/22/2018 and approved by the Building Inspector.
To expire on 11/21/2019.
Fees:
ELECTRIC $85.00
Total: $85.00
uilding Inspector
pF SOUTyoI
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Town Hall Annex Telephone(631)765-1802
54375 Main Road y Fax(631)765-9502
P.O.Box 1179 G Q
Southold,NY 11971-0959 '`O ® ao roper.richert(Q)town.southold.ny.us
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Gayson
Address: 2030 Kerwin Blvd City- Greenport St. New York Zip: 11944
Building Permit* 42710 Section- 53 Block- 4 Lot 446
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA- Hanrich Inc License No: 4453-ME
SITE DETAILS
Office Use Only
Residential X Indoor 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 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 Fixtures Time Clocks
Disconnect 200a Switches Twist Lock Exit Fixtures TVSS
Other Equipment Existing 200a underground service, re-locate meter pan only.
Notes
Inspector Signature: Y,4kDate: September 12 2018
81-Cert Electrical Compliance Form xls
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* # TOWN OF SOUTHOLD BUILDING DEPT.
`yco 765-1802 Z '6
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG. 27
[ ] FOUNDATION 2ND [ ] INSULATION , 7�
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
cA/ 1/1,te
DATE / / P( t� INSPECT �'
k,
OR
OGy� BUILDING DEPARTMENT-Electrical Inspector
l� C TOWN OF SOUTHOLD
O Town Hall Annex-54375 Main Road-PO Box 1179-Southold, NY 11971-0959
y�01 * � Telephone(631)76t1802-FAX(631)765-9502
Temporary Certificate # Date 1#/W Z'Z"� 2018
Customer Name Electrician Name k(P_( l t�
Address p EeW 114 'FLVK�l Phone
e-mail e-mail Kksct�z( G 6 oNLI'i ,
Phone License# 3
Size_ 06 A Phase Overhead Underground #of Meters
Remarks ��- Z-o
#of Underground Laterals 1 2 New
"H" Frame or Polel H P Fire Reconnect
Was work done on Service? Y/N Flood Reconnect
Old Meter# - 'j!%$ Service Reconnected
Application for electrical service equipment is on file with the town of Southold.On the applicant's notification that this installation
is complete,the town will conduct a premises inspection of the service equipment.
This veritication is valid for 90 the date above.
Authorized by
r�
� EIOtk�o BUILDING DEPARTMENT-Electrical Inspector
TOWN OF SOUTHOLD
Town Hall Annex - 54375 Main Road - PO Box 1179
+ Southold, New York 11971-0959
Telephone (631) 765-1802 - FAX(631) 765-9502 ;
roper-richertitown.southold.ny:us
APPLICATION FOR ELECTRICAL INSPECTION,
REQUESTED BY: �ie�1e1 ���.LkTit
Date!,-
Company Name:
Name:
License No.: ema Kdean&a in 0erono,n,e-r
Address: - _ . _
Phone No::
JOB SITE INFORMATION: (All Information Required)
Name: __ Vaii&A 6C-145 6A
Address: ke �A - _ I - orr
Cross Street: Av - T- _ L&,n t
Phone No:: -
BIdg.Permit#: `��,\(� _ __ email: aUr/eS l.C,a�
Fax Map District: _ 1000 Section: Block: ; _ -Lot.- I-
.fin(,
BRIEF DESCRIPTION OF WORK(Please Print Clearly) We, race, CeJOCG3.\Ind �.
2C>� AMP McTef &8-o
Circle All That Apply:
Is job ready for inspection?: YES X9 Rough In Final
Do you need a Temp Certificate?: YES NO Issued On ,
Temp Information: (All information required)
Service Size 1 Ph 3 Ph Size:- DO - A #Meters�_ Old Meter#
New Service- Fire Reconnect- Flood Reconnect-Service Reconnected < nderground Overhead
#-Unde'rground Laterals _1 2 H Frame Pole Work done on Service? Y N _
Additionallnfoiftmation:
a
PAYMENT.DUE WITH APPLICATION _
MAY 22 2018
82-Request for lnspedon Form AsP`f 5� C - t 1 Te -Fd +D IG 1�
k4e,w4lorl— TOWN OF SO 00, �_5
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