HomeMy WebLinkAbout43114-Z ®�OpFFQqCpG Town of Southold 10/25/2018
o, P.O.Box 1179
53095 Main Rd
d4 �yo�� Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40001 Date: 10/25/2018
THIS CERTIFIES that the building ELECTRICAL
Location of Property: August Ln, Greenport
SCTM#: 473889 See/Block/Lot: 53.-6-46.10
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
10/9/2018 pursuant to which Building Permit No. 43114 dated 10/9/2018
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:
300 AMP UNDERGROUND ELECTRIC SERVICE
The certificate is issued to Polena, Sotir&Mellos-Polena,Adrianne
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 43114 10-19-2018
PLUMBERS CERTIFICATION DATED
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Authorized Signature
f
o�g�ffoa �oTOWN OF SOUTHOLD
BUILDING DEPARTMENT
y a TOWN CLERK'S OFFICE
oy 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#: 43114 Date: 10/9/2018
Permission is hereby granted to:
Polena, Sotir
57 Westgate Blvd
Manhasset, NY 11030
To: New Electric Service
At premises located at:
August Ln, Greenport
SCTM #473889
Sec/Block/Lot# 53.-6-46.10
Pursuant to application dated 10/9/2018 and approved by the Building Inspector.
To expire on 4/9/2020.
Fees:
ELECTRIC $85.00
Total: $85.00
ing Inspector
pF SOUTyo!
Town Hall Annex Telephone(631)765-1802
54375 Main Road y Fax(631)765-9502
P.O.Box 1179 �Q roper.richerttccD-town.Southold.nV.us
Southold,NY 11971-0959 �M"COU�'��
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To. Sotir Polena
Address: August Ln City: Greenport St: New York Zip. 11944
Building Permit#: 43114 Section 53 Block. 6 Lot: 461
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Spiro Basho License No: 42765-ME
SITE DETAILS
Office Use Only
Residential X Indoor Basement Service Only X
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph 300a Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt 2 Wall Fixtures Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel 125a A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency FixtureTime Clocks
Disconnect 400a Switches Twist Lock Exit Fixtures TVSS 11
Other Equipment. 300a underground service to "H" frame, 125a sub panel
Notes
Inspector Signature: Date: October 19 2018
81-Cert Electrical Compliance Form As
SOUIyo�
# TOWN OF SOUTHOLD BUILDING DEPT.
°ycourm��' 765-1802
INSPECTION43 "
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
ice -
DATE la 1 INSPECTOR
�$uFFot,t
app COGy� BUILDING DEPARTMENT-Electrical Inspector
TOWN OF SOUTHOLD
oy • ! Town Hall Annex-54375 Main Road-PO Box 1179-Southold, NY 11971-0959
.1J►O! �a0 Telephone (631)765--1802-FAX(631)765-9502
Temporary Certificate # %04 Date 2018
Customer Name `� rZ. jootdAJO Electrician Name 15rP(,P_,5 T�Ifts 1+0
Address Aulstf Lti. �� iEj_ Phone Pit& '6Z3 — T4s7�
e-mail a-mail
Phone License#
Size 3 M�' Phase Overhead Underground �'� #of Meters
Remarks
#of Underground Laterals 1 2 New
"H" Frame or Pole H P Fire Reconnect
Was work done on Service? Y/N Flood Reconnect
Old Meter# Service Reconnected
,9 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 verification is valid for 90 days from the date above.
Authorized by
BUILDING DEPARTMENT-Elecfiri ®rt t!!5��
201
TOWN OF SOUTHOL
Town Hall Annex - 54375 Main Roa 'RO PRX T 117 r
Southold, New York 11971-0959
2018
Telephone (631) 765-1802 - FAX(631) 765-9502
roxer;richertOtown,south"old.ih us
r S T; Y :3 �
APPLICATION FOR ELECTRICAL INSPECTION;
REQUESTED BY: Dater I
Company Name: s .SSo kIN C
Name:
License No.: email: EB A-S q-,o Hj M As-(LCID
Andress: — j L7-tt''4-G2'� S ti
_
Phone No:: — S
JOB SITE INFORMATION: (All Information Required)
Name: �-�_
Address: A- G S L_}�'I� FEN F-02
Cross Street: o
Phone No.: /`7 Op 5 1
Bldg.Permit#: C email•_Qp LtN At5 F-Ar2m@ I L-
Tax Map District: 1000 Section: j Block: _ _ Lot,-
BRIEF
ot;BRIEF DESCRIPTION OF WORK(Please Print Clearly)
Circle All That Apply:
Is job ready for,inspection?: ES NO Rough In Final
Do you need a Temp Certificate?: YES / NO Issued On
F
rmati®n- (Ali information required)
.1 P 3 Ph Size: .. A #Meters Old MMeter#
- Fire Reconnect- Flood Reconnect- Service ReconnectedCde:r ::nd'�verhead
rground Laterals 1 2 Frame Pole Work done on , Y
Additional Information': Y
- _ PAYMENT DUE WITH APPLICATION
82-Request for Inspection FormAs