HomeMy WebLinkAbout43229-Z 4*0
Town of Southold 11/27/2018
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40066 Date: 11/27/2018
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1690 Paradise Shore Rd, Southold
SCTM#: 473889 Sec/Block/Lot: 80.4-18
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
11/16/2018 pursuant to which Building Permit No. 43229 dated 11/16/2018
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:
REPLACE ELECTRIC METER PAN 100 AMP MAIN DISCONNECT
The certificate is issued to Bloom, Laurie&Thon, Leonard
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 43229 11-20-2018
PLUMBERS CERTIFICATION DATED
Authorized Signature
JB
HOLD
� � B , ENT
T �F CE
Annex Telephone(631)765-1802
in Road Fax(631)765-9502
a 'i x 1179Southold,NY 11971-0959 IT
(THIS PERMIT MUST T ON THE PREMISES
WITH ONE SET OFAPg )4FQ, 4jffi& JD SPECIFICATIONS
UNTIL FULL )�K AUTHORIZED)
Permit#: 43229 Date: 11/16/2018
Permission is hereby granted to:
Bloom, Laurie & Thon, Leonard
487 N Windsor Ave
Brightwaters, NY 11718
To: repair existing 100a overhead service and replace meter enclosure and main breaker.
At premises located at:
1690 Paradise Shore Rd, Southold
SCTM # 473889
Sec/Block/Lot# 80.-1-18
Pursuant to application dated 11/16/2018 and approved by the Building Inspector.
To expire on 5/17/2020.
Fees:
ELECTRIC $85.00
Total: $85.00
BW'inEfInspector
pF SOUryQI
0
Town Hall Annex Telephone(631)76.5-1802
54375 Main Road IA Fax(631)765-9502
P.O.Box 1179 • iQ roger.richertCa�town.southold.ny.us
Southold,NY 11971-0959 Q
�y�DUNTY,N�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To Laurie Bloom
Address. 1690 Paradise Shore Rd City Southold St: New York Zip 11971
Building Permit#- 43229 Section: 80 Block: 1 Lot: 18
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor- DBA. RJ Corazzini Electric License No- 33419-ME
SITE DETAILS
Office Use Only
Residential X Indoor Basement Service Only X
Commerical Outdoor X 1 st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph 100a Heat Duplec Recpt Ceiling 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 100a Switches Twist Lock Exit Fixtures TVSS
Other Equipment: Replace deteriated meter pan and 100a main disconnect
Notes.
Inspector Signature: Date: November 20 2018
81-Cert Electrical Compliance Form.xls
pf SOUTyo�
# TOWN OF SOUTHOLD BUILDING DEPT.
um, 765-1802
INSPECTION
22
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] 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 �� w �� INSPECTOR'�-71
--------------------------------------------
BUILDING DEPARTMENT-Electrical Inspector _
TOWN OF SOUTHOLD ` D
�{ Town Hall Annex-54375 Main Road-PO Box 1179-Southol;d, NY 11971-0959
1 Telephone (631)765-1802-FAX(631)76 --9`5/02 /
Temporary Certificate # Z Date (!t/ zY 2018
Customer Name qQ l' &Z"6U< Electrician Name &ter_
Address 14,16 p4g4yacPhone (31- 9 Z
e-mail u G e-mail G zs41 l We:, 6Y
Phone License# 511S"I — mu_
Size O A Phase Overhead Underground #of Meters
Remarks jwbw
#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#1 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 veritic is valid for tro a above.
Authorized by IWO/
Vim- I j-a p /J
%%SfF01,- BUILDING DEPARTMENT - Electrical Inspector
C TOWN OF SOUTHOLD
�O
Town Hall Annex - 54375 Main Road - PO Box 1179
QSouthold, New York 11971-0959
�- • Telephone (631) 765-1802 - FAX (631) 765-9502
�1Q1 >r c roger.rich ertgtown.south old.ny.us
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY:-
Company Name: rA-ZZ A �� ��'C
Name:
License No.: email: Q J r;' ,1 ed OQ 16,1,,,e
Address: p
Phone No.:
JOB SITE INFORMATION: (All Information Required)
Name: 3 I bo 8n,
Address: r o
Cross Street:
Phone No.:
B(dg.Permit#: email:
Tax Map District: 1000 Section: Block: ( Lot:
< / / 4"7
6
BRIEF DESCRIPTION OF WORK (Please Print Clearly) Qe oc., r - 12c'V I t.cc � MC �
PnC `0 5 u r + /'4(A,, �c� / �u -fo �� Clt+ ri4; n Ipcf
r
Circle All That Apply:
�10 Fi
Is job ready for inspection?: Rough In -
Do you need a Temp Certificate?: NO Issued On
Temp Informatio (All information required).
Z;�
Service Size 3 Ph Size: !D 0 A # Meters Old Meter#
New Service-Fire Reconnect- Flood Reconnect- Service Reconnected - Underground - efiea
# Underground Laterals 1 2 H Frame Pole Work done on Service? Y N
Additional Information:
7,),Olf�Jonl,`wr .. (AC-4
PAY NT DUE WITH APPLICATION /� c
Request for Inspection Foan.xls