HomeMy WebLinkAbout43272-Z C;N004
Town of Southold 12/7/2018
P.O.Box 1179
53095 Main Rd
p? Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40085 Date: 12/7/2018
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 4845 S Harbor Rd, Southold
SCTM#: 473889 Sec/Block/Lot: 87.-1-11
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
12/4/2018 pursuant to which Building Permit No. 43272 dated 12/4/2018
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:
ELECTRIC SERVICE UPGRADE TO 200 AMP
The certificate is issued to Harbor 13 Rty Ltd
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 43272 11-30-2018
PLUMBERS CERTIFICATION DATED
r Authorized Signature
TOWN OF SOUTHOLD
IN
BUILDING DEPARTMENT
# TOWN CLERK'S OFFICE
61-0,06 EV
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#: 43272 Date: 12/4/2018
Permission is hereby granted to:
Harbor 13 Rty Ltd
PO BOX 1651
Southold, NY 11971
To: 200a underground electric service upgrade
At premises located at:
4845 S Harbor Rd, Southold
SCTM # 473889
Sec/Block/Lot# 87.-1-11
Pursuant to application dated 12/4/2018 and approved by the Building Inspector.
To expire on 6/4/2020.
Fees:
ELECTRIC $85.00
Total: $85.00
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Town Hall Annex Telephone(631)765-1802
54375 Main RoadN Fax(631)765-9502
P.O. ox 117
Southoldd,,NY 11971-0959 �l� �Q roger.richertt-town.southold.ny.us
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Harbor 13 Realty LTD
Address: 4845 South Harbor Rd City Southold St: New York Zip 11971
Building Permit#• 43272 Section: 87 Block: 1 Lot: 11
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor, Home Owner DBA. License No.
SITE DETAILS
Office Use Only
Residential X Indoor X Basement X 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: Service up grade to 200a underground
Notes.
Inspector Signature: ?-cti` Date: November 30 2018
81-Cert Electrical Compliance Form.xls
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# TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION ,,'
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[ ] FOUNDATION 1ST ( ] ROUGH PL13G. �L�
,
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ELECTRICi
(FINAL)
[ ] CODE VIOLATION [ ] CAUL NG
REMARKS:
DATE /� 1� INSPECTOR � ' ^
y� fR't BUILDING DEPARTMENT- Electrical Inspector
qJLN TOWN OF SOUTHOLD
Town Hall Annex - 54375 Main Road - PO Box 1179
a Southold, New York 11971-0959
'�' Telephone (631) 765-1802 - FAX (631) 765-9502
roger.richert _town.southold.ny.us
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: 1�1,���l� p,��Y Date:
Company Name' k(z jD(L-L 6DdL,-c-Y L-;,C9
Name:
License No.: email: crf^I L G or
Address: ' �iOV� Rgz'Vi0g- fur' 'p
Phone No.: ( `Z67 - (0g
JOB SITE INFORMATION: (All Information Required)
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Name: 3r� L%
Address: + 9115 C700-r o f2 P
Cross Street: o t'LOA-P
Phone No.: y'6T S /1
Bldg.Permit#: email: 9 c to c�eq A
Tax Map District: 1000 Section: Block: Lot:
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?: ES / NO Issued On
Temp Information' (All information required)
Service Size 1 Ph 3 Ph Size: LLL A # Meters t Old Meter#
New Service - Fire econnect- Flood Reconnect- Service Reconnecte Underground - Overhead
# Underground Laterals 1 2 H Frame Pole Work done on Se Y N
Additional Information.
1gr
PAYMENT DUE WITH APPLICATION
/ Form.)ds