HomeMy WebLinkAbout36493-Z �4�SUFFOt,��o Town of Southold Annex 6/20/2011
Gym 54375 Main Road
x Southold,New York 11971
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CERTIFICATE OF OCCUPANCY
No: 35005 Date: 6/20/2011
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 62253 CR 48, Greenport,
SCTM#: 473889 See/Block/Lot: 40,14
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
'6/20/2011 pursuant to which Building Permit No. 36493 dated 6/20/2011
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:
underground electric service upgrade.
The certificate is issued to Grzesik, Stefan&Grzesik,Norma
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 36493 6/17/11
PLUMBERS CERTIFICATION DATED
uthorized Signature
TOWN OF SOUTHOLD
��4�g11FfD( BUILDING DEPARTMENT
y $ ' TOWN CLERK'S OFFICE
wp . fi 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 #: 36493 Date: 6/20/2011
Permission is hereby granted to:
Grzesik, Stefan & Grzesik, Norma
62253 CR 48
Greenport, NY 11944
To: underground electric service upgrade.
At premises located at:
62253 CR 48, Greenport
SCTM # 473889
Sec/Block/Lot# 40.-1-4
Pursuant to application dated 6/20/2011 and approved by the Building Inspector.
To expire on 12/19/2012.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
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Town Hall Annex Telephone(631)765-1802
54375 Main Road y Fax(631)765-9502
P.O.Box 1179 G
Southold,New York 11971-0959 �� roger.riche rt(a�town.southold.ny.us
COUNT`I,Nc�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Stephen Grzesil
Address: 62253 Rt 48 City: Greenport St: NY Zip: 11944
Building Permit#: (o 14 O)22 Section: ).D Block: t Lot:
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: service only DBA: License No:
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 100a Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel 100a 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 100a Switches Twist Lock Exit Fixtures TVSS
Other Equipment: 100a underground service upgrade
Notes:
Inspector Signature: Date: June 17 2011
81-Cert Electrical Compliance Form
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TOWN OF SOUTHOLD BUILDING T.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ELECTRICAL (FINAL)
REMARKS:
DATE 64711INSPECTOR e
o�'�XOF SO(/j�o!
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Town Hall Annex Telephone(631)765-1802
54375 Main Road CA ,ax(631)765-95QQ22,
P.O.Box 1179 rd ` roger.richertlrTOwn;southold.ny.us
Southold,NY 1197 -0959 QIyC�
CI
1 BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: Date:
Company Name:
Name:
License No.:
Address:
Phone No.:
JOBSITE INFORMATION: (*Indicates required information)
*Name: 'S �-�_C1f� G
*Address: C U;LG A&CiA A20 n d
*Cross Street: L �[ Lae
*Phone No.: G3 / 57 7_ '&qq 1
Permit No.:
Tax Map District: 1000 Section: Block: Lot
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
(Please Circle All That Apply).
*Is job ready for inspection: YES / NO Rough In Final
*Do you need a Temp Certificate: YES / NO
Temp Information (If needed)
*Service Size: 1 Phase 3Phase 41 150 200 300 350 400 Other l
*New Service: Re-connect U ergroun Number of Meters Change of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
82-Request for Inspection Form