HomeMy WebLinkAbout37136-Z Town of Southold Annex 6/7/2012
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CERTIFICATE OF OCCUPANCY
No: 35741 Date: 6/7/2012
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 900 Gardiners Ln, Southold,
SCTM#: 473889 Sec/Block/Lot: 70.-8-7
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
4/12/2012 pursuant to which Building Permit No. 37136 dated 4/12/2012
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:
overhead electric service.
The certificate is issued to Kristyensen,Eric&Kristyensen,Annmarie
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 37136 4/13/12
PLUMBERS CERTIFICATION DATED
Authorized Signature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
y 2 TOWN CLERK'S OFFICE
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#: 37136 Date: 4/12/2012
Permission is hereby granted to:
Kristyensen, Eric & Kristyensen, Annmarie
186 Meridian Rd
Levittown, NY 11756
To: overhead service.
At premises located at:
900 Gardiners Ln, Southold
SCTM # 473889
Sec/Block/Lot# 70.-8-7
Pursuant to application dated 4/12/2012 and approved by the Building Inspector.
To expire on 10/12/2013.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
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Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 G • roger.richert(a7town.Southold.ny.us
Southold,NY 11971-0959
COWN
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Kristyensen
Address: 900 Gardiners Lane City: Southold St: NY Zip: 11971
Building Permit#: � I�f� Section: Block: Lot:
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Double-Pole Electric License No: 3913-me
SITE DETAILS
Office Use Only
Residential X Indoor X Basement X Service Only
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 Fixtures Time Clocks
Disconnect 200a Switches Twist Lock Exit Fixtures TVSS
Other Equipment: 200a Overhead service
Notes:
Inspector Signature: I'c Date: April 13 2012
81-Cert Electrical Compliance Form.xls
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TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING/STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) (ALECTRICAL (FINAL)
REMARKS:
DATE ��`" �3 �� INSPECTORS
Town of Southold
Town Hall Annex COPY
Telephone (631) 765-1802
54375 Main Road Fax (631) 765-9502
P.O. Box 1179 roger.richertCciltown.southold.ny.us
Southold NY.11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: DATE: APRIL 10, 2012
COMPANY NAME: DOUBLE-POLE ELECTRIC INC
NAME: STEVE NEGRI
LICENSE NUMBER 3913-ME
ADDRESS P.O. BOX 130 NESCONSET NY 11767
PHONE # 361-6440 CELL # 672-0241
JOBSITE INFORMATION
NAME: MR. & MRS. KRISTYENSEN
ADDRESS: 900 GARDINERS LANE
CROSS STREET: SOUTHOLD NY 11971
PHONE NUMBER: CELL # (516) 520-0912 ANN-MARIE
PERMIT NUMBER:
TAX MAP DISTRICT: Section: 70 Block: $ Lot: 'j
BRIEF DESCRIPTION OF WORK: SERVICE UP-GRADE
Is job ready for inspection: APRIL 13, 2012
Do you need a Temp Certificate: PLEASE FAX TEMP 361-6442
TEMP INFORMATION (if needed)
Service Size` 200 AMP
New.Service YES
Additional Information SERVICE IS OVERHEAD