HomeMy WebLinkAbout37280-Z guFFQ(,f Town of Southold Annex 6/7/2012
P.O.Box 1179
co 54375 Main Road
oy �;LL�' Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 35743 Date: 6/7/2012
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 145 Wood Ln, Greenport,
SCTM#: 473889 Sec/Block/Lot: 43.-4-26
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
6/6/2012 pursuant to which Building Permit No. 37280 dated 6/6/2012
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 Hickson Jr,William&Hickson,Eileen
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 37280 4/4/12
PLUMBERS CERTIFICATION DATED
on
OTC-1�1�-
Authorized Signature
TOWN OF SOUTHOLD
,� ay BUILDING DEPARTMENT
y x TOWN CLERK'S OFFICE
oy . 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#: 37280 Date: 6/6/2012
Permission is hereby granted to:
Hickson Jr, William & Hickson, Eileen
4 Lincoln PI
Port Washington, NY 110503221
To: overhead electric service.
At premises located at:
145 Wood Ln, Greenport
SCTM # 473889
Sec/Block/Lot# 43.-4-26
Pursuant to application dated 6/6/2012 and approved by the Building Inspector.
To expire on 12/6/2013.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
*pF SO(/j�olo
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 iQ roger.richert(-town.southold.ny.us
Southold,NY 11971-0959 1
o�yCoum��'
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Kevin Hickson
Address: 70 Wood Lane City: Greenport St: NY Zip: 11944
Building Permit#: Section: 4--�s Block: 4 Lot: a
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Daniel Wilcenski Elec License No: 4723-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 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 Fixtures Time Clocks
Disconnect Switches Twist Lock Exit Fixtures TVSS
Other Equipment: Install new 100a overhead service
Notes:
Inspector Signature: q, Date: April 4 2012
81-Cert Electrical Compliance Form.xls
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Town Hall Annex J�f Telephone(631)765-1802
54375 Main Road ontg p
5.P.O.Box 1179 roger.richertwsoU0ny.us
Southold,NY 11971-0959 ��
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: ��,. i ( CC C I� ' Date: Z 3
Company Name: ,` r✓I _ sly ---
�Gv Ll��� � ICI e�--i-i- �-i �'o .�-t -, .�✓'C .
Name: elt
License No.: q7 Z _
Address: g o 30
Phone No.: -7 F-
JOBSITE INFORMATION: (*Indicates, required information)
*Name: c_I� S �
*Address: L,4
*Cross Street: `
*Phone No.:
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: ESQ/ NO
Temp-information (If needed} -
*Service Size: 1 Phas 3Phase 150 200 300 350 400 Other
*New Service: Re-connect Underground Number of Meters Change of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
G ID
82-Request for Inspection Form d-