HomeMy WebLinkAbout37262-Z SUF Town of Southold Annex 7/6/2012
P.O.Box 1179
fA 54375 Main Road
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CERTIFICATE OF OCCUPANCY
No: 35802 Date: 7/6/2012
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 140 Founders Path, Southold,
SCTM#: 473889 Sec/Block/Lot: 64.-2-27.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
5/30/2012 pursuant to which Building Permit No. 37262 dated 5/30/2012
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:
electric service upgrade.
The certificate is issued to Widirstky,Betsy
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 37262 6/11/12
PLUMBERS CERTIFICATION DATED
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Authorized Signature
,.:gUF fat I( TOWN OF SOUTHOLD
� co. BUILDING DEPARTMENT
�4 G TOWN CLERK'S OFFICE
0
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#: 37262 Date: 5/30/2012
Permission is hereby granted to:
Widirstky, Betsy
PO BOX 523
Southold, NY 11971
To: electric service
At premises located at:
140 Founders Path, Southold
SCTM # 473889
Sec/Block/Lot# 64.-2-27.1
Pursuant to application dated 5/30/2012 and approved by the Building Inspector.
To expire on 11/29/2013.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
o�*rjf so�ryol
Town Hall Annex ~ Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 roger.riche rKED-town.so utho Id.ny.us
Southold,NY 11971-0959
CUUNTY,�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Widertsky
Address: 140 Founders Path City: Southold St: NY Zip: 11971
Building Permit#: Section: 64 Block: 2 Lot: 27.1
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
contractor: DBA: Brian Brooks Elec Inc License No: 3613-e
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 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: new 200a overhead service
Notes:
Inspector Signature: Date: June 11 2012
81-Cert Electrical Compliance Form.xls
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Telephone(631)765 1802
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()F SOIJTHOLD
R ELECTRICAL. INSPECTION
u Date: 3D
REQUESTED BY: 22 _ —
Company Name: r
Name: r
License No.:
Address: TO 4 C�1 c,1�' 11g3
Phone No.: 6o3I- 7 1411
JOBSITE. INFORMATION: (*Indicates required information)
*Name:
*Address:
*Cross Street: OY vt
*Phone No_:
Permit No.: Lot: a-7,
Tax-Map District: 1000 Section: _ ' Block: a
*BRIEF DESCRIPTION OF WORK(Please Print Clearly) r
(Please Circle All That Apply)
*Is job ready for inspection: ES NO Rough In Final
*do you need a Temp Certificate: ES NO
Temp Information (If-needed)
*Service Size: �Phase3Phase 100 150 00 300 350 400 Oth
*New Service: Re-connect Underground Number of Meters Change of Servic erhea
Additional Information: PAYMENT DUE WITH APPLICATION \�
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