HomeMy WebLinkAbout37289-Z S FF 4 Town of Southold Annex 7/3/2012
P.O.Box 1179
c x 54375 Main Road
o Southold,New York 11971
o
CERTIFICATE OF OCCUPANCY
No: 35794 Date: 7/3/2012
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 860 Old North Rd, Southold,
SCTM#: 473889 Sec/Block/Lot: 55.4-7
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this of iced dated
6/11/2012 pursuant to which Building Permit No. 37289 dated 6/11/2012
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 New Suff Land Co II LLC
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 37289 6/29/12
PLUMBERS CERTIFICATION DATED
Authorized Signature
4�guFFnd��o TOWN OF SOUTHOLD
�� ay BUILDING DEPARTMENT
y z TOWN CLERK'S OFFICE
;oy . SOUTHOLD, NY
° `�05
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#: 37289 Date: 6/11/2012
Permission is hereby granted to:
New Suff Land Co II LLC
25 G St
Salt Lake City, UT 841032949
To: overhead electric service.
At premises located at:
860 Old North Rd, Southold
SCTM # 473889
Sec/Block/Lot# 55.-1-7
Pursuant to application dated 6/11/2012 and approved by the Building Inspector.
To expire on 12/11/2013.
Fees:
ELECTRIC $85.00
Total: $85.00
` Building Inspector
pF SO l!/ryo
Town Hall Annex o Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 a roper..riche rt(aD-town.Southold.ny.us
Southold,NY 11971-0959
C4UNTY,�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: R&C Meador
Address: 860 Old North Rd City: Southold St: . NY Zip: 11971
Building Permit#: 3��.$� Section: 55 Block: 1 Lot: 7
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC.CODE
Contractor: DBA: SJ O'Connor Electrical Cor License No: 5085-me
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 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: Date: June 29 2012
81-Cert Electrical Compliance Form.xls
Town Hall Annex l (: l Telephone(631)765-1802
54375 Main Road N ax(631)765- 5
P.Q.Box 1179 G roger.richert uWdWn.soutl -.ny us
Southold,NY 11971-0959 �l ''•
�CQUI�I`l,�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: - 'i-re jjSSJ 0160 AJO&- Date:
Company Name:
Name:
License No.: r- 0S_
Address:
Phone No.:
JOBSITE INFORMATION: (*Ind.icates required information)
*Name: vd 6)q(-P-V AFAR
*Address: S&O ous
-4'Cross Street:
*Phone No.: - p7-,p 'I CA
Permit No.:
Tax-Map District: 1000 Section: _sG - Block: i - Lot: `T
*BRIEF DESCRIPTION OF WORK(Please Print Clearly)
JPlease Circle All That Apply)
*Is job ready for inspection: S NO Rough In Final
*Do-you need a Temp Certificate: E / NO
Temp In#onnation(it needed)
*Service Size: 1 Phase -3Phase 100 150 00 300 350 400 Other
*New Service: Re-connect Underground Number of Met rs C�ofService Overfiead
Additional Information: PAYMENT DUE WITH APPLICATION
.82=11equest for Inspection Form �C