HomeMy WebLinkAbout37379-Z Town of Southold Annex 7/20/2012
fot�cO°y� P.O.Box 1179
�
54375 Main Road
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 35832 Date: 7/20/2012
THIS CERTIFIES that the building ELECTRICAL
Location of Property: Shipyard Ln, East Marion,
SCTM#: 473889 Sec/Block/Lot: 38.-7-12
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
7/20/2012 pursuant to which Building Permit No. 37379 dated 7/20/2012
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:
lights and recgpticles on dock.
The certificate is issued to Summit Ests Hme Assc Inc
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 37379 6/27/12
PLUMBERS CERTIFICATION DATED
Authorized Signature
�S�F of TOWN OF SOUTHOLD
BUILDING DEPARTMENT
y i TOWN CLERK'S OFFICE
oy • SOUTHOLD, NY
�ipl `�ao0y
r 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#: 37379 Date: 7/20/2012
Permission is hereby granted to:
Summit Ests Hme Assc Inc
PO BOX 779
East Marion, NY 11939
To: lights and recepticles on dock
At premises located at:
Shipyard Ln, East Marion
SCTM # 473889
Sec/Block/Lot# 38.-7-12
Pursuant to application dated 7/20/2012 and approved by the Building Inspector.
To expire on 1/19/2014.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
SO�lyOlo
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box1179 iQ roger.richert(-town.southo Id.ny.us
Southold,NY 11971-0959
COUN N
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Summit Estates Home owners Association
Address: Shipyard La City: East Marion St: NY Zip: 11'939
Building Permit#: -'7 Section: 38 Block: 7 Lot: 12
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: F&M Electrical License No: 31893-me
SITE DETAILS
Office Use Only
Residential Indoor Basement Service Only
Commerical X Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph 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' TVSSEl
Other Equipment: install lights and recpticles on dock---&-lights, 1-20a recpticle., 2-GFCI circuit break
Notes:
Inspector Signature: Date: June 27 2012
81-Cert Electrical Compliance Form.xls
OF SOUryO�
�j TOWN OF SOUTHOLD BUILDING DEPT. .
a
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING/STRAPPING [ ] FINAL
[ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) WELECTRICAL (FINAL)
REMARKS:
4 �I'Zt me-f GCS
DATE �z l INSPECTOR -
`
Town Hal!Annex
5975 Maus Rout � �. TeIeplione(631)76mgm
P.Q.Box 1179 lei:i'i0hetteg nY
t ►7
S*UdWK NY 11971-0959 —"�•--- -�-• o
BU"iNG DPPAVnMqT
TOWN OF SOU TROLD
AP LICATIO t)R twL C fC I Si' TiCifV
- =�..-__i•.�,1�.--•',�..��.•ti ��•:,.-,..y.-,:j ,.�."'-.�.P4.'r'.r'\.-,ago.r•'4�•„ri..•,•m.,..+.w•w+.�'pw,s.+�,
REQUESTED BY:
Date.
Company Name: '
Name: `
i+cense No.: f 1s'9 3 -�d'r�
ddtess: 1 Ge v't /
Phc�No.:
r 9' 7
JOBSITB INFORMATfo-N: (*Indicates required Information)
*Name: _--
*Address: S fiad s� ,t bap
.�• ' w,._�.. E S �a•�c� t �7 cde
Cc�oss'Street: ��r
*Phone No.: 1 Z�!7-�,
Permit No.: �
Tax-Map District: 10 Section: Bfock:
�^ Lot:
*BfVEF DESCRIPTION OF WORK{Please Print Clearly} �} .�
-�� e .Ice c �a CSC'
MONO Cftle All Tfhat Apply)
Is job ready for inspection: (` NO rjUON
*p0-you need a Temp CerfMcete: YES ou h InTemp Inforintatio� ff nee 1
needed] �1 9 2012
*Servloe Size: 1 Phase .3Phase 00 950 200 840
N�YV9sCe: fN1@ct' Un DG. DEPT.
dm9mund Number Change of TOWN
Addioonat information: P YMB T PUfLWITH/ PPLI TION
le w e C-,0 —/- -
4, �
Th�4
+824Request for Inspection Form
4 A # : 699OLZL 8Z:9l :Z1-90-90