HomeMy WebLinkAbout37456-Z OF pF 4caG� Town of Southold Annex 8/31/2012
P.O.Box 1179
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54375 Main Road
o Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 35927 Date: 8/31/2012
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 3360 Minnehaha Blvd, Southold,
SCTM#: 473889 Sec/Block/Lot: 87.-3-66.4
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
8/20/2012 pursuant to which Building Permit No. 37456 dated 8/20/2012
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:
200 amp Overhead Service
The certificate is issued to Stiber,Carolyn&Stiber,Alexander
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 37456 08/29/2012
PLUMBERS CERTIFICATION DATED
Authorized Signature
TOWN OF SOUTHOLD
�g11FF0(,�coG�
moo BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
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#: 37456 Date: 8/20/2012
Permission is hereby granted to:
Stiber, Carolyn & Stiber, Alexander
PO BOX 1624
Southold, NY 11971
To: 200 amp Overhead Service
At premises located at:
3360 Minnehaha Blvd, Southold
SCTM # 473889
Sec/Block/Lot# 87.-3-66.4
Pursuant to application dated 8/20/2012 and approved by the Building Inspector.
To expire on 2119/2014.
Fees:
ELECTRIC $85.00
Total: $85.00
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Building Inspector
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Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 ao roger.riche rt(oD-town.southo Id.ny.us
Southold,NY 11971-0959
cDUNT`I
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Sean McCoyd
Address: 3360 Minnehaha Blvd City: Southold St: NY Zip: 11971
Building Permit#: 3-I 4 5(v Section: 87 Block: 3 Lot: 66.4
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Safeway Electrical Cont. License No: 5160-me
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service Only X
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph 200a Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel 200a A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks
Disconnect 200a Switches Twist Lock Exit Fixtures TVSS
Other Equipment: 200a overhead service
Notes:
Inspector Signature: Date: Aug 29 2012
81-Cert Electrical Compliance Form.xls
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Town Hall Annex Telephone(631)765-18d2
54375 Main Road �x 31)7 -1
P.O.Box 1179 G roQe_r.richer�(a�town soutllo[tl.ny.us
Southold,NY 11971-0959
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BUIIAING DEPARTMENT :
TOWN OF SOUT$OLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY:
t�Trlc�SDate: � ►� �-L
. Company Name: � � ,,� C 1�o v sj -
Name:
License No.: l 6Z o Sc L �v PorLS�
Address: Co3� ^ g1�� 3Ca3Z -
Phone No.:
JOBSITE INFORMATION: (*Indicates required information)
*Name: SE I
*Address:
*Cross Street: —'
*Phone No..
Permit No.:
Tax Map District: 1000 Section: - Block: _ Lot: (,,
*BRIEF DESCRIPTION OF WORK(Please Print Clearly)
.Zoc) ,v-1 by��►-ti� ti'-!� S��-V C�`c
(Please Circle All That Apply)
Is job ready for inspection: NO. Rough In Final
Vo-you need a Temp Certificate: / NO
Temp Information(if needed)
*Service Size: Phase 317hase 100 150 C00 300 350 400 Other
*New Service: Re-connect" Underground Number of Meters Change of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
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B2=Request for Inspedon Form