HomeMy WebLinkAbout37500-Z f SuffOt,�c Town of Southold Annex 9/25/2012
P.O.Box 1179
o� 54375 Main Road
oy Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 35966 Date: 9/25/2012
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 200 Westwood Ln, Greenport,
SCTM#: 473889 Sec/Block/Lot: 33.-2-12
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
9/7/2012 pursuant to which Building Permit No. 37500 dated 9/7/2012
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 electric service.
The certificate is issued to Learned,Gary&Mckennell,Danielle
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 37500 9/20/12
PLUMBERS CERTIFICATION DATED
Authorized Signature
TOWN OF SOUTHOLD
moo �y� BUILDING DEPARTMENT
sty"N' TOWN CLERK'S OFFICE
Vl IF
'� • ,/// SOUTHOLD' NY
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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#: 37500 Date: 9/7/2012
Permission is hereby granted to:
Learned, Gary & Mckennell, Danielle
29 Polo Ln
Westbury, NY 11590
To: 200 amp Service change
At premises located at:
200 Westwood Ln, Greenport
SCTM # 473889
Sec/Block/Lot# 33.-2-12
Pursuant to application dated 9/7/2012 and approved by the Building Inspector.
To expire on 3/9/2014.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
o��pF SO(/r�,ol
Town Hall Annex ~ Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 • aQ roger.richerKD-town.southold.ny.us
Southold,NY 11971-0959
C4UNT`I,�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Gary Learned
Address: 200 Westwood Lane City: Greenport St: NY Zip: 11.944
Building Permit#: Section: 33 Block: 2 Lot: 12
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
!Contractor: DBA: Bobs Electric License No: 694-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 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 11 TVSS
Other Equipment: service up grade, 200a overhead service
Notes:
Inspector Signature: Date: Sept 20 2012
81-Cert Electrical Compliance Form.xls
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SEP _ 7 2012
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APPE.lCATtO CTR F R�L ICA�.l PECT ON TOWN LOF SOUTHOLD
FiEL1UES Date: y
Corn n ame:
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Name:
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JOBSITEINFORMATION: ('`Indicates required Information)
*Name: Aity Le A
*Address: Z' n 7 ryy
*Croce tr et. A �7 - e d0_a PV kAoe.. 69 A4-"'
*Phone No �•�`jL.� �y�- ���.
Permit No.
Tax-Map D'sWet - 1000 Sedion:_ �f� Blooi Lot:_ 3 . R
*BRIEP DE SCRIPTION OF WORK(Please Print Clearly) Vie,
tPlease C le All That APPIA
*Is job fbr inspection: �! NO Dough In In8
*C?o-you a Temp Ceirtificate: E` /NO
Temp I a tort(U-needed)
*Servlce S 1 Phase 3Phase 100 150 300 400 Other
'New 3e _ Re-connect Underground Number of Meters Change of 3ervi
Additional 1 ` ormation: PAYMRE DUE WITH APPLICATION
7 7'for Inspection Form (�
rt 90 L esse