HomeMy WebLinkAbout37557-Z 'e-dfF04 o Town of Southold Annex 10/10/2012
P.O.Box 1179
C3 54375 Main Road
1 Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 35994 Date: 10/10/2012
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1040 Nokomis Rd, Southold,
SCTM#: 473889 Sec/Block/Lot: 78.-3-16
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
10/4/2012 pursuant to which Building Permit No. 37557 dated 10/4/2012
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:
J
replace electric wiring
The certificate is issued to Harbin,Andrew
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 37557 10/09/2012
PLUMBERS CERTIFICATION DATED
Authorized Signature
T'fn" TOWN OF SOUTHOLD
4�SUFFOIKc�
BUILDING DEPARTMENT
CO
� TOWN CLERK'S OFFICE
o . 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#: 37557 Date: 10/4/2012
Permission is hereby granted to:
Harbin, Andrew
1040 Nokomis Rd
Southold, NY 11971
To: replace electric wiring
At premises located at:
1040 Nokomis Rd, Southold
SCTM # 473889
Sec/Block/Lot# 78.-3-16
Pursuant to application dated 10/4/2012 and approved by the Building Inspector.
To expire on 4/5/2014.
Fees:
ELECTRIC $90.00
Total: $90.00
Building Inspector
OF SOUI�o
Town Hall Annex ~� l0 Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.sox 1179 roger.riche rt(a-town.southold.ny.us
Southold,NY 11971-0959
COUM`I
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Andy Harbin
Address: 1040 Nokomis Rd City: Southold St:- NY Zip: 11971
Building Permit#: Section: 78 Block: 3 Lot: 16
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: REP Electric License No: 46288-me
SITE DETAILS
Office Use Only
Residential X Indoor X Basement X Service Only
Commerical Outdoor 1st Floor X Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt 10 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 3 Twist Lock Exit Fixtures .TVSS
Other Equipment: remove aluminum wire and replace with copper, including oil furnace, 2-circuts
Notes:
Inspector Signature: Date: Oct 9 2012
81-Cert Electrical Compliance Form.xls
pF sopl�ol
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courm,��''
TOWN OF SOUTHOLD BUILDING DEPT.
;l
765-1802
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INSPECTION.
[ ] FOUNDATION '1 ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING/STRAPPING [ ] FINAL
[ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) _V<ELECTRICAL (FINAL)
REMARKS:
vim' i t.G-L Ct
DATE b INSPECTORS
Town Hall Annex .* Telephone(631)765-1802
M75 Main Road
v� ��r?ax(631)Mr- 5�
nVUS
P.O.Box 1179 G'. rogerriChert(�tOWn
Southold,NY 11971-0959 SOUt�O
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY:. � +f�G Date:
Company Name:
Name:
License No.:
Address: �3 .
Phone No.. I
JOBSITE INFORMATION: (*Indicates required information)
*Name:
*Address: J p Lit) O vy
t
*Cross Street:
*Phone No.: (� •- 72 C !�(
Permit No_:
Tax-Map District: 1000 Section:-_- Block: Lot:
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)I
{Please Circle All That Apply)
Is job ready for inspection: YE / O Rough In Final
*Do.you need a Temp Certificate: YES/ NO
Temp Information(If needed)
*Service Size: 1 Phase .3Phase 100 150 200 300 350 400 Other
*New Service: Re-connect Underground Number of Meters Change of Service Overhead
Addit' Information: PAYME T DU ITH APPLICATION -
----------------
.82-12equest for Inspection Form