HomeMy WebLinkAbout37522-Z �UFfA(� Town of Southold Annex 12/11/2012
P.O.Box 1179
y z 54375 Main Road
oy Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 36081 Date: 12/11/2012
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 195 Youngs Ave, Southold,
SCTM#: 473889 Sec/Block/Lot: 61.-4-38.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
9/18/2012 pursuant to which Building Permit No. 37522 dated 9/18/2012
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:
electric for existing nonhabitable accessorygarage.
The certificate is issued to Fredriksson,Jim&Fredriksson,Elaine
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 37522 12/10/12
PLUMBERS CERTIFICATION DATED
Authorized Signature
TOWN OF SOUTHOLD
guFF01/r
job ��ay�H 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#: 37522 Date: 9/18/2012
Permission is hereby granted to:
Fredriksson, Jim & Fredriksson, Elaine
PO BOX 1906
Southold, NY 11971
To: Electric for existing garage
At premises located at:
195 Youngs Ave, Southold
SCTM # 473889
Sec/Block/Lot# 61.-4-38.1
Pursuant to application dated 9/18/2012 and approved by the Building Inspector.
To expire on 3/20/2014.
Fees:
ELECTRIC $90.00
Total: $90.00
Building Inspector
SO!/ryolo
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 roger.riche rtCc�town.southold.ny.us
Southold,NY 1 1 97 1-0959 �` O
COUNV il-
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: E&J Fredriksson
Address: 195 Youngs Ave City: Southold St: NY Zip: 11971
Building Permit#: Section: Block: L�i Lot: ;3 8.
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: home owner DBA: License No:
SITE DETAILS
Office Use Only
Residential X Indoor Basement Service Only
Commerical Outdoor 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage X
INVENTORY
Service 1 ph Heat Duplec Recpt 11 Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures 9 CO Detectors
Sub Panel 80a A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks
Disconnect Switches 8 Twist Lock Exit Fixtures 11 TVSS
Other Equipment: "DETACHED GARAGE", 2-special 20a recpticles, 2-specisl 30a recpticles
Notes:
Inspector Signature: Date: Dec 10 2012
81-Cert Electrical Compliance Form.xls
I �� OF SOpr�olo
" cOUNiY,� LL'
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING/STRAPPING [ ] FINAL
[ FIREPLACE & CHIMNEY FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
59�ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) �c-'y
REMARKS:
DATE 1)1'7112`�' INSPECTOR
hOy,Oof SOUl,���
OWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION ... .
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION""
[ ] FRAMING/STRAPPING [ ] FINAL
[ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL)
REMARKS:
DATE /_6 lz__ INSPECTOR --�
,of SO�Tyol
0
Town Hall Annex Telephone(631)765-1802
54375 Main Road (631)765 50
P.O.Box 1179 CAP • Q roger.richert(aown.sout�io�d.ny.us
Southold,NY 11971-0959 Q
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: Date:
Company Name:
Name:
License No.:
Address:
Phone No.:
JOBSITE INFORMATION: (*Indicates required information)
*Name:
*Address: l llau�,oqg Ao;-c , Soc�T�(z) mac-( ! 97/
*Cross Street:
*Phone No.: (p 3) . 7 fe< 2�3
Permit No.: 35 59A )/
Tax Map District: 1000 Section: �� I _ Block: �-J- Lot:_ g• I
*BRIEF DESCRIPTION OF WORK (Please Print Clearly) --(—
(Please Circle All That Apply)
*Is job ready for inspection: YES / NO 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
Additional Information: PAYMENT DUE WITH APPLICATION-
82-Request for Inspection Form