HomeMy WebLinkAbout38067-Z Town of Southold Amex 6/7/2013
g�FFat,fcdG� P.O.Box 1179
as x
54375 Main Road
vy �, Southold,New York 11971
CERTIFICATE OF OCCUPANCY .
No: 36286 Date: 6/7/2013
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1375 Ackerly Pd Ln, Southold,
SCTM#: 473889 Sec/Block/Lot: 69.-5-7.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
5/31/2013 pursuant to which Building Permit No. 38067 dated 5/31/2013
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:
Overhead Electrical Service
The certificate is issued to Glenn,Brian
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 38067 06-03-2013
PLUMBERS CERTIFICATION DATED
Authorized Signature
y
Lam. TOWN OF SOUTHOLD
S�FFot BUILDING DEPARTMENT
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TOWN CLERK'S OFFICE
oy • � $ 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#: 38067 Date: 5/31/2013
Permission is hereby granted to:
Glenn, Brian
PO BOX 329
Southold, NY 11971
To: New Overhead Electrical Service
At premises located at:
1375 Ackerly Pd Ln, Southold
SCTM # 473889
Sec/Block/Lot# 69.-5-7.1
Pursuant to application dated 5/31/2013 and approved by the Building Inspector.
To expire on 11/30/2014.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
��SUFFot4,
Town Hall Annex h�0 Gy Telephone(631) 765-1802
54375 Main Road o Fax (631) 765-9502
to 2
P.O. Box 1179 0 "�
Southold, NY 11971-0959 - •D��� roger.richertCcD-town.southold.mus
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Brian S Glenn
Address: 1375 Ackerly Pond Ln City:Southold St: NY Zip: 11971
Building Permit#: 38067 Section: 69 Block: 5 Lot: 7.1
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Parks Electric License No: 4458-me
SITE DETAILS
Office Use Only
Residential X Indoor Basement Service Only X
Commerical Outdoor X 1 st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph 400a 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 2-20 Switches Twist Lock Exit Fixtures TVSS
Other Equipment: 400a overhead service, 2-200a disconnects (on H frame)
Notes:
Inspector Signature: Date: June 3 2013
Electrical Certificate.xls
aF�ryo
Tom Hal!Annex � 4 Telephone(631)765-1802
54375 Main Road (681)7W�.gJQ5
P.O.Box 1179 .. @ Wn.s2. 0[f1.
roger rlChett� nY.us
Southold,NY 11971-0959 �►
BUII,DING DEPARTMENT 1
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY:
. Date:
Company Name: f
,Name*
��-s -.
License No.: C
Address: 4 41. -AZZL G C 0 R,27
Phone No.: . t3l3 ^ A S
JOBSITE INFORMATION: (*Indicates required information)
*Name: FVI&A S -Cp I fI
*Address: 7 La
*Cross Street:
*Phone No.: 3 ( -
Permit No.:
Tax-Map District: 1000 Section:. Block:_�3 Lot:
*BRIEF DESCRIPTION OF WORK(Please Print Clearly) 116 4 - ��
_11 rT 44,2 e e-5�
(Please Circle All That Apply)
*Is job ready for inspection: YES NO. Rough In Final
*Do-you need a Temp Certificate: YES 'NO
Temp informadon(if needed)
*Service Size: 1 Phase Whase 100 150 200 300 350 400 Other
*New Service. Re-connect Underground Number of Meters,Change of Service Overtiead
Additional Information: PAYMENT DUEVITH APPLICATION
8241equest for inspection Form J i°