HomeMy WebLinkAbout38299-Z gUEF01�o Town of Southold Annex 9/30/2013
go �Gy P.O.Box 1179
y 54375 Main Road
o ! Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 36542 Date: 9/30/2013
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 250 Wendy Dr, Laurel,
SCTM#: 473889 See/Block/Lot: 128.-5-2
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
9/3/2013 pursuant to which Building Permit No. 38299 dated 9/3/2013
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:
ELECTRICAL SERVICE UPGRADE TO 150 AMPS
The certificate is issued to Gorecki,Maria&Black,Michael Joseph
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 38299 09-09-2013
PLUMBERS CERTIFICATION DATED
Authorized Signature
o�s�FFnt��o TOWN OF SOUTHOLD
h� BUILDING DEPARTMENT
y z 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#: 38299 Date: 9/3/2013
Permission is hereby granted to:
Gorecki, Maria & Black, Michael Joseph
246 Withers St
Brooklyn, NY 11211
To: Electrical Service Upgrade to 150 Amps
At premises located at:
250 Wendy Dr, Laurel
SCTM # 473889
Sec/Block/Lot# 128.-5-2
Pursuant to application dated 9/3/2013 and approved by the Building Inspector.
To expire on 3/5/2015.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
*pF SO yol
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 � �� roger.riche rt(aD-town.southoId.ny.us
Southold,NY 11971-0959
COUNT`I
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Michael Black
Address: 250 Wendy Drive City: Laurel St: NY Zip: 11948
Building Permit#: 38299 Section: 128 Block: 5 Lot: 2
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Direct Connection Const License No: 44943-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 150a Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel 150a 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 150a Switches 11 Twist Lock Exit Fixtures TVSS
Other Equipment: service up grade to 150a overhead
Notes:
Inspector Signature: VDate: Sept 9 2013
81-Cert Electrical Compliance Form.xls
I
Town Hall Annex Telephone(63311))7g65--1802
S4375 P.O.B 1179d G • roQer.richer&-01 n soltt1101�.ny.us
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: i
Date:
Company Name:
Name:
License No.:
Address- I DS A r
Phone No.: (0 1 . 1 3S (63 l Z SS® 8"r e-C-
JOBSITE INFORMATION: (*Indicates required information).
*Name: �1lI cd9L �(�e 1
*Address: 50 w _ � 4 F �
*Cr+oss Street: L
*Phone No.: G 3 2 &G L 1-7
Permit No.:
Tax-Map District: 1000 Section: Block: Lot:
*BRIEF DESCRIPTION OF WORK(Please Print Clearly)
{Please Circle All That Apply)
Is job ready for inspection: YE ! NO. Rough In Final
*Do.you need a Temp Certificate: YE ! NO
Temp Information(if needed)
*Service Size: 1 Phase 3Phase 100 200 300 350 . 400 Other
*New Service: "Re-connect Undeccroun f Met Change of Servi Overhead
Additional Infiormation: _ -C_ E VA�I DUE WITH APPLICATION
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