HomeMy WebLinkAbout37867-Z SZ-fFDt/r Town of Southold Annex 12/2/2013
P.O.Box 1179
y 54375 Main Road
off, �F Southold,New York 11971
�Ol
CERTIFICATE OF OCCUPANCY
No: 36624 Date: 12/2/2013
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1700 Village Ln, Orient,
SCTM#: 473889 Sec/Block/Lot: 24.-2-17
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
3/15/2013 pursuant to which Building Permit No. 37867 dated 3/15/2013
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:
400 AMP UNDERGROUND ELECTRIC SERVICE
The certificate is issued to Hossenlopp G J Revoc Trt&Hossenlopp L L
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 37867 11-21-2013
PLUMBERS CERTIFICATION DATED
Authorized Signature
o�sunl��o TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
o . SOUTHOLD, NY
9,�p1
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#: 37867 Date: 3/15/2013
Permission is hereby granted to:
Hossenlopp G J Revoc Trt & Hossenlopp L L Revoc Trust
1101 Spinnakers Reach Dr
Ponte Vedra Beach, FL 32082
To: 400 amp Underground Service
At premises located at:
1700 Village Ln, Orient
SCTM # 473889
Sec/Block/Lot# 24.-2-17
Pursuant to application dated 3/15/2013 and approved by the Building Inspector.
To expire on 9/14/2014.
Fees:
ELECTRIC $85.00
Total: $85.00
uild' Inspector
O�*pG SOUjy�l
Town Hall Annex ~ Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 CAQ roger.riche rt(a)town.southo Id.ny.us
Southold,NY 11971-0959
o�yCOUMy,��
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Hassenloop
Address: 1700 Village La City: Orient St: NY Zip: 11957
Building Permit#: 37867 Section: 24 Block: 2 Lot: 17
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: BJ Electric License No: 2670-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 400a Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel 2-20 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 11 Twist Lock Exit Fixtures TVSS
Other Equipment: 400a underground service with 2-meters and 2-200a main panels
Notes:
Inspector Signature: 7Date: Nov 21 2013
Idr
81-Cert Electrical Compliance Form.xis
Town Hall Annex lf ( Telephone(631)765-1802
54375 Main Road (631).765,�"g95QQ2
P.O.Box 1179 G� �. roger richert oWrl.SouUl016V us
Southold,NY 11971-0959
S1JIIDING DEPARTMI'rW
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: / Date: 3
Company Name: ��;��`�
Name: o U vV A-�6 cZ
License No.: (�
Address:
Phone No::
JOBSITE INFORMATION: (*Indicates required information)
*Name: qE0 2 q&5
*Address: / D 6 0 o c � 14, D Y j
*Cross Street: �J2 (' p.y� �!.
*Phone No.: &S t lit el�"A r
Permit No.: Glf!Gi
Tax-Map District: 1000 Section: Block: ` Lot:
'BRIEF DESCRIPTION OF WORK(Please Print Clearly)
(Please Circle All That Appty)
*Is job ready for inspection: YES ONO. Rough In Final
*Do-you need a Temp Certificate: YES NO
Temp Information If neededl
'Service Size: Q Phase 3Phase 100 150 200 300 350 '400 Other "
*New Service: Re-connect Underground Number of Meters Change of Service verhead
Additional Information: PAYMENT DUE WITH APPLICATION
OY82-Req
A
est for Inspection Fon-n I�j