HomeMy WebLinkAbout37676-Z ✓F� Town of Southold Annex
guFFat�„ 12/14/2012
o25� P.O.Box 1179
co 54375 Main Road
rh
oy s o� 4{ Southold,New York 11971
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CERTIFICATE OF OCCUPANCY
No: 36084 Date: 12/14/2012
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 135 Birch Ave, Southold,
SCTM#: 473889 Sec/Block/Lot: 77.-1-21
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
12/10/2012 pursuant to which Building Permit No. 37676 dated 12/10/2012
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:
overhead electric service.
The certificate is issued to Beaton,Harry
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 37676 12/11/12
PLUMBERS CERTIFICATION DATED
Authorized Signature
pF SO�ryOlo
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 �. Q roger.riche rt(a)_town.southold.ny.us
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Harry Beaton
Address: 135 Birch Ave City: Southold St: NY Zip: 11971
Building Permit#: J-7 u'7(p Section: Block: Lot:
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
contractor: DBA: Telsan Electric Inc License No: 4934-me
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service Only X
Commerical Outdoor 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph 200a Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel 200a 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 200a Switches Toast Lock Exit Fixtures TVSS
Other Equipment: 200a overhead service
Notes:
Inspector Signature: _ "0Date: Dec 11 2012
81-Cert Electrical Compliance Form.xls
TOWN OF SOUTHOLD
�y BUILDING DEPARTMENT
y i 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#: 37676 Date: 12/10/2012
Permission is hereby granted to:
Beaton, Harry
73 Sunflower Ridge Rd
So Setauket, NY 11720
To: New Electrical Service
At premises located at:
135 Birch Ave, Southold
SCTM # 473889
Sec/Block/Lot# 77.-1-21
Pursuant to application dated 12/10/2012 and approved by the Building Inspector.
To expire on 6/11/2014.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
of S
O '
Town Hall Annex 4 Telephone(631)765-1802
54375 Main road 02
P.O.Box 1179' G� Q roger.dchertd-own soutgioQ� ny us l
Southold,NY 11971-0959 �O j
BUILDING DEPARTMENT
TOWN OF SOUTHOLD i
I,
APPLICATION FOR ELECTRICAL INSPECTION
j-
REQUESTED BY: <<i S <&AA Date: �Z 2
Company Name: 10"1 e.
Name: S S rh- ;
License No.: /wJ6 - &Y S
Address: 2--(- S
DI-
'Phone No.:
JOBSITE INFORMATION: (*Indicates requiIJ
red information)
*Name: H►9rru
*Address:
*Cross Street: �}
*Phone.No,:
Permit No.:
Tax-Map District: 1000 Section: Block: Lot:
*BRILF DESCRIPTION OF WORK(Please Print Clearly)
ZM Ayr'J t 4: '
- luow
� .
(Please Circle All That Apply)
Is job ready for inspection: / NO. Rough In Final
*Do-you need a Temp Certificate: YES/ NO
Temp Information I - ded)
*Service Size: 1 Ph 3Phase 100 150 �20300 350 400 Other
*New.Service: Re-connect Underground Number of Meters han a of Servic Overhead
------------
Additional Information:' Q E C WITH APPLICATION
DEC 10 2012
B2=Request for Inspection Form BLDG.DEPT.
TOWN OF SOUTHOLD