HomeMy WebLinkAbout43707-Z �o�c�UTrFO��-cO�y Town of Southold 5/28/2019
P.O.Box 1179
a
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40421 Date: 5/28/2019
THIS CERTIFIES that the building ELECTRICAL
Location of Property: Crescent Ave, Fishers Island
SCTM#: 473889 Sec/Block/Lot: 6.-1-9
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
5/3/2019 pursuant to which Building Permit No. 43707 dated 5/3/2019
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:
re-locate existing panels and organize 400a electrical service.
The certificate is issued to Rothfeld,Michael&Foshay,Ella
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 43707' 5/9/2019
PLUMBERS CERTIFICATION DATED
Authorized Signature
guFFn�K TOWN OF SOUTHOLD
BUILDING DEPARTMENT
a TOW_ N CLERK'S OFFICE
oy • SOUTHOLD, NY
�ipl � .dao
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#: 43707 Date: 5/3/2019
Permission is hereby granted to:
Rothfeld, Michael
1220 Park Ave
New York, NY 10128
To: Electric
At premises located at:
Crescent Ave, Fishers Island '
SCTM # 473889
Sec/Block/Lot# 6.-1-9
Pursuant to application dated 5/3/2019 and approved by the Building Inspector:
To expire on 11/1/2020.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
rjv so
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 G
a® roper.
Southold,NY 11971-0959 richertCc�town.Southold.ny.us
®��C®� 9��
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To- Michael Rothfeld
Address. Crescent Ave City: Fishers Island St: New York Zip: 6390
Building Permit#. 43707 Section. 6 Block- 1 Lot: 9
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: NI Electric License No: 34408-ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement X Service Only
Commerical Outdoor X 1 st Floor Pool
New Renovation 2nd Floor X Hot Tub
Addition Survey Attic Garage X
INVENTORY
Service 1 ph 400a Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel 2 A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel 2 A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks
Disconnect R2-20 Switches Twist Lock Exit Fixtures TVSS
Other Equipment, Re-locate existing panels, organize 400a electrical service to include,
200a generator transfer switch, 1-200a generator panel, 1-200a general panel, 1-100a sub panel, 1-60a sub panel
Notes:
Inspector Signature: Date: May 9 2019
81-Cert Electrical Compliance Form.xls
so�,ry® ,
Town Hall Annex
54375 Main Road Q
P.O.Box 1179 GQ rWr1 sou o .n u
Southold,NY 11971-0959 Q� � ,�
MAY - 3 2019
BUMDUNG IaS§ •0'r11
TOWN OF SOUTHOLD TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: AWO L PS C. Wg)Q5
p D Date:
Company Name: p b& C L C_
Name: JC
License No.:
Address: - L L
Phone No.: Ci
JOBSITE INFORMATION: (Indicates required information)
Name: l I'C 14 t) 1;�L a art$ � �p
'Address: fU 1 �� �✓ ._.._
`Cross Street: `
`Phone No_: 3 7
'ermit No.- Lt 310-1
rax Map District: 1000 Section: (0 Block: Lot:
'BRIEF DESCRIPTION OF WORK(Please Print Clearly)1P)qj0Q,—S,/ - -
2v
~prly t�, Ie. O O S Er IZ I ,ut> 5
Please Circle Alf That Apply)
Is job ready for inspection: YES NO Rough in Final
Do'you need a Temp Certificate: YES 1
'emp Information(If needed)
Service Size: 1 Phase 3Phase 100 150 200 300 350 Other
New Service: Re-connect Underground Number of
Meters Change of Service Overhead
►dditional Information: PAYMENT DUE WITH APPLI TION
82-Request for Inspection Form - /3 l