HomeMy WebLinkAbout44016-Z guFFO(�
Town of Southold 8/20/2019
Fi P.O.Box 1179
53095 Main Rd
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CERTIFICATE OF OCCUPANCY
No: 40635 Date: 8/20/2019
THIS CERTIFIES that the building ELECTRICAL
Location of Property: Glenmaine Ave,Fishers Island
SCTM#: 473889 Sec/Block/Lot: 9.-5-13
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
7/11/2019 pursuant to which Building Permit No. 44016 dated 7/29/2019
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:
200 AMP ELECTRIC SERVICE UPGRADE
The certificate is issued to Fisher-Owens Living Trt
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 44016 07-30-2019
PLUMBERS CERTIFICATION DATED
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Authorized Signature
�SVFFoc�c TOWN OF SOUTHOLD
BUILDING DEPARTMENT
C TOWN CLERK'S OFFICE
oy . �1' SOUTHOLD, NY
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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#: 44016 Date: 7/29/2019
Permission is hereby granted to:
Fisher-Owens Living Trt
321 Warren Dr
San Francisco, CA 94131
To: electric service upgrade
At premises located at:
Glenmaine Ave, Fishers Island
SCTM # 473889
Sec/Block/Lot# 9.-5-13
Pursuant to application dated 7/11/2019_ and approved by the Building Inspector.
To expire on 1/27/2021.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
pE SOUryol
Town Hall Annex h ® Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 G roger.riche rt D-town.south old.ny.us
Southold,NY 11971-0959 • ��
®lyCOUNT`I,��
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To. Fisher Owens Living Trust (Daniel Fisher Owens)
Address: Glenmaine Ave (145 Cresent Ave) City: Fishers Island St: New York Zip: 6390
Building Permit#: 44016 Section: 9 Block 5 Lot 13
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: TPI Electric License No: 33396-ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement X Service Only
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph 200a Heat Duplec Recpt Ceding 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 F1 Twist Lock Exit Fixtures TVSS
Other Equipment, SERVICE UP GRADE, 200a meter pan and main panel, 15-ARC fault circuit
breakers
Notes.
Inspector Signature: _s?vZ;a� Date: July 30 2019
81-Cert Electrical Compliance Form As
BUILDING DEPARTMENT-Electrical 1jr@y t4r
TD1ll;IN OF SOUTHOLD � � 1 ,
v ,a; �t Town Hall Annex - 54375 Main Road -'P boxjh j79 9 2019
-095
Telephone (6311) 765-1802 k
p FAX (631) 765-9502
ro-ger.richert a,town.southold.ny.tas
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: —J'd nj Py(AiJ 7 Date:_�—
Company Name: _ Ord
Name:
License No.: email:
Address: A,) l2c 2-d
Phone No.: =13 SZ L S—d
JOB SITE INFORMATION: (Ail Information Required)
Name: J�ati� I P l �SL►2,?_�
Address: ( -r P-'j U
Cross Street:
Phone No.: �le R
Bldg.Permit : email:
Tax Map District: 1000 Section, Block: Lot. /
BRIEF DESCRIPTION OF WORK(Please Print Clearly)
Circle All That Apply:
Is job ready for inspection?: YES&N Rough In Final
Do you need a Temp Certificate?: YES/ O Issued On
Temp Information: (All information required)
Service Size 1 Ph 3 Ph Size: A # Meters _ Old Meter#
New Service- Fire Reconnect- Flood Reconnect-Service Reconnected - Underground -Overhead
#Underground Laterals 1 2 H Frame Pole Work done on Service? Y N
Aciditi��onal Information:
77-d-6 9-Pitty Zce w (TA
A
PAYMENT DUE WITH APPLICATION
to82-Request for Inspection Form.As G�
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