HomeMy WebLinkAbout44032-Z :rte'
ff.FOt�-�QG, Town of Southold 10/8/2019
P.O.Box 1179
o53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40753 Date: 10/8/2019
THIS CERTIFIES that the building ELECTRICAL
Location of Property: Crescent Ave, Fishers Island
SCTM#: 473889 Sec/Block/Lot: 9.-2-12.1
Subdivision: Filed Map No. 'Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
8/6/2019 pursuant to which Building Permit No. 44032 dated 8/6/2019
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:
100 AMP ELECTRIC SERVICE
The certificate is issued to FI Union Chapel Inc
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 44032 08-27-2019
PLUMBERS CERTIFICATION DATED
on
Authorized Signature
pE SO
Town Hall Annex ® Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 • Q roger.riche rt(Qtown.south old.ny.us
Southold,NY 11971-0959 �` y
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To. FI Union Chapel Inc (thrift store)
Address: Crescent Ave City: Fishers Island St: New York Zip: 6390
Budding Permit* 44032 Section 9 Block- 2 Lot 121
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 Indoor X Basement Service Only X
Commerical X Outdoor X 1st Floor X Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph 100a Heat Duplec Recpt Ceding Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures Smoke Detectors
Main Panel 100a 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 100a Switches Twist Lock Exit Fixtures 11 TVSS
Other Equipment: Service up grade to 100a overhead
Notes
Inspector Signature: Date: August 27 2019
81-Cert Electrical Compliance Form As
zz TOWN OF SOUTHOLD
BUILDING DEPARTMENT
y TOWN CLERIC'S OFFICE
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#: 44032 Date: 8/6/2019
Permission is hereby granted to:
FI Union Chapel Inc
PO BOX 192
Fishers Island, NY 06390
To: install new 100a electrical service.
At premises located at:
Crescent Ave, Fishers Island
SCTM # 473889
Sec/Block/Lot# 9.-2-12.1
Pursuant to application dated 8/6/2019 and approved by the Building Inspector.
To expire on 2/4/2021.
Fees:
ELECTRIC $85.00
Total: $85.00
Bui ding nspector
�Q5�1ffOlkC BUILDING DEPARTMENT- Electric sPectgr-
TOWN OF SOUTHOLD
: Town Hall Annex - 54375 Main Road O Box 1179 {
off • a��� Southold, New York 11971-)1359' AUG - 2 2019 -
' ` Telephone (631) 765-1802 - FAX-(631) 765-9502
roqer.richert(a_town.south old.ny.us,",,,,
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: IV I(_[4 COLA S C, N)D U_)D S R D 1e Q Date:
Company Name: tfY ZLc
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Name:
License No.: email: c
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Address: �W L N ®LD l✓ rvl GT 3 �/
Phone No.: e 60 9 3
JOB SITE INFORMATION: (ASI Information Required)
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Name:
Address: 6rLr ft1/0
Cross Street:
Phone No.: al
Bldg.Permit M. t-� ,("�` j� email:
Fax Map District: 1000 Section: Ct Block: Lot: [a ,
BRIEF DESCRIPTION OF WORK (Please Print Clearly) 5&PIL4 r✓C UP_6_1F_> b
CSO Ile: a0 84 01 F1 C sEkrA0CE-- 11V,57�2c
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Circle All That Apply:
Is job ready for inspection?: 09NO Rough In Final
Do you need a Temp Certificate?: YES / NO Issued On
Temp Information: (All information required) 4
Service Size 1 P 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? 0 N
Additional Information:
PAYMENT DUE WITH APPLICATIONzt� '2�'
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82-Request for Inspection FormAs