HomeMy WebLinkAbout44339-Z �o�05U�1t Town of Southold 12/14/2019
P.O.Box 1179
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d' "1 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40934 Date: 12/16/2019
THIS CERTIFIES that the building ELECTRICAL
Location of Property: Bell Hill Ave, Fishers Island
SCTM#: 473889 Sec/Block/Lot: 9.-3-4
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
10/28/2019 pursuant to which Building Permit No. 44339 dated 10/28/2019
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:
"as built"electrical survey.
The certificate is issued to Gaillard Wm D Revoc Trust
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Authorized Sig-nature
4�5uFFoc TOWN OF SOUTHOLD
ekky BUILDING DEPARTMENT
M TOWN CLERK'S OFFICE
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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#: 44339 Date: 10/27/2019
Permission is hereby granted to:
Gaillard Wm D Revoc Trust
17 Meeting House Rd
Greenwich, CT 06830
To: electric
At premises located at:
Bell Hill Ave, Fishers Island
SCTM # 473889
Sec/Block/Lot# 9.-3-4
Pursuant to application dated 10/28/2019 and approved by the Building Inspector.
To expire on 4/27/2021.
Fees:
ELECTRIC $90.00
Total: $90.00
Building Inspector
Town Hall Annex ® Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 roger.richert(cD-town.southold.ny.us
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Gaillard
Address: 556 Bell Hill Ave #647 City. Fishers Island St: New York Zip: 6390
Budding Permit# 44339 Section 9 Block 3 Lot 4
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
contractor: DBA- Z&S Contracting License No- 4798-ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service Only
Commerical Outdoor X 1st Floor X Pool
New Renovation 2nd Floor X Hot Tub
Addition Survey X Attic Garage
INVENTORY
Service 1 ph 100a Heat Duplec Recpt 19 Ceiling Fixtures 8 HID Fixtures
Service 3 ph Hot Water elec GFCI Recpt 3 Wall Fixtures 7 Smoke Detectors 4
Main Panel 100a A/C Condenser Single Recpt Recessed Fixtures CO Detectors 1
Sub Panel A/C Blower Range Recpt 50a Fluorescent Fixture Pumps
Transformer Appliancesdw Dryer Recpt 30a Emergency Fixtures Time Clocks
Disconnect 100a Switches 20 Twist Lock rl Exit Fixtures TVSS
Other Equipment. "AS BUILT" "ELECTRICAL SURVEY" "NO VISUAL DEFECTS"
Notes. electric base board heat, 1-bath fan
"DEFECTS REMOVED"
Inspector Signature: Date: November 7 2019
81-Cert Electrical Compliance Form As
BUILDING DEPARTMENT-Electrical Inspector
s°tea ` . TOWN,OF,SOUTHOLD
;dl-71Town Hall Annex-_54375 Main Road -
F PO Box 1179
> 'S Southold, New York 11971-0959
Telephone (631) 765-1802- FAX (631) 765-9502
Merr(c-Dsoutholdtownny.gov seand .southoldtownny.gov
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APPLfOATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (Au Information Required); Date: /p d/ /
Company Name: Z S CU►�l�t✓ �i7� ,1nG-
Name: �j4e4o SwotPw1,e��2.,
License No.: �?'f'�-�F email: zanws Go►�r1� r�
Address: o?S x �CanG - '�C;eivy, pJf
Phone No.:
JOB SITE INFORMATION (All Information Required)
Name: a11-f &illand
Address: s-- / it i4re. *'Gyy
Cross'Street:
Phone No.: c7v.3-
Bldg.Permit#: 3 email: y�Wine-.,
Tax Map,District:, 1000 Section: Block: Lot:
BRIEF DESCRIPTION OF WORK (Please Print Clearly)
Circle All That Apply,:
Is job ready for insp•edtion?`: YES NQ Rough In Final
Do you need a Temp Certificate?: YES / NO
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
J#-Underground Laterals 1 2 H,Frarne Pole Work done on Service? Y N
Additional Information:
PAYMENT DUEVITH APPLICATION
-' OCT 2 5 2019
Request for Inspection Form.icts, -9 d