HomeMy WebLinkAbout45528-Z �o�OS� FE �t'fcoG Town of Southold 1/23/2021
> P.O.Box 1179
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d' 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 41742 1Date: 1/23/2021
THIS CERTIFIES that the building ELECTRICAL
Location of Property: Halcyon Ave., Fishers Island
SCTM#: 473889 Sec/Block/Lot: 9.42-2
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
12/3/2020 pursuant to which Building Permit No. 45528 dated 12/3/2020
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:
200a electrical service disconnected and replaced with 400a electrical service.
The certificate is issued to Four Winds FI LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 45528 1/7/2021
PLUMBERS CERTIFICATION DATED
744o4 �
Authorized Signature
�Suffat�c TOWN OF SOUTHOLD
BUILDING DEPARTMENT
H x TOWN CLERK'S OFFICE
"oy e• �� 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#: 45528 Date: 12/3/2020
Permission is hereby granted to:
Four Winds FI LLC
80 Turtleback Ln E
New Canaan, CT 06840
To: 200A electric service.
At premises located at:
Halcyon Ave., Fishers Island
SCTM # 473889
Sec/Block/Lot# 9.-12-2
Pursuant to application dated 12/3/2020 and approved by the Building Inspector.
To expire on 6/4/2022.
Fees:
ELECTRIC $85.00
Total: $85.00
110-117.
07 f%ftmw
Building Inspector
so
Town Hall Annex ® Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 roper.riche rt(7town.south old.ny.us
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Four Winds FI LLC (Kinlin)
Address: Halcyon Ave City: Fishers Island St: New York Zip: 6390
Building Permit#. 45528 Section: 9 Block 12 Lot- 2
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 Service Only
Commerical Outdoor X 1st Floor Pool
New X Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph 400a Heat Duplec Recpt Ceding Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel 2-20 A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks
Disconnect 2-20 Switches Ll Twist Lock Exit Fixtures TVSS
Other Equipment
Notes- Disconnect existing 200a service and install new 400a underground service in new location, remove unused wireing and remove
defects in basement.
Inspector Signature: Date: January 7 2021
81-Cert Electrical Compliance Form.xls
ur 30
Town H i Road
.1437,5 Main Roadd Telephone(631)765-1802
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P.O.Hoa 1178 Q roger richertrago 1.S0 tnmmy.us
Southold,NY 11971.0959 1%
BLU I)LN IG DEPARTMENT
T01W OF SOUTHOL D
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: �1�,�.�.�LIQ Com' C. yUf)(!t�0��� Date:
Company Name: L[_
Name: Ain-
License No.:
Address: �
Phone No.:
JOBSITE INFORMATION: (1ndicates required information)
'Name: L, 1
`Address: C
`Cross Street-
`Phone No.:
Permit No.:
fax Map District: "i000 SeCtiOn. Block: Lot:
BRIEF DESCRIPTION OF WORT((Please Print Clear!
,CIO (� 1����L= `� L`'Y►�I O
Please Circle All That Apply)
Is job ready for inspection: YES I No Rough In Final
Do you need a Temp Certificate: YES t NO
°emP Information (!f needed)
Service Size: 9 Pha 3Phase 100 150 200 300 350 Other
New Service: Re-c annectnde round
� Number of Meters Change of Service Overhea �
,dditional Information: PAYMENT DUE WITH APPLICATION
_ �\
82-Request for Inspection Form
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