HomeMy WebLinkAbout46256-Z �o`OgOEFOCQh?a Town of Southold 7/11/2021
A P.O.Box 1179
o 53095 Main Rd
oy?jo� Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 42151 Date: 7/11/2021
THIS CERTIFIES that the building ELECTRICAL
Location of Property: Private Rd.,Fishers Island
SCTM#: 473889 Sec/Block/Lot: 3.-6-4.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
5/14/2021 pursuant to which Building Permit No. 46256 dated 5/14/2021
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 underground electric service due to utilijy company re-location of transformer.
The certificate is issued to Fransson,Karl&Ors.
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 46256 6/17/2021
PLUMBERS CERTIFICATION DATED
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Authorized Signature
rif so
Town Hall Annex L ® Telephone(631)765-1802
54375 Main Road air Fax(631)765-9502
P.O.Box 1179 G • roger.richert(a-town.southold.ny.us
Southold,NY 11971-0959
COMM
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To Karl Fransson
Address: Private Road (1044 Cedar Ridge) City: Fishers Island St: New York Zip: 6390
Building Permit#: 46256 Section: 3 Block: 6 Lot: 4.1
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: BD Electric License No: 35821-ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement X Service Only X
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph 200a Heat Duplec Recpt Ceiling 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
200
Disconnect 1 Switches Twist Lock Exit Fixtures [] TVSS
Other Equipment. Install new conduit and conductors due to utility company re-locating transformer
Notes: Service up grade to include new main electrical panel
Inspector Signature: Date: June 17 2021
81-Cert Electrical Compliance Form.xls
o�SUFFoc,r�o TOWN OF SOUTHOLD
�y BUILDING DEPARTMENT
y x TOWN CLERK'S OFFICE
"may • � �{ 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#: 46256 Date: 5/14/2021
Permission is hereby granted to:
Fransson, Karl
11 Dodge Dr
West Hartford, CT 06107
To: 200A underground electric service.
At premises located at:
Private Rd., Fishers Island
SCTM #473889
Sec/Block/Lot# 3.-6-4.1
Pursuant to application dated 5/14/2021 and approved by the Building Inspector.
To expire on 11/13/2022.
Fees:
ELECTRIC $85.00
Total: $85.00
B ector
BUILDING DEPARTMENT-Electrical Inspector
TOWN OF SOUTHOLD
CD 1 tTgwtVHall_Annex - 54375 Main Road - PO Box 1179
�' �'` Southold,
1+- '� A , r•" -
®y � � �;. .^--r•- ,, � New York 11971-0959
Telephone (631) 765-1802 - FAX (631) 765-9502
rocierr@southoldtownny.aov - seand(aDsoutholdtownny.gov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (AM Information Required) Date: <j
Company Name:
Name:
License No.: iZ email: a+ ® i
- Phone No: - request an email copy of Certificate of Compliance
Address.: 2n
JOB SITE INFORMATION (All Information Required)
Name: K&-d
Address:
Cross Street:
Phone No.:
Bldg.Permit#: (D j(� email:
Tax Map District: 1000 Section: Block: G Lot:
BRIEF DESCRIPTION OF WORK (Please Print Clearly) .t,�f�It Cc -4 f c01
m,,✓ 7.0 0_!#
Check All That Apply:
Is job ready for inspection?: �YES El N E]Rough In Final
Do you need a Temp Certificate?: YES NO Issued On
Temp Informati n: (AII information required)
Sery a Size 1 Ph 03 Ph Size: ®�A #Meters_ Old Meter#
New Service ❑ Service Reconnect [�U derground [:]Overhead
#Underground Laterals & 1 02 ❑H Frame QPole Work done on Service? D ®N
Additional Information:
PAYMENT DUE WITH APPLICATION
Electrical Inspection Form 2020.x1sx ��