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Home My WebLink About43201-Z T?r �o f0[N Town of Southold 7/15/2021 o P.O.Box 1179 co �cc' 53095 Main Rd iyjj0 ap� 5r� Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 42163 Date: 7/15/2021 THIS CERTIFIES that the building ELECTRICAL Location of Property: Oriental Ave,Fishers Island SCTM#: 473889 Sec/Block/Lot: 12.-2-8 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 11/7/2018 pursuant to which Building Permit No. 43201 dated 11/7/2018 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. The certificate is issued to Rubinow,Laurence&Betty Ann of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 43201 6/8/2021 PLUMBERS CERTIFICATION DATED Authorized Signature o�Sv�Fn��coTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE oy o� 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#: 43201 Date: 11/7/2018 Permission is hereby granted to: Rubinow, Laurence & Betty Ann 239 Cedar Ridge Dr Glatonbury, CT 06033 To: storm damage electrical repair At premises located at: Oriental Ave, Fishers Island SCTM #473889 Sec/Block/Lot# 12.-2-8 Pursuant to application dated 11/7/2018 and approved by the Building Inspector. To expire on 5/8/2020. Fees: ELECTRIC $85.00 Total: $85.00 Bui g Inspector oc sov��®� Town Hall Annex ® Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 ® �Q roper.richert@town.southold.ny.us OWN, BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Laurence Rubinow Address: Oriental Ave. (1745 Wilderness Rd) City: Fishers Island St: New York Zip: 6390 Building Permit#. 43201 Section- 12 Block 2 Lot: 8 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: NI Electric License No: 34408-ME SITE DETAILS Office Use Only Residential X Indoor Basement Service Only X Commerical Outdoor X 1st Floor Pool New X Renovation 2nd Floor Hot Tub Addition Surrey Attic Garage INVENTORY Service 1 ph 200a Heat Duplec Recpt Ceiling Fixtures HID Fixtures Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors Main Panel 200a A/C Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks Disconnect 200a Switches Twist Lock Exit Fixtures TVSS Other Equipment. Repair storm damage-install new 200a underground service Notes: Inspector Signature: Date: June 8 2021 81-Cert Electrical Compliance Form.xls �o�SUFfoc,��o BUILDING DEPARTMENT-Electrical Inspector co TOWN OF SOUTHOLD W • Town Hall Annex-54375 Main Road-PO Box 1179-Southold, NY 11971-0959 Telephone (631)765-1802-FAX(631)795-9502 Temporary Certificate # Date A(df-) 7 2018 Customer Name (,�a RM ft aw Electrician Name A1,T Oct '/2GC�, Address /74 WtLvalWoe-5 J.b, Phone g(6. (02 e-mail jV01 aerc-v-1odL Avc e-mailr L- CC-rt2rG 6-f1,eKtL • COC44 Phone A License# 2 f Q$- /if G Size--?,!�A Phase Overhead Underground #of Meters Remarks root144 #of Underground Laterals 2 New "H" Frame or Polel H P Fire Reconnect Was work done on Service? Y/N Flood Reconnect Old Meter# Service Reconnected Application for electrical service equipment is on file with the town of Southold.On the applicant's notification that this installation is complete,the town will conduct a premises inspection of the service equipment. This verification is valid for 9 day tr ove. Authorized by o��c,�1FF0(K��G BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD Town Hall Annex - 54375 Main Road - PO Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX-(631) 765-9502 roger.richert(cD-town.southold.ny.us APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: 1')IC-L46LO ; C. IVQU-)DS P�J)1<0 Date: ja-ac -/9- Company Name: AJYL17-c-T C L Name: License No.: (� �; yY) email: ,vi L G G@#0 AI 1 L`C.OI� Address: �l h�?E- 414D LVIO 67- CT 0637/ Phone No.: C' JOB SITE INFORMATION: (All Inform tion Required) �, r �- Name: `fi t` (� 1 N � i Address: 1-7q 5 Ly 1 L 6)L-fZ iUS Lb , L Cross Street: yam/ Phone No.: G31 l» TAN �• Bldg.Permit#: t3 'i email: A•r;,E "�t g r_ :U'f.r T Tax Map District: 1000 Section: / 'a Block: `� Lot: BRIEF DESCRIPTION OF WORK (Please Print Clearly) S 77)RM 61411146-6- N DD Circle All That Apply: Is job ready for inspection?: YES / Rough In Final Do you need a Temp Certificate?: YES / NO Issued On }s Temp Information: (Ali information required) Service Size 1 P 3 Ph Size: 2�A #Meters f Old Meter# New Service - Fire Reconnect Flood Reconnect-Service Reconnected -EiunD Overhead # Underground Laterals 1 2 H Frame Pole Work done on Service? Y N Additional Information: �1G 0 1 aA1L-5- ARC--- wl TY-U0l /JDWL- -- fLL-40(-�1 PS S P2C-y�nJ C— — t� PAYMENT DUE WITH APPLICATION r&1"P P--Fc-� u t 2e-D P L� SLS 82-Request for Inspection FormAs ��e