HomeMy WebLinkAbout46706-Z �O�gt1FFO1K�o Town of Southold 9/2/2021
a Gym P.O.Box 1179
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Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 42319 Date: 9/2/2021
THIS CERTIFIES that the building ELECTRICAL
Location of Property: Off Equestrian Ave.,Fishers Island
SCTM#: 473889 Sec/Block/Lot: 9.-9-23
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
8/18/2021 pursuant to which Building Permit No. 46706 dated 8/18/2021
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 overhead electric service.
The certificate is issued to Doherty,Carolyn
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 46706 8/31/2021
PLUMBERS CERTIFICATION DATED
Authorized Signature
�o�S�FF TOWN OF SOUTHOLD
�y BUILDING DEPARTMENT
N TOWN CLERK'S OFFICE
oy • Vol SOUTHOLD, NY
Sao"
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#: 46706 Date: 8/18/2021
Permission is hereby granted to:
Doherty, Carolyn
PO BOX 102
Fishers Island, NY 06390
To: New 200A electric service.
At premises located at:
Off Equestrian Ave., Fishers Island
SCTM # 473889
Sec/Block/Lot# 9.-9-23
Pursuant to application dated 8/18/2021 and approved by the Building Inspector.
To expire on 2/17/2023.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
OG SOUr�,®!
Town Hall Annex ® Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 @ roger.riche lt(U7town.south old.n us
Southold,NY 11971-0959 Y'
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To- Doherty
Address: Off Equestrian Ave (4231) City: Fishers Island St: New York Zip: 6390
Building Permit#: 46706 Section 9 Block. 9 Lot: 23
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: TPI Electric License No: 33396-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 Fixture Time Clocks
Disconnect 200a Switches Twist Lock Exit Fixtures f� TVSS
Other Equipment: 200a overhead service to include, 18 ARC fault circuit breakers
Notes*
Inspector Signature: TDate: August 312021
81-Cert Electrical Compliance Form As
BUILDING DEPARTMENT-Electri �11
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APPLICATION FOR ELECTRICAL INSPECTION
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ELECTRICIM tHFORMATION w w aw Required) Dace: 46u67ha2W
Company Name:
Name:
License No_: 33.�`1�CE / �' erra: '?Z 4f4d•4M/f
Address: nt—t- 6&Z#1J f
Phone No.:
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.#OB SITE INFORMATION pw In. Req&ed3
Name: 4/L
Address:
Cross Street f N7►tc}Q L� J
Phone No.: a
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BIdg.Peit#: 91 02&19 entail:
Tax--Map District 1000 Section: Bleck: Lot
BRIEF DESCRIPTION OF WORK(Please Print Clearly) Apri
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Circle All That Apply:
Is job ready for inspection?: GS NO Rough In Final
Do you need a Temp Certificate?: YES I NO Issued On
Temp Informatiidn: (Auk9brmation regtiwed)
Service Size_<[:P: 3 Ph Size: a'bo A #Meters _Old Meter#
Now Service-Ftit Rewrmecj-Rood Recmnect-sa-vim -Undergmund-Ovedwad
#Underground Laterals 4 2 H Frame Pole Work clone on Service? Y N
Additional Information:
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PAYMENT DUE WITH APPLICATION
Request for Inspection FormAs /
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