HomeMy WebLinkAbout46759-Z �o�g11fF0i/� Town of Southold 9/2/2021
a y� P.O.Box 1179
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CERTIFICATE OF' OCCUPANCY
No: 42321 Date: 9/2/2021
THIS CERTIFIES that the building ELECTRICAL
Location of Property: Hedge St.,Fishers Island
SCTM#: 473889 Sec/Block/Lot: 10.-7-18
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
8/30/2021 pursuant to which Building Permit No. 46759 dated 8/30/2021
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.
The certificate is issued to W Harbor Bungalow LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 46759 8/31/2021
PLUMBERS CERTIFICATION DATED
Authorized Signature
�o4�S�FFO � TOWN OF SOUTHOLD
oy BUILDING DEPARTMENT
C" x TOWN CLERK'S OFFICE
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#: 46759 Date: 8/30/2021
Permission is hereby granted to:
W Harbor Bungalow LLC
PO BOX 351
Mystic, CT 06355
To: 200A underground electric service.
At premises located at:
Hedge St., Fishers Island
SCTM #473889
Sec/Block/Lot# 10.-7-18
Pursuant to application dated 8/30/2021 and approved by the Building Inspector.
To expire on 3/1/2023.
Fees:
ELECTRIC $85.00
Total: $85.00
"'—w/CL
Building Inspector
irtf S10
Town Hall Annex ® Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 ® roger.rich ertCcD-town.south old.ny.us
Southold,NY 11971-0959 �` a
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: W Harbor Bungalow LLC
Address: Hedge Street (371) City: Fishers Island St: New York Zip: 6390
Building Permit#: 46759 Section: 10 Block: 7 Lot: 18
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 Basement Service Only X
Commerical Outdoor 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 1 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 FixturesTime Clocks
Disconnect 200a Switches Twist Lock Exit Fixtures TVSS
Other Equipment: 200a underground service to include, 4-ARC fault circuit breakers, 5-combination
GFCI/ARC fault circuit breakers
Notes:
Inspector Signature: Date: August 31 2021
81-Cert Electrical Compliance Form.xls
BUILDING DEPAEiTMENT-Electrical inspector
TOWN OF SOUTHOLD
AX
12
Hail Annex-54375 Main Road -PO Box 1179
So€thold, Nei York 11971-0959 1 3 2021 Telephone(631)765A 802-FAX(631) 765-9502
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BI1LtDING DEPT.
ThAO- TMO TFOR ELECTRICAL INSPECTION
ELECTRICIAN WFOR IAM (An info rm Requ:jad) Date_ 7 �
Company Mame: 1 T .T L rGc.T2lC
Name: /K Q(A&A
License No_: ZZ%% A46 email_
Address: Q
Phone No.: O f�
JOB SITE INFORMATION fie n Required)
Name: &4,r69 t7Z
Address: T"'S UJ0
Cross Street: ,
Phone No_: 60-
Bldg_Permiit#: 9 �7 5 f email.-
Tax
mail:Tax Map District: 1000 Section: J() Block —J Lot:
BRIEF DESCRIPTION OF WORK(Please Print Clearly) A d
Circle All That Apply:
Is job ready for inspection?: �NO Rough In Final
Do you need a Temp Certificate?: YES 1 NO Issued On
Temp Information' (AD irilbrination required) y
Service Siz 1 P 3 Ph Size:Agj1 t #Meters / Old Meter#
New Service-Fire Recor ett-Florid R.eccnneict-Service Ramr inec ed-Underground-Overhead
#Underground Laterals 1 2 H Frame Pale Work done on Service? " Y N
Additional Information_
PAYMENT DUE WITH APPLICATION!
Request for Inspection Forrrr.As 9 —1 3 ;F5
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