HomeMy WebLinkAbout45493-Z �o�g�FFUd�g'�p Town of Southold 11/4/2021
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P.O.Box 1179
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Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 42498 Date: 11/4/2021
THIS CERTIFIES that the building ELECTRICAL
Location of Property: Pvt Rd Off E End Rd.,Fishers Island
SCTM#: 473889 Sec/Block/Lot: 4.-5-3
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
11/24/2020 pursuant to which Building Permit No. 45493 dated 11/24/2020
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:
200 amp electric service.
The certificate is issued to WLLBJR 2013 Res Hld One LL
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 45493 10/20/2021
PLUMBERS CERTIFICATION DATED
Authorized Signature
o�soFFat,��o TOWN OF SOUTHOLD
BUILDING DEPARTMENT
z, TOWN CLERK'S OFFICE
SOUTHOLD, NY
a 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#: 45493 Date: 11/24/2020
Permission is hereby granted to:
WLLBJR 2013 Res Hid One LL
c/o W.L. Lyons Brown Jr
657 S Hurstbourne Pkwy#228
Louisville, KY 40223
To: 200A electric service.
At premises located at:
Pvt Rd Off E End Rd., Fishers Island
SCTM # 473889
Sec/Block/Lot#4.-5-3
Pursuant to application dated 11/24/2020 and approved by the Building Inspector.
To expire on 5/26/2022.
Fees:
ELECTRIC $85.00
Total: $85.00
1
Building Inspector
rjf SO
Town Hall Annex �t� ® Telephone(631)765-1802
54375 Main Road '~ s�{. Fax(631)765-9502
P.O.Box 1179 roger.rich ert(cD-town.south old.ny.us
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To WLLBJR 2013 Res-Hid One LL
Address: Pvt Rd Off E End Rd City: Fishers Island St New York Zip: 6390
Building Permit#. 45493 Section 4 Block 5 Lot 3
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 Ceding Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel X 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 11 TVSS
Other Equipment: 200 a service up grade due to power company alterations.
Notes,
Inspector Signature: Date: October 20 2021
81-Cert Electrical Compliance Form As
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NOV 2 0 2020
BUILDING DEPARTMENT-Electrical Inspector
A, TOWN OF SOUTHOLD
Town Hall Annex-54375 Main Road -PO Box 1179
r4 - Southold, New York 11971-0959
alp
;a Telephone(631) 765-1802- FAX(631) 765-9502
roger rC°)southoldtownn,2:gov—seand .southoldtownny.clov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date: Gei �
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Company Name:
Name:
License No.: j �3'LIi~'I email:
Address: IpfAiv
Phone No.:
JOB SITE INFORMATION (All information Required)
Name:
Address: _ QK
Cross Street: ('
Phone No.:
BIdg.Permit#:
Tax Map District: 1000 Section: Block:
BRIEF DESCRIPTI OF WORK (Please Print Clearly) _ �er� _ Q;rt���
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Circle All That Apply:
Is job ready for inspection?: YES / O Rough In Final
Do you need a Temp Certificate?: YES! O Issued On
Temp Inf®rmation: (Ali information required)
Service Size(fPh) 3 Ph Size: A #Meters _ Old Meter#
New Service-Fire Reconnect-Flood Reconnect-Service Reconnected- Underground-Overhead
#Underground Laterals 9`_2 H Frame Pole Work done on Service? N
Additional InformLatiort:
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PAYMENT DUE WITH APPLICATION
iCP
Request for Inspection FormAs
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