HomeMy WebLinkAbout45494-Z �o�S�EFDt�-4 Town of Southold 11/4/2021
y� P.O.Box 1179
0
W 53095 Main Rd
�y�j oma` Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 42499 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: 7.4-5
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. 45494 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:
600A electric service.
The certificate is issued to Grey Gulls LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 45494 10/20/2021
PLUMBERS CERTIFICATION DATED
Authorized Signature
62 TOWN OF SOUTHOLD
aye BUILDING DEPARTMENT
y x TOWN CLERK'S OFFICE
�y • �� 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#: 45494 Date: 11/24/2020
Permission is hereby granted to:
Grey Gulls LLC
5803 Kennett Pike Ste A
Wilmington, DE 19807
To: 600A electric service.
At premises located at:
Pvt Rd Off E End Rd., Fishers Island
SCTM # 473889
Sec/Block/Lot# 7.-4-5
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
e
Bui g spector
®�"NpF SOUr�®�
Town Hall Annex ® Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 roger.richert(a)-town.Southold.ny.us
Southold,NY 11971-0959 ® a®
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Grey Gulls LLC
Address: Prvt Rd Off E End Rd (3800 East Main Rd) City: Fishers Island St: New York Zip: 6390
Building Permit* 45494 Section. 7 Block. 4 Lot. 5
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: BD Electrical License No: 35821-ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service Only
Commerical Outdoor X 1st Floor X Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage X
INVENTORY
Service 1 ph Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel 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 Switches Twist Lock Exit Fixtures TVSS Ll
Other Equipment, Service up grade due to power company alterations
Notes. 3-houses, 1-work shop,600a service,4 meters,5-150A disconnects
Inspector Signature: Date: October 20 2021
81-Cert Electrical Compliance Form As
f', ,.•�� � � 202
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) 763-9502
s:HI ro err -southoldtownny.gov seandCcr�,southoldtownny:aov
APPLICATION_FOR ELECTRLCAL_INSPECTION
ELECTRICIAN INFORMATION (All Intormation Required) Date:( Z®
Company Name: `�� `
us—
Name:License-No.: 155'aZ-j Uva i= - email:
Address:
Phone No.: gam-ZZ
JOB SITE INFORMATION (All Information Required)
Name:
Address:
Cross Street:-
Phone No.: I L -
Bldg.Permit#: �{ q email: -
Tax Map District: 1000 Section: _ Block:_ Lot: "'
BRIEF DESC TION OF WORK (Please Print Clearly) �Q� ��
�. kA
Circle All That Apply:
Is job ready for inspection?: YES Rough In Final
Do you need a Temp Certificate?: YES / Issued On
Temp Information: (All Information required)
Service Size1 P 3 Ph Size: (o Vo - _A #Meters _Old Meter# _.
New Service- Fire Reconnect- Flood Reconnect-Service Reconnected-Underground-Overhead
# Underground Laterals-- 1_ 12,_ H Frame Pole Work done on Service? .7-) 'N
Additional Infomaation:
(7C- '0✓44-
PAYMENT_DUE WITH APPLICATION p
Request for Inspection Form.xls
f�