HomeMy WebLinkAbout47655-Z Town of Southold 4/10/2023
P.O.Box 1179
y 53095 Main Rd
Wpol ��p'r Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 43119 Date: 6/4/2022
THIS CERTIFIES that the building ELECTRICAL
Location of Property: The Gloaming,Fishers Island
SCTM#: 473889 Sec/Block/Lot: 10.-9-15.4
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
4/7/2022 pursuant to which Building Permit No. 47655 dated 4/7/2022
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 overhead electric service.
The certificate is issued to Rivers,S David
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 47655 5/24/2022
PLUMBERS CERTIFICATION DATED
Authorized Sign e
o�osu fF ai TOWN OF SOUTHOLD
aye BUILDING DEPARTMENT
C, TOWN CLERK'S OFFICE
Wo . 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#: 47655 Date: 4/7/2022
Permission is hereby granted to:
Rivers, S David
146 Spofford Rd
Boxford, MA 01921
To: 200A electric service.
At premises located at:
The Gloaming, Fishers Island
SCTM # 473889
Sec/Block/Lot# 10.-9-15.4
Pursuant to application dated 4/7/2022 and approved by the Building Inspector.
I
To expire on 10/7/2023.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
ov so�ryQl
� o
Town Hall Annex Telephone(631)765-1802
54375 Main Road
P.O.Box 1179 roqer.riche rKED-town.southoId.ny.us
Southold,NY 11971-0959 'QlyCOU
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: David Rivers
Address: the Gloaming (271 Gloaming Ext) City: Fishers Island St: New York Zip: 6390
Building Permit* 47655 Section: 10 Block: 9 Lot: 15.4
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 Fixtures Time Clocks
Disconnect 200a Switches Twist Lock Exit Fixtures TVSS
Other Equipment: 200a overhead service, 200a main panel with 16 ARC fault circuit breakers.
Notes:
Inspector Signature: Date: May 24 2022
81-Cert Electrical Compliance Form.xls
UILDING DEPARTMENT-Electrical Inspector
' OWN
0�SO�S I's�O9.€I
ILDING DEPT Town Hall Annex-54375 Main Road - PO Box 1179
- `NUN of SOUTHOLD Southold, New York 111971-0959
Coo -4 jF2,�
t, Telephone(631) 7 X5-1 Sa - FAX (631) 755-95432
roperr southoldtovinny.gov— seand(cDsoutholdtownny.gov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (Ate intnrasz_,r.Require ; Date: /
Company blame: T?. 'I__ 4�
Marne:
License Na_: ?S,7��LV ernail: �{'610- 4c 6WA-Tt
Address: -,j RD (Q
Phone No.: Eco
JOB SITE INFORMATION (All Is ormaWn Required)
Dame: Ulc( 2L VC eJ
Address: c27t GloisolV.6 - a7
Cross Street: Re 7Wwar
Phone No.: /
Bldg.Permit : email:
Tax Map District: 1040 Section: G Block: Lot:
BRIEF DESCRIPTION OF WORK (Please Print Clearly) AQ2c
Circle All That Apply:
Is jab ready for inspection?: YE ! NO Rough In Final
Do you need-a Temp Certificate?: YE I NO Issued On
Temp Information: (All information required)
Service Size(1 Ph 3 Ph Size: -,20-A #Meters _ Old Meter#
New Service-Fire Reconnect-Flood Reconnect-Service Reconnected-Underground-O-verhead
#Underground Laterals 1 2 H Frame Pole Work done on Service? Y N
Additional Information:
PAYMENT DUE WITH APPLICATION
Request for Inspection FormAs