HomeMy WebLinkAbout41174-Z ��p�OS�FfOlxcoG� Town of Southold 10/12/2022
a P.O.Box 1179
o • , 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 43472 Date: 10/12/2022
THIS CERTIFIES that the building ELECTRICAL
Location of Property: Equestrian Ave,Fishers Island
SCTM#: 473889 Sec/Block/Lot: 9.4-14.2
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
11/18/2016 pursuant to which Building Permit No. 41174 dated 11/18/2016
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 Harvey,Ellen
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 41174 10/14/2021
PLUMBERS CERTIFICATION DATED
Authori Signatur
gf'D0 TOWN OF SOUTHOLD
' BUILDING DEPARTMENT
y 2 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 #: 41174 Date: 11/18/2016
Permission is hereby granted to:
Harvey, Ellen
756 Rugby Rd
Bryn Mawr, PA 19010
To: 200a underground electrical service
At premises located at:
Equestrian Ave, Fishers Island
SCTM #473889
Sec/Block/Lot# 9.-4-14.2
Pursuant to application dated 11/18/2016 and approved by the Building Inspector.
To expire on 5/20/2018.
Fees:
ELECTRIC $85.00
Total: $85.00
Buil ing Inspector
o��OF SOUlyol
Town Hall Annex ~ ® Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 Q roger.richertCaD-town.southold.ny.us
Southold,NY 11971-0959
UNT`l,�c�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Harvey
Address: Equestrian Ave City: Fishers Island St: New York Zip: 6390
Building Permit#: 41174 Section: 9 Block: 4 Lot: 14.2
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 Basement Service Only X
Commerical Outdoor X 1 st Floor Pool
New X 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 11 TVSS
Other Equipment: Up grade service from overhead to underground 200a, to include new meter pan.
Notes:
Inspector Signature: c�� Date: October 14 2021
81-Cert Electrical Compliance Form.xls
SO(/l01
yo
Town Hall Annex 4 Telephone(631)765-1802
54375 Main Road
P.O.Box 1179 G Q roaer.richert aO`wri sou RI015.n .us ,
Southold,NY 11971-0959 �O
BUILDING DEPARTMENT i
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
i.
REQUESTED BY:
Date:
Company Name:
Name: hr i
License No.:
Address: -
Phone No.:
JOBSITE INFORMATION. (*Indicates required information)
*Name: f 1
� err A4,��
*Address:
lent
*Cross Street: - j
*Phone No.: �-.
' E
Permit No.: S
Tax Map District: 9 000 Section: 0---- Block: Lot:
*BRIEF DESCRIPTION OF WORK(Please Print Clearly)
(Please Circle All That Apply)
*Is job ready for inspection:
RENO
NO. Rough in*Do.you need a Temp Certificate:
Temp Information(if needed) .
`Service Size: 1 Phase 3Phase 100 150 j 200 300 350 400 Other
*New Service: Re-connect I'Under ro nd Number of Meters Change of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
BZ-Request for Inspection Form
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