HomeMy WebLinkAbout49877-Z SUFFe' � TOWN OF SOUTHOLD
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TOWN CLERKS OFFICE
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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#: 49877 Date: 10/12/2023
Permission is hereby granted to:
FTKS Holdings LLC
60 E 42nd St Ste 2450
New York, NY 10165
To: Electric Temporary Service - 200amp OH Pole and electric panel for security, lighting,
CCTV
At premises located at:
2835 Shipyard Ln, East Marion
SCTM #473889
Sec/Block/Lot# 38.-7-7.1
Pursuant to application dated 10/5/2023 and approved by the Building Inspector.
To expire on 4/12/2025.
Fees:
ELECTRIC $150.00
Total: $150.00
Building Inspector
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Town Hall Annex Telephone(631)765-1802
54375 Main Road
P.O.Box 1179 Q sean.devlin(cD-town.southold.ny.us
Southold,NY 11971-0959 '� • ��
COUN NI
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: FTKS Holdings LLC
Address: 2835 Shipyard Ln city:East Marion st: NY zip: 11939
Building Permit#: 49877 Section: 38 Block: 7 Lot: 7.1
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: Electrician: Empire Electric License No: 57024ME
SITE DETAILS
Office Use Only
Residential X Indoor Basement Service X
Commerical Outdoor X 1st Floor Pool
New X Renovation 2nd Floor Hot Tub
Addition Survey X Attic Garage
INVENTORY
Service 1 ph X Heat Duplec Recpt Ceiling Fixtures Bath Exhaust Fan
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel 200A A/C Condenser Single Recpt Recessed Fixtures CO2 Detectors
Sub Panel A/C Blower Range Recpt Ceiling Fan Combo Smoke/CO
Transfer Switch UC Lights Dryer Recpt Emergency Strobe Heat Detectors
Disconnect Switches 4'LED Exit Fixtures Sump Pump
Other Equipment:
Notes: Temporary Service
Inspector Signature: Date: November 2, 2023
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S. Devlin-Cert Electrical Compliance Form
———————
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Town Hall Annex-54375 Main Road-PO Box 1179-Southold, NY 11971-0959
Telephone (631) 765-1802
Temporary Certificate #_,66'6D Date C b2023
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Size 00A Phase I Overhead Underground #of Meters l
Remarks
#of Underground Laterals 1 2 New ✓
"H" Frame or Pole H P Fire Reconnect
Was work done on Service? Y/ N o Flood Reconnect
Old Meter# Service Reconnected
Application for electrical service equipment is on file with the town of Southold.on the applicant's notification that this installation
is complete,the town will conduct a premises inspection of the service equipment.
This verification is valid fo day a date above.
Authorized by
SOUTyOIo �IN
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INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) LECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL
REMARKS:
DATE INSPECTOR
Y E C E
BUILDING DEPARTMENT- Electcc Inspector
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® ` ' Town Hall Annex - 54375 Main RoSC PO�rc�x �T
;} Southold, New York 11971-0959
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rogerr(acasoutholdtownny.gov seandCa�south l 8 n Biu 'ov`�
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date: 09/26/23
Company Name: Empire Electric & Maintenance LLC
Electrician's Name: Steven Leqqio
License No.: ME-57024 Elec. email: jplazo@empireelectric.co
Elec. Phone No: 516-373-5064 01 request an email copy of Certificate of Compliance
Elec. Address.: 1 Shore Rd Suite 903 Glenwood Landinq, NY 11547
JOB SITE INFORMATION (All Information Required)
Name: FTKS Holdinqs LLC
Address: 2835 Shipyard Ln, East Marion, NY 11939
Cross Street: Gus Dr
Phone No.: 917-747-8849
Bldg.Permit#: n/a q g-1-7 email: bill@paracc.com
Tax Map District: 1000 Section: 038.00 Block: 07.00 Lot: 007.0
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
Temporary 1 PH 2O0AMP 120/240v Service. Pole and electric panel for
site security, lighting and CCTV
Square Footage: N/A
Circle All That Apply: -* I
Is job ready for inspection?: F-1YES FV NO F-]Rough In 0 Final
Do you need a Temp Certificate?: 0 YES ❑ NO Issued On 09/26/23
Temp Information: (All information required)
Service SizeFV-11 PhF-]3 Ph Size: 200 A # Meters 1 Old Meter#
Z New Service❑Fire Reconnect❑Flood Reconnect❑Service Reconnect❑Underground❑✓Overhead
# Underground Laterals 0 1 2 D H Frame ✓ Pole Work done on Service? Y ✓ N
Additional Information:TAmn rniArhPnrl carwirA
PAYMENT DUE WITH APPLICATION
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APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date: 09/26/23
Company Name: Empire Electric & Maintenance LLC
Electrician's Name: Steven Leggio
License No.: ME-57024 Elec. email: iplazo@empireelbctric.co
Elec. Phone No: 516-373-5064 211 request an email copy of Certificate of Compliance
Elec. Address.: 1 Shore ulte 903 Glenwood Lan Ing, NY 11547
JOB SITE INFORMATION (All Information Required)
Name: FTKS Holdings LLC
Address: 2835 Shipyard Ln, East Marion, NY 11939
Cross Street: Gus Dr
Phone No.: 917-747-8849
Bldg.Permit#: n/a lia $-1-7 email: bill@paracc.com
Tax Map District: 1000 Section: 038.00 Block: 07.00 Lot: 007.Oql
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
Temporary 1 PH 2O0AMP 120/240v Service. Pole and electric panel for
site security, lighting and CCTV
Square Footage: I N/A
Circle All That Apply: -jt-156'O I a) 1W71,3
Is job ready for inspection?: ❑ YES ❑✓ NO ❑Rough In ❑ Final
Do you need a Temp Certificate?: 0 YES ❑ NO Issued On 09/26/23
Temp Information: (All information required)
Service SizeFV�1 PhF—]3 Ph Size: 200 A #Meters 1 Old Meter#
❑✓ New Service❑Fire Reconnect[]Flood Reconnect[:]Service Reconnect❑Underground❑✓Overhead
# Underground Laterals 0 1 2 H Frame ✓ Pole Work done on Service? DY ✓ N
Additional Information:TAmn rwarhaarl cAniirrA
PAYMENT DUE WITH APPLICATION 10
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