HomeMy WebLinkAbout35713-ZTown of Southold Annex
P.O. Box 1179
54375 Main Road
Southoid, New York 11971
CERTIFICATE OF OCCUPANCY
6/10/2013
No: 36283
Date:
6/6/2013
THIS CERTIFIES that the building
Location of Property:
SCTM #: 473889
Subdivision:
ELECTRICAL
FOX AVE FISHERS ISLAND,
Sec/Block/Lot: 9.-1-21
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
7/22/2010 pursuant to which Building Permit No. 35713 dated 7/22/2010
was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for
which tiffs certificate is issued is:
electric service.
The certificate is issued to
William C. Ridgway, 1II
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
357 l 3 6/5/13
Authorized-Signature
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
(THIS
BUILDING PERMIT
PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PEP~4IT NO. 35713 Z
Date JULY 22, 2010
Permission is hereby granted to:
WILLIAM C RIDGWAY III
68 NECK ROAD
OLD LYME,CT 06371
for :
NEW ELECTRIC SERVICE AS APPLIED FOR.
at premises located at
County Tax Map No. 473889 Section 009
pursuant to application dated JULY
Building Inspector to expire on JANUARY
FOX AVE FISHERS ISLAND
Block 0001 Lot No. 021
22, 2010 a/id approved by the
22, 2012.
Fee $ 85.00
Authorized Signature
ORIGINAL
Rev. 5/8/02
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Telephone (631) 765-1802
Fax (631) 765-9502
roqer.richert(~,town.southold.ny.us
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
ssued To: William Ridgway
~,ddress: 672 Lower Shingle Rd (Fox Ave) City: Fishers Island St: NY Zip: 6390
3uilding Permit #: 35713 Section: 9 Block: I Lot: 21
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
2,ontractor: DBA: NI Electric LLC License No: 34408-me
SITE DETNLS
Office Use Only
Residential ~ Indoor ~ Basement ~ Se~iceOnly ~
Commedcal Outdoor 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 3 ph Hot Water GFCI Recpt Wail Fixtures Smoke Detectors
Main Panel NC Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel NC Blower Range Recpt Fluorescent Fixture ~ Pumps
Transformer Appliances Dryer Recpt Emergency Fixtures I I Time Clocks
Disconnect Switches Twist Lock Exit Fixtures LJ TVSS
Other Equipment: 200a overhead service, including main panel
Inspector Signature:
Date: June 5 2013
Elect rical_Certificate.xls
Tom~ Hall Annex
54375 Main Road
P.O. Box 1179
Southold, NY 11971-0959
Telephone (631) 765-1802
. , _,.~.ax (631) 764-,95q2.
ro.qer, ncnerRw,~own.sou~no~a.ny.us
'~ BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION U
REQUESTED BY:
Company Name:
Name:
License No.:
~,ddress:
Phone No.:
Date:
JOBSITE INFORMATION: (*Indicates required information)
*Name:
*Address:
*Cross Street:
*Phone No.:
Permit No.:
Tax Map District:
1000 Section: o~ Block:
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
(Please Circle All That Apply)
*Is job ready for inspection:
*Do you need a Temp Certificate:
Temp Information (If needed]
*Service Size: ~
*New Service: Re-connect
Additional Information:
3Phase
YES / NO Rough In Final
(~)/NO
100 150 (~ 300 350 400 Other
Underground Number of Meters ha~o-; Servic~ ~
PAYMENT DUE WITH APPLICATION
82-Request for Inspection Form