HomeMy WebLinkAbout42948-Z ��p�g11FFDt,f�dG� Town of Southold 8/16/2018
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P.O.Box 1179
co 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39847 Date: 8/16/2018
THIS CERTIFIES that the building ELECTRICAL
Location of Property: Row Off Peninsula Rd, Fishers Island
SCTM#: 473889 Sec/Block/Lot: 10.-3-11
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
8/15/2018 pursuant to which Building Permit No. 42948 dated 8/15/2018
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 Electric Service Upgrade
The certificate is issued to Oliveri,Cynthia&Johnson,Elizabeth
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 42948 08-08-2018
PLUMBERS CERTIFICATION DATED
Authorized Signature
Offat'rTOWN OF SOUTHOLD
��o� Crow BUILDING DEPARTMENT
y TOWN CLERK'S OFFICE
vow a o� 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#: 42948 Date: 8/15/2018
Permission is hereby granted to:
Oliveri, Cynthia
7503 Old Bridge Ct
Sugar Land, TX 77479
To: 200 Amp Electric Service
At premises located at:
Row Off Peninsula Rd, Fishers Island
SCTM # 473889
Sec/Block/Lot# 10.-3-11
Pursuant to application dated 8/15/2018 and approved by the Building Inspector.
To expire on 2/14/2020.
Fees:
ELECTRIC $85.00
Total: $85.00
nspector
pF SO(�j�®l®
Town Hall Annex Telephone(631)765-1802
54375 Main Road � Fax(631)765-9502
P.O.Box 1179 � Q
Southold,NY 11971-0959 '`O • �® roger.richert(a)-town.southold.ny.us
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Betty Johnson (Oliveri)
Address: Row Off Peninsula Rd City: Fishers Island St. New York Zip- 6390
Building Permit#. 42948 Section 10 Block: 3 Lot 11
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 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 F1 Twist Lock Exit Fixtures 11 TVSS
Other Equipment: 200a underground service up grade
Notes:
Inspector Signature: Date: August 8 2018
81-Cert Electrical Compliance Form As
FF
UILDING DEPARTMENT-Electrical Inspector
TOWN OF SOUTHOLD
Town Hall Annex- 54375 Main Road - PO Box 1179
Southold, New York 11971-0959
10-110 e,,01-,iWeIephon' e (631) 765-1802 - FAX (631) 765-91502
1100 roger.richert(D_town.southol d.ny.us
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: Date: te—1A
Company Name: o2
Name:
License No.: 3email:' Vz eucmtc-
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Address:
6fdM)-J-4' la-A�JAR-,A Ck &Z&39
,Phone No.: 6 QY-YSaV
JOB SITE INFORMATION: (AJI Information Required)
Name: P-I&e to
Address:
Cross Street:
Phone No.: (0,*� I _qq7
Bldg.PerTnft#:
email:
,Tax Map District: 1006 Section: 10 Block: Lot:
BRIEF DESCRIPTION OF WORK(Please Print Clearly)
--Blew,
Circle All That Apply:
Is job ready for inspection?: YES NO Rough In, Final
Do you need a Temp Certificate?: YES NO Issued On
�Temp Information: (All information required)
Service Size I Ph 3-Ph Size: A #Meters Old Meter#
New Service-Fire Reconnect- Flood Reconnect-Service Reconnected -Underground - '
Overhead
L# Underground Laterals 1 2 H Frame Pole Work done on Service? Y N
Additional Information.,
PAYMENT DUE WITH APPLICATION �
N
X,
dd
,82-Request for inspecoon Form.xis