HomeMy WebLinkAbout42757-Z Town of Southold 9/14/2015
P.O.Box 1179
� 53095 Main Rd
I Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39902 Date: 9/14/2018
THIS CERTIFIES that the building ELECTRICAL
Location of Property: Private Rd,Fishers Island
SCTM#: 473889 Sec/Block/Lot: 9.-9-4
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
6/5/2018 pursuant to which Building Permit No. 42757 dated 6/5/2018
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:
Two 200a main service panels, one sub panel and circuit breakers for an existing one family dwelling(with one kitchen
only)as applied for.
The certificate is issued to Conant G K GST Exempt Trt
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 42757 6/13/2018
PLUMBERS CERTIFICATION DATED
Authorized Signature
y
rsUoc.r TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
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#: 42757 Date: 6/5/2018
Permission is hereby granted to:
Conant G K GST Exempt Trt
3712 Caruth Blvd
Dallas, TX 75225
To: 2 electric services.
At premises located at:
Private Rd, Fishers Island
SCTM # 473889
Sec/Block/Lot# 9.-9-4
Pursuant to application dated 6/5/2018 and approved by the Building Inspector.
To expire on 12/5/2019.
Fees:
ELECTRIC $170.00
Total: $170.00
Iding Inspector
O�,t,OF 50!/T�OI
h O
Town Hall Annex Telephone(631)765-1802
54375 Main Road CPR Fax(631)765-9502
P.O.Box 1179 ao roger.richerticD-town.southoId.ny.us
Southold,NY 11971-0959
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Conant G K GST Exempt Trt
Address: 1493 Resevoir Rd. (Private Rd.) city,Fishers Island st: New York zip: 06390
Building Permit#: 42757 Section: 9 Block: 9 Lot: 4
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: NI Electric License No: 34408-ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement X Service Only
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent'Fixture Pumps
Transformer Appliances Dryer Recpt Emergency FixtureTime Clocks
Disconnect Switches Twist Lock Exit Fixtures TVSS ri
Other Equipment: Install 2 New 200A Main Service Panels From All Existing 400A Single Meter
Service, 1- 100A Sub Panel, 24 Combination ARC/ GFCI Circuit Breakers in One
Notes: Panel, 15 Combination ARC/ GFCI Circuit Breakers in the Second One.
Inspector Signature: . Date: June 13, 2018
0-Cert Electrical Compliance Form As
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Southold,-071-09.59
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BUILDING DEM Wa DLNG DEPARTNEW
TOWN OFSOUTHOLD TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: hjICA40L_ S C il3f�Ze)bS Date:
Company Name: _ G
Name:
License No.: C L i :
Address: CQ 14 k.? s
Phone No.: G o
JOBSITE INFORMATION: (Indicates required information)
Name: I\JT— (- Df Z -6
"Address: �f7 W I fq3 12C-7
`Cross Street: hV LA
`Phone No.: 3 17 RW 7 a-7
'ermit No.: aTs
rax Map District: 1000 Section: Block: Lot:
'BRIEF DESCRIPTION OF WORK (Please Print Clearly)
w I TN Ivy cy y� ,c,� [T
Please Circle Alf That Apply)
Is job ready for inspection: (DSNO Rough in Final
Do you need a Temp Certificate: YES
'ernp Infonnation(If needed) 1710 -00
eucq�o
Service Size: 1 Phase 3Phase 100 150 200 300 � 350 5 f
400 Other
New Service: Re-wnnect Underground Number giiMeters Change of Service Overread
►dditional Information: 'AyMENT DUE WITH APPLICATION
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82-Request forinspecOon Form �2)aoo f�-n��
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