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ONE/ Town of Southold 2/19/2019 . P.O. Box 1179 53095 Main Rd } Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 40216 Date: 2/19/2019 THIS CERTIFIES that the building ELECTRICAL Location of Property: 1385 Delmar Dr, Laurel SCTM#: 473889 Sec/Block/Lot: 127.4-11 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 2/5/2019 pursuant to which Building Permit No. 43444 dated 2/5/2019 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 overhead electric service. The certificate is issued to Tolosa,Mariano of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 43444 2/12/2019 PLUMBERS CERTIFICATION DATED Authorized Signature TOWN OF SOUTHOLD BUILDING DEPARTMENT 44 TOWN CLERK'S OFFICE I hl"o, SOUTHOLD, NY f 'FU 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#: 43444 Date: 2/5/2019 Permission is hereby granted to: Tolosa, Mariano 147-47 41st Ave Flushing, NY 11355 To: Upgrade to 200 Amp Electric Service At premises located at: 1385 Delmar Dr, Laurel SCTM # 473889 Sec/Block/Lot# 127.-4-11 Pursuant to application dated 2/5/2019 and approved by the Building Inspector. To expire on 8/6/2020. Fees: ELECTRIC $85.00 Total: $85.00 u ing Inspector pE SO�IyQI 0 Town Hall Annex Telephone(631)765-1802 54375 Main Road N Fax(631)765-9502 P.O.Box 1179 • �o roper.richerta-town.southoId.ny.us Southold,NY 11971-0959 Q �yOOUNT` 1 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Palencia (Tolosa) Address. 1385 Delmar Dr City Laurel St: New York Zip- 11948 Building Permit#' 43444 Section: 127 Block: 4 Lot: 11 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE contractor: DBA. Promaster Electric License No. 59226-ME SITE DETAILS Office Use Only Residential X Indoor X Basement X 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 200 Switches Twist Lock Ll Exit Fixtures TVSS Other Equipment: 200a overhead service upgrade Notes: Inspector Signature: Date: February 12 2019 81-Cert Electrical Compliance Form.xls EFpI�, IIII-DING DEPARTMENT- Electrical Inspector TOWN 8 ToII Annex - 543 o� . 4 Southold, N '0 F Eg ` 4 2019Telephone (631) 765 D� ro er.richert B�II'D OD[�y"g OLD AP (Rt��Tl�OR ELECTRICA 2EQUESTED BY: ',ompany Name: PpoMas f G ICCrrl�. dame: s o2 _icense No.: 22 G' - email: �o %ddress: 63! 37 $0 T phone NO.: 2 JOB SITE INFORMATION: (All Information R quired) .' game: Wil/Ctf� Valle-nci2. 4ddress: i3$S / mnr CLureI AJ7 gross Street: PCICO 17 i c. Raj ?hone No.: 631 8--/-/ g530 �Idg.Permit#: 3qlqemail: Tax Map District: 1000 Section: Block: // Lot: BRIEF DESCRIPTION OF WPRK (Please Print Clearly) o /pp Am(a O&t,-- )rad fo 2-00em p 0W'J- 1-r c ►'cn., servl c e Circle All That Apply: Is job ready for inspection?: �/ NO Rough In Final Do you need a Temp Certificate?: ES NO Issued On a- q— �9 Temp Information: (All information required). Service Size 1 Ph Ph Size: Zn0 A #Meters Old Meter# i New Service- Fire Reconnect- Flood Reconnect-Service Reconnected - Underground - Ove ead # Underground Laterals 1 2 H Frame Pole Work done on Service? Y N Additional Information: PAYMENT DUE WITH APPLICATION Request for Inspection FormAs ` 4 �� (�q ()\b �gUEFUI,�, ILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD To 11 Annex - 54375 Main Road - PO Box 1179 o EB ` 4 X019 Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 _ roger.riche rt(a_)town.southoId.ny.us API 6014qOR ELECTRICAL INSPECTION 2E-QUESTED BY: tom as e' - &7o-rp. Date: company Name: fJ1vMn , dame: Flus o jx2 -icense No.: 6qZ2,�' - /y5 email: / romn r-f >^ic � 1m2, .com, \ddress: 94r3 693e1-)e-1 ,V phone No.: JOB SITE INFORMATION: (All information R quired) dame: / n,lenc,'t2. %ddress: /3 f S VC11rcV ILUIC 11?q I. Street: cco n, 'hone No.: 631 8-;'l qSD 3ldg.Permit#: email: Tax Map District: 1000 Section: a'1 Block: Lot: BRIEF DESCRIPTION OF WORK (Please Print Clearly) , o /00omp ©� kad f 20081"P oma- � ��." SG, Circle All That Apply: Is job ready for inspection?: �/ NO Rough In Final Do you need a Temp Certificate?: ES NO Issued On a— y-- Iq Temp Information: (All information required) Service Size 1 Ph:) h Ph Size: Ze2 0 A # Meters Old Meter# New Service- Fire Reconnect- Flood Reconnect- Service Reconnected - Underground(2)lead # Underground Laterals 1 2 H Frame Pole Work done on Service? Y N Additional Information: PAYMENT DUE WITH APPLICATION Request for Inspection Form.xis `Y 0\ y