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Town of Southold 8/23/2019
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40656 Date: 8/23/2019
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 28225 CR 48. Peconic
SCTM#: 473889 Sec/Block/Lot: 74.4-42.6
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
6/14/2019 pursuant to which Building Permit No. 43871 dated 6/14/2019
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:
200 AMP OVERHEAD ELECTRIC SERVICE UPGRADE
The certificate is issued to CR 48 Peconic LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 43871 08-01-2019
PLUMBERS CERTIFICATION DATED
Authorized Signature
rza'� TOWN OF SOUTHOLD
� SU 014'�oG BUILDING DEPARTMENT
TOWN CLERKS 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#: 43871 Date: 6/14/2019
Permission is hereby granted to:
CR 48 Peconic LLC
c/o Solow Reatly & Dev
9 W 57th St Ste 4500
New York, NY 10019
To: 200a overhead electrical service upgrade.
At premises located at:
28225 CR 48. Peconic
SCTM #473889
Sec/Block/Lot# 74.-1-42.6
Pursuant to application dated 6/14/2019 and approved by the Building Inspector.
To expire on 12/13/2020.
Fees:
ELECTRIC $90.00
' T $90.00
Building Inspector
OF SO(/j�ol
Town Hall Annex ~ O Telephone(631)765-1802
54375 Main Road 411 Fax(631)765-9502
P.O.Box 1179 G i@ roger.riche rt(D_town.south old.ny.us
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To. CR 48 Peconic LLC
Address: 28225 CR 48 City: Peconic St: New York Zip. 11958
Building Permit#• 43871 Section 74 Block- 1 Lot: 426
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor DBA: DAZ Electric License No: 5093-ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement X Service Only
Commerical Outdoor X 1st Floor X Pool
New Renovation 2nd Floor X Hot Tub
Addition Survey X Attic Garage
INVENTORY
Service 1 ph 200a Heat Duplec Recpt 22 Ceiling Fixtures 15 HID Fixtures
Service 3 ph Hot Water GFCI Recpt 4 Wall Fixtures 4 Smoke Detectors 7
Main Panel 200a A/C Condenser Single Recpt Recessed Fixtures 2 CO Detectors
Sub Panel A/C Blower Range Recpt 20 Fluorescent Fixture Pumps
Transformer Appliances dw Dryer Recpt Emergency Fixtures Time Clocks
Disconnect 200a Switches 24 Twist Lock Exit Fixtures TVSS
Other Equipment, "AS BUILT' "ELECTRICAL SURVEY" "NO VISUAL DEFECTS"
Notes, 1-combination smoke/co detector, 1-bath fan
i
Inspector Signature: Date: August 12019
81-Cert Electrical Compliance Form.xls
�ggaf0tKC BUILDING DEPARTMENT- Electrical Inspector
�o ¢� TOWN OF SOUTHOLD
Town Hall Annex - 54375 Main Road - PO Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1802 - FAX (631) 765-9502
roger richert@town southold.ny.us
APPLICATION FOR ELECTRICAL INSPECTION
Date:
REQUESTED BY: _
Company Name: f l -1-c,
Name: S
d' email: Ft 9C� 02-�leT is l •C�
License No.: � ®G�
Address: ,® Qo 89_17 ls5 q
Phone No.: 2> 0
JOB SITE INFORMATION: (All Information Required) �G � c)
Name: �� 0V4
Address: f riflCkti/Cl
Cross Street: e-C-0<i 6 C
Phone No.: �P>
1 email:ICS(�fqAj irvx ArU l 00'
BIdg.Permit#: Block: Lof: 4!2.6
Tax Map District: 1000 Section: 7
BRIEF DESCRIPTION OF WORK(Please Print Clearly)
Circle All That Apply= + YES / NO Rough In Fina(
Is job ready for inspection?: i
Do you need a Temp Certificate?: C✓ I NO Issued On
(All informafion required) i
Temp Information: (All
Meters
` Old Meter#
Ph
Service Size 1 3 Ph Size: °
New Service - Fire Reconnect- Flood Reconnect- Service Reconnected - Underground Overhead
# Underground Laterals 1 2 H Frame Pole Work done on Service? Y
Additional Information:
PAYMENT DUE WITH APPLICATION
9 Jc_
�9
82-Request for inspectionForm•xis