HomeMy WebLinkAbout44295-Z ®�ag�FFol,fcoGy� Town of Southold 12/22/2019
n P.O.Box 1179
in x 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40955 Date: 12/22/2019
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1115 Main Bayview Rd, Southold
SCTM#: 473889 Sec/Block/Lot: 70.-8-2
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
10/15/2019 pursuant to which Building Permit No. 44295 dated 10/15/2019
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:
4 universal electric vehicle charging stations,2 tesla electric vehicle charging stations and a 300a service.
The certificate is issued to Custer Institute
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 44295 12/16/2019
PLUMBERS CERTIFICATION DATED
Authorize Signaturez
o�SU TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
oy 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#: 44295 Date: 10/15/2019
Permission is hereby granted to:
Custer Institute
PO BOX 1204
Southold, NY 11971
To: 4 universal electric car charging stations
r
At premises located at:
1115 Main Bayview Rd, Southold
SCTM # 473889
Sec/Block/Lot# 70.-8-2
Pursuant to application dated 10/15/2019 and approved by the Building Inspector.
To expire on 4/15/2021.
Fees:
ELECTRIC $125.00
Total: $125.00
Buildin or
®�'�XpF SO(/jy®l
Town Hall Annex ® Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 G Q sean.devlin(a-town.southold.ny.us
Southold,NY 11971-0959 �• • a®
®lyC®UN N
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To- Custer Institute
Address: 1115 Main Bayview Rd City Southold st: NY zip: 11971
Building Permit#: 44295 Section: 70 Block- 8 Lot- 2
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Elite Electric License No: 55232-ME
SITE DETAILS
Office Use Only
Residential Indoor X Basement X Service X
Commerical X Outdoor X 1st Floor X Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph X Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel 150X2 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 ri Switches Twist Lock Exit Fixtures Combo SD/CO
Other Equipment New 150A Main Panel, New Meterpan for 300A Service, 4- Universal Electric
Vehicle Charging Stations, 2- Tesla Electric Vehicle Charging Stations
Notes
Inspector Signature: Date: December 16, 2019
S Devlin-Cert Electrical Compliance Form.xls
O�aOf 50UT6o
# TOWN OF SOUTHOLD BUILDING DEPT.
o`�roum 765-1802
r INSPECTION
[ ] FOUNDATION 1ST [ '] ROUGH PL13G.
[ ] FOUNDATION 2ND [ ]ANSULATION/CAULKING
[ ] FRAMING/STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION-
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION -
[ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL) 60
[ ] CODE VIOLATION rl PRE C/O
REMARKS:
NO ACC,��S�
CqA-/ZC UV6r ';--'rA--T- /0 V S-
DATE l INSPECTOR
BUILDING DEPARTMENT-Electrical Inspector
TOWN OF SOUTHOLD
%3''f S � �r 4 1 6
, -c,•i QC`� 9 Town Hall Annex - 54375 Main Road - PO Box 1179
;-
�" Southold, New York 11971-09
59
Telephone (631) 765-1802 FAX (631) 765-9502
"rogerr southoldtownnygov � seand(cr�southoldtownny.go
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date: to / 1
Company Name. E\ 1 ec A--r; ,G.
Name: vc C
License No.: - S S'Laj 2_ email: C� �,� i del c,®c a '1
Address: `Z3 6C can de S of �I`I 117 0
1 Phone No.:( 3 ►) 76 -9 3r6 3
JOB SITE INFORMATION (All Information Required)
f! Name: CU14'e'r 1n541 ok In L
I Address: MGi ( 0�4 1 -7 1
3
Cross Street:
Phone No.: (,3 I )
Bldg.Permit#: email: �4hs� ► r
� � C de Ga e c�a, owl
1 Tax Map District: 1000 Section:_ 70 Block: Lot: i
BRIEF DESCRIPTION OF WORK (Please Print Clearly)
C c\c C.hacc�1 nq 5 rn�rt4n - hower6)(,, e )Nfo^d)
Circle All That Apply:
Is job ready for inspection?: YE / NO Rough In Final
Do you need a Temp Certificate?: YES / NO Issued On
Temp Information: (All information required)
Service Size 1 Ph 3 Ph Size: A #Meters Old Meter#
New Service- Fire Reconnect- Flood Reconnect-Service Reconnected - Underground - Overhead
# Underground Laterals 1 2 H Frame Pole Work done on Service? Y N
Additional Information:
PAYMENT DUE WITH APPLICATION
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