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P.O.Box 1179
o 53095 Main Rd
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�� Southold,New York 11971
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CERTIFICATE OF OCCUPANCY
No: 42279 Date: 8/25/2021
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1000 Terry Ln, Southold
SCTM#: 473889 Sec/Block/Lot: 64.-3-11
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
7/1/2021 pursuant to which Building Permit No. 46523 dated 7/1/2021
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 underground electric service, meter and panel.
The certificate is issued to Founders Lndg Boat Yard LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 46523 7/7/2021
PLUMBERS CERTIFICATION DATED �)
Authorized Signature
' TOWN OF SOUTHOLD
o��g11iFQL,�co
aye BUILDING DEPARTMENT
y TOWN CLERK'S OFFICE
may.• � �� SOUTHOLD, NY
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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#: 46623 Date: 7/1/2021
Permission is hereby granted to:
Founders Lndg Boat Yard LLC
413 Sth St
PO BOX 2124
Greenport, NY 11944
To: New 200 AMP meter pan and panel (fire damaged)
At premises located at:
1000 Terry Ln, Southold
SCTM #473889
Sec/Block/Lot# 64.-3-11
Pursuant to application dated 7/1/2021 and approved by the Building Inspector.
To expire on 12/31/2022.
Fees:
ELECTRIC $125.00
Total: $125.00
Building Inspector
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Town Hall Annex ® Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 ® sean.devlin(&-town.Southold.ny.us
Southold,NY 11971-0959
C®UNTd,�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: Founders Lndg Boat Yard LLC
Address: 1000 Terry Ln city,Southold st: NY zip: 11971
Budding Permit#: 46523 Section: 64 Block 3 Lot: 11
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
contractor: DBA: Modern Electric East License No: 34283ME
SITE DETAILS
Office Use Only
Residential Indoor Basement Service X
Commerical X Outdoor X 1st Floor Pool
New X Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph X Heat Duplec Recpt Ceiling Fixtures Bath Exhaust Fan
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel 200A A/C Condenser Single Recpt Recessed Fixtures CO2 Detectors
Sub Panel A/C Blower Range Recpt Ceiling Fan Combo Smoke/CO
Transformer UC Lights Dryer Recpt Emergency Fixtures Time Clocks
Disconnect Switches 4'LED Exit Fixtures Pump
Other Equipment. 30 Circuit Panel - 10 Used
Notes. New Service
Inspector Signature: � �� ��� Date:
July 7, 2021
S.Devlin-Cert Electrical Compliance Form
--:
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Gy< BUILDING DEPARTMENT-Electrical Inspector
W x TOWN OF SOUTHOLD
•oTown Hall Annex-54375 Main Road-PO Box 1179-Southold, NY 11971-0959
4401 Telephone (631) 765-1802-FAX(631)765-9502
Temporary Certificate # I bl(o Date u l 5t 2021
Customer Name OA-tyElectrician Name
Address 1000 Phone 71
e-mail e-mail o �
Phone License#
Size A Phase Overhead Underground #of Meters
Remarks
#of Underground Laterals 1 2 New
"H" Frame or Pole H P Fire Reconnect
Was work done on Service? Y/N Flood Reconnect
Old Meter# Service Reconnected
Application for electrical service equipment is on file with the town of Southold.On the applicant's notification that this installation
is complete,the town will conduct a premises inspection of the service equipment.
This verification is valid for 90qrom the date abo e.
Authorized by
�omxpf so(/lyolo I 2, UPT.
TOWN OF OUTHOLD BUILDING
comaa 765-1802
:-� «=n1 NSPEOTION -
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING %STRAPPING [ ] FINAL
rt [ ] FIREPLACE & CHIMNEY [ ] ' FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] -FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL)
[
]' CODE VIOLATION [ ] PRE C/O
REMARKS:.
y
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DATE - 7 4� INSPECTOR
N
L5 I
�OFF01It BUILDING DEPARTMEN-T-Electrical Inspector
JUL 2021 TOWN OF SOUTHOLD
o z Town Hall Annex- 54375-Main-Road- PO-Box 1179
elm
Southold, New York 11971-0959
,jjo �O� ,•? telephone (631)765-1802 - FAX (631) 765-9502
rogerr(cDsoutholdtownny.gov- seand(uD-southoldtownny.gov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRtCtaN INFORMATION-(All Information Required) Date: 07/0112021
Company Name: MODERN ELECTRIC EAST, INC.
Name: f>,,o 6.v r"� �-� (?>�
License No.: ME-34283 email: q 9 ® A o L . c-D vv-,
Phone No: ,6-f 1[@ -90& - -71y9 ZI request an email copy of Certificate of Compliance
Address.: ,(' O, Box 3 a.I /yl A t r /-T cA_c K N 119 S^2
JOB SITE INFORMATION (Ail Information Required)
Name: B o A l'`I AM.W> A7 Fo t"WAQ_tr S
Address:
Cross Street: TERRY LANE
Phone No.. (031 -'L47-7- I k 9 9
Bldg.Permit#: al I la`j2 email:c3 tcE 0 C0s4 a t10 Mcxr.Me 'Ceti
Tax Map District: 1000 Section: LP4 Block:- 3 Lot:
BRIEF DESCRIPTION OF WORK (Please Print Clearly)
INSTALLATION OF 200 AMP METER PAN AND 200 AMP WEATHERPROOF PANELBOARD
INSTALLATION OF 200 AMP METER PAN AND 200 AMP WEATHERPROOF.PANELBOARD
Check All That Apply:
Is job ready for inspection?: ❑✓ YES- ❑NO ❑Bough In ❑Final
Do you need a Temp Certificate?: ❑✓ YES ONO Issued On 07/01/2021
Temp lnformation: (All information required)
Service Size ❑✓ 1 Ph ❑3 Ph Size: 200 A ##Meters 1 Old Meter#
❑New Service ❑✓ Service Reconnect !rJ Underground [DOverhead
#Underground Laterals Z1 E]2 ❑H Frame❑Pole Work done on Service? QY ❑N
Additional Information: SERVICE DAMAGED-CAUSED BY FIRE-SERVICE RECONNECT
SERVICE DAMAGED - CAUSED BY FIRE - SERVICE RECONNECT
SERVICE DAMAGED- CAUSED BY FIRE - SERVICE RECONNECT
PAYMENT DUE WITH APPLICATION
Electrical Inspection Form 2020.x1sx ��)
PERMIT# Address:
Switches
Outlets
G FI's
Surface
Sconces
H H's
UC Lts
Fans Fridge HW
Exhaust Oven Dryer
Smokes DW Service
Carbon Micro Generator
Combo Cooktop Transferr
AC AH Mini
-Special:-- - - - - - -
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