HomeMy WebLinkAbout45799-Z y O�og�FFOI,�cQ . Town of Southold 9/3/2021
G�< P.O.Box 1179
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o - 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 42327 Date: 9/3/2021
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 750 Old Main Rd., Southold
SCTM#: 473889 Sec/Block/Lot: 56.-6-8.7
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
1/29/2021 pursuant to which Building Permit No. 45799 dated 2/8/2021
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:
100A underground electric service and street light service.
The certificate is issued to New York State DEC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 45799 8/27/2021
PLUMBERS CERTIFICATION DATED
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ut Signature
o�SUFEoI,��o TOWN OF SOUTHOLD
BUILDING DEPARTMENT
y x TOWN CLERK'S OFFICE
oy . 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#: 45799 Date: 2/8/2021
Permission is hereby granted to:
New York State DEC
625 Broadway
Albany, NY 12233
To: 100A underground electric service and street light service.
At premises located at:
750 Old Main Rd., Southold
SCTM #473889
Sec/Block/Lot# 56.-6-8.7
Pursuant to application dated 1/29/2021 and approved by the Building Inspector.
To expire on 8/10/2022.
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.deviine-town.southold.ny.us
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: New York State DEC
Address: 750 Old Main Rd city,Southold st: NY zip: 11971
Budding Permit#- 45799 Section: 56 Block: 6 Lot: 8.7
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: K Schrage & Sons Inc License No: 3507ME
SITE DETAILS
Office Use Only
Residential Indoor X Basement Service X
Commerical X Outdoor X 1 st Floor Pool
New X Renovation 2nd Floor Hot Tub
Addition Survey X 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 100A 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 1 Switches 4'LED Exit Fixtures Pump 1
Other Equipment: Septic Pump, Street Lamp (1), 100A Panel 30 Circuit/7 Used
Notes: Service, Pump Out and Street Lamp in New DEC Building
IDate:
August 27, 2021
Inspector Signature:
S.Devlin-Cert Electrical Compliance Form
S�trFOLIC ,
��p� cOGy BUILDING DEPARTMENT-Electrical Inspector
c TOWN OF SOUTHOLD
Town Hall Annex-54375 Main Road-PO Box 1179-Southold NY 11971-0959
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�'j �aI%- Telephone (631) 765-1802-FAX(631)765-9502
Temporary Certificate # Bq() Date 2-- (B s 2021
Customer Name NYS DEC Electrician Name
Address PA. lel Phone 5I -7aq
e-mail e-maila e
Phone ? g --- License 350 — ME
Size JOD A Phase I Overhead Underground X #of Meters rl
Remarks
#of Underground Laterals 2 New
"H" Frame or Pole H Fire Reconnect
Was work done on Service. 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 fo days to above.
Authorized by
OE 50UTyo / , 7
# TOWN OF SO THOLD BUILDING DEPT.
`ycOUrm� 765-1802
- INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND- ° [ °] INSULATIOWCAULKING
[ ] FRAMING /STRAPPING [ ] FINAL
[ ]
FIREPLACE-&-CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ELECTRICAL (FINAL)
[ ] CODE VIOLATION ] PRE C/O I
REMARKS: '� 1�1 4r�
DATES INSPECTOR '
f
AN 2 9 2021 ` BUILDING DEPARTMENT- Electrical Inspector
TOWN OF SOUTHOLD
CD
Town Hall Annex- 54375 Main Road - PO Box 1179
Southold, New York 11971-0959
DE
Telephone (631) 765-1802 - FAX (631) 765-9502
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APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All information Required) Date: 1/30/2021
Company Name: K. Schrage & Son Inc
Name:NYS Dept of Environmental Conservation
License No.: 3507-ME email: R g- schrage@optonline.net
Phone No: 516-729-8456 R]l request an-email copy of Certificate of Compliance.
Address.: 75 Old Main Rd.
JOB SITE INFORMATION (All Information Required)
Name: NYS Dept of Environmental Conservation
Address: 7MOld Main Rd.
Cross Street: E/O Port of Egypt Marine
Phone No.: 516-729=8456
Bldg.Permit#: NYS DECJ0wn-er--� email: kgschrage@optonline.net
1 Tax Map District: 1000 Section:056 Block: 060000 Lot: 9002
BRIEF DESCRIPTION OF WORK (Please Print Clearly) M-1 11-1P111111-11 11—W
Install 100-amp-underground-service to prefabricated-pumph- and-6-;�f-nd I street light------.,
_
Install 100-amp underground service_topumphouse and I street light
Check All That Apply:
Is job ready for inspection?: E]YES ZNO 0 Rough In [:]Final
Do you need a Temp Certificate?: R]YES ONO Issued On 1/30/2021 �Zo CMNIA�9_
Temp Information: (All information required)
Service Size FV]l Ph F-13 Ph Size: 100 - A #Meters 1 Old Meter# N/A
Fi/]New Service F-1 Service Reconnect F&/J underground [:]Overhead
I# Underground Laterals Z1 E:]2 E]H Frame ZPole Work done on Service? ZY
Additional Information:
PAYMENT DUE WITH APPLICATION
Electrical Inspection Form 2020 xlsx
PERMIT# Address:
Switches
Outlets
G F I's
Surface
Sconces
H H's
UC Lts
Fans Fridge HW
Exhaust Oven W/D
Smokes DW Mini
Carbon Micro Generator
Combo Cooktop Transfer
AC AH Hood Service
Amps Have Used
Special: Q 7Oeo
Comments ` ��Pf