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Home My WebLink About48222-Z �o�OgtlFf �. Town of Southold 10/20/2022 0 P.O.Box 1179 53095 Main Rd �,�! �asSouthold,New York 11971 CERTIFICATE OF OCCUPANCY No: 43524 Date: 10/20/2022 THIS CERTIFIES that the building ELECTRICAL Location of Property: 5250 Vanston Rd.,Cutchogue SCTM#: 473889 Sec/Block/Lot: 111.-10-14 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 8/29/2022 pursuant to which Building Permit No. 48222 dated 8/29/2022 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: electric vehicle charger as applied for. The certificate is issued to Vanston Bear LLC of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 48222 10/11/2022 PLUMBERS CERTIFICATION DATED Aut orized Signature �o�aSUF TOWN OF SOUTHOLD r BUILDING DEPARTMENT TOWN CLERK'S OFFICE • 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#: 48222 Date: 8/29/2022 Permission is hereby granted to: Vanston Bear LLC c/o Archway Technology PO BOX 17754 Denver, CO 80217 To: Electric vehicle charger as applied for. At premises located at: 5250 Vanston Rd., Cutchogue SCTM #473889 Sec/Block/Lot# 111.-10-14 Pursuant to application dated 8/29/2022 and approved by the Building Inspector. To expire on 2128/2024. Fees: ELECTRIC $90.00 Total: $90.00 Building Inspector pF SO!/r,�Ol 0 Town Hall Annex Telephone(631)765-1802 54375 Main Road P.O.Box 1179 aQ sean.deviina-town.southold.ny.us Southold,NY 11971-0959 COUW'�� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Vanston Bear LLC Address: 5250 Vanston Rd city:Cutchogue st: NY zip: 11935 Building Permit#: 48222 section: 111 Block: 10 Lot: 14 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: License No: SITE DETAILS Office Use Only Residential X Indoor X Basement Service Commerical Outdoor 1st Floor Pool New X Renovation 2nd Floor Hot Tub Addition Survey Attic Garage X INVENTORY Service 1 ph Heat Duplec Recpt Ceiling Fixtures Bath Exhaust Fan Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors Main Panel 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: EV Car Charger Juice Box 40 Level 2 Notes: Car Charger Inspector Signature: Date: October 11, 2022 S.Devlin-Cert Electrical Compliance Form # TOWN OF SOUTHOLD BUILDING DEPT. `ycourm��'' 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ]' RENTAL REMARKS: C Cdne!�4 DATE Q l t r!i INSPECTOR '`` BUILDING DEPARTMENT- �c 'I Ins e/cctor TOWN OF SO 11-11013 (� Town Hall Annex- 54375 M ii ad,41FT0 Box 1 71-0 1Pf7l d 2 Southold, New York 9� ?o?? Telephone (631) 765-1802 - FA;",p IAAI)I65-9502 APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: 8/11/22 Company Name: Vanston Bear, LLC Electrician's Name: Rony Electric License No.: Elec. email: ronyespana@hotmail.com Elec. Phone No: 631860 3116 ❑I request an email copy of Certificate of Compliance Elec. Address.: 433 Mill Rd. Calverton NY 11943 JOB SITE INFORMATION (All Information Required) Name: Vanston Bear LLC Address: 5250 Vanston Rd, Cutchogue Ny 11930 Cross Street: Phone No.: 631 8049150 Bldg.Permit#: 1-4738-00444/00023 email: Paulette@hellogreystone.com Tax Map District: 1000 - Section: 1000111001000014000 Block: Lot: BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): EV car charger, located inside garage at center column JuiceBox 40 Level 2 EV charger Square Footage: Circle All That Apply: Is job ready for inspection?: YES❑NO �Rough In Rj Final Do you need a Temp Certificate?: ❑ YES ❑✓ NO Issued On Temp Information: (All information required) Service SizeF-11 Ph❑3 Ph Size: A # Meters Old Meter# ❑New ServiceOFire Reconnect[:]Flood Reconnect ElService ReconnectQUnderground Overhead #Underground Laterals 1 2 H Frame Pole Work done on Service? Y N Additional Information: PAYMENT DUE WITH APPLICATION �2 Welcome to JuiceBox 5. fy: 3 f 1�1 • 0 O O [150.000mm] 5.906in 4 . 116.921 mm • [ ] o00 4.603in [57.380mm] 2.259in [173.291 mm] 6.822in [296.673mm] [469.465mm] 11 .680in 18.4831 n 0 0 2/3 Specifications Characteristics Output Power 32A max:Up to 7.7 kW,32A,1-phase 40A max:Up to 9.6 kW,40A,1-phase 48A max Up to 11.5 kW,48A,1-phase BOA max Up to 19.2 kW,80A,1-phase Input Voltage 208 or 240 VAC i Charging Mode Mode 3 --------- --- LEDs Dynamic LEDs displaying charging status Protection IP67 AC 20mA Ground Fault Detection Temperature Range From-40°C to+60°C Standards and Certifications IEC 61851-1 UL Certified Connectivity WiFi IEE 802.11b/g/n 2.4 GHz (Optional)Cellular LTE(CAT-1)Bands B2,B4,B5,B12/B13 3G Bands B2(1900),B5(850);PTCRB and GCF certification Dimensions [I 46.353mml 5.762in 1/3