HomeMy WebLinkAbout51154-Z ho�aof souryo`o Town of Southold
* * P.O. Box 1179
% io 53095 Main Rd
0.outi Southold, New-York 11971
CERTIFICATE OF OCCUPANCY
No: 45739 Date: 11/09/2024
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 475 Clark Rd Southold, NY 11971
Sec/Block/Lot: 51.-3-20
Conforms substantially to.the Application for Building Permit heretofore, filed in this office dated: 09/10/2024
Pursuant to which Building Permit No. 51154 and dated: 09/10/2024
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:
"as built" electrical service and devices.
The certificate is issued to: 475 Clark Road LLC
Of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL:
ELECTRICAL CERTIFICATE: 51154 10/23/2024
PLUMBERS CERTIFICATION:
Authorized Signature
AN\00fSouTyo TOWN OF SOUTHOLD
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#: 51154 Date: 09/10/2024
Permission is hereby granted to:
475 Clark Road LLC
211 E 53rd St Apt 9D
New York, NY
To:
as built electric meter
Premises Located at:
475 Clark Rd, Southold, NY 11971
SCTM#51.-3-20
Pursuant to application dated 09/10/2024 and approved by the Building Inspector.
To expire on 03/12/2026.
Contractors:
Required Inspections:
Fees:
ELECTRIC SERVICE $200.00
Total S200.00
Building Inspector
�ok\OF SO�ryolo
Town Hall Annex Telephone(631)765-1802
54375 Main Road
P.O.Box 1179 coo Q
Southold,NY 11971-0959 .c�ly� � �� sean.devlin(a�town.southold.ny.us
ou 1 1 e
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: 475 Clark Rd LLC
Address: 475 Clark Rd city:Southold st: NY zip: 11971
Building Permit#: 51 154 Section: 51 Block: 3 Lot: 20
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: Electrician: AS BUILT License No:
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service X
Commerical Outdoor X 1 st Floor X Pool
New Renovation 2nd Floor Hot Tub
Addition Survey X Attic X Garage
INVENTORY
Service 1 ph X Heat Duplec Recpt 18 Ceiling Fixtures 7 Bath Exhaust Fan
Service 3 ph Hot Water GFCI Recpt 6 Wall Fixtures 8 Smoke Detectors 3
Main Panel 200A A/C Condenser 1 Single Recpt Recessed Fixtures CO Detectors
Sub Panel A/C Blower 1 Range Recpt Ceiling Fan Combo Smoke/CO 2
Transfer Switch UC Lights Dryer Recpt 30A Emergency Strobe Heat Detectors
Disconnect Switches 2 4'LED Exit Fixtures Sump Pump
Other Equipment: 200A Panel 30 Circuit/ 16 Used (5) 115ARC Fault Breakers
Notes: AS BUILT NO VISUAL DEFECTS " Service & New Devices
Inspector Signature: Date: October 23, 2024
Copy
* # TOWN OF/�SOUTHOLD BUILDING DEPT.
631-765-1802
INSPECTION
[ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATIOWCAULKING
[ ] FRAMING/STRAPPING [ ] .FINAL
[ ] FIREPLACE & CHIMNEY . [ ] FIRE SAFETY INSPECTION
[ ] FIRERESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION .
[ ]. ELECTRICAL (ROUGH) ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL
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DATE INSPECTOR
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WN OF SOUTHOLD BUIG DEP .
co 631-765-1802
INSPECTION '.
[. ] FOUNDATION 1ST/ REBAR [ ] 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: MIA-1 - Ca wil-e C�j
DATE Z INSPECTOR
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BUILDING DEPARTMENT- Electric l' pectom IQ n24 -�
'Vel, ` TOWN OF SOUTHOLD
Town Hall Annex - 54375-Mai Road - PO
F So thold New York I 71-09 ,T,4,�- � y x,
"d`�ip' � 3 �f,•�_i�?dam
Telephone (631) 765-1802 - FAX (631) 765-9502
lamesh southo d.to_wnny o��wand a2southoldtownny.gov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date: 2ZL5 12Cl
Company Name:
Electrician's Name:
License No.: Elec. email:
Elec. Phone No 5l(0 -{0L0- 21t10 ❑1 request an email copy of Certificate of Compliance
Elec. Address.:
JOB SITE INFORMATION (All Information Required)
Name: 0 j 5 1v100-�2-
Address: L(-75 Ci60- IL ,
Cross Street: &` C ,La ock C'�
Phone No.: Vj. - L�)t 1 � -- q 0
Bldg.Permit#: �5-(( SL{ email: 0.4— oU-<-e -72ge, coo
Tax Tax Map District: 1000 Section: 5 Block: 3 Lot: 2u
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
5'v� <��SSC-'�i•���
Square Footage:
Circle All That Apply:
Is job ready for inspection?: YES [] NO []Rough In ❑ Final
Do'you need a Temp Certificate?: YES aNO Issued.On frfW41 V6
Temp Information: (All information required)
Service Size❑1 Ph❑3 Ph Size: =-A # Meters Old Meter#
❑New Service❑Fire Reconnect[-]Flood Reconnect❑Service Reconnect❑Underground[overhead
# Underground Laterals F1 1 72 H Frame Pole Work done on Service? M Y DN
Additional Information-
PAYMENT DUE WITH APPLICATION o�_(c)-�c.P
PERMIT# Address:
Switches
Outlets
G F I's
Surface
Sconces
H H's
UC Lts Fridge HW POOL
Fans Mini Fr. W/D
Panel
Pump
Exhaust Oven Sump Heater
Trnsfmr
Smokes DW Generator Salt Gen.
Carbon Micro GrbDis Water Bond
Lights
Heat Pucks ERV
H'OT TUB/SPA
Inst Hot DeHum Transfer Disc
Combo Cooktop Minisplit
Blower
AC AH Hood Blower
Service Amps Have Used
Sub _" AmpS` ' Have Used
Comments
�y� BUILDING DEPARTMENT-Electrical Inspector
x TOWN OF SOUTHOLD-
�,� !� Town Hall Annex-54375 Main Road-PO Box 1179-Southol;d, NY 11971-0959
Telephone (631) 765-1802
Temporary Certificate # I-XI-1 Date QVok . 2024
Customer Name "nore Electrician Name
Address L41b k Phone
e-mail e-mail
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 90 days from the date above.
Authorized by
D
BUILDING DEPARTMENT- Electrica&l pectTP IQ' 2024
TOWN OF SOUTHOLD
-"� Town Hall Annex - 54375 Main Road - PO I ,Mlgft DFpT.
Southold, New York 11 971-09 z LeOUTyov-�
Telephone (631) 765-1802 - FAX (631) 765-9502
iamesh .southoldtownny.aov - seandp_southoldtownny.gov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date: 1? S1zcl
Company Name: e V' 005� - r1
Electrician's Name:
License No.: Elec. email:
Elec. Phone 'No:' ❑I request an email copy of Certificate of Compliance
Elec. Address.:
JOB SITE INFORMATION (All Information Required)
Name: Q Lovr 5 jVL �2
Address: q-75 Cla r lC_ (j�(r
0 o1
Cross Street: f1/l t C�c,L.P_ A oo,-C
C t�-�-e-- z-1 .
Phone No.: <(0. - Co
Bldg.Permit#: email:
Tax Map District: 1000 Section: S-I Block:' 3 Lot: 2a
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE-(Please Print'Clearly):
cca
Gct^ �✓�5.1�'c�kr��
Square Footage:
Circle All That Apply:
Is job ready for inspection?: YES ❑ NO' ❑Rough In ❑ Final
Do you need a Temp Certificate?: ❑ YESF:;]:Nj O Issued On
Temp Information: (All information required) u
Service Size❑1 Ph❑3 Ph Size: A - # Meters l Old Meter#
[]New Service[]Fire Reconnect[]Flood Reconnect❑Service Reconnect❑Underground❑Overhead
# Underground Laterals 1 2 H Frame Pole Work done on Service? Y N
Additional,Information:
PAYMENT DUE.WITH APPLICATION o`_�oL
g� �ao� rec�i�83�1y