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HomeMy WebLinkAbout51670-Z �oy��°F SO�ry�`o Town of Southold ' * P.O: Box 1119 �0 53095 Main Rd °�ycou �' Southold, New York 11971 CERTIFICATE -OF OCCUPANCY No: 46097 Date: 04/09/N25 THIS CERTIFIES that the building EV CHARGER Location of Property: 295 Mockingbird Ln Southold, NY 11971 Sec/Block/Lot: 55.-6-15.59 Conforms substantially to the Application for Building Permit heretofore, filed in this office dated: 01/10/2025 Pursuant to which Building Permit No.51670 and dated: 02/21/2025 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: EV charger in attached garage of existing single-family dwelling as applied for. The certificate-is issued to: David Lewis,Louise Cohen Of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL: ELECTRICAL CERTIFICATE: 51670 03/17/2025 PLUMBERS CERTIFICATION: l ut or' a Signature ho�aofSOO,,o�c 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#: 51670 Date: 02/21/2025 Permission is hereby granted to: David Lewis 295 Mockingbird Ln Southold, NY 11971 To: install an EV charger in the attached garage of an existing single-family dwelling as applied for. Premises Located at: 295 Mockingbird Ln, Southold, NY 11971 SCTM#55.-6-15.59 Pursuant to application dated 01/10/2025 and approved by the Building Inspector. To expire on 02/21/2027. Contractors: Required Inspections: Fees: EV Charger $125.00 ELECTRIC -Residential $100.00 CO- ESIDENTIAL $100.00 Total $325.00 ---- ---- ---------------- ui ding Inspector pF SOUryo Town Hall Annex Telephone(631)765-1802 54375 Main Road P.O.Box 1179 G Q Southold,NY 1 1 97 1-0959 �`Oly� Jamesh southoldtownny.gov �! OUNV I BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: David Lewis Address: 295 Mockingbird Lane city:Southold st: New York zip: 11971 Building Permit#: 51670 Section: 55 Block: 6 Lot: 15.59 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: Electrician: License No: SITE DETAILS Office Use Only Residential X Indoor X Basement X 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 Transfer Switch UC Lights Dryer Recpt Emergency Strobe Heat Detectors Disconnect Switches 4'LED Exit Fixtures Sump Pump Other Equipment: 50amp Ev charger [FORD] Notes: EV CHARGER Inspector Signature: , Date: March 17, 2025 295 mockingbird In OF SOUIyO� �5 7- 0 /zl� J V 5 1 1, / r�/ ---- # # TOWN OF SOU.THOLD BUILDING D EP✓T. d uto, 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: \ • 11,2giz J DATE f 'INSPECTOR OF SOUly�lo --- -- # TOWWOF SOUTHOLDBUILDING DEPT. `ycoo 631-765-1802 INSPECTION ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] NSULATION/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 EMARKS: �(D ::�2 Dli�- Z�/u CA . L.C. DATE INSPECTOR OF SO(/T�°� # TOWN OF SOUTHOLD BUILDING DEPT. couffm 631-765-1802 INSPECTION ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION'2ND [ ] SULATION/CAULKING �7F;NAL ] FRAMING /STRAPPING [ � CA&JOL/ -] FIREPLACE-& CHIMNEY [ ] FIRE SAFETY INSPECTION [ -] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE.VIOLATION [ ] PRE C/O [ ] RENTAL CA REMARKS: �* wl F(yy U-./ DATE l INSPECTOR �✓ l UF SOUTyO� 6-/6 7© v 'oC,11 �" �f ` ` �V # # TOWN OF SOUTHOLD 66ILDING DEPT. cou � 631-765-1802 INSPECTION [ ] FOUNDATION 1 ST/ 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: DATE .- INSPECTOR FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION (1ST) - - ---- ----------- ----- --- -- riil FOUNDATION (2ND) --- POP ROUGH FRAMING& --- - Q PLUMBING - - - 7sr v1 - r INSULATION PER N.Y. STATE ENERGY CODE 4p FINAL - -- ADDITIONAL COMMENTS Flu? x b os°fFatK � TOWN OF SOUTHOLD—BUILDING DEPARTMENT H Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 19, • �; Telephone(631) 765-1802 Fax (631) 765-9502 https://www.southoldtgMM.gov Date Received APPLICATION FOR.BUILDING PERMIT Jl�i f i 1�...?i lea L [; For Office Use Only .,F =v Rq� 99 PERMIT NO. Building Inspector: . JAN 9 0 2025 .,�, Applications and forms must b'e-filled out in their.entirety.Incomplete- applications will not be accepted: Where the Applicants not the owner,an Owner's Authorization form.(Page 2)shall be completed. Date: OWNER(S)-OF PROPERTY: - / 1sCTm#1000-S5, ,1, ' Name: OAvi ip is W1 I-©uig- (, cv 5�. Project Address: a S N(,L310J • SQL;TJ401-Q11 41Y 11911 Phone#: 1 , g66, i6S 3 Email: P)Pr/ACE @ D CAM - Mailing Address: CONTACT PERSON: Name: PAVID L�WIS Mailing Address: aq S L lL 1✓V�Q 1 �/• S0v_r1401-b IV)l 1 J Phone#: -71Y 366 6&83 , Email: PF;A& O Act . cc>^ DESIGN'PROFESSIONAL IINFORMATION. Name: /V A Mailing Address: Phone#: Email: CONTRACTOR INFORMATION; Name: S-CROW6- ISILAIVl7 E _C- R C /gyp. Mailing Address: 7s IN -Al �-a� � L l Al 7 l�v 12S�' /V Y C 1: 7S- 1 Phone#: 6 3 1 - 0-7 _ I M Email: �T'f�dA,16-1 Apr 'C Ir 1 C�G�k(1L .CV/k DESCRIPTION OF-PROPOSED CONSTRUCTION: ❑New Structure ❑Addition ❑Alteration []Repair ❑Demolition Estimated Cost of Project: %Other 6 V C RAAG'�i; m/S i A-g L.4-n 0A) $ 3800 Will the lot be re-graded? ❑Yes%No Will excess fill be removed from premises? ❑Yes j(No 1 PROPERTY INFORMATION Existing use of property: R�'1- ( 12 1�--Al—I Intended use of property: 51 ID64/�1 )A,1, Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to 4 this property? ❑Yes �No IF YES, PROVIDE A COPY. X6eck'Box After Reading:. The owner/contractor/design,professional is.responsible for all,drainage and storm water issues as provided by h,ptdr 236 of the Town Code. APPUCATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant.to the Building Zone Ordinance of the Town of Southold,Suffolk,County,New York and other applicable Laws,Ordinances or Regulations,for the construction of buildings, additions,,alterations or for removal or demolition as herein described.The applicant agrees to comply with all applicable laws,ordinances,building code, housing.code and regulations and to admit authorized inspectors on premises and in building(s)for necessary inspections,False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the,New York State Penal Law. Application Submitted By(print name): (7Av-w ❑Authorized Agent 100wner Signature of Applicant: Date: 110 a _ STATE OF NEW YORK) SS: COUNTY OF S ) AVI 9 LIB W I S being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)he is the d\✓/I/F—R (Contractor,Agent,Corporate Officer,etc.) of said owner or owners,and is duly authorized to perform or have performed the said work and to make and file this application;that all statements contained in this application are true to the best of his/her knowledge and belief; and that the work will be performed in the manner set forth in the application file therewith. Sworn before me this 4day of >At1U � ,20 gf) Notary Public SHAMECCA ANDREWS PROPERTY OWNER AUTHORIZATION Notary Public-State of New York No.01 AN62901013 (Where the applicant is not the owner) Qualified in Kings County My Commission Exp.10/07/2026 I, residing at do hereby authorize to apply on my behalf to the Town of Southold Building Department for approval as described herein. Owner's Signature Date Print Owner's Name 2 . t FO(�ca BUILDING DEPARTMENT- Electrical Inspector yr�,t0 Gym.Y TOWN OF SOUTHOLD o z Town Hall Annex- 54375 Main Road - PO Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 jamesh(cD-southoldtownny.gov — seand(c southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Informati n Re uired) Date: Company Name: f1 l✓ chi G Electrician's Name: License No.: ��� Elec. email: Elec. Phone No: ❑1 request an emaA366py of Certificate of Compliance Elec. Address.: JOB SITE INFORMATION (All Information Required) Name: David Lewis Address: 295 Mockingbird Lane, Southold, NY 11971 Cross Street: Tuthill Road Ext. Phone No.: 718 866 6583 Bldg.Permit#: S_ —J email: pipeace@aol.com Tax Map District: 1000 Section: 55 Block: 6 Lot: 15.59 BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Installation of electric vehicle charger in attached garage. Approx 40' run from panel. Square Footage: Circle All That Apply: Is job ready for inspection?: ❑ YES R] 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 Reconnect❑Underground❑Overhead # Underground Laterals 1 2 D H Frame 0 Pole Work done on Service? DY ✓ N Additional Information: PAYMENT DUE WITH APPLICATION PERMIT# Address: Switches Outlets GFI's Surface Sconces H H's UC Lts Fridge HW POOL Panel Fans Mini Fr. W/D Pump Exhaust Oven Sump Heater Trnsfmr Smokes DW Generator Salt Gen. Carbon Micro GrbDis . Water BondLights Heat Pucks ERV HOT TUB/SPA Inst Hot DeHum Transfer Disc 'nrn Combo ('OOL, on Minicplit Blower p. AC AH Hood Blower Service Amps Have Used Sub Amps Have Used Comments w Ford Charge Station Pro—Technical data Features and Functions Charging Mode Level J1772 CCS Combo 1 lu Vehicle Connection with 25 ft cable, 80 A I integrated cable management U to 19.2 kW (240VAC@80A) - Requires a 1 OOA breaker AC Power Output Mounting options Wall Communication Wi-Fi, Bluetooth interfaces Configuration via Char a Station Pro Configuration A pp Software Upgrade over the air (OTA) Electrical Desi n Power Su I Voltage 208VI240V AC, 60Hz Rated Current Settings [A] 12, 16, 32, 40, 48, 64, 80 Wire Cross Section 3 AWG, Min. 90°C Rated Network Type Phase shift I Split phacip Ground Fault Protection 20 mA Over Current Protection +10%above configured threshold General Desi n Environmental Ratin 3 ULType 4 Dimensions (HxWxD) 23.8 in.x 12.7 in. x 7 in. (60.4 cm x 32.2 cm x 18 cm) Boxed Weight 24 Ibs (11 k ) Ambient Conditions -40°C to+45°C Operational, -40°C to+85°C Storage Certificates. accordin to UL 9741, UL 991, UL 1998, UL 2231,file no. E522055 UL Listed UL R817957 R03 Y 'noW or formerly Francis & Patricia O'Malley —�---� ��..., —�— EDGE OF yIETLppgJ. N.88°56'32"E. 173.34 -- ELa IL2 EL.I6.8 In M i CONSeRy4T/pN AMv I e'QSF 'v MFHr I � TEST HOLE DATE: 9-9-98 180 �h/°rFI' EL.19= 0.0' ...� DARK BROWN L o f 5,3 C CLAYEY LOAM E B' I A rep a 30 /V�v T� BROWNO FINE Lot 54 640 S.f, 4 y COARSE SAND 7 7. (DWELLING) EL=u.3 With Public Wbter \ WATER IN I BROWN PINE 1 \ TO ;0 COARSE SAND /D at52 N O WATER R/b P<</MG) n IN GREYISH BROWN BANDY Sr CLAY AND W pkOvpS CLAYEY SAND Lr T EC ' m 39.0' w X WATER IN p J BROWN PINE —_I D�w Qp oa �8 N COARSE BAND �' CL m LL IWW �T °Nf0 Z 41.0' � U1CPJ �FJI TLM �:)g0.54' eL.zo.a 1ca �. Z .30.00' AR(\J SAry PpSEp R= _ 30 d L FL SYS T-f4RY Ra4�283' y [L.21.I MOCKINGej D \ EL eZ0 g With Public WD'S, HOUSE FINISH GRADE .A F.F.e235! 20 3 2 .V'•t,Q� 21 2 ' I E•19.0 I.E=19 2 EXCAVgji0 NSP - I.E'18.3 I.E.1e9 CESSPOOL, FOR E�SYSTEMUIREp 1000 DAL. M A SEPTIC TANK BYft L C PAR WATER EL•N.3 SEWAGE DISPOSAL (USE(3) POOL SYSTEM) SUIT IXCOUNTYDEPARTMBNTOFHEALTHSERVICES SURVEY FOR D.B.M. COMPANY PP,RMFORAPPROVALOFCONSTRUCTION FOR A LOT NO.53,°HIGHPOINT MEADOWS,SECTION THREE" SEPT.21,1998 . AMIIFYRT"9IDi'sNC13ONLY DEC, 9,1991 AT SOU7HOLD DATE: DEC. 16,1991 DATE C7 ,lI(p, a TOWN,OF SOUTHOLD SCALE% 1":40' APPROVED FFOLK COUNTY, NEW YORK No. 91-1036 t r IZE0 ALTERATION OR ADDITION TO THIS CERTIFIED TO: •FOJIARpy(EyIOg SURVEY IS A VIOLATION OFF SECTION 7209 OF THE N[W YORK STATE EDUCATION LAM D.B.M.COMPANY / rC0►IES OF THIS SURVEY MOT SEARMO THE LAND ' WIRESTfMM YEARS FRO DATE OF APPROVAL SYRVEY011S IMNCD SEAL OR EMBOSSED SISALSNALL' BRIOGEHAMPTON NATIONAL BANK NOT.ME-CONSIDERED TO SE A VALID TRUE COPY ' TICOR TITLE GUARANTEE r OUARANTEES INDICATED HEREON SHALL RUMONLY TO HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT THE RRSON FOR WHOM THE SURVEY 13 PREPARED AND OR"IS BEHALF TO THE 71TLE COMPANY,OOVERM- M NIAAEST MAZER BAIN MI.t*SOURCE OP WATEP'FRIVATC_PUSLIC_„� MENTAL AGENCY AND LENDING IMl TITUf1OM LISTED ■Mf►CO.TM YAP OMTI�OD.SEC �—OLDER—6L_LOT J�..AS HEREON.AND TO THE ASSIGNEES OF THE LIE MO � �w r O� M 1M[R[ ARE NO DWELLINGS WITNIM 100 FEET OF THIS PROPERTY INST TUTION GUARANTEES ARE NOT TR MSFE04BLE OTHER TNAM THOSE SMOWM H[R[ON TO A TONAL INSTITUTIONS OR SUSS%OY[NT ((n. M THE WATER GUNILY AM 3106E DISMAL SYSTEM FOR THIS RESIDENCE OWNERS 7'O�dJ WILL COIIORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT R DISTANCES SHOWN HEREON FROM PROPERTY UNES TO[KITTING STRUCTURES ARE FOR A SPECIPIC 0/HEALTH PURPOSE 0 ARE NOT TO BE USED TO ESTAOLISN APPLICANT' ^�L'�/� �7^� ►RO►ERTY LINES OR FOR THE ERECTION OF FENCES ' ADDRESS C) o O eo TEL 3ob YOUNG YOUN 0 DER AVENUE NEW YORK NOTE% Received SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF ALDEN W YOUNG,PROFESSIONAL ENGINEER Su(6'';,Coultty •.SUFFPLK COUNTY ON MARCH 19,199.0 AS FILE NO.8912. AND LAND SURVEYOR N.Y.S.UCENSE No.12845 _ NOWARO W.YOUNG, LAND SURVEYOR $EP 2 a i998998 o MTIK LOCATION OFWMLDTI,W"CTANNST)OCUOOOLS(CF)SHOWN""ION N.Y.S.LICENSE No.45893 AIE FROM FIXLD OMWAkTNINB ARDOR DATA OBTAINED FROM OTHERS DBpI �. :ijDiih Bervlce BRANDIS A SONS INC. �„� (•' 4 966 320.6 335 130.7 130.7 [12.6] [13.2] [5.1] 15.1] 174.5 [6.9] 211.2 83.0 [8.3] [3.3] 0 0 595.0 [23.41 310.0 [12.2] o 89-152 cm [35-60"] 134.3 134.3 15.31 [5.3] FLOOR Legal Manufacturer OCCUPANCY OR Siemens Industry, Inc. 3617 Peachtree Comeway USE IS UNLAWFUL Peachtree Corners,GA 30092 United States 1(800)America WITHOUT CERTIFIC/ Telephone: +1(800)333-7421 com @ 01.recha 022,Siemens Industry, ry OF OCCUPANCY ©01.2022,Siemens Indust Inc. This document contains a general description of available technical options only,and its effectiveness will be subject to specific variables including field conditions and project parameters.Siemens does not make representations,warranties,or assurances as to the accuracy or ELECTRI^6�r� completeness of the content contained herein.Siemens reserves the right to modify the technology and product specifications in its sole discretion INSPECTION REQUIRED without advance notice. i APPR !El AS NOTED COMPLY WITH ALL CODES OF DA SB.P.f NEW YORK STATE&TOWN CODES FEE is, AS REQUIRED AND CO DITIONS OF NOTIFY BUILDING DEPARTMENT AT SOUTTiOID WN ZBA 631-765-1602 6AM TO 4PM FOR THE S4llTMO pWN pLgNNING 80ARD FOLLOWING INSPECTIONS: 1. FOUNDATION-TWO REQUIRED VM TOWN TRUSTEES FOR POURED CONCRETE (II, & 2. ROUGH-FRAMING&PLUMBING 3. INSULATION 4. FINAL-CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTON ERRORS -d Ford Charge Station Pro—Technical data Features and Functions Charging Mode Level 2 Vehicle Connection J1772 CCS Combo 1 plug with 25 ft cable, 80 A I integrated cable management AC Power Output Up to 19.2 kW (240VAC@80A) - Requires a 100A breaker Mounting Options Wall Communication Interfaces Wi-Fi, Bluetooth Configuration via Charge Station Pro Configuration App Software Upgrade over the air (OTA) Electrical Design Power Supply Voltage 208V1240V AC, 60Hz _ Rated Current Settings [A] 12, 16, 32, 40; 48, 64, 80 Wire Cross Section 3 AWG, Min. 900C Rated Network Type Phase shift 1 Split phase- Ground Fault Protection 20 mA Over Current Protection +10%above configured threshold General Design Environmental Rating UL Type 4 Dimensions (HxWxD) 23.8 in. x 12.7 in. x 7 in. (60.4 cm x 32.2 cm x 18 cm) Boxed Weight 24 Ibs (11 kg) Ambient Conditions -400C to+45°C Operational, -400C to+85°C Storage Certificates UL Listed according to UL 9741, UL 991, UL 1998, UL 2231, file no. E522055 u SAFETY US-CA R817957 R03