HomeMy WebLinkAbout42783-Z Town of Southold 7/3/2018
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39745 Date: 7/3/2018
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1405 Village Ln, Orient
SCTM#: 473889 Sec/Block/Lot: 25.-3-1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
6/13/2018 pursuant to which Building Permit No. 42783 dated 6/13/2018
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 SERVICE UPGRADE, GARAGE SUB-PANEL AND TELSA CHARGER
The certificate is issued to Forstmann, Stephan&Allison
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 42783 06-15-2018
PLUMBERS CERTIFICATION DATED
OCS
Authorized Signature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
c� • o� SOUTHOLD, NY
Cpl � ,��►
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#: 42783 Date: 6/13/2018
Permission is hereby granted to:
Forstmann, Stephan &Allison
116 Altamont Ave
Tarrytown, NY 10591
To: overhead electric service upgrade from 100a to 200a and subpanel from main house to
garage.
At premises located at:
1405 Village Ln, Orient
SCTM # 473889
Sec/Block/Lot# 25.-3-1
Pursuant to application dated 6/13/2018 and approved by the Building Inspector.
To expire on 12/13/2019.
Fees:
ELECTRIC $85.00
Total: $85.00
Bui ector
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Town Hall Annex Telephone(631)765-1802
54375 Main Road y Fax(631)765-9502
P.O.Box 1179 �Q roger.rich ert(aD-town.southoId.ny.us
Southold,NY 11971-0959
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To- Forstmann
Address: 1405 Village Lane city:Orient st: New York zip: 11957
Budding Permit#: 42783 Section: 25 Block: 3 Lot: 1
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Promaster Electric License No: 59226-ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service Only
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph 200A. Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures Smoke Detectors
Main Panel 200A A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel 100 A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks
Disconnect 200A Switches Twist Lock Exit Fixtures TVSS
Other Equipment: 200A Overhead Service Up-Grade.
Garage - Sub Panel, 50A "Tesla" Charger.
Notes:
Inspector Signature: Date: June 15 2018
9 ,
0-Cert Electrical Compliance Form.xls
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Town MU Annex !� � Telephone(631)765-1802
54375 Main Road
P.O.Box 1179 ` n 0 ro er riche t fow 31)765 5
Southold,NY 11971-0959
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BUMDING DEPARTMENT
JUN 12 2018
TOWN OF SOUTHOLD �
APPLICATION FOR ELECTRICAL INSPECTION BUjLDV
'TOWN O� RO
SOU Txi.D
REQUESTED BY: Pfoma�er G �G �1��'• Date:®� ^ /
Company Name: Plo rn a5 Fe t tc, at'
r/"C,
Name: 2 U 5 O
License No.: 5172 2 U — lie
Address: . Q. QnX yes feel! oi-
Phone No.:
JOBSITE INFORMATION: ( indicates required information)
*Name: �11 5 he p h an
*Address: A/06 t lig e 2n c. ri en //95 44
*Cross Street:
*Phone No.:
Permit No.:
Tax-Map District: 1000 Section: - Block: Lot:
*BRIEF DESCRIPTION OF WORK(Please Print Clearly) o1/Ct� �7end `
6e,rvrc,e ti rndCld�olv /OD rn s
20 m s.
Sub Panil 'Worn rVai'n house o. a.rae
(Please Circle Al!That Apply)
*IS job ready for inspection: (�9 f NO Rough In Final
*Do-you need a Temp Certificate: YES! NO
Temp Information(If needed)
'Service Size: 1 Phase 3Phase 100 950 200 300 350 400 Other
*New Service: Re-connect Underground Number of Meters Change of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION -
824Request for Inspection Form
1