HomeMy WebLinkAbout45566-Z ��o�os�e to o TOWN OF SOUTHOLD
aye BUILDING DEPARTMENT
y t{ TOWN CLERK'S OFFICE
oy . SOUTHOLD, NY
ry 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 #: 455" Date: 12/14/2020
Permission is her by granted to:
Schwa man, Allan
28 W 25th St
New York, NY 10010
To: 200A undergroun electric ervi a and met r to acc ssory pool hou e.
At premises located at:
1165 West Rd., Cutcho
SCTM #473889 Vj
Sec/Block/Lot# 110.-7-2
Pursuant to application dated 12/14/2020 and approved by the Building Inspector.
To expire on 6/15/2022.
Fees:
ELECTRIC $170.00
Total: $170.00
Building Inspector
r��(1 I DINGDEPARTMENT- Electrical Ins r
TOWN�OF SO;UTHOLDD
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, .. Tow -Nall Annex - 54375 Main Roai�SPO Box 1179
Southold,: New York 1197`x-:6959NO�J 2 3 2020
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Telephone (631) 765 1802 - FAX (631)765-9502
�rE' �O tholdtow.nn ov seand soot
FORELECTRICAL INSPECT1`Q
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ELECTRICIAN INFORMATION (All InforrnaflonRequired) 139t6,
Company Name: Custom Lighting of Suffolk
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Tame: Benjamin Doroski
License No.:. 38893-ME . en�ailr CLOS5170@gmail.com
Address
PO Box 169$ Maituc NY 11952 — - -... ... ..... ................._
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Phone No:: 631-298-4588 ;
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JOB SITE INFORMATION (All Information Required)
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Allah. war z
man _......._-___:.:.:.:.:,.:.:.:.::.::.:.::...e.,....._.................._._.._:._...._.....__..._.___.:........_..._.,�...........__._..
NY 1;1935
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Address: Cutcho ue
Cross Street:
Phone No::
646 fi. 5 .8.9:54.,._.: _....:._...... .....:__..__. _......_:.- _
7 a
Bldg.Permit#: emarl elsa allanschwartzman com
aTax Map.:.Distriot 10Q0.:. ._....._ SectioR� 10 Block :.. ..7 x-9 2
BRIEF DCRlPTI )t OI;_alVi`)RI (I'lease PrinfClearf. .
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:
Circle All That Apply: .
Is job ready for inspection?: /.NQ. .. Rou In Final
Do you need a Temp Certificate?: ES . NO-
Issued On -:..:::::..
Temp l formation: (All information required)
:.
Service Size Ph ...-.o�3 Ph Size: _A #Mefer ,Old Mdter#,. .... .. .. ._ .
W' Se - Fire:Reconnect- Flood Reconnect- rvi econnecte.. n erground - Overhead
Und'erg.round Laterals 1 rame Pole. Work done on Service? Y N
Additional l nfvrmatiorf
.
PAYIii NT DUE 1NITH APM CATION.
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Request for lnspecilon r.—xis. ,