HomeMy WebLinkAbout48761-Z �=�`� TOWN OF SOUTHOLD
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BUILDING DEPARTMENT
a TOWN CLERK'S OFFICE
o . SOUTHOLD, NY
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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#: 48761 Date: 1/19/2023
Permission is hereby granted to:
67480 Main Rd LLC
67480 Route 25
Greenport, NY 11944
To: 200 amp electric service
At premises located at:
67480 Route 25. Greenport
SCTM # 473889
Sec/Block/Lot# 53.-2-27.2
Pursuant to application dated 1/1/1900 and approved by the Building Inspector.
To expire on 7/20/2024.
Fees:
ELECTRIC $125.00
Total: $125.00
Buil ing Inspector
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i Nor-t T� —BUILDING DEPARTMENT-Electrical Inspector
• Y' v TOWN OF SOUTHOLD
To all Annex- 54375 Main Road - PO Box 1179
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j4w �� Southold, New York 11971-0959
11Aj6Telephone (631) 765-1802 - FAX (631) 765-9502
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APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (Ali information Required) Date: J rj' Z_7Company Name:--1-3a Iv I Icy It-,
Electrician's Name: � I„� .1 C C�A- I
License No.: _ y-7 Z-3 Elec. email: W I/ceh s iG cl�c164-,� /o
Elec. Phone No: 3 1- z3 6 z9� lel request an email copy of Certifical:6 of Compliance
Elec. Address.: g J 3 1 T S f-
JOB SITE INFORMATION (All Information Required)
Name: a r-+—_ Ahs i.,
Address: LJ F O 1)1A-1 ,1 IZJ !7 .z, +,. a
Cross Street: A
Phone No.: 3 /- c/-772- Z 3 Z
BIdg.Permit#: / , . email: n
Tax Map District. 1000 Section: Block: Lot:
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
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,fit,✓J c—� -
Square Footage:
Circle All That Apply:
Is job ready for inspection?: r7 YES❑NO ❑Rough In Final
Do you need a Temp Certificate?: LZSJ YES NO
❑ Issued On 13$� IA,r,,�c` c_q/�3
Temp Information: (All information required)
Service Si ' VIJ Ph 113 Ph Size: �A #Meters Old Meter#
gZNew Service[:] Reconnect[]Flood Reconnect[]Service Reconnect❑UndergroundWverhead
#Underground Laterals 1 F12 H Frame M Pole Work done on Service? Y FIN
Additional Information:
PAYMENT DUE WITH APPLICATION
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_� y� BUILDING DEPARTMENT-Electrical Inspector
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TOWN OF SOUTHOLD
oy �� Town Hall Annex-54375 Main Road-PO Box 1179-Southold, NY 11971-0959
Telephone 631) 765-1802
Temporary Certificate # Date l 2022
Customer Name &-7160 Moon Rd LL( Electrician Name banW `: .e,,7.5• /
Address 627 V60let ZS (ShPeyJ Phone &3/-Z36
e-mail a-mail A1jod ,Ce'),
Phone (03H07 _033p icense# �
Size .GYJ A Phase�_Overhead Underground #of Meters /
Remarks
#of Underground Laterals 1) New
"H" Frame or Pol 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 verifi n is va'd o 90 from the above.
Authorized by