HomeMy WebLinkAbout45625-Z �oSa�Fat�co TOWN OF SOUTHOLD
moo oy� BUILDING DEPARTMENT
y 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#: 45625 Date: 12/29/2020
Permission is hereby granted to:
Mclaughlin, Robert
Attn: Mr & Mrs Mclaughlin
24 Goodrich St
Williston Park, NY 11596
To: 300A underground electric service
At premises located at: `'_r�'a� �0 f 0 n n
3700 Vanston Rd., Cutchogue Gx�C
SCTM # 473889 Mc7oi (h LAA d-" Z -7-
Sec/Block/Lot# 111.-5-13
Pursuant to application dated 12/29/2020 and approved by the Building Inspector.
To expire on 6/30/2022.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
-----------v----------------
�Q�s�FFo�Koo
a Gy1 BUILDING DEPARTMENT-Electrical Inspector
<<'i, x TOWN OF SOUTHOLD
oy • �� Town Hall Annex-54375 Main Road-PO Box 1179-Southol;d, NY 11971-0959
�Ol `lad Telephone(631)765-1802-FAX(631)765-9502
Temporary Certificate #__910 Date J2, 2020
Customer Name l Electrician Name
Address 0U p Phone ?g 14 q q.;-
e-mail
Se-mail e-mail4 (,p
Phone License# , B
Size O2 A Phase Overhead Underground S_ #of Meters
Remarks
#of Underground Laterals t 2 New
"H" Frame or Pole E3 P , Fire Reconnect
Was work done on Service? Y/N Flood Reconnect
Old Meter#1 1 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 troT the date above.
Authorized by
r4 S�fFQj, `� BUILDING DEPARTMENT-Electrical lnspeic�Qr(
AS
4 GAY TOWN OFSOUTHOLD
,7 Town Hall Annex- 54375 Main Road - P.O,Box W92 g 2020
Southold, New York 11971-0959
p� t Telephone (631) 765-1802 - FAX (631) 765-9502
roQerr(cDsoutholdtownn Aov seand southoldtoFwnti "`` 'y •
APPLICATION FOR ELECTRICAL INSPECTION:
ELECTRICIAN INFORMATION (All Information Required) Date:
Company Name: - �� ,2 L-LC
Name: G
License No.: 1h6 email: ,�
Address: , 112-5-'2—
Phone
1 '2—Phone No.: a g 5 •e1i 3 ��
JOB SITE INFORMATION (AII Information Required)
Name:Ef �'S-h�.c��'QGS-fnAe 'd l�rl 1r s�"'t/nct'er1#14D 04
'
Address: `kip es P '!eracoa , 11,1
Cross Street: ,��;,l (j G-S-r T r(.f-t-
Phone No.:
Bldg.Permit#: 456 a5 email:
Tax Map District: , 1600 Section;,_ I Block: Lot:
BRIEF DESCRIPTION OF WORK (Please Print Clearly)
Cu,r. Ur\AQ(:? gra �" SFS.4
Circle All That Apply:
Is job ready nnCertiflica
Y S / 10 Rough In Final
Do you ne a TeYE NOY Issued On twia_i
Temp Information. {AII information required)
Service Size(LP P 3 Ph Size: ? -A #Meters f Old Meter#
New Service - Fire Reconnect- Flood Reconnect-Service Reconnected ndergroun - Overhead
#Underground Lateral 1 2Fra Pole Work done on Service? Y N
Additional Information:.
-PAYMENT DUE WITH APPLICATION
Request for Inspection FormAs