HomeMy WebLinkAbout40452-Z o�gaFFnt�co TOWN OF SOUTHOLD
BUILDING DEPARTMENT
y TOWN CLERK'S OFFICE
SOUTHOLD, NY
°l � •ia s
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#: 40452 Date: 2/4/2016
Permission is hereby granted to:
Rosenbaum, Charles
450 Lexington Ave #621
New York, NY 10163
To: Electric Service
At premises located at:
6710 Soundview Ave,:Southold. �"'�^a�tio1 VdID
SCTM # 473889 Ne4IJ wf,1 11 bpi I�- �oaa
Sec/Block/Lot# 59.-8-6.2
Pursuant to application dated 2/4/2016 and approved by the Building Inspector.
To expire'on 8/5/2017.
Fees:
ELECTRIC $85.00
Total: $85.00
Buil pector .
SD(/r�ol
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Town Hall Annex Jir l�[ Telephone(631)765-1802
54375 Main Road c� 1)765_�(6 - 50
P.O.Box 1179 roper.rchert tlwno nV.us o
Southold,NY 11971-0959 �� i s , �
t ! FEB - 4 2016 '
BUILDING DEPARTMENT
TOWN OF SOUTHOLD i
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: � �'� Date: 0Z YZ/6
Company Name: G a LAC_ 1 I c.
Name:
License No.: cry
Address: _5. cc L, -�L
'Phone No.: 6 41 — 9 6 - �2 0
JOBSITE INFORMATION: (*Indicates required information)
*Name:
v�
*Addr-ess: (101
*Cross Street: e�N
*Phone No.:
Permit No.: rj�
Tax-Map District: 1000 Section: 4y I Block: Lot:
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
(Please Circle All That Apply)
Is job ready for inspection: c` "! NO. Rough In Final
*Do-you need a Temp Certificate: / NO
Temp Information (if needed)
Service Size: 3Phase 100 150 200 300 350 400 Other
'New Service: Re-co nnecf ndergroun Number of Meters-1-Change of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
V-
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82=Request for Inspection Form Z(�(
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B;UIL"DIN:G: DEAPARTMENT
'TOWN:O,F SO ^�
UTH.01D.,
�. Town ball Anneii 54375 Main Road•.PQ;'Box 1179 bouthold,.'NY 11971-0959"
Telephone(631)•765-1802%Fax 631.765=9502
/.. ... . Date")
Number'of:'Meters /" ;20 '
` Temporary Certificate
. "Size
s Phase /. r
`0Verhead l7n i
f, detground Q.
er
New Svice•. CQ:,.":Chan e•'of:
9... Service,; .ReconriecY'Existing"Service'.'.0. "
Location' `7
Issued-to" '
Installeii:tiy_ , fly. la�;,a�� ''f -.; ,
Reference'
Applicatiomfor eiectncal service equipment,is on,fiie with the"Town.of:'Southold..On I
_ that this installation is•com"I' the .applicant's notification '
p town will ciinduct.a:premises inspection,of f sei d6',e' quipment
-This v ion is
90 d - s from the above.date.,
i;: .:Authorized by
L .