HomeMy WebLinkAbout48083-Z �SUFFQ TOWN OF SOUTHOLD
moo ay BUILDING DEPARTMENT
y x TOWN CLERK'S OFFICE
o . 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#: 48083 Date: 7/19/2022
Permission is hereby granted to:
Of Oregon 2021 LLC
149 Brewster Rd
Massapequa, NY 11758
To: 200A electric service.
At premises located at:
Jy3�19 Oregon Rd., Cutcho ue
JD 10
SCTM # 473889
Sec/Block/Lot# 72.-2-2.3
Pursuant to application dated 7/19/2022 and approved by the Building Inspector.
To expire on 1/18/2024.
Fees:
ELECTRIC $85.00
Total: $85.00
Build in Inspector
S�FF04 B I DING DEPARTMENT- Electrical Inspector
Jul 1 a 922 TOWN OF SOUTHOLD
o BUI oI oU�,T�wn Hall Annex- 54375 Main Road - PO Box 1179
-Towti Southold, New York 11971-0959
ti O� Telephone (631) 765-1802 - FAX (631) 765-9502
rogerr(cD-southoldtownny.gov- seand(ab-southoldtownny.gov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (Ail Information Required) Date:
Company Name: jb,af.
Ele cian's Name:
License No.: fii'e`c. email: ebeC' rcKvk % q�)A:v,COv1
EP e"' Phone No: �J J� --55r05 ❑I request an email copy of Certificate of Compliance
Pi�c. Address.: Al t� P®/9P � itL
JOB SITE INFORMATION (All Information Required)
Name: 401FOI 201L U.C, Lcum k/*'4t4 lJ
Address: OR y l ,
Cross Street: a=2::4 s'W p V-14 COG UA
Phone No.: (!BM 312>- e;0-
BIdg.Permit#: OJ a email: L(o -OtSoo Q-Vyssh
Tax Map District: 1000 Section: Block: Lot: '�j
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
AWPLA►OCR tes...AN Pic, regnv ' rVR 1Na21c 1Q. b�4
Vor
Lea®a�'4 �� �►r� e��s , .ve 'aut
Square Footage:
Circle All That Apply:
Is job ready for inspection?: ❑ YES 2LNO ❑Rough In ❑ Final
Do you need a Temp Certificate?: ❑ YES INO Issued On
Temp Information: (All information required)
Service Size Ph❑3 Ph Size: Wa -A # Meters Old Meter#
�lew Service❑Fire Reconnect[]Flood Reconnect❑Service ReconnecoUnderground❑Overhead
#Underground Laterals M 1 F12 F1 H Frame D Pole Work done on Service? Y N
Additional Information:
PAYMENT DUE WITH APPLICATION 0X
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