HomeMy WebLinkAbout39581-Z ods x TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
oy . SOUTHOLD, NY
SP1 � dao
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#: 39581 Date: 3/11/2015
Permission is hereby granted to:
Warlan, Michael &Warlan, Erin
165 E 66th St
New York, NY 10065
To: Electric Service Vo I
At premises located at:
1145 Jackson St, New Suffolk
SCTM # 473889
Sec/Block/Lot# 117.-9-8.1
Pursuant to application dated 3/11/2015 and approved by the Building Inspector.
To expire on 9/9/2016.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Ins r
i
- pF S0�/lyo!
� o �
Town Hall Annex 4 Telephone(631)765.1802
54375 Main Road ��xx(631)76 gg5Q
P.O.Box 1179 G Q roger.dchert IOW11.S0U1CM ny us
Southold,NY 11971-0959 y0
o% Qyfm,�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: 4y,,� un Date:
Company Name: � e� e- °G 3A, '?lAf -
Name:
License No.:
0 AK
Address: - K 0J v
Phone No.: i
fJOBSITE INFORMATION: (*Indicates required information)
*Name:
*Address:
*Cross Street:
*Phone No.:
Permit No.:
Tax-Map District: 1000 Scfi
an: Block:Im do Lot: /
i
*BRIEF DESCRIPTION OF WORK(Please Print Clearly) `c G
IL
(Please Circle All That Apply)
*Is job ready for inspection: YES 4 ONO Rough In Final i
*Do you need a Temp Certificate: YES NO
Temp Information If ne ded)
*Service Size: 1 phase 3Phase 100 150 200 300 350 C4,0 Other
*New Service: Re-connect Unde round Number of Meters j Change of Service Overhead
A7,nalE tr€sn: DUE WITH APPLICATION
arr�,�� � PAYMENT -
MAR 11 gms
2-Re luest for Inspection Form
BLDG DEPT Le6-3 o "lY cJ
TONIN OF SOUTHOLD