HomeMy WebLinkAbout38363-Z ��' TOWN OF SOUTHOLD
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BUILDING DEPARTMENT
2 TOWN CLERK'S OFFICE
oy . 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#: 38363 Date: 9/27/2013
Permission is hereby granted to:
Lohr, George & Conte, Alyssa
1215 Saltaire Way
Mattituck, NY 11952
To: Temporary Electric Pole
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At premises located at:
325 Oak Ave, Southold
SCTM # 473889
Sec/Block/Lot# 77.-2-11
Pursuant to application dated 9/25/2013 and approved by the Building Inspector.
To expire on 3/29/2015.
Fees:
ELECTRIC $85.00
Total: $85.00
Building Inspector
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Town Hall Annex 1f J�[ Telephone(631)765-1802
54375 Main Road ax
P.O.Box 1179 rogeCdchert - own SUoQl
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Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD \
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: Date: 9 ZS
Company Name:
Name:
License No.:
Address: I2I5 al a;re o�} Uc>C I SZ
Phone No.: (�t5�1� 3H7_ �r `I
JOBSITE INFORMATION: (*Indicates required information)
*Name: Cae)rQP
*Address: 32$ 6A A .—
*Cross Street: AUAt
*Phone No.: 95y) 3 H ri- o. `7
Permit No.: 3 g 3(p 3.1
Tax Map District: 4000 Section: Block:_ Lot:
*BRIEF DESCRIPTION OF WORK(Please Print Clearly) 1eyn perayy PC.)
(Please Circle All That Apply)
*Is job ready for inspection: YES/(NO Rough In Final
*[3o you need a Temp Certificate: / NO
Temp Information(if needed)
*Service Size: 1 Phas 3Phase 900 950 200 300 350 • 400 Other
*New Service: Re-connect Underground Number of Meters Change of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
C'
82-Request for Inspection Form