HomeMy WebLinkAbout39016-Z TOWN OF SOUTHOLD
BUILDING DEPARTMENT
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#: 39016 Date: 7/8/2014
Permission is hereby granted to:
Principi, Gilda
445 Lenox Rd
Huntington Station, NY 11746
To: Electric Service
At premises located at:
4690 Blue Horizon Bluffs, Peconic
SCTM # 473889
Sec/Block/Lot# 74.-1-35.53
Pursuant to application dated 7/8/2014 and approved by the Building Inspector.
To expire on 1/7/2016.
Fees:
ELECTRIC $85.00
Total: $85.00
4
Building
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SO�T,�o! ;
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Town Hall Annex Telep o� iZ151P02
54375 Main Road lJ
P.O.Box 1179 G Q ro er.richert o Q� --n .us
Southold,NY 11971-0959
J U L 8 2014
BUILDING DEPARTMENT BLDG DEPT.
TOWN OF SOUTHOLD TOWN OF SOUTHOLD
I
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY. P, Date-A4,llel, -�
Company Name:
Name:
License No.:
Address:
Phone No..
JOBSITE INFORMATION: (*Indicates required information)
*Name;
1171o.;o-,z
*Address:
*Cross Street:
*Phone No.:
Permit No.:
Tax-Map District: 1000 Section: Block: Lot:
*BRIEF DESCRIPTION OF WORK(Please Print Clearly)
(Please Circle All That Apply)
*Is job ready for inspection: YES/-b!Q, Rough In Final
*too you need a Temp Certificate: YE NO
Temp Information(If ed)
*'Service Size: 1 Phase 3Phase 146) 150 ' 200 300 350 400- Other
*New Service: Re-conne Underground Number of Meters Change of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
82-Request for Inspection Form ���