ELECTRICAL PERMIT APPLICATION

Project Information

Owner First name

Owner Last name

Owner Email

Owner Phone

Street Address of Project

Is Applicant Same as Owner Above?

Yes

Applicant First Name

Applicant Last Name

Applicant Email

Applicant Phone

Applicant Address

Check all that apply:

Residential

Commercial

As Built

New Work

Scope of Work:

Electrician Information

Electrician Name

Electrician Phone

Electrician Email

Electrician - Malverne Lic. #

Electrician Business Address

Inspection Agency Name:

Areas to be Inspected:

Qty

Item

Location

Qty

Item

Location

Qty

Item

Location

Qty

Item

Location

Qty

Item

Location

Qty

Item

Location

Qty

Item

Location

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Location

Qty

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Location

TOTAL AREAS

Upload Supporting Documents

File upload

NOTE: After submitting, a representative will review your application in a few days and will be in contact regarding next steps and total fees required. Your permit will not be issued until fully approved and payment is received.

KEY CONTACTS

Louis J. Santora, R.A.

Superintendent of Buildings

Certified NYS CEO

(516) 599-1200 Ext.107

Luis Lora

Certified NYS CEO

Building Inspector

(516) 599-1200 Ext. 111

MaryKate Schnaars

Building Department Clerk

(516) 599-1200 Ext.114

General Inquiries

(516) 599-1200 Ext. 113

VILLAGE OF

MALVERNE, NY

ELECTRICAL PERMIT APPLICATION

Project Information

Electrician Information

Areas to be Inspected:

Upload Supporting Documents

KEY CONTACTS

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