NCC192678_Contact Update Record_20240501

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by bethany.georgoulias 5/1/2024 9:21:09 AM(Contact Changes Submitted)

Contact • - for • • • ONLY)
updatesThis form • . .
Certificate of NCC192678
Coverage(COC) No.* Enter the Certificate of Coverage Number(Use capital letters)
NC Reference No. NCG01-2019-2678
Original NOI No.* 18127
Project information associated with this permit(cannot change):
Permittee Listed Organizaiton cannot be changed(new COC required)
Intercon Building Corp.
Project Name Berkshire Lakemont-Pineville Distribution Street-Lot 1
Address 10100 Pineville Distribution Street, Pineville, NC
County Mecklenburg
Latitude 35.0990
Longitude -80.8935
Date COC Issued* 04/01/2024
Prior Rescission Date This field will populate only if COC has already been rescinded.
Which Contacts Have Billing Only
Changed?* Legally Responsible Individual Only
Site Contact Only
BOTH Legally Responsible Individual and Site Contact
Has Billing Contact Choose'Yes'to revise Billing Contact details.
Changed? Q No
n Yes
Billing Email
NEW Billing Email [e-mail]
Billing Telephone No.
NEW Billing [phone]
Telephone No. (Optional)
Legally Responsible Individual Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Legally Responsible David White
Individual(Previous)
First Name(New)* Michael
Last Name(New)* Tulini

NEW Legally Reflects any revisions above
Responsible Michael Tulini
Individual*
Permittee Email [e-mail]
(Previous)
NEW Permittee [e-mail]
Email*
Permittee Telephone [phone]
No.(Previous)
NEW Permittee [phone]
Telephone No.*
Permittee Mailing P.O. Box 34443,0, Charlotte, NC 28203-5602
Address(Previous)
NEW Permittee Street Address
Mailing Address* 211 Atherton Street
Address Line 2
City State/Province/Region
Charlotte NC
Postal/Zip Code Country
28203 us
Permittee Street 211 Atherton St,0,Charlotte, NC 28203-5602
Address(Previous)
NEW Permittee Street Street Address
Address* 211 Atherton Street
Address Line 2
City State/Province/Region
Charlotte NC
Postal/Zip Code Country
28203 us
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact David White
(Previous)
Site Contact Title
(Previous)
Organization
(Previous)
First Name(New)* Michael
Last Name(New)* Tulini
NEW Site Contact* Reflects any revisions above
Michael Tulini

NEW Site Contact Project Manager
Title
NEW Organization InterCon Building Corp.
This field is not required on the NOI form and may not pre-populate.
Site Contact Email [e-mail]
(Previous)
NEW Site Contact [e-mail]
Email*
Site Contact 7046089394
Telephone No.
(Previous)
NEW Site Contact [phone]
Telephone No.*
Site Contact Mailing PO Box 34443,0, Charlotte, NC 28234
Address(Previous)
NEW Site Contact Street Address
Mailing Address* 211 Atherton Street
Address Line 2
City State/Province/Region
Charlotte NC
Postal/Zip Code Country
28203 us
Change Requested Michael Tulini via Modification request submitted 4/29/2024.
by:* Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date* 05/01/2024