NCC192233_Contact Update Record_20210122

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Selkane, Aziza 1/22/2021 2:48:28 PM (Contact Changes Submitted)

Certificate of NCC192233
Coverage (COC) Enter the Certificate of Coverage Ninber (Use capital letters)
No.*
NC Reference No. NCG01-2019-2233
Original NOI No.* 16845
Project information associated with this permit (cannot change):
Permittee Listed Crganizaitoncannot bechanged (new COC required)
ABI Investments, LLC
Project Name
American Builders West Star Industrial Park Lot 14
Address
805 West Star Street, Greenville, NC
County
Pitt
Latitude
35.5683
Longitude
-77.4382
Date COC Issued*
10/09/2019
Prior Rescission
This field will populate only if COChas already been rescinded.
Date
Which Contacts
f Billing Only
Have Changed?*
f Legally Responsible Individual Only
f Site Contact Only
r BOTH Legally Responsible Individual and Site Contact
Has Billing Contact
Choose'Yes'torevise Billing Contact details.
Changed?
r No
r Yes
Billing Email
NEW Billing Email [e-mail]
Billing Telephone
No.
NEW Billing 252-756-1996
Telephone No. (Cptional)
Legally Responsible Individual Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Legally Responsible Billy Tyson Sr.
Individual
(Previous)

First Name (New)* Billy
Last Name (New) * Tyson Sr.
NEW Legally Reflects any revisions above
Responsible Billy Tyson Sr.
Individual*
Permittee Email [e-mail]
(Previous)
NEW Permittee [e-mail]
Email*
Permittee 2527561996
Telephone No.
(Previous)
NEW Permittee 2527561996
Telephone No.*
Permittee Mailing 805 West Star Street, 0, Greenville, NC
Address (Previous) 27834
NEW Permittee
Mailing Address*
Street Address
805 West Star Street
Address Line 2
City
Greenville
Fbstal / Zip Code
27834
Permittee Street 805 West Star Street, 0, Greenville, NC
Address (Previous) 27834
NEW Permittee Street Address
Street Address* 805 West Star Street
Address Line 2
City
Greenville
Fbstal / Zip Code
27834
State / Rovince / Fbgion
NC
Country
US
State / F rovince / Region
NC
Country
us
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact
Billy Tyson Sr.
(Previous)
Site Contact Title
Managing Member
(Previous)
Organization
ABllnvestments
(Previous)
First Name (New)*
Billy

Last Name (New) * Tyson Sr.
NEW Site Contact* Fbflects any revisions above
Billy Tyson Sr.
NEW Site Contact Managing Member
Title
NEW Organization ABI Investments
This field is not required on the NCI form and nay not pre -populate.
Site Contact Email [e-mail]
(Previous)
NEW Site Contact [e-mail]
Email*
Site Contact 2527561996
Telephone No.
(Previous)
NEW Site Contact 2527561996
Telephone No.*
Site Contact Mailing 805 West Star Street, 0, Greenville, NC
Address (Previous) 27834
NEW Site Contact
Mailing Address*
Street Address
805 West Star Street
Address Line 2
Cty
Greenville
Fbstal / Zip Code
27834
State / Rovince / F;bgion
NC
Country
us
Change Requested Susie Taylor
by: * Include any additional correspondence records in the Fbpository 00Cfolder.
Additional Information for this update to contact information:
Addional
Explanation
(Optional)
Date * 01 /22/2021