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HomeMy WebLinkAboutNCC223258_Contact Update Record (Site Contact)_20230905 Action History (UTC-05:00)Eastern Time(US&Canada) Submit by bethany.georgoulias 9/5/2023 5:13:07 PM(Contact Changes Submitted) Contact • - for • • • ONLY) updatesThis form • . . Certificate of NCC223258 Coverage(COC) No.* Enter the Certificate of Coverage Number(Use capital letters) NC Reference No. NCG01-2022-3258 Original NOI No.* 105615 Project information associated with this permit(cannot change): Permittee Listed Organizaiton cannot be changed(new COC required) Triple A Homes Project Name Chapel Ridge Address 807 Cabin Creek,Pittsboro, NC County Chatham Latitude 35.7948 Longitude -79.2293 Date COC Issued* 09/16/2022 Prior Rescission Date This field will populate only if COC has already been rescinded.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 0 Yes Billing Email laura@tripleahomes.org Billing Telephone No. 9498120991 Site Contact Information REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES! Site Contact David Dail (Previous) Site Contact Title Construction Manager (Previous) Organization Triple A Homes (Previous) First Name(New)* Justin Last Name(New)* Cook NEW Site Contact* Reflects any revisions above Justin Cook NEW Site Contact Title NEW Organization Triple A Homes This field is not required on the NOI form and may not pre-populate. Site Contact Email david@tripleahomes.org (Previous) NEW Site Contact justin@tripleahomes.org Email* Site Contact 919-270-1928 Telephone No. (Previous) NEW Site Contact (910)748-6105 Telephone No.* Site Contact Mailing 1013 Green Oaks Parkway, 0, Holly Springs, Address(Previous) NC 27540 NEW Site Contact Street Address Mailing Address* 1013 Green Oaks Parkway Address Line 2 City State/Province/Region Holly Springs NC Postal/Zip Code Country 27540 us Change Requested Laura Peters via email on 9/1/2023. by:* Include any additional correspondence records in the Repository COC folder. Additional Information for this update to contact information: Addional Explanation (Optional) Date* 09/05/2023