HomeMy WebLinkAbout178 Abbe Road (4) 1
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT PERMIT#
Application is hereby: TOWN of SOUTH WINDSOR
BUILDING DEPARTMENT Bldg Permit#
APPROVED` 1540 SULLIVAN AVENUE
644-2511 ext.230
Date Building Inspector Application must be printed or typed
Location of job
I �tg ebb C� �
Street No. Street Lot No.
FEE SCHEDULE
Floor Apt.No.
$0 - $1,000 - $12.00
Over $1,000 '
$12.00 per$1,000
OWNER L o r ;
or any fraction thereof 11
ADDRESS 1 7 8 t9 6 b R d
SoQA-h W ► rvjSor', C.T 0 ( O7V
OWNERS PHONE# S Co _ 9 3
APPLICANT i c5 A.)OWN S ADDRESS G$ L s-V c-h
%
Lac-L's CA 0 (oaq
ESTIIvMATED COST$ i
IS THIS A CONTRACT COST?
psi `: YES NO
FEE ENCLOSED $ l5
�SOR-Cow TYPE OF JOB:
Original Installation
Alteration/Addition/Repair
Revised 11/95
APPLICATION FOR ELECTRICAL PERMIT(Continued from reverse side)
TYPE OF BUILDING
IS THIS APPLICATION ASSOCIATED WITH A
RESIDENTIAL BUILDING PERMIT APPLICATION YES / NO
BUSINESS
ASSEMBLY CURRENT USE AND OCCUPANCY
MERCANTILE
EDUCATIONAL FUTURE USE AND OCCUPANCY
INSTITUTIONAL
FACTORY
STORAGE ENGINEER'S NAME PHONE
GARAGE
MIXED USE ADDRESS
CITY STATE ZIP
(Other please specify)
TYPE OF INSTALLATION/WRUNG METHOD
SIZE OF MAIN FEEDERS AND RATING OF WIRE USED
NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS
NUMBER OF PANELS REMOTE DISCONNECT REQUIRED?YES/NO
NUMBER OF LIGHT CIRCUITS NUMBER OF POWER CIRCUITS
NUMBER OF SWITCHES NUMBER OF OUTLETS
NUMBER OF LIGHT FIXTURES
NUMBER OF HEAT CIRCUITS NUMBER OF A/C CIRCUITS
SEPERATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED,
DESCRIPTION OF WORK
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS
TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONN.BUILDING CODES IN THE
PERFORMANCE OF SUCH WORK.
NAME STATE LICENSE NO. TYPE SIGNATURE OF APPL ANT
PHONE NO. a�'3 ��i3 DATE bb-3to
Shirley Wilhelm -CRS Ap royal Confirmation: Request No. 255462 a..,.
Page 1
From: <clpsvc@nu.com>
To: <WILHEL@SOUTHWINDSOR.ORG>
Date: 5/23/03 12:28PM
Subject: CRS Approval Confirmation: Request No. 255462
Your approval of the following CRS Request has been successfully processed.
CRS Work Request#: 255462
House No: 178
Lot No:
Street Name: ABBY RD
Town Name: SOUTH WINDSOR, CT
Inspector: JOHN COLLINS
Approval Date: May 23, 2003