HomeMy WebLinkAbout155 Abbe Road (3) DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
PERMIT#
Application is hereby: TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
APPROVED 1540 SULLIVAN AVENUE Bldg.Permit#
z A3 644-2511 ext. 230
Date Building Inspector
Application must be printed or typed
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EE SCHEDULE tipn of Job:
� AgerTO�1
$0-$1,000=$15.00 Street No. Street Lot No.
Over$1,000=
$15.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT PC I )3
APPLICANT ADDRESS 0 C W-1 I�
APPLICANT PHONE# 136 0 , "1 5-dL 3
W N 3 OWNER
° Fqt OWNER ADDRESS211
�= L
M # OWNER PHONE
0 _
C ESTIMATED COST$
* IS THIS A CONTRACT COST? /Yes No
FEE ENCLOSED$ 157, 611
TYPE OF JOB:
OR-Co
New Installation
-7 Alteration/Addition/Repair
Revised 4/01//2002
APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH y
—// BUILDING PERMIT APPLICATION? ❑YES O
I9'RESIDENTIAL
❑BUSINESS CURRENT USE AND OCCUPANCY
❑ASSEMBLY
❑MERCANTILE FUTURE USE AND OCCUPANCY
❑EDUCATIONAL
❑INSTITUTIONAL PHONE
❑FACTORY ENGINEER'S NAME
❑STORAGE
❑GARAGE ADDRESS
❑MIXED USE
CITY STATE ZIP
(Other please specify)
TYPE OF INSTALLATION/WIRING METHOD
SIZE OF SERVICE ,�00 P 1�1 SIZE OF MAIN CONDUCTORS i-Ile
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
SEPARATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED.
DESCRIPTION OF WORK
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THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS TO
COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE
PERFORMANCE OF SUCH WORK.
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT � � DATE
Shirle Wilhelm -CRS A royal Confirmation: Re uest No. 243168 Pa e 1
_,... _
From: <clpsvc@nu.com>
To: <W ILHEL@SOUTHW INDSOR.ORG>
Date: 5/1/03 8:29AM
Subj ct: CRS Approval Confirmation: Request No. 243168
Your approval of the following CRS Request has been successfully processed.
CRS Work Request#: 243168
House No:
Lot No: 2
Street Name: r ABBE RD
Town Name: SOUTH WINDSOR, CT
Inspector: JOHN COLLINS
Approval Date: May 01, 2003