HomeMy WebLinkAbout159 Burgess Road P
N
m
e—f
W DEPARTMENT DEcsSIOx APPLICATION FOR ELECTRICAL PERMIT
Applicatioa is herby: TOWN OF SOUTH WINDSOR PEItMIC#
BUIi.DI1�G DEPARTMENT
APPRO 15Q SUTLLIVAN AVENUE
644-2511 ext.230 Bldg.Pesnat#
Building Inspector
Applies"most be rrbsted or typed
FEE SCHEDULE Location of Job:
o 159 Burgess Rd. South Windsor, CT.06074-2514
cn $0-SI,000=$I5.4D Street No. Street
Lot No.
z over$1,000
2 v5.00 per T1,000
as any fractiaz reo€ Test Des pefin Apt:No.
0
U
APPLW,ANT Eastside Electric, Inc.
APPLICANT ADDRESS P.O. Box 476, 23 Garfield St.
Torrington, CT. 06790-0476
APPLWANTPHONE# (860) 482-2405 _
D1N N 3 OWNER . Gregory L. Mele - -
OWNERADDRESS South Windsor D.O.T.
1540 ullivan Ave. , South Windsor, Ct. 06074
LD
0LO OW1VEP-PRONE _ -2 1 1
s , ES'IIMATP.D COSTS $6 7 5 . 0 0
Ln ';�`► �'� IS TM A CONTRACT COST? X.)L yes No
L� -
4 �► FEE ENCLOSED S .0 0
��� TYPE OF JOB:
w ; L
m .
0 R C New bmuntion
LO
AltezationlAdditimz%pur
m
s
i
APPLICATION FOR ELECTRICAL PERMIT(Can in=4 from reverse side)
7' OF l)m'G IS THIS APPLICATION ASSOCIATED WTM A
BUILDING PERWr APPLICATION? M YES❑NO
❑RESMENTIAL
BUSINESS CTMR NT USE AND OCCUPANCY Temporary Service
0 ASSEMBLY
(3 hMCA.NTILE FUT M USE AND OCCUPANCY T. Salt Shed
13 EDUCATIONAL D,Q.
13 INSTITLMONAL
Ll FACTORY ENGOIEER'S NAME_ -PHONE
❑STORAGE
❑GARAGE ADDRESS
❑MIXED USE
---. CITY STATE ZIP
(Other please specify)
TYPE OF INSTALLATTON/WDMG MMTHOD
SIZE OF SERVICE 11 0 0 A SIZE OF MAIN CONDUCTORS #3 c u
NUMBER OF N.IETERS. 1__ NUMMER OT'DISCONNECTS AND RATINGS 1�1 0 0 A
NUMBER OF PANELS 1 REMOTE DISCONNECT REQt MM? Q YES )]NO
NUMBPA OF LIGHT CIRCUITS NUhTBER OF POWER CIRCUITS 3
NUMBER OF SWITCU ES NUMBER OF OUTLETS 1
NUMBER OF LIGHT FrXn RES NUMBER OF HEAT CIRCUITS
NUMBER,OF A/C CIRCUITS
SEPARATZ HEAT DOSS AND A/C CALCULATIONS MUST BE SUBMITTED.
DESCRIPnON OF WORK
Install 100amp overhead service for D.O.T. Project, Temporary power.
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM.THE WORK DESCRIBED AND IS TO
COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT RMLDING CODES IN THE
PERFORMANCE OF SUCH WORK,
1 251 20 E-1 Connecticut
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT DATE April 1 61 2003
01-0-
Z,0/?a aOSGt4IM Hinos 087LVV9098 Gz:ht 8.00Z/q 4/b0
Shirley Wilhelm -CRS Approval Confirmationy Request No. 252751
rr
From: <clpsvc@nu.com>
To: <WILHEL@SOUTHWINDSOR.ORG>
Date: 4/30/03 9:25AM
Subj ct: CRS Approval Confirmation: Request No. 252751
Your approval of the following CRS Request has been successfully processed.
CRS Work Request M 252751
House No: 159
Lot No: NA
Street Name: BURGESS RD
Town Name: SOUTH WINDSOR, CT
Inspector: JOHN COLLINS
Approval Date: Apr 30, 2003