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HomeMy WebLinkAbout102 Deepwood Drive DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT TOWN OF SOUTH WIlVDSOR PERMIT# Application is hereby: /j?0 7 6 BUILDING DEPARTMENT APPROVED 1540 SULLIVAN AVENUE Bldg.Permit# 644-2511 ext. 230 ate Building Inspector Application must be printed or typed FEE SCHEDULE Location of Job: I0z IDectV9 c,v©® —0i;z tQE-1 $0-$1,000=$15.00 Street No. Street Lot No. Over$1,000= $15.00 per$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANT APPLICANT ADDRESS I L-y� IZ 1 V APPLICANT PHONE# ($—!::?e/0 O 4 ` ? O W N S OWNER v-vle OWNER ADDRESS 0 _ OWNER PHONE S►A VV-\. -_ C ESTIMATED COST$ * IS THIS A CONTRACT COST? Yes No FEE ENCLOSED$ /,. . TYPE OF JOB: sOR-CO ',New Installation Alteration/Addition/Repair Revised 4/01//2002 APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A BUILDING PERMIT APPLICATION? ❑ YESV NO ❑RESIDENTIAL ❑BUSINESS CURRENT USE AND OCCUPANCY ❑ASSEMBLY ❑MERCANTILE FUTURE USE AND OCCUPANCY ❑EDUCATIONAL ❑INSTITUTIONAL ❑FACTORY ENGINEER'S NAME PHONE ❑STORAGE ❑GARAGE ADDRESS ❑MIXED USE CITY STATE ZIP (Other please specify) TYPE OF INSTALLATION/WIRING METHOD ` 'L'f`� �0 ��©!'•� ►'v1.1� SIZE OF SERVICE Z A✓ I e SIZE OF MAIN CONDUCTORS �,o CG'Pp 1e 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 P /O 0 A-vim,, <z:7c-:) 2cn A ,-,,A e r131Z,64 CC477/- � 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. 1/0-Yne 6UJn e-e- CONTRACTORS LICENSE NO TYPE STATE SIGNATURE OF APPLICANT DATE �l Shirley Wilhelm - CRS Approval Confirmation: Request No. 235649 Page-1 From: <clpsvc@nu.com> To: <WILHEL@SOUTHWINDSOR.ORG> Dat 12/4/02 11:06AM Subject: CRS Approval Confirmation: Request No. 235649 Your approval of the following CRS Request has been successfully processed. CRS Work Request M 235649 House No: 102 Lot No: Street Name: DEEPWOOD DR Town Name: SOUTH WINDSOR, CT Inspector: JOHN COLLINS Approval Date: Dec 04, 2002