HomeMy WebLinkAbout100 Farmstead Drive DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
TOWN OF SOUTH WINDSOR PERNIIT#
Application is hereby: gQ Q
BUILDING DEPARTMENT
APPROVED 1540 SULLIVAN AVENUE Bldg.Permit#
U Z J 644-2511 ext. 230 c2 7k
ate Building Inspector
Application must be printed or typed
FEE SCHEDULE Location of Job:
/00 4�,;r"r Iq/,=q C l �in 1
$0-$1,000=$15.00 Street No. Street Lot No.
Over$1,000=
$15.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
0
APPLICANT
APPLICANT ADDRESS v
SS42
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APPLICANT PHONE#
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� N S OWNER ��U� � Ccr r o
�q OWNER ADDRESS /Dd d-nl r�cc3 .d rye
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;R # OWNER PHONE
ESTIMATED COST$
IS THIS A CONTRACT COST? Yes No
FEE ENCLOSED$
TYPE OF JOB:
OR-Co� w 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
(RESIDENTIAL BUILDING PERMIT APPLICATION? S ❑NO
❑BUSINESS CURRENT USE AND OCCUPANCY
❑ASSEMBLY
❑DUCAT ONE FUTURE USE AND OCCUPANCY a
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❑INSTITUTIONAL
❑FACTORY ENGINEER'S NAME PHONE
❑ STORAGE
❑GARAGE ADDRESS
❑MIXED USE
CITY STATE ZIP
(Other please specify)
TYPE OF INSTALLATION/WIRING METHOD e
SIZE OF SERVICE D SIZE OF MAIN CONDUCTORS
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
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.
f a97 8 v�` / ell/'
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT DATE
Shirley Wilhelm -CRS Approval Confirmation: Request No. 230753 Page 1
From: <clpsvc@nu.com>
To: <W ILHEL@SOUTHW INDSOR.ORG>
Date: 10/17/02 4:11 PM
Subj ct: CRS Approval Confirmation: Request No. 230753
Your approval of the following CRS Request has been successfully processed.
CRS Work Request#: 230753
House No: 100
Lot No:
Street Name: FARMSTEAD DR
Town Name: SOUTH W INDSOR, CT
Inspector: JOHN COLLINS
Approval Date: Oct 17, 2002