HomeMy WebLinkAbout18 Fox Hill Road DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
PERMIT#
TOWN OF SOUTH WINDSOR
Appli ereby: �Cf
BUILDING DEPARTMENT
APPROVED 1540 SULLIVAN AVENUE Bldg.Permit#
644-2511 ext. 230
r
Date ing spector
Application must be printed or typed
Location of Job:
FEE SCHEDULE
$0-$1,000=$400 Street No. Street Lot No.
Over$1,000=
�9 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT
APPLICANT ADDRESS o2 7 w G rt1 er— Dr.
V tf�t— rn o rN
APPLICANT PHONE# 9 '7 2 2 '3 Cs [�
�0 V�I N S F,q �,
OWNER 469 bla -4ss Vj ^ L
OWNER ADDRESS 0 •
z yf 3 r S
r' OWNER PHONE
C 'ESTIMATED COST$owl f Q •�D
'U IS THIS A CONTRACT COST? Yes 0 No
{ CJ FEE ENCLOSED$_ � ® _
�� TYPE OF JOB:
s�R C 0 0 New Installation
0 Alteration/Addition/Repair Revised 8/99
APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
BUILDING PERMIT APPLICATION? ❑ YES ❑NO
PgRESIDENTL&L
❑BUSINESS CURRENT USE AND OCCUPANCY
❑ASSEMBLY
❑MERCANTILE FUTURE USE AND OCCUPANCY
❑EDUCATIONAL
❑INSTITUTIONAL ENGINEER'S NAME PHONE
❑FACTORY
❑ STORAGE ADDRESS
❑GARAGE
❑MIXED USE CITY STATE ZIP
(Other please specify)
TYPE OF INSTALLATION/WIRING METHOD c—.s i C 'ice G f
SIZE OF SERVICE O o SIZE OF MAIN CONDUCTORS
NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS / J v2 a O
NUMBER OF PANELS REMOTE DISCONNECT REQUIRED? ❑ YES XNO
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 art ° Dd cl
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.
/6 3�" 90 Z51 a,'2"
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT DATE 3 '? 7/6
11
ShirleyaWilhelm -CRS Approval Confirmation: Request No. 250009 Page 1
From: <clpsvc@nu.com>
To: <WILHEL@SOUTHWINDSOR.ORG>
Date: 4/14/03 12:26PM
Subject: CRS Approval Confirmation: Request No. 250009
Your approval of the following CRS Request has been successfully processed.
CRS Work Request#: 250009
House No: 18
Lot No:
Street Name: FOX HILL RD
Town Name: SOUTH WINDSOR, CT
Inspector: JOHN COLLINS
Approval Date: Apr 14, 2003