HomeMy WebLinkAbout111 McGrath Road [DEP:MENT DECISION APPLICATION FOR ELECTRICAL PERMIT
. PERMIT#
ation is hereby: TOWN OF SOUTH WINDSOR zRo
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BUILDING DEPARTMENT
PRO D 1540 SULLIVAN AVENUE Bldg.Permit#
644-2511 ext. 230
Building Inspector
Application must be printed or typed
FEE SCHEDULE Location of Job:
1
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$0-$1,000=$15.00 Street No. Street Lot No.
Over$1,000=
$15.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT r1�I i�i A sit i l e. fj o G-K- c--
APPLICANT ADDRESS 13 L 1 E U i
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APPLICANT PHONE#
N OW OWNER 4,/ 1;11�✓1
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q� OWNER ADDRESS I I C C4.&r—;L
OWNER PHONE ^
C ESTIMATED COST$ �QQQ
� IS THIS A CONTRACT COST? Yes No
{ FEE ENCLOSED$ 7J" `
TYPE OF JOB:
OR C 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? ❑ YES NO
SIDENTIAL /
BUSINESS
CURRENT USE AND OCCUPANCY � (L i
❑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 2 —Sec)
SIZE OF SERVICE 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
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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. STATE
SIG
NATURE OF APPLICANT DATE
Shirle Wilhelm -CRS A royal Confirmation: Re uest No. 229466 v =ae
From: <clpsvc@nu.com>
To: <WILHEL@SOUTHWINDSOR.ORG>
Date: 11/4/02 12:14PM
Subj ct: CRS Approval Confirmation: Request No. 229466
Your approval of the following CRS Request has been successfully processed.
CRS Work Request M 229466
House No: 111
Lot No:
Street Name: MCGRATH RD
Town Name: SOUTH WINDSOR, CT
Inspector: JOHN COLLINS
Approval Date: Nov 04, 2002