HomeMy WebLinkAbout106 Sweet Meadow Drive DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
TOWN OF SOUTH WINDSOR PERNIIT#
Application is hereby: BUILDING DEPARTMENT
APPROVED 1540 SULLIVAN AVENUE
Bldg.Permit#
0 3 644-2511 ext. 230 t/ 3
bate Building Inspector
Application must be printed or typed
FEE SCHEDULE �w 7— Location of Job:
&IC
� C�Dow -
$0-$1,000=$15.00 Street No. Street Lot No.
Over$1,000=
$15.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT
APPLICANT ADDRESS �� �'��/� C S'7-
APPLICANT PHONE# 4000W1-
O W N S OWNER 1?2 f4 AIAIfi2 10000-t/O .Qyi G,���01.1' -,Z;�
q4( OWNER ADDRESS z/�,9
OWNER PHONE 02
7dsr
C ESTIMATED COST$ ®o .
IS THIS A CONTRACT COST? ✓Yes No
FEE ENCLOSED$
TYPE OF JOB:
�SOR.Cps
ew Installation
Alteration/Addition/Rep air
Revised 4/01//2002
APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED E7 A
BUILDING PERMIT APPLICATION? S ❑NO
RESIDENTIAL
❑BUSINESS CURRENT USE AND OCCUPANCY A1�4—
❑ASSEMBLY
❑MERCANTILE FUTURE USE AND OCCUPANCY f��� ,� .-L, �
❑EDUCATIONAL
❑INSTITUTIONAL
❑FACTORY ENGINEER'S NAME PHONE
❑ STORAGE
❑GARAGE ADDRESS
❑MIXED USE
CITY STATE ZIP
(Other please specify)
TYPE OF INSTALLATION/WIRING METHOD �✓ �''�
SIZE OF SERVICE) SIZE OF MAIN CONDUCTORS
�P
NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS
NUMBER OF PANELS � REMOTE DISCONNECT REQUIRED? ❑YES NdNO
NUMBER OF LIGHT CIRCUITS NUMBER OF POWER CIRCUITS 3
NUMBER OF SWITCHES_�� NUMBER OF OUTLETS 6.
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.
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT � DATE L) )3 0 40 3
;/- d A n GL,d /dcj /! C e.//O
Shirley Wilhelm -CRS A royal Confirmation: Request No.}225878
.. f.. _. ,
From: <clpsvc@nu.com>
To: <W ILHEL@SOUTHW INDSOR.ORG>
Date: 5/13/03 2:48PM
Subj ct: CRS Approval Confirmation: Request No. 225878
Your approval of the following CRS Request has been successfully processed.
CRS Work Request#: 225878
House No: ,a4
Lot No: 16
Street Name: 4WEET IwAEADCYU 13R
Town Name: SOUTH WINDSOR, CT
Inspector: JOHN COLLINS
Approval Date: May 13, 2003