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HomeMy WebLinkAbout100 Bidwell Road (38) DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT TOWN OF SOUTH WINDSOR PERMIT# Application is hereby: BUILDING DEPARTMENT �� 7 7�oZ APPROVED 1540 SULLIVAN AVENUE Bldg.Permit# S10E 644-2511 ext. 230 ate �'ding Inspector Application must be printed or typed FEE SCHEDULE Location of Job: l oo dwell i?ov,)o $0-$1,000=$13.00 Street No. Street Lot No. Over$1,000= $13.00 per$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANT , 4 r)C APPLICANT ADDRESS ,('�. L3 -Porn Fi,e 7— o j e j— e--t--. g<ci APPLICANT PHONE# 9 C 3 ?C OW N St OWNER ' < OWNER ADDRESS 1 S s_�-�c� -n.t a r f OWNER PHONE �� —7a? [� ESTIMATED COST$ � V IS THIS A CONTRACT COST? 64ZYes 0 No p 1 r r i G FEE ENCLOSED$ ` 90C)4-= TYPE OF JOB: Original Installation 13 Alteration/Addition/Repair Revised 8/99 • _ _r APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A BUILDING PERMIT APPLICATION?a-YES ❑ NO ❑RESIDENTIAL ❑BUSINESS CURRENT USE AND OCCUPANCY /kjj ❑ASSEMBLY ❑MERCANTILE FUTURE USE AND OCCUPANCY c>Fr--,'L e S n x e ❑EDUCATIONAL ❑ INSTITUTIONAL ENGINEER'S NAME f�r 1,4r I,sg n PHONE '9 0-'O Q-c77/ ❑FACTORY ❑ STORAGE ADDRESS Lj O Tz>_�e r ❑ GARAGE ❑MIXED USE CITY ,l r, STATE mT ZIP ©6c>c (Other please specify) TYPE OF INSTALLATIONIWIRING METHOD ��, �,, Anb o-)C SIZE OF MAIN FEEDERS AND RATING OF WIRE USED 2Q u}e 12,V,41 NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS NUMBER OF PANELS REMOTE DISCONNECT REQUIRED? ❑YES ;Ef-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 �J �r• �� d����Q d a 1p n� C.�y NAj, 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. av 102-�r "S- C- ) 0f T. CONTRACTORS LICENSE NO. TYPE STATE SIGNATURE OF APPLICANT DATE