HomeMy WebLinkAbout101 Abbe Road Ext. (21) DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT PERMIT#
Application is hereby: TOWN of SOUTH WINDSOR
BUILDING DEPARTMENT Bldg Permit#
APPROVED 1540 SULLIVAN AVENUE
/ 644-2511 ext. 230
Date Building Inspector Application must be printed or typed
i?oiA 1Zy Pp W LIoiV Location of job
101 Aleor 14,s d y7xre vyoN
Street No. Street Lot No.
FEE SCHEDULE Is T
Floor Apt.No.
$0 - $1,000 - $12.00
Over $1,000
$12.00 per$1,000 OWNER �]yt�►ri O �7ouTH WtNCISy�-
or any fraction thereof Ale
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ADDRESS I SyO 5 �/1� V~ IAle Sou rm �,vd Sores
A,,Al 0(PO 7q /
OWNERS PHONE# loyy- 25-/! C-YT• 21( -Rout 2e.4t•cc.r'
CLIP-A,J /Uc lsw-�
APPLICANT Il tc rn tcr¢1 LUw Tn A G rDnS
�0* N SFq ADDRESS 3,710 iM4jn/ -5 661OLT /xJ CT 06/z0
(� . ..` � � ESTIMATED COST$ /DD(?• 00
10. F"
C - IS THIS A CONTRACT COST? ✓
"i YES N
ICJ FEE ENCLOSED $ N fI Y I'
OR-
Co TYPE OF JOB:
Original Installation
Alteration/Addition/Repair
t
Revised 11/95
APPLICATION FOR ELECTRICAL PERMIT(Continued from reverse side)
TYPE OF BUILDING
IS THIS APPLICATION ASSOCIATED WITH A
RESIDENTIAL BUILDING PERMIT APPLICATION YES / NO
BUSINESS
ASSEMBLY CURRENT USE AND OCCUPANCY
MERCANTILE
EDUCATIONAL FUTURE USE AND OCCUPANCY
INSTITUTIONAL
FACTORY
STORAGE ENGINEER'S NAME PHONE
GARAGE
MIXED USE ADDRESS
CITY STATE ZIP
(Other please specify)
TYPE OF INSTALLATION/WIRING METHOD 4--In 7— THH/✓ . I?�n��-x
SIZE OF MAIN FEEDERS AND RATING OF WIRE USED 49L /Z TN/f/I/ ���►+rX
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 3 NUMBER OF OUTLETS
NUMBER OF LIGHT FIXTURES
NUMBER OF HEAT CIRCUITS NUMBER OF A/C CIRCUITS
SEPERATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED.
DESCRIPTION OF WORK
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( ViyST/4// CZ) OVULT 70Arwo TeC,f-dS TU/` 40ayc-
auT/r r-5 .
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS
TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONN. BUILDING CODES IN THE
PERFORMANCE OF SUCH WORK.
6w. 1034 33 -- E/
NAME STATE LICENSE NO. TYPE SIGNXTUVVF APPLICANT
PHONE NOMd ryy-ZfZZ DATE 6 z6 fu
x'
STATE OF CONNECTICUT
This is to certify that under the provisions of the General Statutes
the following person or firm is licensed or registered.
ELECTRICAL UNLIMITED CONTRACTOR - E1
CLIFFORD L NELSON
51 O ' MELIA RD
BROAD BROOK , CT 06016
LIC./REG. NO. EFFECTIVE EXPIRES
00103633 10 / 01 / 97 9 /30/ 98
SIGNED: