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HomeMy WebLinkAbout102 Deepwood DriveDEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT TOWN OF SOUTH WIlVDSOR PERMIT# Application is hereby: j?0 7 6BUILDINGDEPARTMENT APPROVED 1540 SULLIVAN AVENUE Bldg.Permit# 644-2511 ext. 230 ate Building Inspector Application must be printed or typed FEE SCHEDULE Location of Job: I0z IDectV9 c,v©® 0i;z tQE-1 0-$1,000=$15.00 Street No. Street Lot No. Over$1,000= 15.00 per$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANT APPLICANT ADDRESS I L-y IZ 1 V APPLICANT PHONE# ($—!::?e/0 O 4 ` ? OW N S OWNER v-vle OWNER ADDRESS 0 OWNER PHONE S A VV-\. C ESTIMATED COST$ IS THIS A CONTRACT COST? Yes No FEE ENCLOSED$ /,. . TYPE OF JOB: sOR-CO 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? YESV NO RESIDENTIAL BUSINESS CURRENT USE AND OCCUPANCY ASSEMBLY MERCANTILE FUTURE USE AND OCCUPANCYEDUCATIONAL INSTITUTIONAL FACTORY ENGINEER'S NAME PHONE STORAGE GARAGE ADDRESS MIXED USE CITY STATE ZIP Other please specify) TYPE OF INSTALLATION/WIRING METHOD L'f` 0 ©!'• 'v1.1 SIZE OF SERVICE Z A I e SIZE OF MAIN CONDUCTORS , o CG'Pp 1e 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 P O 0 A-vim,, z:7c-:) 2cn A ,-,,A e r131Z,64 CC477/- 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. 1/0-Yne 6UJn e-e- CONTRACTORS LICENSE NO TYPE STATE SIGNATURE OF APPLICANT DATE l Shirley Wilhelm - CRS Approval Confirmation: Request No. 235649 Page-1 From: clpsvc@nu.com> To: WILHEL@SOUTHWINDSOR.ORG> Dat 12/4/02 11:06AM Subject: CRS Approval Confirmation: Request No. 235649 Your approval of the following CRS Request has been successfully processed. CRS Work Request M 235649 House No: 102 Lot No: Street Name: DEEPWOOD DR Town Name:SOUTH WINDSOR, CT Inspector:JOHN COLLINS Approval Date: Dec 04, 2002