HomeMy WebLinkAbout109 Benedict DriveCRS # 232843
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
TOWN O SOUTH WINDSOR
PERMIT#
Applicatio 963BUILDGDEPARTMENTl
APPROVED 1540 SU LIVAN AVENUE
b 2 64 Bldg.Permit#-
2511 ext. 230
Date Bui ng Inspector
Application must be printed or typed
FEE SCHEDULE Location of Job:
109 Benedict Drive
0-$1,000=$13.00 Street No. Street Lot No.
Over$1,000=
13.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
I
APPLICANT Joseph Dumas
APPLICANT ADDRESS 55 Winter St.
Manchester Conn.
APPLICANT PHONE# 646-525 3
OW N Se OWNER John Dougenik
k
q< OWNER ADDRESS 109 Benedict Drive South Windsor Conn.
der' A.# E,, OWNERPHONE 044-4343
ESTIMATED COST$ 5 0 0.0 0
IS THIS A CONTRACT COST? Yes No
FEE ENCLOSED$ 1
SOR. TYPE OF JOB:
IM New Installation
0 Alteration/Addition/Repair Revised 5101
APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
BUILDING PERMIT APPLICATION? YES NO
RESIDENTIAL
BUSINESS CURRENT USE AND OCCUPANCY
ASSEMBLY
MERCANTILE FUTURE USE AND OCCUPANCY
EDUCATIONAL
INSTITLJTIONAL ENGINEER'S NAME PHONE
FACTORY
STORAGE ADDRESS
GARAGE
MIXED USE CITY STATE ZIP
TYPE OF INSTALLATION/WIRING METHOD Temporary Service
SIZE OF SERVICE 10 0a SIZE OF MAIN CONDUCTORS # 2 a1
NUMBER OF METERS 1 NUMBER OF DISCONNECTS AND RATINGS 1-10 Oa
NUMBER OF PANELS 1 REMOTE DISCONNECT REQUIRED? YES LJ'NO
NUMBER OF LIGHT CIRCUITS NUMBER OF POWER CIRCUITS 2—gf i
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
Install temporary service while house addition is
being completed.
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.
E-102888 E-1 Conn.
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT DATE October 2 3, 0 2
Shirley Wilhelm -CRSApjproval Confirmation: Request No. 232843
F
Pa e 1
From: clpsvc@nu.com>
To: WILHEL@SOUTHWINDSOR.ORG>
Date:10/29/02 2:18PM
Subject: CRS Approval Confirmation: Request No. 232843
Your approval of the following CRS Request has been successfully processed.
CRS Work Request#:232843
House No: 109
Lot No:
Street Name: BENEDICT DR
Town Name:SOUTH WINDSOR, CT
Inspector: JOHN COLLINS
Approval Date: Oct 29, 2002