HomeMy WebLinkAbout111 McGrath RoadDEP:MENT DECISION APPLICATION FOR ELECTRICAL PERMIT PERMIT#
ation is hereby:TOWN OF SOUTH WINDSOR zRo 3BUILDINGDEPARTMENT
PRO D 1540 SULLIVAN AVENUE Bldg.Permit#
644-2511 ext. 230
Building Inspector
Application must be printed or typed
FEE SCHEDULE Location of Job:
1 Ne-C9AAT9
0-$1,000=$15.00 Street No. Street Lot No.
Over$1,000=
15.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT r1 I i i A sit i l e. fjo G-K- c--
APPLICANT ADDRESS 13L 1E U i
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APPLICANT PHONE#
NOW OWNER 4,/ 1;11 1SFq OWNER ADDRESS I I CC4.&r—;L
OWNER PHONE
C ESTIMATED COST$ QQQ
IS THIS A CONTRACT COST? Yes No
FEE ENCLOSED$ 7J" `
TYPE OF JOB:
OR C 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? YES NO
SIDENTIAL
BUSINESS CURRENT USE AND OCCUPANCY L i
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 2 —Sec)
SIZE OF SERVICE SIZE OF MAIN CONDUCTORS
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
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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. STATE
SIGNATURE OF APPLICANT DATE
Shirle Wilhelm -CRS A royal Confirmation: Re uest No. 229466
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ae
From: clpsvc@nu.com>
To: WILHEL@SOUTHWINDSOR.ORG>
Date:11/4/02 12:14PM
Subj ct: CRS Approval Confirmation: Request No. 229466
Your approval of the following CRS Request has been successfully processed.
CRS Work Request M 229466
House No: 111
Lot No:
Street Name: MCGRATH RD
Town Name:SOUTH WINDSOR, CT
Inspector:JOHN COLLINS
Approval Date: Nov 04, 2002