HomeMy WebLinkAbout117 Bridlewood Road (2)DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT PERMIT#
Application is hereby:TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT Z Y0 Y
IRrrzeerra 1540 SULLIVAN AVENUE Bldg.Permit#
A/wL
644-2511 ext. 230
Date Building Inspector
Application must be printed or typed
Location of Job:
FEE SCHEDULE
7 BRJba0 O 0 3 A-b-
0-$1,000= Street No. Street Lot No.
Over$1,000=
13.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT 16/0tD #y F!E C•b E C?-A-/ C
APPLICANT ADDRESS 3
d CQ Cf (40
APPLICANT PHONE# tea d
OWN S OWNER CJ B C-/l
q OWNER ADDRESS y^ -'- S• 'y 4-e `C
OWNER PHONE 7Sr 5 - a c
C ESTIMATED COST$ 7 ado
IS THIS A CONTRACT COST? des 0 No
CJ FEE ENCLOSED$ l0
TYPE OF JOB:dsOR.Cps w Installation
13 Alteration/Addition/Repair Revised 8/99
APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
RESIDENTIALV,
BUILDING PERMIT APPLICATION?RYES El NO
BUSINESS CURRENT USE AND OCCUPANCY
ASSEMBLY
MERCANTILE FUTURE USE AND OCCUPANCY
EDUCATIONAL
INSTITUTIONAL ENGINEER'S NAME PHONE
FACTORY
STORAGE ADDRESS
GARAGE
MIXED USE CITY STATE ZIP
Other please specify)
TYPE OF INSTALLATION/WIRING METHOD
SIZE OF SERVICE 7 oo 4"'t SIZE OF MAIN CONDUCTORS
NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS
NUMBER OF PANELS REMOTE DISCONNECT REQUIRED? YES M(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
c)/l.< lam S
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.
ate k/ F,-/ C-
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT DATE 8 6
ShirleyWilhelm -CRS Approval Confirmation: Re uest No.232113
From: cipsvc@nu.com>
To: WILHEL@SOUTHWINDSOR.ORG>
Date:12/20/02 4:07PM
Subject: CRS Approval Confirmation: Request No. 232113
Your approval of the following CRS Request has been successfully processed.
CRS Work Request M 232113
House No:117
Lot No: 17
Street Name: BRIDLEWOOD RD
Town Name:SOUTH WINDSOR, CT
Inspector: JOHN COLLINS
Approval Date: Dec 20, 2002