HomeMy WebLinkAbout15 Ahern Drive (9)DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT PERMIT#
Application is hereby:TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
APPROVED 1540 SULLIVAN AVENUE Bldg.Permit#
I , 4/,X-644-2511 ext. 230 NA
Date Building Inspector
Application must be printed or typed
Location of Job:
FEE SCHEDULE y nnrYANCh-n0 N
0-$1,000=$13.00 Street No. Street Lot No.
Over$1,000=
13.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT t e- c 6 f le- C Vt 1'
APPLICANT ADDRESS l v --tl
1ze/A-" l 0 0-
APPLICANT PHONE# C- 02 '7 /
SOWN SFq N
OWNER it o jgc SNry
OWNER ADDRESS erns D V N
OWNER PHONE Lc-, Ll`c— `,
C ESTIMATED COST$ 5G
r IS THIS A CONTRACT COST? es
FEE ENCLOSED$
SOR Co
TYPE OF JOB:
0 New Installation
E3 Alteration/Additio air Revised 8/99
APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
iv SIDENTIAL
BUILDING PERMIT APPLICATION? YES NO
BUSINESS CURRENT USE AND OCCUPANCY VfS
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 LJ Se u C U
SIZE OF SERVICE 1O0• A-,P SIZE OF MAIN CONDUCTORS AV
NUMBER OF METERS ( NUMBER OF DISCONNECTS AND RATINGS
NUMBER OF PANELS 1 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
Lo 9 e 2 iA w
C)u w
6 XJ
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. TYPESTATE
q
SIGNATURE OF APPLICANT r DATE
f`•.•:.A+ •3y :rA`'n , _ :lr:-S,-`Ai?.. r'-'K j.`,/Ei^au'I'-'k- -
INSPECTOR U G S DATE l ( TIME AM
LOCATION
INSPECTION: CODE: RESULT(D/A) :
BUILDING:
ELECTRICAL:
PLUMBING:
1
HVAC:
OTHER:
i Iu CC,/
6
i