HomeMy WebLinkAbout15 Jean Lane (2)DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT PERMIT#
Application is hereby:TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
1540 SULLIVAN AVENUE Bldg.Permit#
644-2511 ext. 230
c,2 315
Date Building Inspector
Application must be printed or typed
FEE SCHEDULE Location of Job:
0-$1,000=$15.00 Street No. Street Lot No.
Over$1,000=
15.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT US7.v7 4L
APPLICANT ADDRESS SCa S OFF
APPLICANT PHONE# 7 '3 v 2 S
N S OWNER . /Y'L AQ 3 lrl oz-
4 OWNER ADDRESS 15
OWNER PHONE0
C ESTIMATED COST$ 3U 0
IS THIS A CONTRACT COST? Yes <
f FEE ENCLOSED$
TYPE OF JOB:
SOR-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? U-YV-S NO
N 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
SIZE OF SERVICE SIZE OF MAIN CONDUCTORS V16 ,4 r
NUMBER OF METERS / NUMBER OF DISCONNECTS AND RATINGS
NUMBER OF PANELS REMOTE DISCONNECT REQUIRED? YES U'T TO
NUMBER OF LIGHT CIRCUITS Z— NUMBER OF POWER CIRCUITS
NUMBER OF SWITCHES !0 NUMBER OF OUTLETS —' d
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
edo 4C I J I
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.
IF3 6 Z16 C-- / C7
CONTRACTORS LICENSE NO. TYPE STATE
DATE S USIGNATUREOFAPPLICANT G
Shirley Wilhelm -CRS Approval Confirmation. Request No. 249783 Pa a 1`
From: clpsvc@nu.com>
To: WILHEL@SOUTHWINDSOR.ORG>
Date: 4/1/03 4:11 PM
Subj ct: CRS Approval Confirmation: Request No. 249783
Your approval of the following CRS Request has been successfully processed.
CRS Work Request M 249783
House No: 15
Lot No: 139
Street Name: JEAN LN
Town Name:SOUTH WINDSOR, CT
Inspector:JOHN COLLINS
Approval Date: Apr 01, 2003