HomeMy WebLinkAbout176 Margaret Drive (3)DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
PERMIT#
Application is hereby: TOWN OF SOUTH WINDSOR
O-BUILDING DEPARTMENT
APPROVED 1540 SULLIVAN AVENUE Bldg.Permit#
v
644-2511 ext. 230
ate Building Inspector
Application must be printed or typed
FEE SCHEDULE Location of 10
7!
0-$1,000=$15.00 Street No. Street Lot No.
Over$1,000=
15.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT CoAj S 7.4-,4/7 R)6,ve1z-
APPLICANT ADDRESS SQ S gcfF-F G <
ll r 6-7. 060P--1
APPLICANT PHONE# F?
ow N s F OWNER
q OWNER ADDRESS 11(o 4i"g 4 L' vet
M OWNER PHONE
C ESTIMATED COST$ 3 0 0 O. — j
V
IS THIS A CONTRACT COST? Yes No
FEE ENCLOSED$ q: --
TYPE OF JOB:
SOR-CO New Installation
Alteration/Addition/Repair
Revised 4/01//2002
APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED.. ' A
BUILDING PERMIT APPLICATION? U YES NO
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 2 Uv SIZE OF MAIN CONDUCTORS c
NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS
NUMBER OF PANELS / REMOTE DISCONNECT REQUIRED? YES '1q—O'
NUMBER OF LIGHT CIRCUITS NUMBER OF POWER CIRCUITS
NUMBER OF SWITCHES 16 NUMBER OF OUTLETS 5 e)
NUMBER OF LIGHT FIXTURES 4:5' NUMBER OF HEAT CIRCUITS
NUMBER OF A/C CIRCUITS ---
SEPARATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED.
DESCRIPTION OF WORK
12- tf lea o--1 rIA
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 G z,6 C47
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT DATE ff—Z 2'_—d
Shirley Wilhelm -CIRS Approval Confirmation: Request No. 238545 Page,1
From: clpsvc@nu.com>
To: WILHEL@SOUTHWINDSOR.ORG>
Date: 1/10/0311:54AM
Subj ct: CRS Approval Confirmation: Request No. 238545
Your approval of the following CRS Request has been successfully processed.
CRS Work Request#:238545
House No:176
Lot No:
Street Name: MARGARET DR
Town Name:SOUTH W INDSOR, CT
Inspector: JOHN COLLINS
Approval Date: Jan 10, 2003