HomeMy WebLinkAbout18 Fox Hill RoadDEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT PERMIT#
TOWN OF SOUTH WINDSORAppliereby: CfBUILDINGDEPARTMENT
APPROVED 1540 SULLIVAN AVENUE Bldg.Permit#
644-2511 ext. 230
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Date ing spector
Application must be printed or typed
Location of Job:
FEE SCHEDULE
0-$1,000=$400 Street No. Street Lot No.
Over$1,000=
9 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT
APPLICANT ADDRESS o2 7 w G rt1 er— Dr.
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APPLICANT PHONE# 9 '72 2 '3 Cs [
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OWNER 469 bla -4ss Vj ^ L
OWNER ADDRESS 0
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3
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r' OWNER PHONE
C ESTIMATED COST$
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IS THIS A CONTRACT COST? Yes 0 No
CJ FEE ENCLOSED$_
TYPE OF JOB:
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0 New Installation
0 Alteration/Addition/Repair Revised 8/99
APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
BUILDING PERMIT APPLICATION? YES NO
PgRESIDENTL&L
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 c—.s i C ice G f
SIZE OF SERVICE O o SIZE OF MAIN CONDUCTORS
NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS /
J v2 a O
NUMBER OF PANELS REMOTE DISCONNECT REQUIRED? YES XNO
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.
6 3" 90 Z51 a,'2"
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT DATE 3 '? 7/6
11
ShirleyaWilhelm -CRS Approval Confirmation: Request No. 250009 Page 1
From: clpsvc@nu.com>
To: WILHEL@SOUTHWINDSOR.ORG>
Date: 4/14/03 12:26PM
Subject: CRS Approval Confirmation: Request No. 250009
Your approval of the following CRS Request has been successfully processed.
CRS Work Request#:250009
House No:18
Lot No:
Street Name: FOX HILL RD
Town Name:SOUTH WINDSOR, CT
Inspector:JOHN COLLINS
Approval Date: Apr 14, 2003