HomeMy WebLinkAbout212 Abbe Road (3)DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
TOWN OF SOUTH WINDSOR
PERMIT#
Application is hereby:
BUILDING DEPARTMENT
APPROV 1540 SULLIVAN AVENUE Bldg.Permit#
644-2511 ext. 230 07c,
ate Building Inspector
Application must be printed or typed
Location of Job:
FEE SCHEDULE
FTenannt0-$1,000=$13.00 Street Lot No.
Over$1,000$
13.00 per$1,000
or any fraction thereof nation Apt.No.
APPLICANT 51—U R. Vhtj G c V V
APPLICANT ADDRESS aIZ. ZG-
APPLICANT PHONE# g " Ll 5 u.
W N S F,q
OWNER S-r 0 b#J }-11 ti•A G ty t`wJ
OWNER ADDRESS Qox C--t
OE"" OWNER PHONE S f-Mty Pt3 Ahcy L-
C ESTIMATED COST$ k i Utl O •a
1 U
IS THIS A CONTRACT COST? 0 Yes RLNo
1
FEE ENCLOSED$ /3. ab
SOR•C
TYPE OF JOB:
0 Original Installation
KAlteration/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
A RESIDENTIAL
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 MAIN FEEDERS AND RATING OF WIRE USED
NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS
NUMBER OF PANELS 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—
T
NUMBER OF A/C CIRCUITS
SEPARATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED.
DESCRIPTION OF WORK
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.
7 nM e 0(10/1 Pl"
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT DATE 4.1n1 y aea
o n o ins-CRS Approvalon Irma i"o"n Iequesit-No. 17 Y9-fg age
Fr m: clpsvc@nu.com>
To: COLLIN@SOUTHWINDSOR.ORG>
Date: 5/8/01 8:31 AM
Subject: CRS Approval Confirmation: Request No. 173918
CRS Work Request#: 173918
House No:212
Lot No:
Street Name:
Inspector:JOHN COLLINS
Approval Date: May 08, 2001