HomeMy WebLinkAbout215 Abbe Road (9)DEPARTMENT DECISION PERMIT#
APPLICATION FOR ELECTRICAL PERMIT
Application is hereby: TOWN of SOUTH WINDSOR
BUILDING DEPARTMENT Bldg P rinnit#
PRO 1540 SULLIVAN AVENUE
V7, 644-2511 ext.230
411419:--A) A
Date ceding Inspector Application must be printed or typed
Location ofjob
Z/6 A e/3 C--
Street No. Street Lot No.
FEE SCHEDULE
Floor Apt.No.
0 - $1,000 - $12.00
Over $1,000
12.00 per$1,000 OWNER M A R-17 A.#
or any fraction thereof
ADDRESS
lt7
OWNERS PHONE# 6z4 L4 g 7 140
APPLICANT
N S ADDRESS
ESTIMATED COST$-
IS THIS A CONTRACT COST?
YES NO-
FEE ENCLOSED $
OR- 0 TYPE OF JOB:
OTigjpA Installation
DC (,A*-rati-o3 Addition Repair
Revised 11/95
APPLICATION FOR ELECTRICAL PERMIT(Continued from reverse side)
TYPE OF BUILDING
IS THIS APPLICATION ASSOCIATED WITH A
RESIDENTIAL BUILDING PERMIT APPLICATION YES / NO
BUSINESS
ASSEMBLY CURRENT USE AND OCCUPANCY
MERCANTILE
EDUCATIONAL FUTURE USE AND OCCUPANCY
INSTITUTIONAL
FACTORY
STORAGE ENGINEER'S NAME PHONE
GARAGE
MIXED USE ADDRESS
CITY STATE ZIP
Other please specify)
TYPE OF INSTALLATION/WIRING METHOD TVC C ,'00,,,.T'S W /V'M(3 bus iacr
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 NUMBER OF A/C CIRCUITS
SEPERATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED.
DESCRIPTION OF WORK
W e-.e nl S Cyr - I r%R L'c.c.Je v5o2 I C!e Y s.5o2
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS
TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONN. BUILDING CODES IN THE
PERFORMANCE OF SUCH WORK.
f 2-6/3'7- 6 1
NAME STATE LICENSE NO. TYPE SIGNA OF APPLIC
PHONE NO.2-7?j`37-:ZS DATE `I
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