HomeMy WebLinkAbout225 Abbe Road (9)DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT P
Application is hereby: TOWN of SOUTH WINDSOR
BUILDING DEPARTMENT Bld&Permit#
PRO 1540 SULLIVAN AVENUE
644-2511 ext.230
Date wilding Inspector Application must be printed or typed
Location of job
A bliv P-0.
Street No. Stleet Lot No.
FEE SCHEDULE
Floor Apt.No.
0 - $1,000 - $12.00
Over $1,000
12.00 per$1,000 OWNER
or any fraction thereof
ADDRESS 5 -,Abb-\j, eD
S0- w1f)63ox CT r)(CO-71/
OWNERS PHONE# l. q4— --s 2 S I
APPLICANT GiroL)x E fec oc"
CN SFq ADDRESS 555 G (a-hcim
00
ESTIMATED COST$ 0C)o ()o
IS THIS A CONTRACT COST?
Vis— NO
FEE ENCLOSED $
OR-Co TYPE OF JOB:
Original Installation
2-', Alteration 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 1 '(Dm eX
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 DS
NUMBER OF LIGHT FIXTURES 10
NUMBER OF HEAT CIRCUITS NUMBER OF A/C CIRCUITS
SEPERATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED.
DESCRIPTION OF WORK
1 C 1 t1s
Sev U C_ C-Vo.-"o,:
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
Fierre. C 1rook 4/,)3YY,
NAME STATE LICENSE NO.(T,YPE/ SIGNATURE OFAPPLICANT
PHONE NO. 7 7 7 7 DATE "0 - /
INSPECTOR C..S DATE QTIME
LOCATION k O-y
3,Y5T-
k:
I INSPECTION: CODE: RESULT(D/A) : a
BUILDING:
ELECTRICAL: Q IT
t PLUMBING:
HVAC:
OTHER:
E
t