HomeMy WebLinkAbout25 Blue Ridge Drive (20)DEPARTMENT DECISION
APPLICATION FOR ELECTRICAL PERMIT PER11"1IT#
Application is hereby: TOWN of SOUTH WINDSOR l
BUILDING DEPARTMENT Bldg Permit#APPROVED 1540 SULLIVAN AVENUE Z=JO 644-2511 ext. 230
D g Inspector
Application must be printed or typed
Location ofjob
Street No. treet Lot No.
FEE SCHEDULE
O - $1,000 - $12.00
Floor Apt.No.
Over $1,000
12.00 per$1,00o
OWNERoranyfiactionthereof
ADDRESS t- I i S del
C
l
OWNERS PHONE#_ 1`I C; ) 5--
APPLICANT e, .k—r
0* N ADDRESS q
i a
0 +a ;: ESTIMATED COST$ C,C.)
C ' r•
IS THIS A CONTRACT COST?
YES NO
FEE ENCLOSED $-
dsOR-CO TYPE OF JOB:
Original Installation
Alteration/Addition/Repair
Revised 11195
r.•
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 OCCUPANCYr-
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 f u v e rn v (c i TP--c, C'Stit
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
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.
Ol
NAME STATE LICENSE NO. TYPE fbNATtJRE OF APPLICANT
PHONE NO. 6 -) L)— 2 DATE 62- -- "?
97-10-03 08:47 JOSEPH—MARTINELLI P.1
Ii EUrc
857 Faster stred
South Winch+CT W074
IfDateDC.` 41 6 4-01 5
To whom this will concern:
1 1eP kA 1(ueC on behalf of j Electric Ca, hereby
authorim il t,n%I l' to obtain an electrical--r pCm for
the Ulm jab:
lab nanw; bn, 11t. µA1L'-tl A.)
e ,Oft
p
iUtzh0H-zcd Sign-aturc
Liaer ed 101 671
mot-
date: y
Install (2) electric outlets
TV*M b alb to under the provisions of the a a WANOd+e ftem np person or firm+a 1"Ased or gift
KCAL =LIMIT= MWMACM.
ffivuemboalm LI
f EFFECTIVE
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Post-W Fax Wula 7571 Faro r(%• e 04101471 10/OX/97
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