HomeMy WebLinkAbout25 Green Lane (3)DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
TOWN OF SOUTH WINDSOR
PERMIT#
Application is hereby: 3BUILDINGDEPARTMENT
APPROVED 1540 SULLIVAN AVENUE Bldg.Permit#
D
644-2511 ext. 230 02 3 o2 7
Date Building Inspector
Application must be printed or typed
Location of Job:
FFEESCHEDULE Z, c."iso0
1,000=$1-3-80 Street No. Street Lot No.
Over$1,000=
13.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT G1!k ef A A10 e:e
APPLICANT ADDRESS "?f Z o--0
APPLICANT PHONE#
N S OWNER Z)0—
OWNER ADDRESS D /tea
C,07 40 71
OWNER PHONE f&D 6 3
OESTIMATED COST$ d OOD-
r
IS THIS A CONTRACT COST? qrYes E3 No
CJ FEE ENCLOSED$ f O•o
OR-Co
TYPE OF JOB:
S
PkOriginal Installation
O Alteration/Addition/Repair Revised 8/99
i
APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
BUILDING PERMIT APPLICATION?O•YES NO14ESIDENTIAL
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 V fr-c eP
SIZE OF MAIN FEEDERS AND RATING OF WIRE USED (?/ ffffW 2-
NUMBER OF METERS t NUMBER OF DISCONNECTS AND RATINGS z 20 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
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 Z Y?-z- l
CONTRACTORS LICENSE NO. TYPE STATE:Z /;7,
SIGNATURE OF APPLICANT DATE OXA '
Shirle Wilhelm -CRS A royal Confirmation: Request No. 251308
From: clpsvc@nu.com>
To: WILHEL@SOUTHWINDSOR.ORG>
Date: 5/21/0312:47PM
Subject: CRS Approval Confirmation: Request No. 251308
Your approval of the following CRS Request has been successfully processed.
CRS Work Request#:251308
House No:25
Lot No: 3
Street Name: GREEN LN
Town Name: SOUTH WINDSOR, CT
Inspector: JOHN COLLINS
Approval Date: May 21, 2003