HomeMy WebLinkAbout275 Diane DriveDEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
TOWN OF SOUTH WINDSOR
PERMIT#
Application is hereby:BUILDING DEPARTMENT
APPROVED 1540 SULLIVAN AVENUE Bldg.Permit#
7 fC UL UdG2.
644-2511 ext. 230
Date Building Inspector
Application must be printed or typed
FEE SCHEDULE Location of Job:
V
0-$1,000=$15.00 S eet No. Street Lot No.
Over$1,000=
15.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT M-h-1 Yl L2, /,IC l e c4-1 C
APPLICANT ADDRESS
CIOVA , 4 16-L C r
APPLICANT PHONE# 6 0
OWN S OWNER J tn4 —
OWNER ADD S
O
b--41-
OWNERPHONE
VESTIMATED COST$
IS THIS A CONTRACT COST? Yes /No
FEE ENCLOSED$ 5 ,
1 TYPE OF JOB:
OR C New Installation
Alteration/Addition/Repair
Revised 4/01//2002
APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
BUILDING PERMIT APPLICATION? YES O
RESIDENTIAL
USINESS CURRENT USE AND OCCUPANCY
ASSEMBLY
MERCANTILE FUTURE USE AND OCCUPANCYEDUCATIONAL
INSTITUTIONAL
FACTORY ENGINEER'S NAME PHONE
STORAGE
GARAGE ADDRESS
MIXED USE
CITY STATE ZIP
Other please specify)
TYPE OF MSTALLATION/WIRING METHOD cAle
SIZE OF SERVICE SIZE OF MAIN CONDUCTORS
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
SEPARATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED.
DESCRIPTION OF WORK
04 A-,L
G'
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.
CONTRACTORS LICENSE O. T STATE
SIGNATURE OF APPLIC T DATE /0__
Shirley Wilhelm -CRS Approval Confirmation: Request No. 220955 Page 1
From: clpsvc@nu.com>
To: WILHEL@SOUTHWINDSOR.ORG>
Date: 8/28/02 2:13PM
Subj ct: CRS Approval Confirmation: Request No. 220955
Your approval of the following CRS Request has been successfully processed.
CRS Work Request M 220955
House No:275
Lot No:
Street Name: DIANE DR
Town Name:SOUTH WINDSOR, CT
Inspector: JOHN COLLINS
Approval Date: Aug 28, 2002