HomeMy WebLinkAbout115 HAYES RD DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
PERMIT#
Applic �s ereby� TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT l'
APPRO 1540 SULLIVAN AVENUE Bldg. Permit#
15,3-0q 644-2511 ext. 230
Date wilding lnspcctor
Application must be printed or typed
FEE SCHEDULE Location of Job:
$0-$1,000=$15.00 Street No. Street Lot No.
Over$1,000=
$15.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT ��le/J)' C/
APPLICANT ADDRESS S �� ✓'/.� IY ,P vtJ .F' Fi _ �'�
_75-. h�
APPLICANT PHONE# ��•� " ���5`��
O W N 8 f OWNER
q� OWNER ADDRESS
OWNER PHONE
C ESTIMATED COST$ PnOa- aT A
r
IS THIS A CONTRACT COST? _No
e (� FEE ENCLOSED$ c?�
TYPE OF JOB:
SOR-CO New Installation
Alteration/Addition/Repair
APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
BUILDING PERMIT APPLICATION? ❑YES ❑NO
❑RESIDENTIAL
❑BUSINESS CURRENT USE AND OCCUPANCY
❑ASSEMBLY
❑MERCANTILE FUTURE USE AND OCCUPANCY
❑EDUCATIONAL
❑INSTITUTIONAL
❑FACTORY ENGINEER'S NAME PHONE
❑ STORAGE
❑GARAGE ADDRESS
❑MIXED USE
CITY STATE ZIP
(Other please specify)
TYPE OF INSTALLATION/WIRING METHOD
SIZE OF SERVICE /j7U,,q 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
/O-F WORK l
fA L� .S�i!/ l�lam'f� �L O✓✓/y
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 NO. -aTYPE STATE /
SIGNATURE OF APPLICANT DATE 40,
l�
LOT # 64
HAYES ROAD
SOUTH WINDSOR , CONN
3 -
THERE ARE NFO, V4,0LAT!0Ai Or 0 L'
.a
THE LAW$ or Twe T011a or � �1
SOUTH .'INDSOR h
o
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LVT AREA Z 00 S'p p '� �•
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RAVES ROAD
MAP REFERENCE
GRAHAM ESTATES SECTICH I .
FROPErTY OP MURRY HOMES INC.
HAYES AND NEVERS ROADS SOUTH WINDSOR FLCT PLAN
CONN . SCALE IM=40" Jt�LV IQ56 POR
M.S. FINE C. E. 7.7-56 REVISED ) MEDALLION HOMES INC.
SOUTH Vi INDSOR , CGNN
,�CSN I HEREBY CERTIFY ^e
vO�RT tite THIS PLAN TO BE
r ENGINEERING AND LAND SURVEYING
c SUBSTANTIALLY
CORRECT; 740 NO. MAIN STREET. CROSSROADS PLAZA
WEST HARTFORD 7. CONNECTICUT
1 NO. S73&
SCALE DATLr REVISED D
�..= I "=40" ;/I IA
E3-715
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