HomeMy WebLinkAbout12 PALMER DR APPLICATION FOR ELECTRICAL PERMIT
DEPARTMENT DECISION TOWN OF SOUTH WINDSOR PERMIT#
Application is hereby: BUILDING DEPARTMENT
APl1jRO 1540 SULLIVAN AVENUE llac7��t#
644-2511 ext. 230 Bldg.Permit#
Date Building Inspector
Application must be printed or typed
FEE SCHEDULE
Location of Job:
$0-$1,000=$15.00 -04,1 01,Q-�
Over$1,000= Street No. Street Lot No.
$15.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT par ;n C A g An o,,
APPLICANT ADDRESS s V:, t j
o li cnCpl C T , O C.O $4
APPLICANT'S PHONE# $6 0 - 090` 9- /6 0 S
OWNER 7n s e Dh 2 ran S,
w N S OWNER ADDRESS /A, P
�� fq< alr-ner Or sov�l. C..)j'f\dJoe. CT_
OWNER PHONE &60- S 3 g- 1 3 S'S
O ' j ESTIMATED COST$ Joao, o o
C
,,.j ► V IS THIS A CONTRACT COST? Yes X No
FEE ENCLOSED$ 1 S
TYPE OF JOB: 3
�SOR•CO� New Installation 2j
_P< Alteration/Addition/Repair
Revised 03/05/10
APPLICATION FOR ELECTRICAL PERMIT(Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
BUILDING PERMIT APPLICATION? ❑ YES 'O-NO
RESIDENTIAL CURRENT USE AND OCCUPANCY
❑ BUSINESS
❑ ASSEMBLY 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
SIZE OF SERVICE_ 90a Any SIZE OF MAIN CONDUCTORS y/d
NUMBERS OF METERS NUMBERS OF DISCONNECTS AND RATINGS "—
NUMBERS OF PANELS ; NUMBERS OF DISCONNECTS REQUIRED? ❑ YES ❑ NO
NUMBERS OF LIGHT CIRCUITS NUMBER OF POWER CIRCUITS
NUMBER OF SWITCHES_0 NUMBER OF OUTLETS 2
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
M I'k.a S� p - JO C O C I t•
THE UNDERSIGNED NEARBY 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 PERFOR-
MANCE OF SUCH WORK
ELC G/ 22og2 - E i
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT DATE
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PROPERTY OF
N'i} . PALV R T"RIVE: SOUTH
Hein; Lot No . Sl) on map en*itled: "Map of Valley View Farms ,
Ellington R3 . 1. South `: indscr, Con•i . Property of 1:mra Palmer t�
Henn.-th Falmer, Scale 1 " 80 ' Nov . 1 , 1960 Hayden L.
Griswold C .E . "
;cafe ] " - 501
HAYDEN L . kIRTSWOU, C .F. ,
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,,UL 0 7 1997
South Windsor
BUILDING DEPARTMENT
TO THE BUILDING DEPT. TOWN GF WWI V44"i—
This Certified that this plan and specifl0atlons aru Ir.,
copies of the proposed building or alterations to br
erected at
�Lt `e...f Y •aer
together with amendments stated in applioatldn at
filed with plan and 1 agree to comply with all 70111n�
Building and state laws and such orders as thall t
issued by the Building Department during pandenr
of this application and final issuanceof a buh6lin.
permit.
Signed
This plan Is approved subject to the Condition orders and and ordinances regulating building slrNll Y.
complied with.
condltionattif Approved These fOW wiffi
e yjnY� MgMt2lm► 7 1 �
Mo. /Z L+
1100135 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER ELECTRICAL PERMIT
DATE: 06/16/11
GIS ID:68400012 FEE: 15.00
MUNIS APPLICATION# 201100591 BUILDING DESCRIPTION:
APPLICANT LOCATION
NAME: CON SERV ADDRESS: '12 PALMER DRIVE
ADDRESS: 45 INDUSTRIAL PARK ROAD _ OWNER: BRETON JOSEPH R JR&KAMILA D
TOLLAND,CT 06084 12 PALMER DR
SOUTH WINDSOR,CT 06074
DESCRIPTION OF WORK: SERVICE CHANGE 100 AMP FUSES TO A 200 AMP WITH A 100 AMP
SUB-PANEL.
SPECIAL CONDITIONS:
ALL WORK TO BE DONE IN ACCORDANCE WITH THE APPLICATION AND PLANS APPROVED BY THE BUILDING DEPARTMENT.
CONSTRUCTION TYPE:
OCCUPANCY GROUP: BUILDING OFFICIAL
6/16/2011 11:15 AM THE FEE ABOVE INCLUDES A$0.26 PER THOUSAND CT STATE EDUCATION SURCHARGE