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Shirle yWilhelm -CRS Approval Confirmation: Request No.302126 Page 1
From: <clpsvc@nu.com>
To: <WILHEL@SOUTHWINDSOR.ORG>
Date: 11/6/03 3:58PM
Subject: CRS Approval Confirmation: Request No. 302126
Your approval of the following CRS Request has been successfully processed.
CRS Work Request#: 302126
House No: 14
Lot No:
Street Name: ' PAM LN
Town Name: SOUTH WINDSOR, CT
Inspector: CHRISTOPHER DOUGAN
Approval Date: Nov 06, 2003
CRS # 302126
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
TOWN OF SOUTH WINDSOR PERMIT#
A=APPROV
'
BUILDING DEPARTMENT
1540 SULLIVAN AVENUE
Bldg.Permit#
644-2511 ext. 230
Date Building In. for
Application must be printed or typed
FEE SCHEDULE Location of Job:
14 Pam Lane
$0-$1,000=$15.00 Street No. Street Lot No.
Over$1,000=
$15.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT Joseph Dumas
APPLICANT ADDRESS 55 Winter St.
kanchester Conn.
APPLICANT PHONE# 646-5253
0W N SC.q OWNER Paul Beaulieu
OWNER ADDRESS 14 Pam Lane
South Windsor Conn.
OWNER PHONE 644-8508
ESTIMATED COST$ 525. 00
x IS THIS A CONTRACT COST? _Yes X No
FEE ENCLOSED$ 15. 00
O�� TYPE OF JOB:
O R C New Installation
x 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 ❑NO
❑RESIDENTIAL
❑BUSINESS CURRENT USE AND OCCUPANCY Residential
❑ASSEMBLY
❑MERCANTILE FU.I.URE 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 10 0 a SIZE OF MAIN CONDUCTORS # 2 a l
NUMBER OF METERS 1 NUMBER OF DISCONNECTS AND RATINGS 1-100a
NUMBER OF PANELS 1 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
Installed new meterbox and outside service cable and also
upgraded grounding system
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.
E-102888 E-1 Conn.
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT ,� `� DATE ) Oct. 3 0, 0 3