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DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
TOWN OF SOUTH WINDSOR PERMIT#
Application is hereby: BUILDING DEPARTMENT Lr10 b0&2
APPROVED 1540 SULLIVAN AVENUE
Bldg. Permit#
y 644-2511 ext. 230
Date Building Inspector
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$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT gA
APPLICANT ADDRESS 7d r
APPLICANT PHONE#
OW N SFq OWNER Av Lac S-- kpn
OWNER ADDRESS
* E., OWNER PHONE -,�Z l q - CLj l
C ESTIMATED COST$ (/()0O—
►-j U
x, IS THIS A CONTRACT COST? _Yes _No
l� �G FEE ENCLOSED$ i to q
l��sOR. TYPE OF JOB: �CO
_New Installation
_Alteration/Addition/Repair
�e 17Go1(�g
Revised 4/01//2002
I
APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
RESIDENTIAL BUILDING PERMIT APPLICATION? ElYES ❑ NO
❑BUSINESS CURRENT USE AND OCCUPANCY jt ��} Q
❑ASSEMBLY
❑MERCANTILE FUTURE USE AND OCCUPANCY p� aQ
❑ EDUCATIONAL
❑ INSTITUTIONAL
❑FACTORY ENGINEER'S NAME PHONE
❑ STORAGE
❑GARAGE ADDRESS
❑MIXED USE
(Other please specify) CITY STATE ZIP
TYPE OF INSTALLATION/WIRING METHOD_ 1.j 2 C 2D
SIZE OF SERVICE! SIZE OF MAIN CONDUCTORS
NUMBER OF METERS t4 _ 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
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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.
0�03530 E- I
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT DATE
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LAND OF
GEGRGE W. & GERTRUDE A. LEWIS
TOWN OF SOUTH WINDSOR, CONN.
>so.oo' /
d� CERTIFIED SUBSTANTIALLY CORRECT
I BUILDINGS LOCATED AS SHOWN
R�vis�d .Sfr�ef Lime fo conform f'o mcz�
FELT ROAD era2 71
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W in dsor Cl " / //o, Aloe-11 /970 R�wised L.S. 4395
/ y CLASS A-2
o, /q7
PARCEL °B" & °C° TO BE CONVEYED TO EDWARD STEBEN
'I s
IA F
i TOWN CLERK'S OFFICE
LEGE N D:
1 EVERETT 0. GARDIVER & ASSOC.
• = EXISTING IRON PIN ®RAWER No. - +�.........
576 OLD POST ROAD
MAP No. V\-CL- .7 TOLLAND, CONNECTICUT
O = IRON PIN TO BE SET PROFESSIONAL ENGINEERS LAND SURVEYORS
BY E. R.K. SCALE JOB NO. DATE SHEET NO.
M. L.T. 1" 40� 4649 6 - 5 — 79 1 OF I
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4649 �
1700062 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER ELECTRICAL PERMIT
DATE: 03/06/2017
GIS ID:32400249 FEE: 120.00
MUNIS APPLICATION# 201700168 BUILDING DESCRIPTION:
APPLICANT LOCATION
NAME: NEWINGTON ELECTRIC CO.INC. ADDRESS: 249 FELT ROAD
ADDRESS: 72 PANE ROAD OWNER: CHAPPELL ENTERPRISES LLC
NEWINGTON,CT 06111, 100 WYNDEMERE LANE
WINDSOR,CT 06095
DESCRIPTION OF WORK: 3 FAMILY 4 METER SERVICE UPGRADE TO 200 AMP. ADD OWNERS
PANEL IN BASEMENT. RELOCATE BASEMENT LIGHTS TO OWNERS 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
3/6/2017 2:18 PM THE FEE ABOVE INCLUDES A$0.26 PER THOUSAND CT STATE EDUCATION SURCHARGE