HomeMy WebLinkAbout115 HAYES RDDEPARTMENT 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 OCCUPANCYEDUCATIONAL
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
lfAL .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. CONNECTICUT1NO. S73&
SCALE DATLr REVISED D
I "=40" I IA E3-715
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