HomeMy WebLinkAbout112 Overlook Road PERMIT #
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
Application is hereby: TOWN OF SOUTH WINDSOR
APPROVED DISAPPROVED BUILDING INSPECTION DEPT.
644-2511 Ext . 230
Application must be printed or typed .
Date Bu lding Inspector
1. LOCATION OF JOB
y
FEE SCHEDULE No . Street
$ 0 - $19000 - $10.00 Floor Apt . No.
Over $1 ,000 - $10.00 2 . OWNER��/-"t''� ���
per $1 ,000 or
fraction thereof
3. ADDRESS jQ�/j/Z L j0>�L
4 . APPLICANT 4,z
5 . ADDRESS f�- /' Z?!fg �y
051. kz
6 . ESTIMATED COST $
7 . IS THIS A CONTRACT COST
Yes No
8 . FEE ENCLOSED $ G -
9. TYPE OF BUILDING :
RESIDENTIAL COMMERCIAL
10 . TYPE OF JOB :
Original Installation
alteration/Addition/Repair
e BD 3A 11/88
APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side)
11 . LOCATION OF JOB f l/2- Ci(/sf�SLOC;
NO . STREET APT. NO
12 . TYPE OF INSTALLATION
13 . SIZE OF MAIN FEEDER
14 . NO. OF LIGHT LOOPS 15 . NO. OF HEAT LOOPS
16. NO. OF POWER LOOPS 17 . NO. OF LIGHT OUTLETS
18 . NO. OF HEAT CIRCUITS 19 . NO. OF POWER OUTLETS
20. NO. OF CONVENIENCE OUTLETS 21. NO. OF HEAT CIRCUITS
22 . NO. OF POWER CIRCUITS 23. NO. OF LIGHT CIRCUITS
24. SIZE OF HEAT CIRCUITS �? • 25 . NO. OF MOTORS
26 . NO. OF PANELS 27 . TOTAL WATTAGE
28 . NO. OF POWER FEEDERS / 29 . NO. OF SWITCHES
30. A/C LOAD 31. SIZE OF POWER FEEDERS
32 . NO. OF FIXTURES 33. TOTAL HORSEPOWER
34 . NAME OF SUBCONTRACTORS AND THEIR TRADES
35 . REMARKS AND FURTHER DETAILS :
LICENSE NO. , SIGNATURE OF APPLICANT D TE
PHONE NUMBER:
Electric# APPLICATION FOR BUILDING PERMIT
Plumbing# 112 OVERLOOK ROAD
HVAC # 23481
Date: L
Sprinkler# No.
FINAL PP V Estimated Cost $/fu-U
Building/ 9� �! COMP LETE RED BOXED AREAS Permit Fee $
Engineers g _ 11 TYPE OR PRINT ONLY Occupancy Fee $
Affidavit SIGN ON REVERSE SIDE
Appr.for CO. Total Fee $ d
TO BUILDING DEPARTMENT, TOWN OF SOUTH WINDSOR,CT (Additional Cost) $
Th undersigned h reby applies to do work according to the following specifications:
Job Location ! 1�Z d V P if L-.0.6 le- 12 D Lot No. Side of Street Zone
Applicant /,--P_ e L? Tel. # C< y
Address I ( `L v-y e Zia2!'d ? Lic. #
Own r ,0 J�-7 , �� L7 d I Z Address
Architect Address
Sq. Ft.N w Area: 1st FI. 2nd FI. 3rd FI. Total New Area
#Rooms #Lavatories #Bathrooms --z— #Garages
Purpose of this permit: !v P C /
%u_T qj< City Water Lr--' Well Septic System ❑ Sewer J
Use Group LJLft Construction Typ Area / Bas m t Garage
Approved by jxx Date
Reveal 6/95
I hereby agree to conform to all the requirements of the Laws of the State of Connecticut and the Ordinances of the Town of
South Windsor and to notify the Building Inspector of any alteration in the plans or specifications of the Building for which this
permit is asked, and agree that this budding is to be located the proper distance from all street lines,side yard lines and required
distances from all other zones and is located in a on which this building and its use is allowed
Signed
I hereby apply for a Certificate of Occupancy fo the work described in this application for the permit
Signed
-- DO NOT WRITE BELOW THIS LINE --
INSPECTION COMMENTS
- DEPARTMENT DECISION Ply
APPLICATION FOR ELECTRICAL PERMIT
E
Application is hereby: TOWN of SOUTH WINDSOR
BUILDING DEPARTMENT Bldg Permit#
APPROVED 1540 SULLIVAN AVENUE
644-2511 ext. 230
Date Building Inspector Application must be printed or typed
Location of job
1 I C2 v.a Las X d d
Street No. Street Lot No.
FEE SCHEDULE
Floor Apt.No.
$0 - $1,000 - $12.00
Over $1,000
$12.00 r$1,000
OWNER /-n/��, ! A40 dda
or any fraction thereof
ADDRESS J O L!'2 Q/d a Igo N
cI
OWNERS PHONE# G 0
APPLICANT 1/e t,e E1J e Ar k
OW p S� ADDRESS -? / t.�/ c m d d lG i P �
x \
' �wr �� C,� 40#K
ESTIMATED COST$
IS THIS A CONTRACT COST? _ I�
a YES NO
C► FEE ENCLOSED $ .
�SOR�C0� TYPE OF JOB:
Original Installation
X—Alteration/Addition/Repair
Revised 11/95
APPLICATION FOR ELECTRICAL PERMIT(Continued from rcvcrse side)
ITYPE011'BUILDING
f IS THIS APPLICATION ASSOCIATED WITH A
V RESIDENTIAL BUILDING PERMIT APPLICATION YES / NO
BUSINESS
ASSEMBLY CURRENT USE AND OCCUPANCY
MERCANTILE
EDUCATIONAL FUTURE USE AND OCCUPANCY
INSTITUTIONAL
FACTORY
STORAGE ENGINEER'S NAME PHONE
GARAGE
MIXED USE ADDRESS
CITY STATE ZIP
(Other please specify)
TYPE OF INSTALLATION/WIRING METHOD P V C
SIZE OF MAIN FEEDERS AND RATING OF WIRE USED xJ
NUMBER OF METERS I 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
SEPERATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED.
DESCRIPTION OF WORK
F-rue ✓'%ki G �)C f ,r i r' w is l�► 11 S� R Y o�C t= A 4 G� ��I l/1 A''hi�.
N t 1 o e A S f 2 v d f r ��r{is G�: G. !'�P�o,�/k.��.�._�,^`�4l
X% 1,I i Q (y C/ R Gv a /J . Tli I' d
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS
TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONN.BUILDING CODES IN THE
PERFORMANCE OF SUCH WORK.
NAME STATE LICENSE NO. TYPE SIGNATURE OF APPLICANT
PHONE NO. _C3 QL. DATE
f X i 34
INSPECTOR D1 4 fj �G1 TIME-4
LOCATION Z12
INSPECTION: CODE: RESULT(D/A) :
BUILDING:
4
4` ELECTRICAL:
4t
PLUMBING: f
HVAC• ,
J
OTHER:
k
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