HomeMy WebLinkAbout15 Benjamin Way (10) Sectric# I 1AR 41 APPLICATION FOR BUILDING PERMIT
Plumbing# 15 BEN JAM I N WAY
Date:
-7 (e
HVAC #
25362
Sprinkler#
FINAL APPROVALS Estimated Cost U
Building is�9� COMPLETE RED BOXED AREAS Permit Fee $ r�0
Engineering TYPE OR PRINT ONLY Occupancy Fee $
Affidavit SIGN ON REVERSE SIDE
Appr.for CO. Total Fee
TO BULDNC WARTMEW,TOWN OF SOUTH WNDSOR,CT Additional Cost)
The undersigned hereby applies to do work according to the following specifications:
Job Location �3miamlnW Lot No. Side of Street,Zone
Applicant K��� TeL# R6Q(o'- c_ 3:_
Address Zip Lic#
Own r Address
Architect Address
Sq.Ft.New Area: 1st FI. 2nd FI. 3rd FL Total New Area
#Rooms #Lavatories #Bathrooms #Garages
Purpose of this permit: # Gc r CJv1 x (s r(x Tec K
City Water Well ❑ Septic System ❑ Sewer ❑
Ins. H.O. S.P. Cert. Area Basement Garage
Approved by Date Use Group V Construction Type
ReAW 1/97
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 building 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 which tois building and its use is allowed.
Signed �&& - la::�
I hereby apply for a Certificate of Occupancy for the work described in this application for the permit.
Signed -
DO NOT WRITE BELOW THIS LINE
INSPECTION COMMENTS
DEPARTMENT DECISION PERMIT#
APPLICATION FOR ELECTRICAL PERMIT
Application is hereby: TOWN of SOUTH WINDSOR
BUILDING DEPARTMENT Bldg Permit#
APPROVED 1540 SULLIVAN AVENUE
644-2511 ext.230
Date .1huilding Inspector Application must be printed or typed
Location of job
Street No. Street Lot No.
FEE SCHEDULE
Floor Apt.No.
$0 - $1,000 - $12.00
Over $1,000
$12.00 per$1,000 OWNER 127AP�
or any fraction thereof
ADDRESS ele-1011-57
OWNERS PHONE#
APPLICANT
OW SADDRESS 400�
4(
o2
COD ESTIMATED COST$
0 40
IS THIS A CONTRACT COST?
YES NO
FEE ENCLOSED $
ORCO E OF JOB:
Original Installation
Alteration/Addition Repair
Revised 11/95
APPLICATION FOR ELECTRICAL PERMIT(Continued from reverse side)
TYPE OF BUILDING
IS THIS APPLICATION ASSOCIATED TH A
Vl'RESIDENTIAL BUILDING PERMIT APPLICATION / 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
SIZE OF MAIN FEEDERS AND RATING OF WIRE USED
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
SEPERATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED.
DESCRIPTION OF WORK
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS
TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONN.BUIL ING CO E IN THE
PERFORMANCE OF SUCH WORK.
NAME STATE LICENSE NO. TYPE SIGNAlIff OF APPLICANT
PHONE NO. DATE 7/(f