HomeMy WebLinkAbout108 Kelly RoadPERMIT
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT 131
Application is hereby : TOWN OF SOUTH WINDSOR
BUILDING INSPECTION DEPT.
APPROVED DISAPPROVED 1540 SULLIVAN AVENUE
S 644-2511 Ext . 230
ate nspe for Application must be printed or typed
1 . LOCATION OF JOB
d ice
FEE SCHEDULE No . Street
0 - $10000 - 10.00 Floor Apt . No.
Over $1,000 - 10.00
per $1 ,000 or
2 . OWNER YAn Nd4 h'1
fraction thereof
3. ADDRESS koe P N_
4, APPLICANT nlc:- e PLC 14y
5. ADDRESS aril,
u-) ,n, Aso c- 6(o(S7
6. ESTIMATED COST $ <*,Q 0
7 . IS THIS A CONTRACT COST
s No
8. FEE ENCLOSED $
9 . TYPE OF BUILDING:
RESIDENTIAL COMMERCIAL
10. TYPE OF JOB:
Original Installation
Alteration/Addition/Repair
RD 3n 11/88
APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side)
11 . LOCATION OF JOB
0. S R ET APT. NO ,
12 . TYPE OF INSTALLATION e ;), CoO
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 LI
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 :
r r co yl-\
T) n Y
LICENSE NO.SIGNATURE OF APPLICANT DATE
PHONE NUMBER:cj(
INrPECTOR DATE \ou\.1 'Z TIME
LOCATION Al/
INSPECTION: CODE: RESULT(D/A) :
BUILDING:
ELECTRICAL:
PLUMBING:
HVAC:
OTHER:
HOME OCCUPATION FORM
0
Minor__Yl ZEO Approval Date 9(o ASSESSOR'S USE ONLY:
Major PZC Approval Date Home Occupation Type
Expiration Date Code
Name W&OLf)nC,
Address of proposed occupation:_ f Q g Kit I(V M_
Telephone (A 9, 132 q Zone A ?-7
Des 'ption of Occupation:
Pn 12 I-Qr- z 0-0"Cul--It Z-IV r U-W-e-
A. PROPOSED SIGN
Please use the boxes or an attached sheet to provide the following:
1. Attach copy of plot plan if applicable.
2. Use box A (or attach sketch)to draw proposed signage .
3. Use box B (or attach sketch) to draw the floor plan of the home
occupation area.
4. Architectural elevations for any proposed additions or modifications
must be provided.
B. FLOOR PLAN _Bfiement 1st Floor 2nd Floor)
Floor area of dwelling 01,5Z)
Floor area of home occupation i d
of floor area
5
I have read the regulations regarding home occupations and intend to comply with said regulations. I
understand I must notify Planning Department in writing upon termination of this occupation at this
address. Y)Signature of Appli Date 3 goo
Signature of Owne 2dA,4CW,41X-, Date 47//A
White = Assessor Yellow — 4plicant Pink = Street File