HomeMy WebLinkAbout143 Robert Drive (2)FINAL INP CT19N
Building APPLICATION FOR BUILDING PERMIT
Plumbing
HVAC 143 ROBERT DRIVE Date:
Sprinkler
Electric Estimated Cost $ l
Zoning Permit Fee $ zc'
Affidavit NO.21854 Occupancy Fee $
Eng. Dept.
Fire Dept.COMPLETE RED BOXED AREAS.Total Fee $ zy
Health Dept. TYPE OR PRINT ONLY
Approved for CO: SIGN ON REVERSE SIDE. Additional Cost) $
TO BUILDING DEPARTMENT, TOWN OF SOUTH WINDSOR, CT
The undersigned, hereby applies to do work according to the following specifications:
Job Location Lot No. Side of Street R Zone
Applicant'4-'D a4, /R b 7 60 T14-.41 k a Tel. # 611¢l*¢3
Address e y to C 6 "-r t_-) 0, , j 'O eYWP 5'0 4q d T Zip a 7 S` Lic.#
STREET CITY STATE
Owner,F.p 1--CJ s-of ft)k I-_Address Y Z (9
Architect Address
Size New Area: Ft. Front Overall Ft. Deep Overall Total Area Garages
Size of Lot Dist. from Street Line LavatoriesBathrooms Rooms 1 st 2nd 3rd
Purpose of this Permit S h 4 5' - 10 4_/1_ ,o
F T ?
City Water 0 Well fad' Septic 0 Sewer O
Use Grou Construction Type nl l)
Approved by Date BD1A 11/88
I h reby agree to conform to all the requirements of the Laws of the State of Connecticut and th Ordinances of th 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 a zone in which this building and its use is allow d.
Signezt`C
I hereby apply for a Certificate of Occupancy for the work described in this application for permit.
Signed
DO NOT WRITE BELOW THIS LINE—
INSPECTION RECORD
Footing Framing
Foundation Fireplace/Chimney Insulation
Plumbing Permit# Inspections:
HVAC Permit# Inspections:
Electrical Permit# Inspections:
Sprinkler Permit#Inspections:
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT PERNTIT#
416) 7
Application is hereby: TOWN of SOUTH WINDSOR
BUILDING DEPARTMENT Bldg Permit#
APPROVED 1540 SULLIVAN AVENUE
10114W?- JoCQ- 644-2511 ext.230
Date- Building Inspector
Application must be printed or typed
Location of job
Rz5aERr
Street No. Street Lot No.
FEE SCHEDULE
Floor Apt.No.
0 - $1,000 - $12.00
Over $1,000
12.00 per$1,000 OWNER Mg ZE&w1 1?D 6Z-Z.-4AfA 0oranyfractionthereof
ADDRESS /4/3 /Ta 4 ea 4- Di-ei t/i-F
OWNERS PHONE#_
APPLICANT D
7—
S
0* N ADDRESS C li J!E
4(
M 11'Al C/i C,S ro!5 R C
ESTIMATED COST$
C M1 '`
0
IS THIS A CONTRACT COST?
YES NO
FEE ENCLOSED $ 0
OR.CO TYPE OF JOB:
ginal Installation
L/Alteration/Addition Repair
Revised 11/95
APPLICATION FOR ELECTRICAL PERMIT(Continued from rcvcrse side)
TYPE OF BUILDING
IS THIS APPLICATION ASSOCIATED WITH A27RESIDENTIALBUILDINGPERMITAPPLICATIONYES / NO
BUSINESS
ASSEMBLY CURRENT USE AND OCCUPANCY ' r_j,den
MERCANTILE
EDUCATIONAL FUTURE USE AND OCCUPANCY
INSTITUTIONAL
FACTORY
STORAGE ENGINEER'S NAME PHONE
GARAGE
MIXED USE ADDRESS
CITY STATE ZIP
Other please spccify)
TYPE OF INSTALLATION/WIRING METHOD
SIZE OF MAIN FEEDERS AND RATING OF WIRE USEDX
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
60 191n Fe v loa Anp /3r ir ee kew cx7i-+i /e
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.
L./ - /D-?d/-? 0 el
NAME STATE LICENSE NO. TYPE S16RATLItS OF APPLICANT
PHONE NO. 6 VT5-?f o DATE 161) ZG
s
1
INSPECTOR Di iTE !TIME
LOCATION
INSPECTION: CODE: RESULT(D/A) :
BUILDING:
ELECTRICAL:
PLUMBING:
f
HVAC:
k,
OTHER:
4
F
e