HomeMy WebLinkAbout176 Jacques LaneS7.Pts_ •.S`.SJ.C' M - Y r- ._SG,w YW...vL.YisYs:i.._.3:-'y•s{S.W:."S.i&
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i?tR Y 4i s..i OSMS. YM `.T...81 3 TO THE
BUMMING INSPEMIR cE dhe APPLICATION
FOR yfOWN CXNM PLAN
EXAMINATION AND OF « BUILDING PERMIT _s 114PORTAHT— Applicant to
complete all items in sections: li I1, 111, IV, aid IX_ 0 I. AT (LOCATION)
LOCATION TNa.) ISTnt[
T)OF BE'TWEEk_
r' fia.r L _ ANC a 'BUILDING lcw TR[
fiTl t ,.-` fatosaTR[[Ti1., Q J k4c,YrJb
LOf f 3• d 1 v SUBDIVISION LOT BLOCKSlssII. TYPE AND
COST OF BUILDING — All applicants complete Parts A — D A. TYPE OF
IMPROVEMENT D. PROPOSED USE — For"Wrecking' most recent use t 7,diflow(
If
buildingRes Hel2
A residential. enterrnromber12Onefeiwilycfopeu,
housing units added, r/ cry, 4Jlrt reed ewe!13we or
more fermi — Enter tit i t Part.D, )3) h v !!R Wove wsawber ofwrits——— —
LJ-10. 20
r.
I OWGI 3 Alteration (See2above) f.14 Trons;om
hotel,metal, 2T Pifii 4 Repair, replacementordormitory — Enter mmb eer l repair5
Wrecking(1/multi/amil y residential, ofunits——————— — i Sevv a sMiert. p Nr g ereg enternumberof
units to building in 1$ Gerago 23 Hospital,lostitutional Part D.- 13)
16 Carport 24
Office,bonli;professional 6 M ving (relocation) 7 Foundation only
17 Other — Specify
25 Public utility 26 School, library,
ether educational B. OWNERSHIP 27
Stores,morcenti I*8V Privet (individual,
corporation, 213 Tonks,,tewe s:nenpr fit institution,
etc.) 29 Other — Specify 9 ( Public(F
derel, State, or 1 c 1
gov rnment) 14 C. COST Omit
cents) Nonresidential — Describe In defeil proposed use of buildings,o.g..,food processing plant,machine
shop,laundry building of hospital,elementary,10. C st
of improvement...............school,secondary school,college, porochial school, parking gereg for,department store,rental
office building,office building at industrial plant.T be installedbutnotincludedIfuseofexistingbuildingisbeingchanged,enter proposed use. 4 :in the above
cost a. Electrical...................... y
s.b. PluAing.......................t..
r,..p...
q.x.r.wro.w osum c.H sting,
air conditioning.........d.Other(elevator,
ate.)............11. TOTAL COST
OF IMPROVEMENT r III. SELECTED
CHARACTERISTICS
OFILTILDING — For new buildings and additions, complete Ports E — L;for wrecking, complete
only Part J, for all others skip to IV.E. PRINCIPAL TYPE
OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS 413. Number of
stories................30 L JMsorry(well bearing) 40 Public or private eompony 4,q, Total
squarefeet of floor area.31 W dframe41Private(septic tank, etc.)all floors,based of exterior G Sf uefW01 steeldimensions ....................33 Reinforced concrete
H. TYPE OF WATER SUPPLY 34 Other — Specify
42 Public or private compony 50• Total land area, se.it............43 Private(well,
cistern) K. NUMBER OF OFF-STREET PARKING SPACES - -F.
PRINCIPAL TYPE
OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed.......................Will
there be
control air 52. Outdoors........................Za conditioning?L. RESIDENTIAL BUILDINGS
ONLY 37[D Electricity44
Y s 45 N 53. Number of bedrooms..............3e C:] Cool
39 Other—Specify
Will there be on elovetor? Full..........54. Number ei
46 Yes a
bethroome kw I Partial........
AIV, IDENTIFICATION — To be comp) t d by all applicants
Nam Meiling address — Number. street, city. and State ZIP c dam, T I. N
1.
Owner iY\_
or
Lessee,,-;§
r •_ -I
2.
Contrec• r
3.
Architect or
Engine
The wner f this building and the undersigned agree to conform to all applicable laws of this jurisdiction. z ;
Signati6re f applicant Address Applic tion that
DO NOT WRITE BELOW THIS LINE
V. PLAN R EVI EW RECORD — For office use
Pion Review Dote Plans Date Plans
Plans Revi w R quired Check Fee Started BY A proved BY lot t
BUILDING S
PLUMBING S y
MECHANICAL S
ELECTRICAL S
OTHER S
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
P rmit or A val Check Date Number' B 'Permit or Approval Check Date
Numb r RPfNObtainedrpfXObtainedr
BOILER PLUMBING
CURB OR SIDEWALK CUT ROOFING
ELEVATOR SEWER
ELECTRICAL SIGN OR BILLBOARD
FURNACE STREET GRADES
GRADING USE OF PUBLIC AREAS
OIL BURNER WRECKING
OTHER OTHER
V11. VALIDATION
Building
Permit number
Bui Iding
P rmit issued 19
Building
P rmit F e S_
Appr b
TITLE
TOWN OF SOUTH WINDSOR
BUILDING PERMIT
Date Oct. 21 19 83
Fee Paid $.456.00 Est Value $. 7.6 000
Permit M 13508
on the aide of
Lot 483 Jacques Lane Sweet
Street No. 176
Owner JMJ Construction
Applicant JMJ Construction
CERTIFICATE OF OCCUPANCY ISSUED:
Date
No. 6554
Fee Paid $ 3.00
CLASSIFICATION
Dwelling
BUn DING PERMIT
N? 13508
OFFICE OF
THE BUILDING INSPECTOR
of the
Town of South Windsor, Conn.
South Windsor, Conn. cjc t . 21 19 83
94is is to (ferfi fy,. That T?vi T C,,,.,.,tr
is hereby granted permission to i)we 1 1 i n g
at estimated value of
on the sine of T n-1 'F4 9 3 T.,r+q,,e s Lane _ Street an land
owned by 11-Co 1$n -(;q-.
Said ti'ork to be.as described in Application
No. 1.3803 and to conform to specifications and plans filed with said Application, and Building By-
Laws of THE TOWN OF SOUTH WINDSOR.
Issued 4:t. 21 1983.
ilding Inspector.
Streets and sidewalks, obstructed by excavations or building materials, must be guarded by barriers
during the day and by both barriers and colored lights by night.
SECTION 1343, GENERAL STATUTES OF CONNECTICUT: "When any person shall place
or keep building materials, or any obstacle in any highway (or any sidewalk) either with or without a
license therefor from the city or borough in which such highway may be situated, he shall pay said city,
town or borough all costa and damages which it shall sustain, or be compelled to reason therefor."
1NSPECT10 REPORT
Permit # Jo
1 Footing V/73 9
2 Foundation
3 Framing
4 Wiring 1\-J
5 Plumbing
6 Heating
7 Lathing
Permit No. TOWN OF SOUTH WINDSOR 3S
SOUTH WINDSOR, CONN.
Permit NO* 6554
Certificate of Occupa cy
THIS,4S TO CEPWIFY that the
at No in the To of South Windsor, Connecticut, has
been erected and mp ed in accordance with the Bui ding Code and Zoning Regulations of
the Town of South W" dsor, and is hereby a roved f r ccupan
i
Bui ing nspector
I
vKner, ffififrer
Fee Paid Date 19
Remo ,f PA & A taociafte
dIVII Engine rs
Glastonbury, Connecticu_t
zz
N ep 50' 00"
1bb 50 I p
PAP' AK
Y
1 O'
nn
v
AFZEA s 20,1-1°S 5.F
N O
r
O
CJ1 o
J O
i
1 10 Zo.a mac. vroc.-ra••n
Ol!!I Lot lines tfrm map an file in
Torn Cleric'• ottic a entitled, Mot Plan
3"Uon 8 Pleasant Valley HaueeSfttbWWOWvConn."
scale 1*0 40, Date 3- 28-83
H 220-T8-I V Rev* --- by R ei n o E.
A-20 ?-ONE
Mypppa t Associates Glastonbury, CT.
PPE PAR E O FOR
1 hweby certify thit this map and survey were prepared iri PLEASANT' VALLEY uO M ESacoordeneewiththestandardsofaClassA-2 survey as defined
M1 ft existing Code of Pre-ti-p for Standards of Accuracy of SO UTI4 W I ND50 Q, C pN NSysandMaps, adopted by the Connecticut Association of
Low&W"Yors, Inc. SCALE 1.,•ao' DATE 9- i5-3 3
43--33
8141
ELECTRICAL APPLICATION
Application No. 9 249
on the Side of
Lot #183 Jacques Lane Stmt
Street No. 176
Owner .1J Construction Co.
Electrician Richard Barrett
FILED IN OFFICE OF
The Building Inspector
Nov. 1 19$ .
INSPECTION.
rA),No Electrical Work shall be started until a Per-
mit is granted by the Building Inspector.
In New Buildings no wiring shall be started
until the plumbing and heating pipes, and the fire
stops fit of wood) are installed, without a special
permit from the office of the Building Inspector.
Electrical Permit No. .....Z/V.....................
Master License No. .../ q al 7. . ...............
I............
TOWN OF SOUTH WINDSOR Building Permit No.
I. Date Filed L
BUILDING DEPARTMENT
Date Final Approval .... ....... .. .....................
APPLICATION FOR ELECTRICAL WORK
Electrical Inspector
g cohf.........JOB OWNER: JOB LOCATION:
Side of Bet een and ................ Bet e 4...........Name of Building Owner Address
If work is for Lessee—Give name Address ................... ...... ................ ....... .... ... . ....... - .. ..
Building now occupied as (unless new) No. of family units now . ... ............
Building to be occupied as Number of family units to be .... ( ........ -
Is this work included i a B ding Permit? Permit Feeu
If no Building Pertm
prmitteeBusiness
Z/ dPCessAddress4WTelehon. ..... .......
COSTOF INSTALLATION: 6................. . ... . ......... ... . .........................................................................................................................
TO BE FILLED OUT BY PERMITTEE
TO BE WIRED EXISTING APPLIANCES
Number of light outlets to be installed
Number of convenience outlets to be installed Number of present Appliance Circuits ........... ............... ............
Number of switches to be installed Do these include Range Water Heater
Number of appliances to be installed
as listed below) Dryer Air Conditioner Oil Burner
TYPE RATING NO.
Range . . . . . . . .
Dish Washer E] Gas Burner
Well Pump E] Elec. Heaters
Range Top . . . . . . Lj
Oven . . . . . . . . REMARKS:
Water Heater Lr,
Clothes Washer . . . .
Clothes Dryer . . . . .
Dish Washer . . . . . .
Air Conditioning Motor .
Oil Burner Motor . . . .
Gas Burner . . . . . . .
Circulator Motor . . . .
Attic or Large Fan . . .
Well Pump . . . . . .
Electric Heat . . . . .
Other . . . . . . . .
Number of new Lighting Circuits
Number of new Appliance Circuits
Number of Heating Circuits . . . . . . ............................
Number of Motor Circuits . * * * ' * * *"--*"'*'*..—'..--
Size of present service ...........
Size of service to be ... ....
6298
PLUMBING APPLICATION
A_M&atim No. 7077
on the-d&of
Lot #183 Jacques Lane
Street No. _ 17 6
own,w .. JMJ Construction Co.
phmlbw So.Windsor Plbg. & Htg.
Filed in Offia of
The BOI&V
Nom. 10 1983
No person SW cmwft mu 0 or altar may
portion of the &aimp wmm of my bold6g
mmpt to rqmdr 66) nod a is pm tad
by the Building LRxnw.
APPLICATION FOR PLUMBING PERMIT (Continu d from R v rs Sid
TOWN OF SOUTH WINDSOR, CONN.
11. LOCATION OF JOB
NO. STWT FLOOR APT.NO.
GENERAL PLUMBING
12. KIND OF INSTALLATION t 13. SIZE OF MAIN DRAIN T
14. NO. OF TOILETS STYLE //IAM :;Z A r 15. NO. OF URINALS STYLE eft-
16. NO.OF BATHTUBS 17.NO.OF LAVATORIES__18. NO.OF SINKS 19. NO. OF WASHTUBS
20. NO.OF CONDUCTORS SIZE 21. NO. OF STACKS _SIZE
22. AREA OF ROOF 23.NO. OF CATCH BASINS 24. NO. OF FLOOR DRAINS
25. NO. OF OTHER FIXTURES KIND j y«
26. ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW? Y j 27. SIZE OF WINDOW
28. IF NO WINDOW,WHAT KIND OF VENTILATION IS THERE? /CC/'- ilG n, r Al
29. SIZE OF DUCTS
I
30. ARE SEWAGE AND WATER FACILITIES AVAILABLE) Ye J
SIGNATURE ADDRESS 11
LICENSE NO. 03c>66-ESTIMATED COST D y TELEPHONE
OWNER t i ^ ADDRESS
WATER HEATER
31. TYPE 0 e2rIly1 GGl 4 f 4eZ 32. MANUFACTURER
TANK SAFETY DEVICES
33. CAPACITY_TC [.4/`D 37. TEMPERATURE RELIEF VALVE
34. TEST PRESSURE_ I 0 j 38. MANUFACTURER
35. WORKING PRESSURE 39. PRESSURE RELIEF VALVE
36. TYPE C 4.S - T0&G 40. MANUFACTURER
ALL WORK COVERED BY THIS APPLICATION HAS BEEN AUTHORIZED BY THE OWNER OF THIS PROPERTY
AND WILL BE DONE IN STRICT ACCORDANCE WITH THE BUILDING CODE.
7,;'e,0
CD962 DATE SIGNAT APPLICANT
PERMIT #
Application For 6870 1770
a DEPARTMENT DECISION
o Heating Permit
3 E APPLICATION IS HEREBY:
DEPARTMENT OF LICENSES AND INSPECTIONS
N e1 APPROVED DISAPPROVED
TOWN OF SOUTH WINDSOR
c a 11/14/83 Thos. P. D'Auria
00 DATE CHIEF INSPECTOR APPLICATIONS MUST BE PRINTED OR TYPED. BEGIN WITH NUMBER ONE BEL WiO
p 1. LOCATION OF JOB
C NO. STREET
0 LOT NO. FLOOR APT. NO.O O
LV
2. OWNER lG
3 S. ADDRESS - n r G gooe//(be
a.PHONE
r—
Ce
s. APPLICANT Uv,
v ad
O
a. ADDRESS 141'e
a
W r /J/6v "/ ds Y.PHONE
J '$ s. LICENSE NO. - Je 7l g U
pQ Jw9. EXPIRATION DATE OF LICENSE ®
e
a 10. ESTIMATED COST s Z 200.dO
be 11. IS THIS A CONTRACT COSTS El YES No
0 12. FEE ENCLOSED s- Pp rmi t l 3 5 0 8
xmas 13. TYPE OF BUILDING:
Go W
Cbo R[SID[NTIAL COMMERCIAL
d
14. TYPE OF JOB: INDUSTRIALv3
ORIGINAL ALTERATIONINSTALLATIONADDITION
REPAIR
APPLICATION FOR HEATING PERMIT (Continued it >m R verse Side)
11. LOCATION OF JOB L. ozz' 3 K n
NO. STREET FLOOR AFT.NO.
12. TYPE OF INSTALLATION: OIL BURNER ELECTRIC VENTILATION SPRINKLER
GAS BURNER STACK INCINERATOR MISCELLANEOUS
IDENTIFY
2ti
SIZE LOCATION SIZE SIZE
13. OF TANK OF TANK OF FILL OF VENT
1a. B.T.U. EQUIP. AT REGISTER FURNACE MAKE AND NO. AT BONNET FIRING RATE
BOILER OR FURNACE MAKE AND NO. DB.T.U. OR SQ. FT. NET 0 B.T.U. OR SQ. FT. GROSS - FIRING RATE
FLOORS TO BE HEATED -42L2 NEW OR OLD BUILDIN INSULATED - YES OR NO y J
TYPE OF WALL PV-vim &AI INSULATION i-C--jlAa/ ROOF OR CEILING r INSULATION
AVG. SYSTEM WATER TEMP. lea B.T.U./SQ. FT./HR. EMISSION
INDOOR-OUTDOOR TEMPERATURE DIFFERENCE 0 FCC) FAHRENHEIT
MAKE OF RADIATION:q ASEB R COPT CONVECTORS. OR C.I. RADIATION. OUTPUT PER SECTION OR LINEAL OF RADIATION. SQ.
FT. OR B.T.U. 5 t 1,A
DESCRIPTION OF WORK
15. TO BE DONE: Mil Cf.0 L r e X•
m HEAT LOSS SCHEDULE. (TO BE INCLUDED FOR ALL JOBS):
WI e.T.u. a -D
ROOM SIZE AND DooRs AREA - SQUARE FEET VOLUME
e.r.u. O<I- DISTRIBUTION INSTALLED
TOTAL TOTAL w LL
ROOM NO'GROSS GLASS NET WALL CEILING FLOOR CU.FT. AT 70•F CORRECTED t j RAD.
REGISTER
L W H AND C INFILT.)
TEMP. TO f O TYPE AND SIZE
SQ Fr
OR LEADER
SIZE < WALL t O FDIFF. F F M FREE AREA
TOTALS
A. HEAT LOSS FROM BUILDING B.T.U./HR.
B. DOMESTIC HOT WATER DEMAND B.T.U./HR.
C. PIPING, OTHER THAN NORMAL B.T.U./HR.
ALLOWANCE FOR HEAT VALVE OF FUEL (A B C) FACTOR
17. ELECTRICAL WORK BY:
NAME ADDRESS
SUBCONTRACTORS AND
18. THEIR TRADES
ALL WORK COVERED BY THIS APPLICATION HAS BEEN AUTHORIZED BY THE (OWNER) OR (AGENT) OF THIS PROPERTY AND WILL
BE DONE IN STRICT ACCORDANCE WITH THE BUILDING CODE.
APPLICATION TO BE COMPLETELY FILLED IN. r
DATE 1GNATUR APPLICANT
1 - t 11
KIND OF BUILDING _.:a A CHIMNEY SIZE
DEALER-
CONSTRUCTION:
it
WALL
WINDOWS A*Ym Q P - tOOF OR CEILING DESIGN TEMP. OIFF
BASEMENT HEIGHT. ABOVE GRADE BELOW MADE pESI iN WATER TEMPERATURE
COL.1 2 3 4 5 d 7 S O 10 11 12 13 14 13 18 17 1A
vowMsw
sA Res
ROOM SIZE WINDOWS AREA•SO. FT. Foa TOTAL TOTAL ACCUSOMIS
tANDCoonstogaMOTt AY TO F COMtCTtD WATER LIEN TN
ROOM NuMs[R 40*089 fiN HILT WALL CtILiNa O/ Tamp. TD TEMP Or,
e O f d pI , ENCLOSURE FIN L R S I.t mat
L W
i<F
H
goat
AREA WALL
D 0
O TUBE
T[Mr.D1F/. FT.
0
0 010 400 3 700 a o
g aG0 3 3,360
o? 8
3 0 o eo 13300 15 0006lMt0 ' `
0 9 80o )12 00 a a
ry 8 Io 39 a D
Coo , 1 D 3 ofl 3??0
r v O 1 Q
roo Too e 5/o l-
0 2 so i
oo . o0 0 0 0 -S3'40 0 i
to 1 0
y
300 60 Oo 0
6 0
50
l6 0haA 'l 8 a 3o a o o 0 21
a 1 47• x
00 8
DQ D 'Il 00 00 7 o 34 o
do 00 3 0
tD y 1 s
TzAl . S0°o
NoWt Me COWCO t t•LOM a»*"WOW OA I"AT~I%&LMM.IM L"W".sat OV ERIe.f.RN.s• rorwus G?G 5" I
row ALL OTHM FLAW"USK SQUAns VWT os AMA.
FINAL INSPECTION
Building - - K APPLICATION FOR BUILDING PERMIT
Plumbing of
HVAC Date:I Z
Sprinkler 176 JACQUES LANE
Electric Ah- f-ED 6 ., Estimated Cost $ 010
Zoning 18 06 3
Permit Fee$
Affidavit NO.Occupancy Fee $
Eng. Dept.COMPLETE RED BOXED AREAS.Fire 2
HealtDhept.Dept. TYPE OR PRINT ONLY
Total Fee $
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 -U7 Zone S.
Applicant eo r a U a t f Tel. # j_J1 E
Address G Uk- k L i k_,Zip GG CIP Lic.#
STREET CITY STATE
Owner 11A&e- E? L cG t-,4 tt - - Address T".&-G sr
Architect Address
Size New Area: Ft. Front Overall Ft. Deep Overall Total Area Garages
Lavatories
No. of Families No. of Stories Construction Bathrooms Rooms 1st 2nd 3rd
Size of Lot Dist. from Street Line Dist. from Side Street Line
Purpose of this Permit c k r 1' l d. loe. I. S'/ .g'd Apr"yrr,44p
City Water Well Septic Sewer
Approved by Date BD1A 11/88
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 a zone in which this building and its use is allowed.
Signed
I hereby apply for a Certificate of Occupancy for the work described in this pplication for permit.
Signed
DO NOT WRITE BELOW THIS LINE—
INSPECTION RECORD
Footing Framing
Foundation Fireplace/Chimney Insulation
Plumbing Permit# Inspections:
HVAC Permit# Inspections:
017
UElectricalPermit# I/ 3 Inspections.
Sprinkler Permit# Inspections:
MORTGAGE SURVEY
FOR
MAC B. & GEORGENE S. LEAVITT
176' JACQUES LANE SOUTH WINDSOR, CONNECTICUT
SCALE: 1" = 40' duly 11, 1986
zone= A120 Map Ref: 'Plot plat Section 8 Plesait Valley Hems
b.l.= 40' South Vmdsw, Ct. scale: 1'WV 3/28/83
s.y.= 101 Reim E. 1&Asso.
r.y.= V Iv
lot are::= 2D,D sq. ft.
lot width= 100'frrnt
JA WE657
DC),VA D36 AV HAP-046 R,
NE G</1\1A
577
er
30
27
O Pod O p
13R/AA T. Q 0 R VAIEL.S
0 cn o
1>0A,,AIA ,7- o \ iz d 1
A Npp34.3
A4 C C A.Z T/A/ V.34' S A L D
DEMA LL/S
2?± L
i 27_
cofq i
457t; W
A
L-/os:
CN•= /oSSZ
tTACQUc5 LAVE
I HEREBY CERTIFY T0: CONNECTICUT ATTORNEYS TITLE INSURANCE COMPANY AND SAVINGS BANK
OF ROCKVILLE THAT THIS MAP IS SUBSTANTIALLY CORRECT, THE STRUCTURE IS Lr(XXaArM AS SHOWN,
AND UNLESS OTHERWISE NOTED, DOES NOT VIOLATE THE ZONING RDGULATIONS OF THE 'TOWN OF
SOUTH' , WINDSOR, CONNECTICUT.
JZ*4 e4
n '+.*• /1 -•i-n^i+r-T^• •• i•i•. ,....•• rn. it
IST3974
5 EP 2 8 190
South Windsor
BUILDING DEPARTMEN-r
JR
is cer"1 I l i I ,I'n n(I re true
hoc ;v„pis o be
ected at
7k--ZA JC$ A-
mcnc rn, rat- ,1 r ,
APd %:th I I -I and I pr , to cn^-`i„
u11, ,lit.tc lows
s1„_d ._v L.Ic Building D,,p,rtm(ni ,t ttr„• .,
r r,nr, appixation and final issuance of -i
ermlt.
Slgnud
I h s 1,1•,n 5 rppro1, subject to th1 c nd to
order o re na lee regulating builuing
co1 ,n
e
Con 'w:<<<.y Approved These telex with
Building Inspector Qkerr*
Dates Ho.
CERTIFICATION OF ZONING COMPLIANCE
Proposed buildings), usA(s) and/or structure(s)
as shown on this plan in
conformances. ;i c j. r .;
may app:y.
ate
7,
PERMIT #
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT J4,D 740
Application- is hereby:
TOWN OF SOUTH WINDSOR
AFPROVED DISAPPROVED BUILDING INSPECTION DEPT.
MJ
644-2511 Ext. 230
Application must be printed or typed.Date Building Inspector
1. LOCATION OF JOB
11(a k, ,
FEE SCHEDULE No . Street
0 - $19000 - 10. 00 Floor Apt . No.
Over $1,000 - 10.00
per $1 ,000 or 2 . OWNER L ,/, tf'
fraction thereof
3. ADDRESS Ile- fdr-
4. APPLICANT c mil' eGvpi
5. ADDRESS
6b 0 7
6. ESTIMATED COST $ ,L S--0
7 . IS THIS A CONTRACT COST
ens No
8. FEE ENCLOSED $
9. TYPE OF BUILDING :
K RESIDENTIAL COMMERCIAL
10. TYPE OF JOB :
Original Installation
X_Alteration/ ddit ' n/Repair
BD 3A 11/88
APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side)
l
11 . LOCATION OF JOB / 7 J of Lc u e L L
NO . STRE11T 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 :
l s
LICENSE NO.SIGNATURE OF APPLIC NT DATE
PHONE NUMBER: I