HomeMy WebLinkAbout190 Buckland RoadPERMIT 11
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
Application is hereby : TOWN OF SOUTH WINDSOR
BUILDING INSPECTION DEPT.
APPROVE DISAPPROVED 1540 SULLIVAN AVENUE
rXC- 644-2511 Ext. 230
Date Building Inspector Application must be printed or typed
1 . LOCATION OF JOB
j
FEE $CIIEDULE No . Street
0 - $19000 -0'0 Floor Apt . No.
Over $1,0 0 0 -
2 . OWNER r-n j le-per $1 ,000 orrfractionthereof
3. ADDRESS
4. APPLICANT SCV& lec n c- jklc-
5, ADDRESS
ll,n n c77— oe-0 0a
6, ESTIMATED COST $ 0,00 _
7 . IS THIS A CONTRACT COST
Yes No
8 . FEE ENCLOSED $ f p0
9. TYPE OF BUILDING:
RESIDENTIAL i//COHk4ERCIAL
10. TYPE OF JOB:
Original Installation
Alteration/Addition /Repair
RD 3A 11/88
APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side)
11 . LOCATION OF JOB 9 n A.l
NO. STREET APT. NO ,
12 . TYPE OF INSTALLATION 0#
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 :
1
LICENSE NO.SIGNATURE OF APPLICANT DATE
PHONE NUMBER: a
INSPECTOR C' DATE TIME
LOCATION
INSPECTION: CODE: RESULT(D/A) :
BUILDING:
ELECTRIC
R
PLUMBING:
HVAC:
OTHER:
APPLICATION FOR BUILDING PERMIT
Bectric# 190 BUCKLAND ROAD
TlAh*,Plumbing# Dte:
HVAC # 26171
Sprinkler#
FWAL O A Estimated Cost
Buildi COMPLETE RED BOXED AREAS Permit Fee I ?
Engi i TYPE OR PRINT ONLY Occupancy Fee
Affida t SIGN ON REVERSES E v17
Appr.for CO. 4 c z) Total Fee
TO BULDh1G DEPARTMENT,TOWN OF SOUTH WINDSOR,CT Additional Cost)
The undersigned hereby applies to do work according to the following specifications:
Job Location OLRWIqD Lot No. Side of Street r, i Zone
Applicant e kped, Tel.#
App
Address `l r h j 13A
Owner Address
Architect Address
Sq.Ft.New Area: lst Fl. 2nd Fl. 3rd Fl. Total New Area
Rooms Lavatories Bathrooms Garages
Purpose of this permit:
ater Well Septic System 0 Sewer
Ins. H.O. S. ._ Cert._____ Area Basement Garage
Approved by Date OO Z q Use Group Construction Type
RwAwd 1197
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 thispermitisasked,and agree that this building is to be located the proper distance from all street lines,side yard lines,and requireddistancesfromallotherzonesandislocatedinwhichthiswildingasuseallowed.
Signe
1 hereby apply for a Certificate of Occupancy fo the work descri i his application for the permit.
Signed X
DO NOT WRITE BELOW THIS LINE
INSPECTION COMMENTS