HomeMy WebLinkAbout215 Lefoll Boulevard0 mac- gd tJi
eo To HE BUMDING INSPECMR01 APPLICATIoftheOH FOR
O" OF SOUTH WINDS01t,CXOW PLAN EXAMINATION ANO
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, Ill, IV, and IX.0
01
ZONING -
AT (LOCATI ) DISTRICT
LOCATION NO.) STREET)
OF BETWEEN AND
BUILDING I CROSS STREET) CROSS ST ET)
LOT /40'SUBDIVISION LOT-LI-1-BLOCK SIZE j24JV x
N
II. TYPE AND COST F BUILDING — All applicants complete Parts A — D v
A. TYPE OF IMPROVEN ENT D. PROPOSED USE - For"Wrecking' most recent use
1 New building Res! ntial Nonresidential
2 Additi n(1/resi4 ential, enter number 12One family 18 Amusement, recreational
o/new housing units added, if any,13 Two or more family - Enter 19 Church, other religiousinPartD, 13)
number of units- - - --20 E] Industrial3Alteration (See above) 14 Transient hotel, mote ,T h ll 21 Parking garage4 Repair, replacement or dormitory - Enter number
5 Wrecking (1/mul i/amily residential, of units ------- --i 22 Service station, repair garage
enter number of units in building in 15 Garage 23 Hospital, institutional
Part D, 13)
16 Carport 24 Office, bank, professional
6 Moving (relocati(n)
7 Foundation only
t7 Other - Specify 25 E] Publicutility
26 School, library, other educational
B. OWNERSHIP 27 Stores, merconti le
8 [2 Private(individu I, corporation, 28 Tanks, towers
nonprofit institution,etc.) 29 Other - Specify
9 Public(Federal, State, or
local gov rnment
C. COST Omit cents) Nonresidential - Describe in detail proposed use of buildings,e.g., food
processing plant, machine shop, laundry building at hospital,elementary
10. Cost f improve nt...............school, secondary school, college, parochial school, parking garage for,
department store, rental office building, office building at industrial plant.
To be installed but not included If use of existing building is being changed,enter proposed use.
in the above co t
a. Electrical.......................
b. Plumbing .......................
c.Heating, air c4 nditioning.........
d. Oth r(elevoto, etc.)............
11. TOTAL COST OF IMPROVEMENT $
III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts 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
30 Masonry(wall bearing) 401KPublic or private company
48. Number of stories................
31.Z W d frame 41 Private(septic tank,etc.)
49• Total square feet of floor area,
O Sallfloors, based on exterior f
32 Structural steel dimensions .................... `
33 Reinf re d cone to H. TYPE OF WATER SUPPLY
34 Other - Specify42,Public or private company
50• Total land area, sq.ft. ........... , /7 F7
43 Private(well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL 1. TYPE OF MECHANICAL
51. Enclosed .......................
35.Gas Will there be central air 52. Outdoors........................
36 Oil conditioning?L. RESIDENTIAL BUILDINGS ONLY
37 El ctricity 44 Yes 45 53. Number f bedr ms..............3
38 C al
39 Oth r- Specil3,. Will th r be an el vat r?
54. Number F
Full..........
46 Yes 47ONo bathrooms
Partial........
NOTES and Data — (For department use)
IV. IDENTIFICATIO — To b complet d by all applicants
Nam Mailing address — Number, str t, city, and State ZIP code Tel. No.
1. EA 9Owneror
Lessee
S+
azwom Q Q7 ry 1 Q
2. IrATi. CaAesr
Contractor
Y
3.
Architect or
Engineer
The owner of this buil ing and the undersigned agree to conform to all applicable laws of this jurisdiction.
ature of pplicant Address Application date
DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Revi w R quired Check Plan Review Date Plans By Date Plans By NotesFeeStartedApproved
BUILDING -
PLUMBING
MECHANICAL
ELECTRICAL
OTHER
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date
Obtained Number By Permit or Approval Check ObDa t
d Number By
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
VII. VALIDATION
Building 1 934Permitnumbr
Building
Permit issued OC . 11 19 82
Building
P rmit Fee $
Ap oved y:
0 /9
TITLE
FRONTVIII.
ZONING PLAN EXAMINERS NOTES
DISTRICT
SIDE YARD SIDE - .
ApplicantREAR
YARD
NOTES
IX. SITE OR PLOT PLAN For
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TOWN OF SOUTH WINDSOR
BUILDING PERMIT
Date Oct. 11 19 82.
288.00
Fee Paid $. . .:Miik Est. Value $. .4 8.,000.00
Permit No 12934
on the side of
Lot #119 LeFoll Blvd Street
Street No. 215
Owner Jean Marc Jacques
Applicant Jean Marc JacntiP c
CERTIFICATE OF OCCUPANCY ISSUED:
Date
No. 6112
Fee Paid $ 3.00
CLASSIFICATION
Dwelling
BURDM Mboffr
N° 12934
OFFICE OF
THE BUILDING INSPECTOR
Of "
Town of South Windsor, Conn.
South Windsor, Conn. nr-t.
94to to to (ferfif-g, That dm T ran ct—ol u on
is hereby granted permission to Dwe l l ine
at estimated value of4
on the side of Txt- 111 T e Fn 1 1 -R 13zd - - Street on land
owned bjtJ
Saicun rk to be as described in Application
Nd 32 34 and to conform to specifications and plans filed with said Application, and Building By-
Laws of THE TOWN OF SOUTH WINDSOR.
iilding Inspector.
Streets and sidewalks, obstructed by excavations or building materials, must be guarded by barrim
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 eery,
town or borough all costs and damages which it shall sustain, or be compelled to reason therefor."
i
INSOECTION EPORT
Permit # Job s
1 Footin
a
2 Foundation
3 Framing
4 Wiring
5 Plumbing
6 Heating
7 Lathing
8 C.O. .Z
35
f7 GfPermitNo. TOWN OF SOUTH WINDSOR
SOUTH WINDSOR, CONN.
Permit N 6112
Certificate of Occupancy
XeIiTHISSTOCE#TIFY that th
at No. 1 %= f { in the wn of South Windsor, Connecticut, has
i been erected and completed in-accordance with the buil i g Code and Zoning Regulations of
the Town of South Windsor, and is hereby app ved fo cupancy.
t`
Building Inspector
f' wner, Builder
Fee rPaif- Date 19
j
Rein Be Hyyppe & Assoeiates
CIVU Engimm
Gla stonbury, Connecticut
All
SCE I
i
NSF P ASAt*1T /A..E f
REAt-Y 1 Nam.
vv
co 1SERVATtoN
Zo A ANT oz
i
iVVi
W W a
t 0OQO
2 I Q v dO tP
I / j occ c.
r a
OC 1
ro• T w
a
TF= I0-1,111 , 4
o
o* 7
No Zot 1 NCs IN Cip/4,8, to"v ova 5
FOuwrWT tor.+ LOCATED Ag SµowN
NOTE: Lot lines
fr.lnl
sap an file in l!E FOL.L- e4)QL.F.1%JPb .OTownClWeOfficntitled$ "Plot plan
Section ca Fleas Valley Hanes Fo- FOUNOATtOO 0"VM %F REQU+taWSouthWindsor, Con
Scale ln• 401 Daleco-2-s+
A-ZO BONEMapNo220-78-IS k*V,z-Z-aZ by Reino E.
Hyyppa & Associates Glastonbury, CT.
P;'EPAQEO FOR
I hereby certify that thi map and survey were prepared iii PL.EASA NT VALLEY O ESaccordancewiththestandrdsofaClassA-2 survey as defined
In the existing Code of Pr ntic-e for Standards of AccuracySysandMaps, adopt by the Connecticut Associatim of
U TI-I W 1 N DSO R C ON N.
LOW hr. c-ALF_ V's 4.0' O ATe 9-Zq-4b2
e r
A P P. O V E D
TOWI'll 0-F- `"'k!T•'_I V1.11NDSOR
EN(-:,l tT:--=:lNG ;J`::,rAr:TMENT
DATE:
7816
ELECTRICAL APPLICATION
Application No. 8927
on the side of
T n t- Al 19 I-P F n I 1 Blvd, Street
Street No. 2 1 5
Owner „jjvj;l_Cnn c t-r_ Co.
Electrician rrripS F.1 Petri c
FILED IN OFFICE OF
The Building Inspector
Nov. 16 19 82
INSPECTION.
mNo 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 (if of wood) are installed, without a special
permit from the office of the Building Inspector.
APPLICATION FOR PERMIT TO DO ELECTRICAI. WORK.
No. fD..r,7. .f...8927
Permit No. . J.816.... . ..
TO THE BUILDING INSPECTOR
of the
TOWN OF SOUTH WINDSOR, CONN.
hereby make application t4 perform Electr cal Work according to detailed description below. All
provisions of the Rules for Electrical Installation, Section 48, Building By-Laws, shall be complied with
whether specified herein or not.
fi
c
South Windsor, Conn., 19 Sign here Y
Address la.
Location Q.T.. / Side of .....
Nature of Building ku How many stories ............. ............ . ................................. .................
New or old Building .. N. How many families ............................../...................................................
Kind of Installation How many Stores ................................................................................................
l
Owner .... .... .... .. Address 1 _.
Architect ......... Address . . . . ... ....... .. .................................................
Builder1.U!t'µ-f . v`.c? Address RIPPS fLECTREC .COS..............
Electrician ......... ........ .....Address .....6+45 JOHN....FITCH....BLVD..........
SOUTH WINDSOR# CT. 06074
Size of Main Wires ... ................................................._
No. of Light Loops .. No. of Heat Loops .. No. of Power Loops .........................
No. of Light Outlets ...... ....... No. of Heat Outlets . No. of Power Outlets ................. ... ........
Nob of Light Circuits .. ... No. of Heat Circuits No. of Power Circuits .
No. of Sockets No. of Heat Receptacles No. of Motors .............. . .
No. of Panels ............................. .. . Size of Heat Circuit No. of Power Receptacles .
No. of Switches .......... ...... .. ... .Total Wattage Size of Power Circuit ..
Total Horsepower
No. of Straight Electric Fixtures ....... . .. .. ... ...... ........ No. of Combination Fixtures ...
No. of Receptacles ........................ ....... ......... . ................... . No. of Cord Drops .. .. ........... ............................ ............ . .... .... ..
L C_..... ........ Remarks: For other kind o! Installation .. .. ... .
I. . , :........
Estimated Cost .. 1. d o.. . .................
6045
6824
an the _.__ Side of
Lot 119 LeFoll Blvd. . s-
Street Igo. .... 215
owm .JMJ Construction
plumber _ So.Windsor f1g. & Htg
Filed in Office of
The BwMing
Nov. 29 1982
No person shall ooasn UM add w or alder ash
portion of the drainage system of my boatmg
emnx to repair leafs) undl a Pier '- is gcaated
by the Building Lnpemr.
Application No....... .6-8.2.4................. Permit No. ..6.0-4.5................
TO THE BUILDING INSPECTOR
of the
TOWN OF SOUTH WINDSOR. CONN.
1 hereby make application to perform plumbing according to detailed description below. All
provisions of the Rules for Sanitation, By-Laws, Sections 33 to 47 inclusive, shall be complied with whether
specified herein or not.
South Windsor, No.vemb er.. 2 2 19 4 .... Sign here . .. .. ..... ...............
Address .19.1.....Ne . err. . S.......... nds-or.
LocationLo..t....11.9.......... .. ...................................................... side of ........zC.60.4.4..........tf1W.......................... Street
Nature of Building Residential....................... . How many stories . Qn-e.................................... ..................................
Owner .....jKj-. Construction..Q..o-..-.......IRC.- Address .6.26.....E.11ingtom...RoadlL......S.A.M.A................
Architect ........... ....... .......... .. ..... .. .............................. .................... Address . .. . ...................... ........................................................ ....................
Builder . . ..... ......... Address . ........ ......... . ... ......................... ................................. ..........
Plumber South Windsor Plumb ing.....&................. Address . Qgp.rge Road South Windsor
Heating ,* ' "'Inc'."
DRAINAGE
CESSPOOLS, How many Where located
Are they water tight Of what materials are they built ...... ........... .........
Size of pipe from house to cesspool ......... Kind of pipe ......... ........................................................... ................
MAIN DRAIN IN CELLAR, Material t Diameter ....................
Aboveor below cellar bottom
SOIL PIPES, Material 117AL.4 C. Diameter J..-2..............3..............................................................
WASTE PIPES, Material .J411S.- —1.1 14.j.k(. Diameter ............
TRAPS, Type proposed to use is
RAIN WATER LEADERS, where do they run to
REFRIGERATORWASTES, where do they run to .. . ........ ..... ................................................................. ........ ...............................
TAI*-M OVERFLOWS, where do they run to I....................................................................
FIXTURES
wWATERCLOSETS, How many .... .........3.......... .. ........ Where located A ......14; I'z- Wr........
Distance from trap to vertical soil pipe ...... .......... .................. Pattern
WASH TRAYS, How many .. . ..... ....................................... Where located . ......... .......................................................................
SINKS, How many ........ . .............................I............................. . Where located i.!S.;...........
BUTLER'S SINKS, How many ....................................................... Where located. . ..............................................................................................
REFRIGERATOR SINKS, How many.. ................................. Where located . .................................
LAVATORIES, How many ..................................9....................... Where located 1&-.q
BATH TUBS,How many........................................I........................... Where located .... .r.A.i...r..i'/Q.4...:..........................................................
URINALS, How many ...- - ........ ............... ............................. Where located ......... .........................................................................................
Are water closets and urinals to be local vented -i If not, is there a window in outer wall
of room where same are to be located . ..... Yc I. ..................................................................................................................................
Estimated Cost
y
PERMIT #
Application For 6649 5548
DEPARTMENT DECISION Heating Permit
O3 APPLICATION IS HEREBY:
DEPARTMENT OF LICENSES AND INSPECTIONS
LAAPPROVED DISAPPROVED
TOWN OF SOUTH WINDSORCd
000
11199189
DATE IEF INSPECTOR APPLICATIONS MUST sE PRINTED OR TYPED. BEGIN WITH NUMBER ONE BELOW
O
o 1. LOCATION OF JOB
O
215 ill/
Cd V.NO.
Cd
STREET
v
0 LOT NO. FLOOR AFT. NO.
O
N
j 4) O
2. OWNER
Cc 0
ADDRESS
3
1.
a) Soot!/ &)L , 1,2/ 4.PHONE %off
Cc
cc S. APPLICANT &6ur?
0
6. ADDRESS ' o
w T.PHONE
LICENSE NO.7,9 2/90
a
or 1 3C .,, s. EXPIRATION DATE OF LICENSEMrl
e,
10. ESTIMATED COST i rot 0 O. 0 0
n N
11. IS THIS A CONTRACT COSTT YES - NOrb0
12. FEE ENCLOSED 6- PP rm i fi 1 2 934
ovn 13. TYPE OF BUILDING:
WrAb RESIDENTIAL COMMERCIAL
C's 3 14. TYPE OF JOB: INDUSTRIAL
ORIGINAL
INSTALLATION ADDITION
ALTERATION
REPAIR
APPLICATION FOR HEATING PERMIT (Continued it m Reverse Side)
11. LOCATION OF JOB lc 6 l( 5 Ad
NO. STREET FLOOR APT.NO.
12. TYPE OF INSTALLATION: OIL BURNER ELECTRIC Cl VENTILATION SPRINKLER
GAS BURNER STACK INCINERATOR MISCELLANEOUS
IDENTIFY
SIZE LOCATION SIZE SIZE
13. OF TANK OF TANK OF FILL OF VENT
14. B.T.U. EQUIP. AT REGISTER FURNACE MAKE AND NO. AT BONNET FIRING RATE
BOILER OR FURNACE MAKE AND NO. ShIiTff B.T.U. OR SQ. FT. NET UC'E.T.U. OR SQ. FT. GROSS - FIRING RATE
FLOORS TO BE HEATED 7 y NEW OR OLD BUILDING /t/z INSULATED - YES OR NO
TYPE OF WALL 1iUUOe? !' hAj!: INSULATION t"% Sc-Ct/a i ROOF OR CEILING LEI - T-
INSULATION
AVG. SYSTEM WATER TEMP. zg U B.T.U./SQ. FT./HR. EMISSION
INDOOR-OUTDOOR TEMPERATURE DIFFERENCE 3- 6100 FAHRENHEIT
MAKE OF RADIATION:dgiRR COPPER CONVECTORS, OR C.I. RADIATION. OUTPUT PER SECTION OR LINEAL OF RADIATION. SQ.
FT. OR B.T.U. zl/ /fM•
DESCRIPTION OF WORK
15. TO BE DONE:C
v T
16. HEAT LOSS SCHEDULE. (TO BE INCLUDED FOR ALL JOBS):
ROOM SIZE WINDOWS AREA - SQUARE FEET B.T.U. B.T.U. O DISTRIBUTION INSTALLEDANDDOORSVOLUMETOTALTOTALy
ROOM NO.Ggpgg GLASS NET WALL CEILING FLOOR CU.FT. AT 70•F CORRECTED -J j 4 REGISTER
L W N AND TEMP. TO <F TYPE AND SIZE qAD' OR LEA MR
SIZE < WALL
f' 10 INFILT.)
DIFF. F m N SQ. FT. FREE AREA
TOTALS
l
A. HEAT LOSS FROM BUILDING B.T.U./HR.
B. DOMESTIC HOT WATER DEMAND U 174A-B.T.U./HR.
C. PIPING. OTHER THAN NORMAL B.T.U./HR.
ALLOWANCE FOR HEAT VALVE OF FUEL (A B C) FACTOR
f
17. ELECTRICAL WORK BY 4 L"lNiI2 Al
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.49 ;
DATE SIGNAT 7 APPLICAN
KIND
Or
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ING /
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CTION:
WALL
f
WINDOWS
A
4-
4—
ROOF
OR
CEILING
BASEMENT
HIPIMHT.
ABOVE
GRADE
BELOW
GRADE
DESIGN
WATER
TEMPERATURE
DESIGN •
TEuP.
offir
COL..
i
2
13
4
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7
8
8
10
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12
13
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4
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Room
SIZE
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AREA-
SC.
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FLOOR
VOLUME
TOTAL
AMC
boobs
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NOTE)
TOTAL
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NET
WALL
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USE
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1 z
FINAL INSPECTI
Building APPLICATION FOR BUILDING PERMIT
Plumbing
HVAC 6ZDate: D
Sprinkler 215 LE FOLL BLVD.
El ctric Estimated Cost $ //i ODOR
Zoning Permit Fee$
Affidavit NO. 18870 Occupancy Fee $ 3
Eng. Dept. COMPLETE RED BOXED AREAS.
Fire Dept. TYPE OR PRINT ONLY Total Fee $ P-4 c)0
Health Dept. SIGN ON REVERSE SIDE.
Approved for CO: Additional Cost) $
TO BUILDING D PARTMENT, TOWN OF SOUTH WINDSOR, CT
The undersigned, hereby applies to do work according to the following specifications:
Job Locatio v 14Lot No. Side of Stree Zone1rjTZ-*?Applicant Z'i- 12-/ Tel. #
Address GF-Zip .0 GOBS Lic.# S Sio-
STREET CITY STATE
Owner a s. Li o Address 4691 oI-A ROCOA PyAve,d
Architect Address ff/ 1'yl yj!'OAj , r
Size New Area: Ft. ront Overall 1 Ft. Deep Overall / Total Area leuq Garages
Lavatories
No. of Families o. of Stories Construction Bathrooms Rooms 1 st 2nd 3rd
Size of Lo Dist. from Street Lined Dist. from Side Street Line
Purpose of this P rmit !o e91Q0 'q /000 kr x5 e Zi iy r
Citv Water 0 Well Septic Sewer O
Approved by Date ll_'-0 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 th 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 line nd 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 a ica 'on for per
Signed
DO NOT WRITE BELOW THIS LINE—
INSPECTION RECORD
Footing U,r- Framing
Foundation Fireplace/Chimney Insulation
Plumbing Permit# Inspections:
HVAC Permit# `e-- Inspections:
Electrical Permlt# Inspections: k,
Sprinkler Permit# Inspections:
BUILDING INSPECTION DEPARTMENT
SOUTH WINDSOR, CONNECTICUT
FEE PAID: $3.00
CERTIFICATE OF OCCUPANCY
ZONE: DATED 4/1 19 91
This is to certify that
A-I+QvSA under permit No. conforms substantially to the requirements of the building ordinances and the
zoning regulations of the Town of South Windsor and is hereby approved for occupancy as indicated below.
Approved for Occupa cy—Residential addition
Use Group: R4
C nstr. Type: 58
Building Official
Notice:ff rhis certificate is lost or destroyed, a duplicate should be obtained immediately from the Building Department.
Any change or extension of the use heiein approved requires a new certificate of occupancy.
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t
Reino E. Hyyppa & Associates
Civil Engineers
Glastonbury, Connecticut
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CONSERVATION
to EASEMENT
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South Windsor
IBUH-DING DEPARTMENT
S
No
CERTIFICATION OF ZONING COKAPLIAi,'iL:1-
proposed bullding(s), use(s) and/or structur-'-.
Aftv- W/ Iwo as shown orl this p!z,,n appear(s) to be
506-Itt. (WIP14")conformance with current South Win"!
foe"'M Cleev. regulations. Variances and special excepti,.---
110XIV") may apply.
Date
q M&t C,
PERMIT #
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
Application is hereby:
TOWN OF SOUTH WINDSOR
APPROVED DISAPPROVED BUILDING INSPECTION DEPT.
644-2511 Ext . 230
Application must be printed or typed .
Date BMding inspector
1. LOCATION OF JOB
e7 Z-fL A
FEE SCHEDULE No . Street
0 - $19000 -10.00 Floor Apt . No .
Over $1,000 -10.00
per $1 ,000 or 2 . OWNE ,py% s. lL 'tzf
fraction thereof
3. ADDRES /5 A4 -V,&A
S'O u rw /,OSopc._,
4. APPLICANT 1 a:5 f7G lJ
5 . ADDRESS
6 . ESTIMATED COST $OD
7 . IS THIS A CONTRACT COST x,
Yes No
8 . FEE ENCLOSED 16,0640C
rs&7a
9. TYPE OF BUILDI :
RESIDENTIAL COMMERCIAL
10. TYPE OF JOB :
Original Installation
Alteration/Addition/Repair
BD 3A 11/88
APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side)
11 . LOCATION OF JOB OVA/ 124 jyk
NO. STREET 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 :
S Gtca it« 3 ! f X'(C/ / O'er-? z I fIli _
G%rrr 4
olvi e o yxe Ir, L ZV4 2 \
1
I I
LICENSE NO.SIGNATURE OF)APPLICANT DATE
PHONE NUMBER: