HomeMy WebLinkAbout25 Lisa DriveIle ,
To THE BUIELDING INSPECTOR
of 111:6 APPLICATION FOR
TO" OF SOUTH WUWSM COW PLAN EXAMINATION AND
BUILDING PERMIT
zIMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX.O
9-1
I Lis* ZONING A-30AT (LOCATION) DISTRICT
LOCATION NO.) STREET
OF BETWEEN-1s'
ER055 STRE T)
FA ILM Ed ANDdess fC'¢•(
c s's TTREET)BUILDING
SUBDIVISION
MOUNTAINVIEW ESTATES LOT7r/1/, BLOCK S1ZE r
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking"most recent use T
1 ETNe,building Reside tial Nonresidential
soof
2 Addition(1/ residential, enter number 12JOne family 18 Amusement, recreational
o/new bousing units added, i/any,13 Two or more family - Enter 19 Church,other religi usinPastD, 13)
number o/units- ---- 20 Industrial3 Alteration (See 2 above)
4 El Repair, replacement
14 E] Transient hotel,motel,21 Parking garageordormitory - Enter number
5 Wrecking (1/multi/amily residential, o/units ------- ---o. 22 Service station, repair garage
enter number o/units in building in 15 Garage 23 Hospital, Institutional
Part D, 13)
16 Carport 24 Office, bank, professional6 Moving (relocation)
17 Other - Speci/y 25 Public utility7 Foundation only 26 School, library, other ducat! nal
B. OWNERSHIP 27 Stores, mercantile
8 Private (individual, corporation, 28 Tanks, towers
nonprofit Institution, etc.) 29 Other - Speci/y
9 Public(Federal, State, or
local government)
C. COST Omit cents) Nonresidential - Describe in detail proposed use of buildings,e.g.,f d
processing plant, machine shop, laundry building of hospital,elementary10. Cost of improvement, ,,,,,,,,,,•,,, S 760 school, secondary school, college, parochial school, parking garage for,
deportment store, rental office building, office building of industrial plant.To be installed but not included If use of existing building is being changed, enter proposed use.in the above cost
a. Electrical......................
b. Plumbing .......................
c.Heating, air conditioning.........
d. Other(elevator, etc.)............
11. TOTAL COST OF IMPROVEMENT $ Qv
111. 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 L J Mae nr wall bearing) 48. Number of stories................y( 40'Public or private company
31 Q W d frame 41 Private(septic tank, etc.) 49• Total square feet of floor area,
all floors, based on exterior32 Structural steel dimensions .....................
33 Reinforc d concrete H. TYPE OF WATER SUPPLY
34 Other Speci/y 42 Public or private company 0• Total land area, sq.ft.
43 Private(well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
Enclosed .......................
35 Gas Will there be central air 52. Outd es........................
36 011 c nditi nine? L. RESIDENTIAL BUILDINGS ONLY37 Electricity 44 Y e 45 CZ3 No 53. Numb r of bedr me..
38 Cool
39 Other- Speci/y Will Cher be on elevator?Full..........54. Number 1 QL
46 Yes 47[allo bathrooms
Partial........
IV. IDENTIFICATION — To be completed by all applicants
Nam Mailing addr ss — Number, street, city, and State ZIP cod Tel. No.
owner Dart Kill RealtyInc, 658 Ellington Roador
Lessee
South Windsor.n
2. Same
Contractor
i
3.
Architect or
Engineer T
The owner of this building and the undersigned agree to conform to all applicable laws of this jurisdiction.
Signature of applicant A Address Applicati n dote
r
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Dote Plans By Date Plans By NotesFeeStartedApproved
BUILDING
PLUMBING
MECHANICAL
ELECTRICAL
OTHER
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit r Approval Check ObDtoined Number By Permit or Approval Check ObtDoined 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
Permit numb r
Bui Iding
Permit issued 9/6 19 ,
Bui Iding t D
Permit Fe $ 6
App ved y:
IiTLE
TOWN OF SOUTH WINDSOR
BUILDING PERMIT
Date 9/16 1967
Fee Paid $4.g6,00 Eat. Value $76- 400
Permit N° 16260
on the aide of
fit &1LE: i atea# ris-4 . Streetter
Street No. 25
Owner Dart Bill Relatyl lncft
Applicant
CERTIFICATE OF OCCUPANCY ISSUED:
Date
No. 4343
Fee Paid $3.00
CLASSIFICATION
ging's frail ydwelling
y
6
I
BUI DING PERMIT
N° 16260
OFFICB OF
THE BUILDING INSPECTOR
of the
Town of South Windsor, Conn.
South Windsor, Conn. 9/16 19 87
M4is is to gertifo, That part u i 1 1 -RoaltyT 6
is hereby granted permission to Build a s ing le family rjwP 1 1 i n cf
at estimated value of
on the side of Q -C- T i c . D-
owned
r; c,,, Street on land
by samez- —A—R a—h^yp
Said work to be as described in Application
No. 16 5 5 8and to conform to specifications and plans filed with said Application, and Building By.
Laws of THE TOWN OF SOUTH WINDSOR.
Issued 16 in 8 7
Building 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 costs and damages which it shall sustain, or be compelled to reason therefor."
DWEW,) T, V/IFVV Z--s r sec,.6- Wli,187
L)7 ) ,
a DR I re
gflg r la 11 I` i-?,roc- Permit #/6 Q bG
Electrician- I i cP#q Ro Z RRRF 7-T- # qq 7 8
Heating Contr. PAKELL-,Qt P1m'3d'4"TC' #G97,-?,
Plumbing I ANELL aS PJ.,n 8G 4 H rC. #75 1
Oil Burner
Certificate of Occupancy-
Sewer Permit
INSPECTION REPORT
Permit # J4 2 zo Job j 46__.-25 lJsg 7R
1 Footing UAIR7' E/,11.T 1
2 Foundation
3 Framing
4 Wiring CNAR
5 Plumbing
6 Heating 97 cc_ B9N jr11-eQ 'S
7 Lathing
8 C.O.
P rmit No. f- - TOWN OF SOUTH WINDSOR
SOUTH WINDSOR, CONN.
Permit `8343
Certificate of Occupancy
f
THIS IS TO CERTIFY ttat the
at No.y';6 r 1 in the Tov of South Windsor, Connecticut, has
been erected and completed in accordance with the Building Code-and Zoning Regulations-4
the Town of South Windsor, and is hereby appro or mpancy.
B i"Iding Inspector
Owner, B ilder
i
Fee Paid.. Date 19
CERTIFICATE OF OCCUPANCY CHECK LIST
Applicant Dart H; i i Certificate of Occupancy 3 3
Addrew Lisa Drive Bldg. Permit No. 1, 21,6
Lot No. 146 Date Submitted
Project Mt. view Estates Reviewed By
Date
As required in the Zoning Regulations, no certificate-of-occupancy
shall be issued until grading plans have been complied with and
approved by the Town Engineer. The minimum requirements shall
inlcude:
Approved Denied N/A
1. Approved building permit plan.
2. Finish grading per approvedPP
building permit plan.
r/3 . Site work, i.e. trees, shrubs, dumpsters
required parking
4 . Utility location
a. sanitary sewer
b. foundation drain
c. electrical & telephone
d. water
e. other
5 . Appropriate certification
6 . Bonding
Sewer Permit No.
Pavement Excay . No.
COMMENTS.
REMIO E. HYYPPA a ASSOCIATES
CIVIL ENGINEERS S LAND SURVEYORS
GLASTONBURY,CONK.
44
1Ne t berd dre tf hao der% prooarod
In 4art ee tho b"ia of a 1 r*ttod in-
o.ttgottem t *I*#-vrtooe aonet tier e.
Y ! evtve roe 011 not Ue reopowo tb l o ter r/
IR1N artr r• rt oot it o i po r to t nt nd to ti 2tta 1'T zo n ,,-to-
oAvsor.tas oawdttias• tneosporat d tilt*
jai d d vaore%!. Aboa t wto ly wo dd iti eint
fiolstd lesN pie** i1thout ti*dt aowratt-
ty Ilti at-1 faai 1 ittee. yLo
L,2E A- Zo,000' F_A
O n n
THIS PROR RTY MAY BE SUBJECT
TO o
TO VARKXJS UTLITY EASEMENTS 1 6)
OF MM AS MAY APPEAR.o N
Z 4.s
za
i
ll1Zt -N
150' 15LE r-i. 1
LI h1E
320
f00.00
t,6 Z.O. 1NXC1Ttp1JS W T 1"D `A»•SCv E ` 1
Q Plf.? -ra N Ai o•v
L I SA
LOT t,.NES FROM MAP aW ME TitLEO,
0 n SWIL 5utOYISION A-30 ZONE
PLor PLAN Sr cT10 d J,tiAouNjA+NV1EW
ESTATES SOUTH WImV509,C WM-"E v
Relao E.HOPM 4 AssOuatEs sCAu.E C. l• PLOT PLANN40' DATg:4-Iu-g(o MWN0.180-65-IP
sHtt-r t of 05 SwErTS PREPARED FOR
i t tweby det wo Owl tM% na" M wAslontioN earoct. TMi mop
DART HILL REALTY INC.Hari rrrvrtr e: dtr«+eA In th. Stonda+ds for
i 1%0"yo 0" Mays In the Sisto of Comoctitur es Wopwod and I
w .Ca wooctic,t t v d s w«..* SOUTH WI ND SO R, C ON N.
oa SvP%"*iw' t3' low.
SCALE ; V'940' PATE: 5-44-e$
S 5- dtivA
A
DATE:
SIG,.
ppplcant Building Permit No
rsss y a 1Li_ Date Submitted
lot. No* Reviewed by
ro j ect Date g1-20171
n accordance with the Subdlvf.sioii Regulationsr prior to the building of
uty- at t-nre on -& lot, a Topographic Plot 'Plan shall: be- submitted for .
Lpproval. Thee m i n imm requtrsmenta: shall include:
kpprovsd Denied NIX
I. Mum,- address a phone number of owner/
applicant.
20 Name, address a phone- number of plan. prepares.
3. Zoning information, - i.e. zonet open space,
floodwar, etc.
l/ 4.. Plot plan at 10 = 401 scale,
a.. Subdivi sion reference, abutting
Properties, etc
Vb-. Easements of record,
i
cw Lot description, bearings, distances,
building 1 uses, area, etc.,
d. Contours, existing a proposed, 1 or, Z
interval where appropriate..
e. Buisdinq location with dimensions.
Elevations of proposed finish Door,
now Now garage floor s center line of road at
driveway.
f/f. Elevations of gravity drainage systeias
sanitary a foundation drain at the
house and the street.
g. Tentative utility location' qas, electr
water, etc.
h. Title, block with name and address. of
preparer, date appropriate certifi catic
live seal sand signature.
low
5. Sedimentation and erosion control.
6. Special Planning a Zoning, Inland/Wetlands
considerations. (Plans on file w/Town Clerk)
BUILD ING DEPT.
P ZC GSIWA/CC pWPCA
OTEams Ot
nU1LLul.tr%a rrsuMui .ui+..+• +•+••5 lam - D 2 \
Applicant Building Pe=it
No. Add gg Date Submitted
Lot NO. Reviewed by
Project Date In. accordance
with the
Subdivision Regulations, prior to the building of any structure" on a
lot, a Topographic Plot Plan shall be submitted for approval. The minimum requirements
shall include:Approved Denied* N/A
1. Name, address & phone
number of owner/applicant.,2. Name, address &
phone
number of plan preparer.3. Zoning information - i.
e. zone, open space,floodway, etc.4. Plot
plan at
1" = 40` scale.a. Subdivision reference, abutting
properties, etc.-b. Easements
df record.
C. Lot description, bearings,
distances, -building lines, area, etc.
Vol"d. Contours, existing &
proposed, 1 or 2 ft.interval where appropriate.LZ
e-. Building location
with dimensions.Elevations of proposed finish
floor,garage floor & center line
of road at driveway.f. Elevations of
gravity
drainag systems,sanitary & foundation drain at
the house and the street.
g. Tentative utility location
gas, electric,water, etc.h.. Title
block with
name and address of preparer, date appropriate certification,
live seal and signature.
S. Sedimentation and erosion
control.6. Special Planning & Zoning,
Inland/Wetlands considerations. (Plans on file
w/Town Clerk)BUILDING DEPT.PZC IWA/
CC 19 /
oe
J 1?WPCA OTHERS COMMENTS:
ELECTRICAL APPLICATION.
Application No. 6
on the ade.E
Street No. ''
14R)
T, cT1orJ H1(
Owner
r A t7,
Electrician R A 2 Sr
FILED IN OFFICE OF
The Building Impeaw
19 L7
Hs fi•o l.
tar No E:lectrkcal 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 In
stops fit of wood) are installed. without a "MW
permit from the office of the Building Inspector.
Electrical Permit Na
Master Umm No. L2
TO OF SOUTH WINDSOR Building Permit No. i,'
BUILDING DEPARTMENT
Date Pled - --I Q -I
Date Final Approval
APPLICATION FOR ELECTRICAL WORK
Electrical Inspector
OB OWNERLOCATION:
f 0 4- ide of ............ Alpf?t.....................................- Between and
Name of Building Owner L\_-as.+-.-- A
If work is for Lessee---Give name .............. Address
1 _. ........... ily units nowBuildingnwoccupiedas (unless new) .........No. of fams
Building t be occupied as ------ Number of family units to be
wr
Is this work included W* Building Permit? Permit Fee
If no B
P
1fi1q* anA.-"
I-
P RkL
7 Business Address Z 0"howermitteeAftftOnP.-
COST OF INSTALLATION: .......
TO BE FILLED OUT BY PERM
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 C3 Water Heater [3Numberofappliancestobeinstalled - - -
as list d below) Dryer E3 Air Conditioner C3 Oil Burner E3
TYPE RATING NO.
Dish Washer [3 Gas Burner [3
Range . . . . . . . . Well Pump E3 Elea. Heaters C3
Range T p . . . . . .
Oven . . . . . . . . ire.
Water Heater
Clothes Washer tk3
Cloth z Dryer 7
Dish Washer t
Air Conditi ring Motor . .
Chl Burner Motor . . . .
Gas Burner . . . . . .
Cu=lauw Motor . . . .
Attic or Large Fan
Well PUMP . . . . .
Electric Hut . . . . .
Other . . . . . . . . .
Number of new Lighting Circuits
Number of new Appliance Circuits
INumberofHeatingCircuits
Number of Mot r Circuits . . . .
Size f present service 7470Sizeofservicetobe
PLUMBING APPLICATION
Appletioa Nay. 7/-76
on the------_...._...
Street No. _
J/,)/
N.-ber ROe/L"-'T /U
Filed in Office of
n rer
No person•hall aoaetsuot, adder at alder ay
portion of the dmimp s'saea any buMm
except to repair ") until a Pheesit s gRa ed
by the B
APPLICATION FOR PLUMBING PERMIT (C ntinu d fr In R verse Side)
TOWN OF SOUTH WINDSOR, CONN.
11. LOCATION OF JOB 5 U P
O. STREET FLO R APT.NO. i
GENERAL PLUMBING
12. KIND OF INSTALLATION P13. SIZE OF MAIN DRAIN
15. NO. OF URINALS STYLE _14. NO. OF TOILETS STYLE
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
26. ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW?27. SIZE OF WINDOW
28. IF NO WINDOW,WHAT KIND OF VENTILATION IS THERE? /;O
29. SIZE OF DUCTS 30. ARE SEWAGE AND WATER FACILITIES AVAILABLE?
SIGNATURE C ADDRESS
LICENSE NO.LL ESTIMATED COST iL U TELEPHONE
OWNER ADDRESS
WATER HEATER
31. TYPE 32. MANUFACTURER
TANK SAFETY DEVICES
33. CAPACITY 37. TEMPERATURE RELIEF VALVE
34. TEST PRESSURE 38. MANUFACTURER_
35. WORKING PRESSURE 39. PRESSURE RELIEF VALVE
36. TYPE 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.
C0962 DATE SIGNA URE OF APPLICANT
7 1, FEWIT
Application For
DEPARTMENT DECISION P rinitDEPARTnesting
APPLICATION Is NEROV: pEPMTMEIrr OF I.ICBN9E8 AND 11VSPW1'10aV
D APmvEo C]wArrRovao TOWN OF SOUTH WIN DSOR
OATH tMN/ INSPECTOR AInICATIONO •IIST at NINTtO M TKO. OAiMI was 1NIMOtw NIO snew
I. LOCATION OF
M. a
MIT
M
ow rum AR. 110.
o OWNER
o a. ADDRESS I
L 4.PHONE
O1LA llv%fv
APPLICANT
A. ADDRESS 6,4 ENr-IELD ST.
P.M Pux
08rg
4. LICENSE NO.
9. EXPIRATION DATE OF LICENSE 8
o. ESTIMATED COST • l 6
ai TM A CONTRACT ooSTt C'YES C1 IN
PEE ENc oSEo •
TM OF BULOM
p 0-MOMMIL O COMIIEOCIA
94. TTPE OF JOB:
4.IMOu0Ti11Al
Ii1NAA O ADDITIOOITIO
A10N
IM=TA LATi011 N
APPLICATION FOR HEATING PERMIT hom Rff
11. LOCATION OR JO
M0. 9=9117 now APT."a
IL TYPE F INSTAL.ATI N: 0'OIL BURNER ELECTRIC VDmLATION SPRINKLER
am BURNER STACK INCINERATOR Cl MISCELLANEOUS
WGNTW
1 S. OFTANK OF TANK ILL or voff.
1 B.T.U. EQUIP. AT REGISTER..,_FURNACE MAKE AND NO. AT BONNET FIRING RATE
BOILER OR FURNACE MAKE AND NO. Ol)B.T.U. OR SQ. FT. NET B.T.U. OR SQ. FT. GROSS_FlRING RATE
FLOORS TO BE HEATED NEW OR OLD BUILDING INSULATED - YES OR NO
TYPE OF WALL INSULATION ROOF OR CEILING INSULATION
AVG. SYSTEM WATER TEMP. LT.U SQ. FT./HR. EMISSION
INDOOR-OUTDOOR TEMPERATURE DIFFERENCE FAHRENHEIT
MAKE OF RADIATION: BASEBOARD. COPPER CONVECTORS. OR C.I. RADIATION. OUTPUT PER SECTION OR LINEAL OF RADIATION. SQ.
FT. OR B.T.U.
KCBI
OONDON
OF WORK
i ; C i L 7' 11s. TOO BE
16. MEAT LOSS SCHEDULL (TO K INCLUDED FOR ALL JOBS):
weer seas wolloom
wwe OOORI) ARIA — SCUMSBTEE 8.*•ei a.T.14 OISTRIGUTI N INSTALLED
TOTAL TWAL
ROOr l"L M O1.Ar NOT GINJ s PLC p1./T. AT 3 r AD. SIC loran
L 0 M Are
eeALb f lww%.TJ Tow. TO ' r{ Tv AMe Gist
GiA K.
OR 6aAOSR
cress s oww. i PRts ARSA
TOTALS
A. HEAT LOSS FROM BUILDING B.T.U HL
B. DOMESTIC HOT WATER DEMAND B.T.U HL
C. PIPING.OTHER THAN NORMAL LT.U HL
ALLOWANCE FOR HEAT VALVE Of FUEL (A B C) FACTOR
17. lLECTRICAL WORK BY•
guilt ABORsss
SUBCONTRACTOR: AND
16. THEIR TRADES
ALL WORK COVERED BY THIS APPLICATION HAS BEEN AUTHORIZED BY THE(OWNER) OR (AGSM OF THIS PROPERTY AND WILL
BE DONE IN STRICT ACCORDANCE WITH THE BUILDING CODE
PLICATION TO BE COMPLETELY FILLED IN.
Building APPLICATION FOR BUILDING PERMIT
Plumbing
HVAC Date: 1/
Sprinkler
Electric
J_I R ')yet c
Estimated Cost $
Zonin Permit Fee$
17379AffidavitNO.Occupancy Fee $
Eng. Dept. COMPLETE RED BOXED AREAS.Fire Dept. Total Fee $
Health Dept.
TYPE OR PRINT ONLY
Approved SIGN ON REVERSE SIDE.
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 Zone
Applicant SACs6'60" Tel. # S/!ZT-
Address2 U S A szI0 4— Lic. # Zip 060
Owner- te Address
Architect nL off Address
Q
Size Main Building: Ft. Front Overall Z Ft. Deep Overall 'Z / Total Area Garages
Lavatories I
No. of Families No. of Stories_ Construction Bathrooms a- Rooms 1st_'1_2nd_4__3rd
Size of Lot Dist. from Street Line Dist. from Side Street Line
Purpose of this Permit TO /`- 5h f 5iflAl etiT iNiD W4rLeOo.-k
City Water Of Well Septic Sewer Pff
Approved by Date /
Dist. from lot line E. W. S. N. Dist. nearest Bldg. ft.
Height of stories -cellar 1st 2nd 3rd 4th 5th
Found depth below grade Above grade Material for footing
Size footing Material for found. Found. thickness
Roof No. of stairways Size of girders
Material for Side Walls Size of pier found.
Floor joists, size: 1st 2nd 3rd stories. Dist. on center
Longest span of floor joist: 1st 2nd 3rd If not wood joist const. what type of floor?
Size of Roof Rafters Longest span on center
Chimneys, size of flues How many? Where does tile start?
Plumbing contractor, Permit No. Oil burners, Permit No. Plot Plan Rec'd:
Heating contractor, Permit No. Checked by Eng. Dept. ;
Electrical Permit No.—/O G Signed by Engineer:
Sprinkler Permit No.
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 azone
in which this building and its use is allowed.
hereby apply for a Certificate of Occupancy for
described in the abo a ap cJ, or permit.
Signed
pel Je'r F1W1 SNGD &SE-M&AIT
INSPECTION REPORT .X W TV mac. /2avfy7
Permit # 7. Job S i v0 O
1 Footing qC, A/ ow ZFQ
2 Foundation
3 Framing
4 Wiring
5 Plumbing
6 Heating
7 Lathing
8 C.O.
r
RMIT #
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT 4
Application is hereby:
TOWN OF SOUTH WINDSORAPPROVEDDAPPIiUILDINGINSPECTIONDEPT.
644 -2M Ext. 230
Date Building Inspecto Applications must be orprinted vPtyped.
I. LOCATION OF JOB
is LISA
FEE SCHEDULE No. S reet
I Floor Apt. No.
0 - $19000 - 10.00
T Over $1,000 - 2. OWNER 0Nt/JAC.SO,4f10.00
per $1,000 or
3. ADDRESS g5 VISAfractionthereof Elyc
0 bv_j
4. APPLICANT
5. ADDRESS_____
ACTUAL COST $ FEE $ 6. ESTIMATED COST S
ESTIMATED COST $_ FEE $ 7. IS THIS A CONTYACT COST? Q YES NO
FILE COMP. BY BALANCE $ 8. FEE ENCLOSED 737
9. n7E OF BUILDING:
RESIDENTTAi. COM.MERCIAL
1.0. TYPE (IF Jr)S:
URIGIXAT, ALTEP.ATIONE3IySTAI.T,ATTc)ti ADDITION
REPAIR
APPLICATION FOR ELECTRI.CAL Ple.1RArr(Continued from t:evarse Side)
11. LOCATION OF JOB Z,5 b SA sEvh i
NO. STREET FLOOR APT. NO.
12. TYPE OF INSTALLATION
13. SIZE OF MAIN FEEDER
14. NO. OF LIGHT LOOPS 15. NO. OF HEAT LOOPS 16. NO. OF Priv,,RR LOOPS
17. NO. OF LIGHT OUTLETS_ _ 18. NO. OF HEAT CIRCUITS 19. NO. OF POWER
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 LNO ORS
26. NO. OF PANELS 27. TOTAL WATTAGE 28. NO. OF POWZR PANELS
29. NO. OF SWITCHES 30. A/C LOAD 31. SIZE OF POWER FEEDERS_
32. N0. OF FIXTURES 33. TOTAL HORSEPOWER
34. NAMES OF SUBCONTRACTORS AND THEIR TRADES
35. REMARKS AND FURTHER DETAILS:
LICENSE)NO. SI ATURE OF APLICANT DAZI;
PHONE NUMBER: