HomeMy WebLinkAbout0 SCANTIC MEADOW RD PUMP STATION Electric # 6 Es� APPLICATION FOR BUILDING PERMIT
Plumbing# o 0 5
HVAC # 15 Scantic Meadow Road Date:-Z-A 1 �a 4
Sprinkler# 32342
G�
FINAL RO ---- - _- Estimated Cost $
Buildin � /r R l - ----- -------- - -- -- -- Permit Fee $
En ine n COMPLETE RED BOXED AREAS Occupancy Fee $
g TYPE OR PRINT ONLY Eng. Insp. Fee $
Affidavit
Appr. for CO. ► SIGN ON REVERSE SIDE
Total Fee $1d1���
TO THE BUILDING DEPARTMENT,TOWN OF SOUTH WINDSOR, CT (Additional Cost) $
The undersigned hereby applies to do work according to the following:
Applicant kQVA-C> 0 �r-4...c) Location of Work / SGAA)f.,. h.P.Mo.0 1 Lot No.
Applicant's Address �-9?wk t-Cc a-/ Tel.# A03-7Y3-YVXX
Town N�� Zip 6 g1 0 Lic.# yL�O 41�
Owner 7 wN ieso cif INOsa Architect V X4 wJ s.�r�tD�✓
Owner's Address Architect's Address
Zip Zip
Sq. Ft. New Area: 1st FI. 2nd FI. 3rd FI. Total New Area
Purpose of this permit �co o
Go AJ
City Water❑ Well❑ Septic System❑ Sewero
Ins: HO SP Cert. Area Basement Garage
Approved by Date Use Group Construction Type
Revised 6/02
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 Windsa 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 which this building and its use is al"wed
Signed_Z��---"'z '�� rJ1,-
I hereby apply for a Certificate of Occupancy work described in this application for the permit.
DO NOT WRITE BELOW THIS LINE
INSPECTION COMMENTS
Inspection / Approval Date By Appl
Code Description Due Whom Code Comment
-------------------------------------------------------------------------------
+*-32642-B 3,000
B10 FINAL 03/19/08 JFF A
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
T#
Application is hereby: TOWN OF SOUTH WINDSOR /E�PERMI3
BUILDING DEPARTMENT
APPR 1540 SULLIVAN AVENUE Bldg.Permit#
' 644-2511 ext. 230
JD e Building I pector
Application must be printed or typed
FEE SCHEDULE Location of Job:
�50
Se- 4"c, �ft$0-$1,000=$15.00
. S treet Lot No.
Over$1,000=
$15.00 per$1,000
or any fraction thereof it Designation Apt. No.
APPLICANT
APPLICANT ADDRESS
S'
APPLICANT PHONE#
O W N S tq OWNER &Z-e G(/iiri P91Si'n..
OWNER ADDRESS I O .9:Q0!/rjW
U) # F, OWNER PHONE
O
C ESTIMATED COST$ ��s lfyd
IS THIS A CONTRACT COST? _Yes --'KNo
FEE ENCLOSED$ c)Q cc.
r�OSO o TYPE OF JOB:
R C New Installation
_Alteration/Addition/Repair
Revised 4/01//2002
J
APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
0 RESIDENTIAL BUILDING PERMIT APPLICATION? ElYES O NO
❑BUSINESS CURRENT USE AND OCCUPANCY
❑ASSEMBLY
❑MERCANTILE FUTURE USE AND OCCUPANCY '
El EDUCATIONAL K�-0 y ��' "
❑ INSTITUTIONAL
❑FACTORY ENGINEER'S NAME /.fIt7VYJfoK/PHONE
U STORAGE
❑GARAGE ADDRESS
❑MIXED USE
(Other please specify) CITY STATE ZIP
TYPE OF INSTALLATION/VVIRING METHOD
SIZE OF SERVICE �� SIZE OF MAIN CONDUCTORS
NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS
NUMBER OF PANELS Z--- REMOTE DISCONNECT REQUIRED? ❑ YESKNO
NUMBER OF LIGHT CIRCUITS_ NUMBER OF POWER CIRCUITS
NUMBER OF SWITCHES_ NUMBER OF OUTLETS
NUMBER OF LIGHT FIXTURES !d NUMBER OF HEAT CIRCUITS
NUMBER OF A/C CIRCUITS
SEPARATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED.
DESCRIPTION OF WORK
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS TO
COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE
PERFORMANCE OF SUCH WORK.
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLIC DATE ��
Shirley Wilhelm-CRS Approval Confirmation: Request No.437118 Page 1
From: <clpsvc@nu.com>
To: <WILHEL@SOUTHWINDSOR.ORG>
Date: 9/20/05 3:08PM
Subject: CRS Approval Confirmation: Request No.437118
Your approval of the following CRS Request has been successfully
processed.
CRS Work Request#: 437118
House No: 15
Lot No:
Street Name: SCANTIC MEADOW RD
Town Name: SOUTH WINDSOR, CT
Inspector: CHRISTOPHER DOUGAN
Approval Date: Sep 20,2005
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