HomeMy WebLinkAbout178 FOSTER ST DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
PERMIT#
Applicati eby: TOWN OF SOUTH WINDSOR o
BUILDING DEPARTMENT
AP
1540 SULLIVAN AVENUE
Bldg. Permit#
644-2511 ext. 230
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Date Iding Inspector
Application must be printed or typed
�$0 FEE SCHEDULE cation of ob:
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-$1,000=$15.00 Street Lot No.
Over$1,000=
$15.00 per$1,000or any fraction thereof gnati n Apt.No.
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APPLICANT 1
APPLICANT ADDRESS
APPLICANT PHONE#) �^ 860-- 6�// SI Z y
�O W N S F-4 OWNER � / V r v �� ('}�t c.%A Kta
OWNER ADDRESS / 7a 4[)Sl�r S
r OWNER PHONE
C ;D ESTIMATED COST$ l ,
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� IS THIS A CONTRACT COST? Ye No
FEE ENCLOSED$ .
TYPE OF JOB:
OR-C New Installation
_Alteration/Addition/Repair
APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
RESIDENTIAL BUILDING PERMIT APPLICATION? ❑YES U0 NO
❑ BUSINESS CURRENT USE AND OCCUPANCY -
❑ASSEMBLY
❑MERCANTILE FUTURE USE AND OCCUPANCY .
❑EDUCATIONAL
❑INSTITUTIONAL
❑FACTORY ENGINEER'S NAME PHONE
❑ STORAGE
❑GARAGE ADDRESS
❑MIXED USE
CITY STATE ZIP
(Other please specify)
TYPE OF INSTALLATION/WIRING METHOD
SIZE OF SERVICE SIZE OF MAIN CONDUCTORS
NUMBER OF METERS L NUMBER OF DISCONNECTS AND RATINGS
NUMBER OF PANELS 1 REMOTE DISCONNECT REQUIRED? ❑YES ❑NO
NUMBER OF LIGHT CIRCUITS NUMBER OF POWER CIRCUITS
NUMBER OF SWITCHES NUMBER OF OUTLETS
NUMBER OF LIGHT FIXTURES NUMBER OF HEAT CIRCUITS
NUMBER OF A/C CIRCUITS
SEPARATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED.
DESCRIPTION OF WORK
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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.
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CONTRACTORS LICENSE NO. = E STATE
SIGNATURE OF APPLICANT DATE
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1 inch = 40 feet MAPPING PROVIDED BY SBC UNDER CONTRACT.
o � DATA MANAGED BY THE SOUTH WINDSOR
y ` ,u ENGINEERING DEPARTMENT AND IT TECHNOLOGY
DEPARTMENT.
�'��SOR
RECEIVED
JUN 13 2016
South Windsor
Building Department
lift "IIUWu UtPI. IUYVN Ut South
•is certdflad that this plan and specifications ,
'Plt's W the proposed building or alterations t e
rected at
�7J Sty ei
�RMher with amendments stated In application o
,�.A with plan and I agree to comply with all zoo, q
•W,ag end state laws and such orders as she: e
d by the Building Department !luring Pend. .y
ands application and final Issuance of a building
"y'o'�:
'�•. PI n Is approved subject to the condition that
rY , ordinances regulating building shall be
M —th
-i—d,tionaily Approved These filed with
"no,ctor Clef/(f
CERTI IGATpON OF 7ON1,14G coR,i 1-3 zsAr,c
Proposed builc:ng(s), u3e(s) and/or struct,rr(s) -13
shown on this plan appear(s)to be i
with current South Windsor reyu.' .tions. Variances
and special exceptions may apply.
Data ` - :1-c20)(,
Z' J En' rr ment Officer
1600518 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER BUILDING PERMIT
DATE: 08/18/2016
GIS ID: 33600178 FEE: 30.00
MUNIS APPLICATION# 201601016 BUILDING DESCRIPTION:
APPLICANT LOCATION
NAME: RUTKOWSKI JENNIFER K ADDRESS:' -178 FOSTER STREET
ADDRESS: 178 FOSTER STREET , OWNER: RUTKOWSKI JENNIFER K
SOUTH WINDSOR,CT 06074 „ry ,178 FOSTER STREET
SOUTH.WINDSOR,CT 06074
DESCRIPTION OF WORK: PUT DECK ON BACK OF HOUSE.
APPROX.',16 X 12.
SPECIAL CONDITIONS:
ALL WORK TO BE DONE IN ACCORDANCE WITH THE APPLICATION AND PLANS APPROVED BY THE BUILDING DEPARTMENT.
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CONSTRUCTION TYPE:
OCCUPANCY GROUP: BUILDING OFFICIAL
8/18/2016 1:58 PM THE FEE ABOVE INCLUDES A$0.26 PER THOUSAND CT STATE EDUCATION SURCHARGE