HomeMy WebLinkAbout20 HENRY RD DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
PERMIT#
Application is hereby: TOWN OF SOUTH WINDSOR - S
BUILDING DEPARTMENT -
`-APP74uildingin
1540 SULLIVAN AVENUE
Bldg.Permit#
644-2511 ext. 230 3 Ufo�,
Date s r
Application must be printed or typed
FEE SCHEDULE Location of Job:
$0-$1,000=$15.00 FTenant
Street Lot No.
Over$1,000=
$15.00 per$1,000
or any fraction thereof gnation Apt.No.
APPLICANT
APPLICANT ADDRESS
APPLICANT PHONE# 3 "- Z S Z
"to W Ni 3 F,q OWNER CAc 0
OWNER ADDRESS ZIP
c-\
• �, �. OWNER PHONE '7 Z Y
C = ESTIMATED COST$
xr
* IS THIS A CONTRACT COST? ✓des _No
FEE ENCLOSED$
TYPE OF JOB:
�SO R C0N New Installation
_k-Alteration/Addition/Repair
Revised 4ro1irz002
APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED A
—/SIDENTIAL BUILDING PERMIT APPLICATION? t�NO
'RE II
❑BUSINESS CURRENT USE AND OCCUPANCY S
❑ASSEMBLY
❑MERCANTILE FUTURE USE AND OCCUPANCY
❑EDUCATIONAL
❑INSTITUTIONAL
❑FACTORY ENGINEER'S NAME PHONE
❑STORAGE
❑GARAGE ADDRESS
❑MDCFD USE
CITY STATE ZIP
(Other please specify)
TYPE OF INSTALLATION/WIRING METHOD
SIZE OF SERVICE SIZE OF MAIN CONDUCTORS
NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS
NUMBER OF PANELS 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
n n r cam-.
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.
`g 3 3 2, 1 C— �=
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT DATE S A l 10 �{
� 3
.c
Betterlivingi
PATIO ROOMS
• •
Betterliving Patio Rooms of Connecticut
1351 Dixwell Avenue
Hamden, CT 06514
Dear Sir or Madam:
This letter gives Patio Rooms of Connecticut the right to pull electrical permits
with my Electrical Contractors License (#183323) for
At Z� �''�-^ "`� 2,z I will be doing the work for them and take full
responsibility for the electrical that will be installed.
Sincerely,
S �
William ortune
Owner
203-389-2521
i
P
t
r
Electric # 14,q a APPLICATION FOR BUILDING PERMIT
Plumbing# 20 Nenry Road Date: �i o
HVAC # I-
Sprinkler# 30682. ____ __
FINAL P -- - Estimated Cost 'b� * a
Building3 �v�� ,}-- COMPLETE RED BOXED AREAS Permit Fee $
Enginee v. Occupancy Fee $ ./O,
170
Affidavit ; TYPE OR PRINT ONLY Eng. Insp. Fee $
Appr. for CO SIGN ON REVERSE SIDE Total Fee $
TO THE BUI ING DEPARTMENT,TOWN OF SOUTH WINDSOR, CT (Additional Cost) $
The undersigned hereby applies to do work according to the following:
Applicant., fr X4 ZJP o 9�=4r,,� ,C=Qpcation of Work ?-,:;, LA ,,,%rzQ (L-a Lot No. t�* io,
Applicant's Addresses c,U (! ,,j C )- C6 s � 4 �Tel.# 20 Zg a zz 1
C k Zip 0 6 s ( 4 -tic.# S 1L D(,o C
Owner Architect
Owner's Address Zci "ef% Architect's Address
Zip Zip
Ft. New Area: 1 st Fl. %4 Z, 2nd FI. 3rd FI. Total New Area
Purpose of this permit Q k Z n
City Water[ Well❑ Septic System❑ Sewertli--,Of
Ins: HO C rt. Area Basement Garage
Approved by to Z Use Group Construction Type/_ ir I _
Rsvissd W02
I hweby mg rw to conform to al the nqukwnwft of the Laws of ttw Stab of Comedied and the Ordirwim of the Town of
So ulh WirKlom and to rwMy the Bubrp! op No of any akwabm in the pbna or spodkdions of the Buildkg for this
pant Is soloed,and ague that IMs buk*V is to be locabd the prapar dletwim from al street km,side yard lines,and rsquind
dlatanoes from all other zorwa and is located in i this bolding and Ib use Is allowed.
� Signed
I tweby apply for a Certlbcab of for the work described In this appication for 1M pwmk.
Signed
DO NOT WRITE BELOW THIS UNE
INSPECTION COMMENTS
Inspection / Approval Date By Appl
Code Description Due Whom Code Comment
-------------------------------------------------------------------------------
**-30682-B 1,700
B10 FINAL 09/29/05 JFF D NO ACCESSS DOOR TAG
B10 FINAL 03/02/06 JFF D N/A DOOR TAG ALSO VOICE MAIL
B10 FINAL 03/03/06 JFF A WITH OWNER
**-18925-E 900
180
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Town of South Windsor General Map N ROAD NAMES
Connecticut WATERCOURSES
CONDOS
Date Printed: May 20,2004 �.
PARCELS
03 c�, -.40 Ia=WETLANDS
0 70 Feet Text Final_annotation.dxf
Property boundaries are derived from the Town of South Windsor Tax Assessor maps,digitized at a scale of 1 inch-100 feet,and include
All other data portrayed is representation only and,due to inherent mapping limitations,should be used as a guide only. The intent of this n
and selected data,and the map is subject to change as more accurate surveys may disclose. Property boundaries mapped as of June 4,:
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MAY ;', 9 2004
South Windsor
BUILDING DEPARTMENT
!dis ck fti.1 d tt+at t..�s plan ana s,,_caic_tluns -1,v.
cope,' of the proposed Oulldins or allerettans to o•
erected at
Opo /H suet
tigother woh dnrnts stated in appliction 0—
,I I.�A .vita, pl:n r:n<l i ler.o to c^mply with alit aontnj,
:.t I, i.,•s and 5,;h ^rd•-rs as shall h,
,3 cC -:y t. c. - r'c,:nt d�.ring pendenc,
.Is I . << n :no .Ina: issuance of a ba Udina
_rmit.
ned
�s nIan to tf,e condition that
nlrs ;ynArd,.r so Ccs nsw nn4 7oilding 'hail Be
<� ..nth
—dllion4lly Approved These filed with
--ilding Inspector l Cler
•In '3 Off.�•�
CERTIFICATION OF ZONING COMPLIANCE
Proposed building(s)t
use(s) and/orstructure(s)
as shown on 'this plan appear(s) to be in
conforrrr,3nce with current
tspec aiSouth
ax exception
regulations. Variances
may apply.
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South Windsor
BUILDING DEPARTMENT
10 TKI 9:.4;:,h .:It
This Certified that this plaa *ad speeMlCstions are tre
copies ul the propwed building or alteratle," to a
erected et
30 1 en P—J .trwt
together with amendments stated In applicaWn anc
filed with plan and I agree to comply with all zoning
Duliding and state laws and such orders as •hall be
issued by the Building Department during pendant}
of this application and final issuance of a bulidlnF
permit.
Signed
This plan is approved subject to the eondltlan that
orders and ordinances regulating building shall tw
dvrnplted with.
Conditionally Approved These riled with
Building lnsp�chr
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