HomeMy WebLinkAbout20 WOODSIDE DR APPLICATION FOR.ELECTRICAL PERMIT
DEPARTMENT DECISION TOWN OF SOUTH WINDSOR PERMIT#
Application is hereby: BUILDING DEPARTMENT
APP O . 1540 SULLIVAN AVENUE Bldg:Permit#
644-2511 ext. 230
Date Building Inspector
Application must be printed or typed
FEE SCHEDULE Location of Job:
$0411000=$15.00 go (,)yc,) 61<0
Over$1,000= street No. Street Lot No.
$15.00per$1,000
or any fraction thereof Tenant Designation Apt No.
APPLICANT CA d e U SZ U 61--e Q .
APPLICANT ADDRESS 17 *r
Cr O 6 2 .fv
APPLICANT'S PHONE
OWN Sly
OWNER !1,�00 r -e 1.yju '
'
OWNER ADDRESS 2 Cif p � �•'
C ,.� .�c F OWNER PHONE
C �
ESTIMATED COST$ goo.
c U
U IS THIS A CONTRACT COST? Yes No
FEE ENCLOSED-$.
TYPE OF JOB:
OR-CO New Installation
/Alteration/Addition/Repair
Revised 03/05/l0
I
APPLICATION FOR ELECTRICAL PERMIT(Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
BUILDING PERMIT APPLICATION? ❑ YES ❑ NO
411ESIDENTIAL CURRENT USE AND OCCUPANCY
Cl BUSINESS
❑. ASSEMBLY FUTURE USE AND OCCUPANCY
❑ EDUCATIONAL
❑ INSTITUTIONAL ENGINEER'S NAME PHONE
❑ FACTORY
❑ STORAGE ADDRESS
❑ GARAGE
❑ MIXED USE CITY STATE ZIP
(Other please'specify)
TYPE OF INSTALLATION/WIRING METHOD
SIZE OF SERVICE SIZE OF MAIN CONDUCTORS
NUMBERS OF METERS NUMBERS OF DISCONNECTS AND RATINGS
NUMBERS OF PANELS NUMBERS OF DISCONNECTS REQUIRED? ❑ YES ❑ NO
NUMBERS 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
V to r'e c� Y'
i701 dSe'o olee-1 ate,"A
THE UNDERSIGNED HEARBY 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 PERFOR-
MANCE OF SUCH WORK
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT DATE__LW Wl
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Lot So I on. m%jp 'Cl c6 'ap o S 111, 11 1 e as a II va 110 v
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PROP11-.RTY OF
J � tom, �-'�l 1.K t
WOODSIDE, DRIVE SOUTH 'l-l"INDSOR., CONIN.
tieing Lot No. 11 on map entitled 112ap o.-" JODSIDEE Pleasant Valley
Road South Windsor, Conn . Property of Janes 11filkie Scale 111 = 401
September 8, 1962 liny6ca L. Griswold C .E . "
Scale 111 = 401
ilhYDEN L. GRISWOLD C .E.
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` PROPERTY OF
WOODSIDE DRIVE SOUTH WINDSOR , CONN .
Reins Lot No . 11 on map entitled "Map of WOODSIDE Pleasant Valley
Road South Windsor, Conn . Property of James ?tilkie Scale 1 " = 4u
September S, 1962 Hayden L. Griswold C .E . "
Scale 1 " = 400
HAYDEN L. GRISWOLD C .E. ,
-`
Home Occupation Information and Application Form
3. 1�_O 9 ASSESSOR'S USE ONLY
Minor Approved by ate ! Home Occupation Type
❑ Major
Code
Name&I-Pe6 ' l7' GXI"4461 DBA /V lnrS- PpiNT/N(-,-
Address of Pro osed Occupation: '2 C) W OO D S I b E
Telephone flo U 96rn 30/2 Zone (Note:in DRZ,MF zones only minor home occupations are
allowed;approval letter from homeowners assn required
Description of Home Occupation:
Please use the boxes below or an attached sheet to provide the following: A.Proposed Sign
1. Attach copy of plot plan if available.
2. Use Box A(or attach sketch)to draw proposed signage.
3. Use Box B(or attach sketch)to draw the floor plan of the Home
Occupation area.
4. Architectural elevations for any proposed additions or modifications
must be provided.
►VuN�
FLOOR PLAN (❑Basement ❑ Is'floor ❑2°d floor)
Floor area of dwelling
Floor area of home occupation
%of floor area devoted to home occupation < ZCS 6�b
t'-D17 -Y-Z-e t-c�. L SteU,��D
P\3(7 CVS-'D —�D
I have read the regulations regarding home occupations and will comply with said regulations.I understand that I must notify
the Planning Department in writing upon termination of this occupation at this address.This permit is not transferable or
assignable to another person.In the event of relocation,the permit holder must notify the Planning Department in writing to
transfer the permit to the new location.
Signature of Applican Date /2 I O
Signature of Owner Date
1600448 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER ELECTRICAL PERMIT
DATE: 10/07/2016
GIS ID:97500020 FEE: 45.00
MUNIS APPLICATION# 201601345 BUILDING DESCRIPTION:
APPLICANT' LOCATION
NAME: DUBIEL TADEUSZ ADDRESS:' 20 WOODSIDE DRIVE
ADDRESS: 17 BRIARCLIFF ROAD OWNER: GRIMALDI GEORGE M&VIRGINIA S
MANSFIELD CENTER,CT 06250 --20 WOODSIDE DRIVE
SOUTH,WINDSOR,CT 06074
DESCRIPTION OF WORK: UPGRADE ELECTRICAL SERVICE FROM 10070 200 AMP. RELOCATE
SERVICE,"I'O SIDE OF THE HOUSE. MAIN DISCONNECTED WITH METER.
SPECIAL CONDITIONS:
ALL WORK TO BE DONE IN ACCORDANCE WITH THE APPLICATION AND PLANS APPROVED BY THE BUILDING DEPARTMENT.
CONSTRUCTION TYPE:
OCCUPANCY GROUP: BUILDING OFFICIAL
10/7/2016 12:06 PM THE FEE ABOVE INCLUDES A$0.26 PER THOUSAND CT STATE EDUCATION SURCHARGE