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South Windsor
BUILDING DEPARTMENT
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This certified that this plan and specific tions are ti -
copies of the proposed building or alteratmns to
erected at
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together wlth mendments stated in appiication ,.
filed with plan and 1 agree to comply with all zont
Yuilding and state laws and such orders as shall
issued by the Building Department during penden
®f this application and final issuance of a buildlr4111*0104 A
1ph* r4as to approved suLlect to the condition the
qille"o°-if+i ordinances regulating building aft" be
tlp[npUed with.
,QW,d;tionally Approved These filed with
puilding Inspector CleO
Date No. -0/�e&
C,-R,[IFICATION OF ZONING COKIPLIANCE
Proposed building(s), use(s) and/or structure(-)
`k as shown on this plan appears) to be in
12 22 conformance with current South Windsor
regulations. Variances and special exceptions
may apply. tj�Lr 9 /990
Date
7�z
ning Enforcement Officer
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APPLICATION FOR ELECTRICAL PERMIT
DEPARTMENT DECISION TOWN OF SOUTH WINDSOR PERMIT#
Application is hereby: BUILDING DEPARTMENT 1100232
APPRO E 1540 SULLIVAN AVENUE
Bldg.Permit#
f� < ,may 644-2511 ext. 230
Date Building Inspector
Application must be printed or typed
FEE SCHEDULE Location of Job:
$041,000=$15.00
Over$1,000= Street No. Street Lot No.
$15.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT M C-G•o/Z 7.4- TR- felt q r7 A-yL
APPLICANT ADDRESS P l
S-,9v- ?'Y w,^-�D 2 , C— c26o7y
APPLICANT'S PHONE#
OWNER M R-L($10 aZ 4-7 4 14" G GL
g O W N S Fq< OWNER ADDRESS A I H I bl-f i'I C-
.S 0 U Z'OY .e.) r 1J D to e2 1 C7 n 6 n 7 5
OWNER PHONE 'B 6 0 G O l- -1/ 14.Z
O ESTIMATED COST$
C
IS THIS A CONTRACT COST? Yes No
FEE ENCLOSED$ a GD r 6"0
TYPE OF JOB:
Sp 0 New Installation
R.CO
Alteration/Addition/Repair
261 l 0 1�o �
Revised 03/05/10
I
-7
APPLICATION FOR ELECTRICAL PERMIT(Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
BUILDING PERMIT APPLICATION? J4 YES ❑ NO
{� RESIDENTIAL CURRENT USE AND OCCUPANCY Z
❑ BUSINESS
❑ ASSEMBLY FUTURE USE AND OCCUPANCY a—
❑ EDUCATIONAL
❑ INSTITUTIONAL ENGINEER'S NAME PHONE
❑ FACTORY
❑ STORAGE ADDRESS
❑ GARAGE
❑ MIXED USE CITY STATE ZIP
(Other please specify)
TYPE OF INSTALLATION/WIRING METHOD ,,?Op lq MP 5 LCff v!c-E
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
L C cnSt - t=_LL S 7 ► - t
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
lAt,Ho 1W& j _ C -T
Pr► CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICAN DATE
2 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER ELECTRICAL PERMIT
DATE: 12/16/11
GIS ID:43200021 FEE: 60.00
MUNIS APPLICATION# 201101508 BUILDING DESCRIPTION:
APPLICANT LOCATION
NAME: ARABASZ MALGORZATA' ADDRESS: 21 HIGHVIEW ROAD
ADDRESS: 21 HIGHVIEW ROAD OWNER: ARABASZ MALGORZATA
SOUTH WINDSOR,CT 06074 -21 HIGHVIEW ROAD
' SOUTH WINDSOR,CT 06074
DESCRIPTION OF WORK: 200 AMP.SERVICE.
P :
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
12/16/201 l 9:23 AM THE FEE ABOVE INCLUDES A$0.26 PER THOUSAND CT STATE EDUCATION SURCHARGE