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Home My WebLink About212 EVERGREEN WAY DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT Applicati TOWN OF SOUTH WINDSOR PERMIT#�q ZZ BUILDING DEPARTMENT Z isw 1540 SULLIVAN AVENUE Bldg.Permit# 644-2511 ext. 230 Date 7Build7ingl4nspectoir Application must be printed or typed FEE SCHEDULE O,J �� 5 O�i Location of Job: Sv'.}G W- IOS� ? 3 S� NS e2 C9 S.2),�2s, S a 9, 543, 50�, HooSao, Sao „ ! aA-ce-i a 5- 4Q4OP,/oo $0-$1,000=$15.00 Street No. Stree �T Lot Over$1,000= $15.00 per$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANT S e ll a L APPLICANT ADDRESS F0 B o,c I 3 S IV e ,, B,6 4.:,,, CT O,F OS 0 APPLICANT PHONE# ��Gy) a 9- OX00 Ow N OWNER C,1r0,^+" S o cef (�r„r wo/,k's) Q� OWNER ADDRESS ;'.. E.. OWNER PHONE ;D ESTIMATED COST$ 15 0,000. UO IS THIS A CONTRACT COST? Yes —No Qf G FEE ENCLOSED$ :+ 2 S 0,00 , �� R� �� TYPE OF JOB: New Installation Alteration/Addition/Repair ' APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side) TYPE OF BUILDING IS TIES APPLICATION ASSOCIATED*M A ❑RESIDENTIAL BUILDING PERMIT APPLICATION? 0 tl YES NO O BUSINESS CURRENT USE AND OCCUPANCY jz�, Cl ASSEMBLY Cl MERCANTILE Cl EDUCATIONAL FUTURE USE AND OCCUPANCY O INSTITUTIONAL ❑FACTORY ENGINEER'S NAME PHONE ❑ STORAGE O GARAGE ADDRESS ❑MDCED USE CITY STATE ZIP (Other please specify) TYPE OF INSTALLATION/WIRING METHOD—rtlrf a t' W`n„ SIZE OF SERVICE SIZE OF MAIN CONDUCTORS NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS NUMBER OF PANELS REMOTE DISCONNECT REQUIRED? ❑YES O 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 :All do 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 LICEN_S-E/NO. E STATE SIGNATURE OF APPLICANTS DATE DEPARTMENT DECISION APPLICATION FOR SPRINKLER PERMIT PfiRMIT Applic a-is-hereby: TOWN OF SOUTH WINDSOR # �.. BUILDING DEPARTMENT D 1540 SULLIVAN AVENUE "� � 30 644-2511 ext. 230 B t# t Date Buil g Mspector Application must be printed or typed FEE SCHEDULE Location of Job: r �51- o kh Rd . � $0-$1,000=$15.00 Street No f� _ ( dv Street 2ti i _ a 3� �a(o Lot No. Over$1,000= $15.00 per$1,000 l U ( - i o� q6b - q� or any fraction thereof Tenant Designation r oZ U� S � � �JApt.No. APPLICANT A ree11Je APPLICANT ADDRESS �) a.XIS(CC�7 ' I e,r(uvCT APPLICANT PH NE# (Y DD- 5ga-`?q S S• 0'* N S Fq r OWNER (YI-A f �r �L�1L' L] Sic Y D 0�e✓1 y l S OWNER ADDRESS / (yq i o p�� . �'c�� k�-d txr� TAJ +w ' 4E (•, OWNER PHONE C ESTIMATED COST$ r,� -9�� 170 G� -- .� IS THIS A CONTRACT COST? Yes _No ti tiG FEE ENCLOSED$ �, f1V ; TYPE OF J . SO CO • 'New Installation Alteration/Addition/Repair Revised 4/01//2002 APPLICATION FOR SPRINKLER PERMIT (Continued from reverse side) TYPE OF BUILDING TYPE OF CONSTRUCTION+l f(J USE GROUP s=06.(kO. OF STORIES ❑RESIDENTIAL *BUSINESS IS THIS APPLICATION ASSOCIATED WITH A *ASSEMBLY BUILDING PERMIT APPLICATION? ❑ YES 0 NO ❑MERCANTILE ❑EDUCATIONAL CURRENT USE AND OCCUPANCY N1er�C,.,�.1� SA-'%r+GS ❑INSTITUTIONAL O FACTORY FUTURE USE AND OCCUPANCY Cj�Mr, O STORAGE LIGARAGE ❑MDG;D USE ENGINEER'S NAME PHONE Q6C 38Z7Y1T'y (Other please specify) ADDRESS /•ilYI p S T CITY �cfr�v.)le__ STATE C 1 ZIP O67 6 KIND OF INSTALLATION SIZE OF MAIN DRAIN N Z WATER PRESSURE AT STREET(PSI) b 0 ARE SPRINKLER HEADS ALTERED? ❑YES FaMO IF YES,CHECK ALL THAT APPLY: O ADDED ❑DELETED ❑ALTERED IF MORE TUAN 3 HEADS ARE ADDED HYDRAULIC CALCULATIONS ARE PROVIDED BY(CHECK ONE) PROFESSIONAL ENGINEER ❑INSURANCE COMPANY WATER FLOW 26 WATER PRESSURE AT SPRINKLER HEADS(PSI) Z6 ARE PUMPS REQUIRED? O YES ;rfiO IF YES,CHECK ALL THAT APPLY: ❑FIRE U BOOSTER O OTHER ARE STANDPIPES PROVIDED? ❑YES �.WO IS A SPRINKLER SYSTEM PROVIDED? U YES ❑NO SPRINKLER SYSTEM MAIN WATER SUPPLY RATING �$� _GPM --- ----- - . -- — TOTAL DYNAMIC HEAD(TDH)OF FIRE PUMP PSI DESCRIPTION OF WORK w h..,,d ra d1 - cy\c�J 4'e,�vta-, 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 APPLICANT DATE �'Z��O`(