HomeMy WebLinkAbout220 DIANE DR DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
TOWN OF SOUTH WINDSOR PERMIT#
Applicati �
BUILDING DEPARTMENT
AP ED 1540 SULLIVAN AVENUE
( 644-2511 ext. 230 Bldg.Permit#
t�
Date wilding Inspector
Application must be printed or typed
FEE SCHEDULE Location of Job:
$0-$11000=$15.00 Street No. Street I of No.
Over$1,000=
$15.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT
APPLICANT ADDRESS %=:�&U
APPLICANT PWNE# ?OO
SOW
OWNER r , V � �N Sc OWNER
OWNER ADDRESS
OWNER PHONE-'
C ESTIMATED COST$ �.
+� IS THIS A CONTRACT COST? _Ye No
FEE ENCLOSED$
r/VOS � TYPE OF JOB:
R-C New Installation
✓-Alteration/Addition/Repair
APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
BUILDING PERMIT APPLICATION? ❑YES ❑NO
U RESIDENTIAL
❑ 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 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
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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.
.y
CONTRACTORS LICENSE NO. ;, E STATE
SIGNATURE OF APPLICANT t� DATE 10—61-Q�O
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PROPERTY OF '
NO. DIANE DRIVE SOUTH WINDSOR, CONN.
Being Lot No. 23 on map entitled "Map of HIGH FARMS Kelly Road
South Windsor, Conn . Property of Edward, Joseph & William Kelly
Subdividers Robert Stone & Jack Goldberg Scale 1" = 501 April 6,
1959 Hayden L. Griswold C.E. Sheet 2 of 2 Rev. Jan. 8, 1963 to
show change of building lines" ��
Scale 1" a 501 '`������ E
HAYD9N L. GRISWOLD ;C.E.
III
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CERTIFICATION OF APR 4 1494
ZONING COMPLIANCESouth Windsor
Proposed buiiding s), uses) and/or structures;
as show., on this , BUILDING pFpgPT�,IC�VT
conformance with Au renp�os�hto Nirtdsor
regulations, Varia;�ceS and special exceptions
may apply.
Date 4
3 C TO THE lJ0.DIK DEPT. TOWN OF SO 1H lal::._
infet`�ement This certified that this plan and specifications are tr:.
VCmOn lOfIk r copies of the proposed building or alterations to t,
!!�� Q // N erected at
AAA------ (ter i together with amendments stated in applic,tion e
r tiled with plan and I agree to comply with all .,.ici
Building and state laws and such orders as s li I
issued by the Building Department during p:n;�-m
of this application and final issuance of a busid,ni,
-I{— Signed
This plan Is approved subject to the condition thhat
orders and ordinances regulating building $hail be
complied with.
Conditionally Approved Those filed with
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FOR BUILDING PURPOSES dNEY
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PROPERTY OF
NO. DIME DRIVE SOUTH WINDSOR, CONN.
Being Lot No . 23 on map entitled "Map of HIGH FARMS Kelly Road
South Windsor, Conn . Property of Edward, Joseph fi William Kelly
Subdividers Robert Stone & Jack Goldberg Scale 1 " a 501 April 6,
1959 Hayden L. Griswold C .E. Sheet 2 of 2 Rev. Jan. 8, 1963 to
show change of building lines"
Scale 1 " a 50 '
HAYDtN L. GRISWOLD C.E .