HomeMy WebLinkAbout240 PLEASANT VALLEY RD Electric# APPLICATION FOR BUILDING PERMIT
Plumbing# 240 Pleasant Valley Road
HVAC #
No. 28738
Sprinkler#
FINAL P Estimated Cost $
Building o `Z COMPLETE RED BOXED AREAS Permit Fee $
E ngin n TYPE OR PRINT ONLY Occupancy Fee $
Affidavit SIGN ON REVERSE SIDE
Appr.for CO. Total Fee $ 7 C
TO BUILDING DEPARTMENT,TOWN OF SOUTH WINDSOR,CT (Additional Cost) $
The undersigned hereby applies to do work accordingto the following specifications:
Job Location '`'U j" t� c,. T Lot No. Side of Street Zone
Applicant _ Tel. # 6L 7-I 'S S
Address 15 �'�a r,fti� �•� �rl - ,a . /i���K �-�. Zip O6 U/C Lic. # '
r•
Owner 0G., c.1 c r Address
Architect Address
Sq. Ft.New Area: lst FI. 2nd FI. 3rd FI. Total New Area
#Rooms #Lavatories #Bathrooms #Garages
Purpose of this permit: k'u 3, Tr S+c- - O�� o��� to rkc Lo� 4 , }4 lI -70 4 s
�• ,�}- ,3—TF b s 1,• �r
City Water ❑ Well ❑ Septic System ❑ Sewer ❑
Ins. H.O. S.P. Cert. Area Basement Garage
Approved by J — Date G3 G 2- Use Group — Construction Type
Revised 9/01
I hereby agree to conform to all the requirements of the Laws of the State of Connecticut an,j the Ordinances of the Town of
South Windsor and to notify the Building Inspector of any alteration in the plans or specificat, )ns of the Building for which this
permit is asked and agree that this building is to be located the proper distance from all stree 1 lines,side yard lines,and required
distances from all other zones and is located in w this wlding and it se is allowed.
Signed1-)41tk/e.�►^
I hereby apply for a Certificate of Occupanc for the work described in this application for the permit.
Signed
DO NOT WRITE BELOW THIS LINE
INSPECTION COMMENTS
Inspection / Approval Date By Appl
Code Description Due Whom Code Comment
-------------------------------------------------------------------------------
**-28738-B 5,700
B10 FINAL 10/08/03 JFF A
B10 FINAL 10/08/03 JFF A CLOSEOUT
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1
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
PERMIT#
Application is hereby:
TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
APPROVED 1540 SULLIVAN AVENUE
t H"I%1 644-2511 ext. 230 Bldg.Permit#
to Building Inspector
Application must be printed or typed
FEE SCHEDULE Location of Job:
Ayd 7Pl a AjAvar Valley i
$0-$1,000=$15.00 Street No. Street Lot No.
Over$1,000=
$15.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT 0LCW IA1a-1-a#V ��•P,etl�li
APPLICANT ADDRESS
C-r- O co r i 1
APPLICANT PHONE# P6 O -4
014 N S F,q OWNER a,97t#w+,e o 4r Zrr4%/aIf-
< OWNER ADDRESS ZG o t''(«s.r••-r Jwl��i
-00LA`[ ,, r�Gfi, a lQ o'I t!
OWNER PHONE"«� ,%D -4r/O—g g(o 2
C ESTIMATED COST$ /"♦r9 o
IS THIS A CONTRACT COST? X Yes _No
ems✓ FEE ENCLOSED$ 145. 00
TYPE OF JOB:
OR-Co _New Installation
ox Alteration/Addition/Repair
Revised 4/01//2002
APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
❑RESIDENTIAL BUILDING PERMIT APPLICATION? ❑ YES ❑NO
E)BUSINESS
❑ASSEMBLY CURRENT USE AND OCCUPANCY 'Zj .et;J
❑MERCANTILE FUTURE USE AND OCCUPANCY
❑EDUCATIONAL
❑INSTITUTIONAL
❑FACTORY ENGINEER'S NAME PHONE
❑ STORAGE
❑GARAGE ADDRESS
❑MIXED USE
(Other please specify) CITY STATE ZIP
TYPE OF INSTALLATION/WIRING METHOD
SIZE OF SERVICE /O U *w& SIZE OF MAIN CONDUCTORS_'$�oZ /p
NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS
NUMBER OF PANELS _ REMOTE DISCONNECT REQUIRED? ❑YES ANO
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
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.
/D 3 Sao '000-/ CT
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT DATE T—ZO O _