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Home My WebLink About131 Trumble Lane Sect# I Wbas APPLICATION FOR BUILDING PERMIT Plumbing# S 131 TRUMBULL LANE HVAC # Date: � Iq Sprinkler# No. 26371 FINAL APPROVALS Estimated Cost 0 000 Building �'S ;134 M COMPLETE RED BOXED AREAS Permit Fee $ Engineering TYPE OR PRINT ONLY Occupancy Fee $ Affidavit SIGN ON REVERSE SIDE Appr.for CO. Total Fee $ ��Os TO BUIL,DM DEPARTMENT,TOWN OF SOUTH WtsIDSOR,CT (Additional Cost) $ The and migned h reby applies to do work according to the following specifications: Job Location 1 a Lot No. Side of Street� Zone "c3 ApplicantClar)c rI Tel 6U7 CQ y 8 b g 3 Addr ss I_^dAb t& S j el S Zip Lic.# ":�Vlo 3 G-6 Owner -Sa 12A= Address %'J Q ca9 - Architect R--el fa n t/*-'S Address S' a Sq.Ft.N w Area: lst FI. 2nd Fl Iq 3rd FL Total New Area 5 #Rooms q #Lavatories / #Bathrooms #Garages4P 4i 1-n i h.1 r�1A �A o� Purpose of this permit: If t City Water Well ❑ Septic System ❑ Sewer, Ins. H.O. S Cert. Area 28 Basement I'7 8 Garage Approved by Date 9 b Use Group Construction Type 15SI�> Reva.d 1197 I hereby agree to conform to all th requirements of the Laws of th State of Connecticut and the Ordinances of the Town of South Windsor and to notify the Building Inspector of any alteration in the plans or specifications of the Building for which this permit is asked,and agree that this building is to be located the proper distance from all street lines,side yard lines,and required distances from all other zones and is located in which is building and its use is allowed. Signed I hereby apply for a Certificate of Occupancy for the work described in this application for the permit. Signed 0(-DL��Ot-j 4-1 nz'z�� DO NOT WRITE BELO HIS LINE INSPECTION COMMENTS Location of Job: AFFIDAVIT Additional Fee S 10 01 0 0 State of Connecticut ss.South Windsor County of Hartford _ Owner of `i f/!/f � �,2�2LJ ��, ,yj�?Lrl Agent for the building erected Contractor under Permit No. 26371 issued by the Building Department of the Town of South Windsor being duly sworn,make oath and say that the actual cost of the completed work authorized under said permit did not exceed the most current accepted BOCA value of S. 16 2 , 6 3 8 . 0 0 Signed Subscribed and sworn to before me this day of A.D.20 Estimated Cost$ 8 6,0 0 0 . Difference: $ 76,638 . Notary Public Inspection / Approval Date By Appl Code Description Due Whom Code Comment ' ------------------------------------------------------------------------------- 99-26371-B 80,000 BO1 FOOTING 10/12/99 JFF A B02 FOUNDATION 10/25/99 DCJ A E01 SERVICE O1/05/00 DCJ A RELEASED TO N.U. P02 UNDERGROUND O1/11/00 JFF A B05 FIREPLACE/CHIMNEY 02/02/00 JFF A WITH ROGER P03 ROUGH 03/07/00 DCJ A B03 FRAMING (ROUGH) 03/10/00 DCJ A E03 ROUGH 03/10/00 DCJ A B04 INSULATION 03/13/00 DCJ A B03 FRAMING (ROUGH) 04/13/00 DCJ A BASEMENT ONLY E03 ROUGH 04/13/00 DCJ A BASEMENT ONLY B04 INSULATION 04/17/00 DCJ A **-16608-E 3,000 **-10533-P 3,000 Total Est Value 86,000 Dwelling 2,849 116,581.08 Basement 1,587 19,678.80 Garage 576 7,142.40 Smoke Det 7 525.00 BOCA Value 162,637.83 Difference 76,637.83 Inspection / Approval Date By Appl Code Description Due Whom Code Commefit ' ------------------------------------------------------------------------------- 99-26371-B 80,000 B01 FOOTING 10/12/99 JFF A B02 FOUNDATION 10/25/99 DCJ A E01 SERVICE 01/05/00 DCJ A RELEASED TO N.U. P02 UNDERGROUND 01/11/00 JFF A B05 FIREPLACE/CHIMNEY 02/02/00 JFF A WITH ROGER P03 ROUGH 03/07/00 DCJ A B03 FRAMING (ROUGH) 03/10/00 DCJ A E03 ROUGH 03/10/00 DCJ A B04 INSULATION 03/13/00 DCJ A B03 FRAMING (ROUGH) 04/13/00 DCJ A BASEMENT ONLY E03 ROUGH 04/13/00 DCJ A BASEMENT ONLY B04 INSULATION 04/17/00 DCJ A PO4 GAS TEST 05/15/00 DCJ A LEFT STICKER B10 FINAL 05/30/00 DCJ A APPROVED FOR CO AND CLOSEOUT **-16608-E 3,000 **-10533-P 3,000 SITE COMPLIANCE CHECKLIST TOWN of SOUTH WINDSOR, CONNECTICUT W 131 TRUMBULL LANE LOT_#32 Reviewed By .-u� (Engineering) CLARK REALTY, INC. Date Reviewed~ 6 eo /Denied 658 ELLINGTON ROAD,SOUTH WINDSOR,CT Reviewed By (Planning) BP_##_26371 Ph_#_(203)528-6054 Date Reviewed r 3 Approved/Denied Date Submitted 07/30/99 ***** FOR C of 0 ***** As required in the Zoning and/or Subdivison Regulations, no Certificate of Occupancy shall be issued until grading plans have been complied with and approved by the Town Engineer. The minimum requirements shall include: Approved Denied N/A 1. Approved building permit plan 3 2. Finish grading per approved building permit plan 3. Site work; i.e. trees, shrubs, dumpsters, required parking 4. Utility location; .7 a. sanitary sewer/septic system Z� b. foundation drain c. electrical & telephone d. water e. other 5. Sewer connection charge paid 0-1-51ti5 6. Appropriate certification 7. Bonding 8. Planning & Zoning/ Inland Wetlands Considerations A. Lighting B. Signage Freestanding Wall Alit�_ C. Fee in lieu of Open Space Sewer Permit No. 20 Pavement Excavation No. COMMENTS: FA FO y � G�C".1',^ "IV .fa V AO � s ss ED V 3�1''2✓�0p �i�o�r d�c v f � � SITE COMPLIANCE CHECKLIST TOWN of SOUTH WINDSOR, CONNECTICUoT 131 TRUMBULL LANE LOT_#32 Reviewed B ineering) CLARK REALTY, INC. Date Reviewed Approved enied 658 ELLINGTON ROAD,SOUTH WINDSOR,CT Reviewed By anning) BP_# 26371 Ph_#_(203)528-6054 Date Review g Approv enied Date Submitted 07/30/99 ***** F �LG P ***** In accordance with the Zoning and/or Subdivision Regulations, prior to the building of any structure on a lot, a Topographic Plot Plan shall be submitted for approval. The minimum requirements shall include: Appro ed Denied N/A 1. Name, address & phone number of owner/applicant 2. Name, address & phone number of plan preparer 3. Zoning Information - i.e. zone, open space, floodway, etc. 4. Plot Plan at 1" = 40' scale a. Subdivision reference, abutting properties, etc b. Easements of record C. Lot description, bearings, building lines, distances, area, etc. d. Contours, existing & proposed, 1 or 2 ft. interval where appropriate 111Z e. Building location with dimensions. Elevations of proposed finish floor, garage floor & centerline of road at driveway f. Elevations of gravity drainage systems, sanitary & foundation drain at the house and the street g. Tentative utility location (gas, water, electric, septic system, etc.) h. Title block with name and address of preparer, date, appropriate certification, live seal and live signature consistent with the Board of Registration requirements. (P.E. & L.S.) 5. Sedimentation and erosion control 6. Special Planning & Zoning, Inland/Wetlands considerations (Plans on file w/Town Clerk) COMMENTS: 8 Aw 21999 ti DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT PERMIT# Application is hereby: TOWN OF SOUTH WINDSOR BUILDING DEPARTMENT CAPPROVED 1540 SULLIVAN AVENUE Bldg.Permit# 644-2511 ext. 230 2C� � Date Building Inspector Application must be printed or typed //Location of Job: FFFEESCHEDULE r , u`,t;4- l r u m b a l $0-$1,000=$13.00 Street No. Street Lot No. Over$1,000= $13.00 per$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANT a2 — W l-e C jr/ APPLICANT ADDRESS PC) `6U '►'J T D Cr2061) ld APPLICANT PHONE# e-( 7, cf c� W N S OWNER Ap r `1/ _ /l e f� L �L l O Fq %p < OWNER ADDRESS r�G' fL'/tJ OWNER PHONE C ESTIMATED COST$ �3 0 0 IS THIS A CONTRACT COST? 0 Yes 0 No f� CJ FEE ENCLOSED$ �. TYPE OF JOB: SCR.CO New Installation 0 Alteration/Addition/Repair Revised 8/99 APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A RESIDENTIAL BUILDING PERMIT APPLICATION? ❑ YES ❑NO r ❑BUSIlVESS CURRENT USE AND OCCUPANCY ❑ASSEMBLY ❑MERCANTILE❑EDUCATIONAL FUTURE USE AND OCCUPANCY h S f L112 0 e- ❑INSTITUTIONAL ENGINEER'S NAME PHONE ❑FACTORY ❑STORAGE ADDRESS ❑GARAGE ❑MIXED USE CITY STATE ZIP (Other please specify) TYPE OF INSTALLATION/WIRING METHOD N e-(x3 13e- ,S i d: 0 y_1 SIZE OF SERVICE �m,� SIZE OF MAIN CONDUCTORS__�L� . L.;:)c)c) rn�J NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS / e Jvc` f rn p NUMBER OF PANELS REMOTE DISCONNECT REQUIRED? ❑YES 14NO NUMBER OF LIGHT CIRCUITS NUMBER OF POWER CIRCUITS 5 NUMBER OF SWITCHES NUMBER OF OUTLETS -NUMBER OF LIGHT F`Ik ES:, 5 NUMBER OF.. A�`bRG'EftTS NUMBER OF A/C CIRCUITS SEPARATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED. DESCRIPTION OF WORK l��r'� ram. �:� ►tee v.3 1��-..5--� 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 L�o y F CTOR DATE_L_TIME LOCATION � 2j � `(�� U ( i INSPECTION: CODE: RESULT(D/A) : f BUILDING: e F ELECTRICAL: C P r E i {! E I ` PLUMBING: j 6 i I f HVAC: H QT ER: i i c DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT PERMIT# Application is hereby: TOWN OF SOUTH WINDSOR BUILDING DEPARTMENT APPROVED 1540 SULLIVAN AVENUE Bldg.Permit# is db 644-2511 ext. 230 21�31 Dat ding Inspector Application must be printed or typed Location of Job: FEE SCHEDULE 1 o- ,31 $0-$1,000=$13.00 Street No. Street j Lot No. Over$1,000= C?.,C $13.00 per$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANT 11 Vi cxn b `1 C U APPLICANT ADDRESS Sc�4; APPLICANT PHONE# OWN S OWNER x OWNER ADDRESS v� &0) , " OWNER PHONE 'Z ESTIMATED COST$ IS THIS A CONTRA OST? AYes 0 No l�f= ICJ FEE ENCLOSED$ �� TYPE OF JO OR CO New Installation 0 Alteration/Addition/Repair Revised 8/99 APPLICATION FOR PLUMBING PERMIT (Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH BUILDING PERMIT APPLICATION? ❑YES YNO' 04ESIDENT'IAL ❑BUSINESS CURRENT USE AND OCCUPANCY ❑ASSEMBLY ❑MERCANTILE 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 2— 2��C�` -Yl SIZE OF MAIN DRAIN �A � NO.OF TOILETS STYLE b NO.URINALS STYLE NO.OF BATHTUBS ` NO.OF SHOWERS NO.OF LAVATORIES NO.OF CONDUCTORS SIZE 'A" NO.OF STACKS \ SIZE \ AREA OF ROOF NO.OF CATCH BASINS NO.OF FLOOR DRAINS NO.OF OTHER FIXTURES KIND ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW ®'YES ❑NO SIZE OF WINDOW IF NONE C.F.M.OF VENTILATOR SIZE OF DUCTS SEWER OR SEPTIC TANK SIZE OF WATER MAIN SIZE OF WATER PIPING&RISER WATER HEATER: TYPE C?. S MANUFACTURER S 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. CONTRACTORS LICENSE NO. TYPE STATE SIGNATURE OF APPLICANT DATE O G DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT TOWN OF SOUTH WINDSOR PERMIT# Application is hereby: BUILDING DEPARTMENT �(� APPROVED 1540 SULLIVAN AVENUE Bldg.Permit# 51/Z U� �� 644-2511 ext. 230 Date Building Inspector Application must be printed or typed Location of Job: FEE SCHEDULE ' 131 c 3 Z $0- $1,000=$13.00 Street No. Tv &d// Street Lot No. Over$1,000= $13.00 per$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANT1- APPLICANT ADDRESS 31a i(/UTi+s gg Rj sayri APPLICANT PHONE# 0 OWN S�,q OWNER — / OWNER ADDRESS /1 c+' OWNER PHONE :.2 C ESTEgATED COST$ IS THIS A CONTRACT COST? M Yes O No x ��J FEE ENCLOSED$ r1`r� TYPE OF JOB: SOR.C Erl�ew Installation 0 Alteration/Addition/Repair Revised 8/99 APPLICATION FOR HVAC PERMIT (Continued from reverse side TYPE OF SYSTEM: TYPE OF BUILDING: ❑HEATING E6ESIDENTIAL e� lc ❑COMMERCIAL ❑VENTILATION ❑INDUSTRIAL ATING STEAM LOW PRESSURE LIMIT LBS. HIGH PRESSURE LIMIT ❑ NIC ❑ WARM AIR ❑UNIT RADIANT HEATER- EXISTING ION ADDITIONAL RADIATION TO DIATION DESIGN TEMP. OU OF INSIDE o DIFFERENCE OF TOTAL HEAT LOSS(BTUH) OF(HEAT LOSS S MUST ACCOMPANY APPLICATION) DESCRIBE ALL HEATING EQUIP UDING MAKE&MODEL NO.) GRO ATING CAPACITY(INPUT—BTUH) NET RATING(OUTPUT— TYPE OF FUEL ❑ OIL—GPM OIL TANK LOCATION:❑INSIDE❑ OUTSIDE CAPACITY ❑ GAS—INPUT LPG TANK CAPACITY ELECTRIC—KW AIR CONDITIONING DESIGN TEMP.OUTSIDE g8' OF INSIDE 70 OF DIFFERENCE IF OF TOTAL HEAT GAIN(BTUH)y3&17 (HEAT GAIN SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL COOLING EQUIPMENT(INCLUDING MAKE&MODEL NO.) r-,,0fi j y� L�vA-"We.v.pdr TONNAGE y COOLING CAPACITY(BTUH)JZ vo VENTILATION DESCRIBE ALL AIR HANDLING EQUIPMENT(INCLUDING KITCHEN EXHAUST EQUIPMENT) TOTAL SIZE OF SYSTEM(CFM) FRESH AIR INTAKE(CFM) (PLANS MUST ACCOMPANY APPLICATION) FURTHER DESCRIPTION OF WORK/�!5;660 ``,+- i.ysT.�!/ (� P�✓Tr.4«��- C' S'i? d for y �•ys (�lo D`U 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. .30.,a 75� b - Z CONTRACTORS LICENSE NO. TYPE STATE SIGNATURE OF APPLICANT DATE S"— Q 0 DETAILED REPORT FOR ENTIRE HOUSE Prepared For : Prepared By : Clark Realty R P 658 Ellington Rd R&E Heating & Cooling So Windsor Ct 06074 Job Name : 234-032 EXPOSURE GLASS NORTH NE/NW EAST SOUTH SE/SW WEST HORZ . TOTAL -------------------------------------------------------------------- ------ AREA ; 36 : 0 ; 102 ; 12 : 0 ; 103 : 0 ; 253 COOLING ; 483 , 0 ; 4 ,429 , 257 , O ; 4 ,473 ; O ; 9 ,642 HEATING 1 ,444 : 0 ; 4 ,092 : 481 : 0 ; 4 ,132 : 0 ; 10 ,150 --------------------------------------------------------------------------- BELOW WALLS NORTH NE/NW EAST SOUTH SE/SW WEST GRADE TOTAL ----------------------------------------------------------------------------- AREA 463 ; 0 ; 530 : 463 ; 0 ; 559 : 0 ; 2 ,015 COOLING ; 320 ; 0 ; 366 , 320 , 0 ; 386 ; 0 ; 1 ,393 HEATING 1 ,311 : 0 ; 1 ,500 : 11311 ; 0 ; 1 ,583 ; O ; 5 ,704 -------------------------------------------------------------------------------- DOORS NORTH NE/NW EAST SOUTH SE/SW WEST TOTAL ------------.--__------------------------------------------------------------ AREA ; 21 : 0 ; 0 ; 21 : 0 ; 42 : ; 84 COOLING ; 66 ; 0 ; 0 ; 56 ; 0 ; 132 ; ; 254 HEATING ; 271 ; 0 ; 0 ; 228 : 0 ; 543 ; ; 1 ,042 -------------------------------------------------------------------------------- FLOOR AREA COOLING HEATING -----------------------------------------------_--------------_-_---------- 2130 ; 0 ; 0 ---------------------------------------------------------------------_------ CEILING AREA COOLING HEATING ----------------------------------------------------------------------------------- 2130 ; 2 ,006 ; 12 ,653 -------------------------------------------------- MISCELLANEOUS COOLING LOADS ---------------------------- People Sensible Load 5 ,625 Latent Load 9 ,606 Lights & Appi . Load 8 ,703 Latent Safety Btuh 480 Ventilation Load 2 ,310 Duct Heat Gain 1 ,386 Infiltration Load 700 Sensible Safety Btuh 1 ,532 TOTAL SENSIBLE LOAD 33 ,551 TOTAL LATENT LOAD 10 ,086 Air Changes/Hour 0 .50 Temp . Swing Mult . 1 .00 =k=kk Total Cooling Load 43 ,637 BTUH Or 3 .64 Tons *** MISCELLANEOUS HEATING LOADS ---------------------------- Infiltration Load 9 ,521 Ventilation Load 15 ,708 Duct Heat Loss 3 ,476 Safety Btuh 2 ,739 ** Total Heating Load 60 ,995 BTUH *** DETAILED REPORT FOR ENTIRE HOUSE Prepared For : Prepared By : Clark Realty R P 658 Ellington Rd R&E Heating & Cooling So Windsor , Ct 06074 Job Name : 234-032 EXPOSURE GLASS NORTH NE/NW EAST SOUTH SE/SW WEST HORZ . TOTAL --------------------------------------------------------------------------- AREA ; 36 : 0 ; 102 : 12 , 0 ; 103 : 0 ; 253 COOLING ; 483 , 0 ; 4 ,429 , 257 , 0 ; 4 ,473 : 0 ; 9 ,642 HEATING ; 1 ,444 , 0 ; 4 ,092 : 481 , 0 ; 4 ,132 , 0 ; 10 ,150 --------------------------------------------------------------------------- BELOW WALLS NORTH NE/NW EAST SOUTH SE/SW WEST GRADE TOTAL AREA ; 463 ; 0 ; 530 : 463 ; 0 ; 559 ; 0 ; 2 ,015 COOLING ; 320 , 0 ; 366 , 320 , 0 ; 386 , 0 ; 1 ,393 HEATING ; 1 ,311 ; 01, 1 ,500 ; 1 ,311 ; 0 : 1 ,583 : 0 : 5 ,704 ---------------------------------------------------------------------------- DOORS NORTH NE/NW EAST SOUTH SE/SW WEST TOTAL --------------------------------------------------------------------------- AREA ; 21 ; 0 ; 0 ; 21 : 0 ; 42 , ; 84 COOLING ; 66 : 0 ; 0 ; 56 : 0 ; 132 : ; 254 HEATING ; 271 ; 0 ; 0 ; 228 : 0 ; 543 , ; 1 ,042 _-_____________________________________________w______________________-____ FLOOR AREA COOLING HEATING w__________________________________________________________________________ 2130 ; 0 ; 0 --------------------------------------------------------------------------- CEILING AREA COOLING HEATING --------------------------------------------------------------------------- 2130 ; 2 ,006 ; 12 ,653 --------------------------------------------------------------------------- MISCELLANEOUS COOLING LOADS --------------------------- People Sensible Load 5 ,625 Latent Load 9 ,606 Lights & Appl . Load 8 ,703 Latent Safety Btuh 480 Ventilation Load 2 ,310 Duct Heat Gain 1 ,386 Infiltration Load 700 Sensible Safety Btuh 1 ,532 TOTAL SENSIBLE LOAD 33 ,551 TOTAL LATENT LOAD 10 ,086 Air Changes/Hour 0 .50 Temp . Swing Mult . 1 .00 ** Total Cooling Load 43 ,637 BTUH Or 3 .64 Tons ** MISCELLANEOUS HEATING LOADS --------------------------- Infiltration Load 9 ,521 Ventilation Load 15 ,708 Duct Heat Loss 3 ,476 Safety Btuh 2 ,739 *** Total Heating Load 60 ,995 BTUH *** ®ectric# APPLICATION FOR BUILDING PERMIT Plumbing# 131 Trumbull Lane HVAC # Date: �" �z- Sprinkler# No. 2 8 6 3 5 FINAL rOV Estimated Cost $ Cam'w Building'{'{ COMPLETE RED BOXED AREAS Permit Fee $ 196 La W� TYPE OR PRINT ONLY Occupancy Fee $ S Affidavit SIGN ON REVERSE SIDE` Appr.for CO o Total Fee $ 3). CO TO BUILDING TMB�ff, TO OF SOUTH WB�SOR,CT (Additional Cost) $ The undersigned hereby applies to do work according to the following specifications: Jo6 Location --,-e 1,1( -T W4 0 1 v L—lot No Side of Street Zone Applicant 4'1 Tel.# As y36 3s4G Addr ss f 3 Zjp oc#2sz Lic.# Own r a ,�e� Address Architect Address Sq.Ft.New Area: lst Fl. 2nd Fl. 3rd Fl. Total New Area #Rooms #Lavatories_ #Bathrooms #Garages Purpose of this permit: tgE-A !1 52") City Water ❑ Well ❑ Septic System ❑ Sewer ❑ Ins. H.O. S.P. Cert. Area Basement Garage Approved by alk- Date 3 l Use Group U Construction Type EG Revised 9/01 I hereby agree to conform to all the requirements of the Laws of the State of Connecticut and the Ordinances of the Town of South Windsor and to notify the Building Inspector of any alteration in the plans or specifications of the Building for which this permit is asked,and agree that this building is to be located the proper distance from all street lines,side yard lines,and required distances from all other zones and is located in which this buil6din and its use is allowed. X Signed ` I hereby apply for a Certificate of Occ an y for thf work described in this application for the permit. )p Signed DO NOT RITE BELOW THIS LINE INSPECTION COMMENTS DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT TOWN OF SOUTH WINDSOR PERMIT# Application is hereby: C-7 t l BUILDING DEPARTMENT PRO 1540 SULLIVAN AVENUE Bldg.Permit# YZ- J 644-2511 ext. 230 Date Building Inspector Application must be printed or typed Location of Job: FEE SCHEDULE 13 t g/- 6 k I I I - $0-$1,000=$13.00 Street No. Street Lot No. Over$1,000= $13.00 per$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANT p APPLICANT ADDRESS 4 APPLICANT PHONE# OWI N S OWNER S4 ✓4 OWNER ADDRESS S 3 OWNER PHONE S& yv Q C ESTIMATED COST$ /6 U IS THIS A CONTRACT COST? 0 Yes G10 A ICJ FEE ENCLOSED$ /_3 TYPE OF JOB: SCR CO 0 New Installation tCAlteration/Addition/Repair Revised 8/99 9 APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATE TH A BUILDING PERMIT APPLICATION? YES ❑NO RESIDENTIAL ❑BUSINESS CURRENT USE AND OCCUPANCY ❑ASSEMBLY ❑MERCANTILE 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 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 Uj f�r-� &::�A 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. f�yw-c w--U r CONTRACTORS LICENSE NO. TYPE STATE SIGNATURE OF APPLICANT DATE