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181 Tumble Brook Drive
?Vz �65 TO THE BUILIDING INSWECMR, of the APPLICATION FOR PLAN EXAMINATION AND TOWN OF S4VTH WINDSO�t,COl�N. BUILDING PERMIT IMPORTANT — Applicant to complete all items in section 1, 11, III, IV, and IX. Z O ZONII• AT (LOCATION) / - d D STM LOCATION (NO.) (STREET) OF BETWEEN AND BUILDING r (CROSS STREET) (CROSS STREET) LOT SUBDIVISIO -:z= rLOT BLOCK SIZE N II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use � 1 New building Residential Nonresidential 2 Addition(If residential, enter number 12 One family 18❑ Amusement, recreational of new housing units added, i/any, 13 Two or more family — Enter 19❑ Church, other religious in Part D, 13) number of units- - - - 20❑ Industrial 3 ❑ Alteration (See 2 above) 14 ❑ Transient hotel, motel, 21 ❑ Parkin 4❑ Repair, re locement g garage p P or dormitory — Enter number 5❑ Wrecking (1/multifamily residential, of units ——————— —-i 22 ❑ Service station, repair garage enter number of units in building in 15❑ Garage 23❑ Hospital, institutional Part D, 13) 16❑ Carport 24❑ Office, bank, professional 6❑ Moving (relocation) 17❑ Other - Specify 25❑ Public utility 7❑ Foundation only 26❑ School, library, other educational B. OWNERSHIP 27❑ Stores, merconfile 8 ® Private(individual, corporation, 28❑ Tanks, towers nonprofit institution,etc.) 29❑ Other — Specify 9 ❑ Public (Federal, State, or local government) C. COST (Omit cents) Nonresidential — Describe in detail proposed use of buildings,e.g., food processing plant, machine shop, laundry building at hospital,elementary 10. Cost of improvement................ S 4 4 school, secondary school, college, parochial school, parking garage for, department store, rental office building, office building at industrial plant. To be installed but not included If use of existing building is being changed, enter proposed use. in the above cost a. Electrical...................... b. Plumbing ...................... c.Heating, air conditioning......... d. Other(elevator, etc.)............ 11. TOTAL COST OF IMPROVEMENT 1144e" III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — L; for wrecking, complete only Part J, for all others skip to IV. E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS 30❑Masonry(wall bearing) 40 R1 Public or private company 48• Number of stories................ 31 Wood frame 41 ❑ Private(septic tank, etc.) 49• Total square feet of floor area, all floors, based on exterior 32❑ Structural steel dimensions .................... v�o� 33❑ Reinforc d concrete H. TYPE OF WATER SUPPLY 34❑ Other — Specify 42[l Public or private company 50• Total land area, sq. ft. ........... 43❑ Private(well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed ....................... 35❑ Gas Will there be central air 52. Outdoors....................... %M Oil c nditioning? L. RESIDENTIAL BUILDINGS ONLY 37 Electricity 44❑ Yes 45® N 53. Numb r of bedr ms.............. 38❑ C al 4` 39❑ Oth r— Specify Will th re be an elevat r? 54. Number f Full.......... , 46❑ Yes 47 U1 N bathrooms / Partial........ NOTES and Data — (For department use) IV. IDENTIFICATION — To b c mpl t d by all applicants am Mailing addr ss — Number, street, city, and State ZIP code Tel. No. Owner or Lessee r 2. Contractor <{r 3. Architect or Ae Engineer oe k. Th owner of this building and the undersigned agree to conform to all applicable laws of this jurisdiction. Signature of applicant. Address Application dot �Lo, 4ten, 0�Oe rZ�Za )Yr- 4 nz�- Z W. 00 NOT WRITE BELOW THIS LINE V. PLAN REVIEW RECORD — For office use Plans R vi w Required Check Plan Review Date Plans By Date Plans By Notes q Fee Started Approved BUILDING K $ Az- PLUMBING $ MECHANICAL $ ELECTRICAL $ OTHER is VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Permit or Appr vaI Check Obtained Number By Permit or Approval Check ObtDate ained Number By BOILER PLUMBING CURB OR SIDEWALK CUT ROOFING ELEVATOR SEWER ELECTRICAL SIGN OR BILLBOARD FURNACE STREET GRADES GRADING USE OF PUBLIC AREAS OIL BURNER WRECKING OTHER OTHER VII. 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Z=sane. .=:sD=.a:=■■.■:■:Z■ ■.1:■..a. •■■■.� ...■.■ ■■ ■■:■■.■■■■.■.■...■■■:■ • ■■ ..f wD ■■Z■ O: `�sl=. ■Zo.:�:•:• :Z■ •.L rZa■rrZZr:■f.HH: �. a■.. ::\.... ■■■ ■r/.■• : : : :: l ::! •.• •■ ■ i. a . N ■.■. ■ .D■■Down lad..:::�i�a:■:■ .::a■■.:.:■f.■:■alD:f�.■.lfwa■:move■..■.■:\■N:■.■��■D■.■r.•■■.::.!■o==!/■ . \ ■:■■■■a■�D■ 1����-.t-l: l--- ---:-�---A�---- --::--\■■■.D:Z- ffJ TOWN OF SOUTH WINDSOR BUILDING PERMIT Date Dec. 7 1978 Fee Paid $. .4 6 2.00 Eat. Value $.7 7-x Q 0 0 Permit N° 1.0624 on the aide of Lot #13 Tumblebrook Drive Sweet Street No. 181 Owner U & R Housing Corp Applicant U & R Housing Corp CERTIFICATE OF OCCUPANCY ISSUED: Date No. 5267 Fee Paid $ 3.00 CLASSIFICATION Dwelling BUILDING PERMIT NY 10624 OFFICE OF THE BUILDING INSPECTOR of the Town of South Windsor, Conn. South Windsor, Conn. Dec. 7 19 78 94is to to (ferfif-v, That U & R Housing Carp ischerebY granted Pion to Dwelling at estimated value of $ 7 7,000 on the side of Lot #13 'P=blebrook Drive Street on land owned by U & R Housing Corp Said Work to be as described in Application No. 10924 and to conform to specifications and plans filed with said Application, and Building By- Laws of THE TOWN OF SOUTH WINDSOR. Isspq Dec. 7 _19 7 8. udding Inspector. Streets and sidewalks, obstructed by excavations or building materials, must be guarded by barriers during the day and by both barriers and colored lights by night. SECTION 1343, GENERAL STATUTES OF CONNECT ICUT: "When any person shall pLce or keep building materials, or any obstacle in any highway (or any sidewalk) either with or without a license therefor from the city or borough in which such highway may be situated, he shall pay said city, town or borough all coats and damages which it shall sustain, or be compelled to reason therefor" Permit.No. TOWN OF SOUTH WINDSOR ` SOUTH WINDSOR, CONN. Permit N? 5267 Certificate of Occupancy THI I TO C RTIFY that the1�� at N j in the T of South Windsor, Connecticut, has been erected and completed in accordance with the B ilding Code and Zoning Regulations of the Town of South Windsor, and is hereby approved for occupancy. ui ector Pwher, Buil Fee Paid Date • 19 7YP ,o GARDNER Et PETERSON ASSOCIATES-"b76 OLD POST ROAD-TOLLAND, CONNECT/CUT o6u84 !VOW PAQCEL. A ZO PRaPoszD 07 13 337•r, asG "r Q 3s3.G a54.1 N 3S4.L 3s4•0 �7 ti � M Q 2S'+ 334.o C 2 4 \3 � r. T w 3 6.4•► j, y3 3A-%•4 N1.=. d 3 3s�•a 352•d 2.4 b 3s='9 3S1 8 'S0 3S2•S G O t -IZ.ate �uMF3�.�gR00W MORTGAGE SURVEY dinn LOT # 13 TIMBER RIDGE SECTION III �,`�� of,c a titi TOWN OF SOUTH WI-NDSOR, CONNECTICUT SCALE. 1 40 I p,c I hereby certify to Savings Bank of Manchester thats N the location of the building as shown is substantially 0 'l� correct and that there are no zoning violations of the "O VEroa same. toeve L.S. # 4395 April 20, 1979 PROFESSIONAL ENGINEERS LAND SURVEYOR$ � �� c E:_D A rja--p - - � --- TH yA!j,,4DsoR TOWN' PARTMENT F-Z.--4GINF-ERING E DATE: SIG.: 6696 ELECTRICAL APPLICATION Application No. 7 004 on the side of Lot #13 Tumblebrook Dr. Street Street No. 181 Owner U & R Housing Corp Electrician DuBaldo Electric FILED IN OFFICE OF The Building Inspector Jan. 17 1979 INSPECTION. &&No Electrical Work shall be started until a Per- mit is granted by the Building Inspector. In New Buildings no wiring shall be started until the plumbing and heating pipes, and the fire stops (if of wood) are installed, without a special permit from the office of the Building Inspector. 1 APPLICATION FOR PERMIT TO DO ELECTRICAI. WORK. No. ....7..0.04...................... Permit No. . ..6 6.9.6... .............. TO THE BUILDING INSPECTOR of the TOWN OF SOUTH WINDSOR, CONN. ................. hereby make application tq perform Electr cal Work according to detailed description below. All provisions of the Rules for Electrical Installation, Section 48, Building By-Laws, shall be complied with whether specified herein or not. South Windsor, Conn., ....... �-�-� . !`� .. . 19 7�Sign here ...... . ...•..• •.. ••••••••••••• Address ?....... .�. Location ..............3...... -. �`�1� Side of . . . .... .. ... ..... .. ... ..... ... .................................................. Nature of Building r%..I�_. � „- .r..'..... How many stories ............................................................................................ Newor old Building ........... 1. �.......... ....... How many families ............................................................................................ Kindof Installation . ........ ....... . How many Stores ...................................................................................................... Owner ......4..7t2.... ....Cz. �............. Address ...Q.... 0x....r-)..Y. .......� :?'C'.'j.........._....._...... Architect ............ ............ .... /..'........ ...... Address ... .... ..... ......... .. ................................................. __..__....._....._._.... �f } -� .��' � Address Builder ...... .. ........ .. .. .. . . .. . . ... .. ........................................................_........... Electrician �,� �t.. �c..t'. �-.. .......... Address . . ...... ......................................................................_......._.... _.�... Size of Main Wires .. .................._ No. of Light Loops .. ...... .../.. . No. of Heat Loops ........ . No. of Power Loops ......................... _._...._.... No. of Light Outlets ......./...� . .......... No. of Heat Outlets ..... No. of Power Outlets .................. ................ NoO of Light Circuits .... .....0.. ....... ..... No. of Heat Circuits . No. of Power Circuits .. ........ ........... . No. of Sockets No. of Heat Receptacles No. of Motors ......... ..... . No. of Panels ................. ......... ... .. Size of Heat Circuit No. of Power Receptacles . . No. of Switches .... ....... . . Total Wattage .... ............ .... .. .... Size of Power Circuit .. ... ... Q Total Horsepower No. of Straight Electric Fixtures No. of Combination Fixtures .... No. of Receptacles ............. ......... ...... ............... . .. No. of Cord Drops ....................................................................................... Remarks: For other kind of Installation ...... ............. ................................ ................. .... ................................. ....... ... .. ................. ... .................. ............................................................................ ......................................................... ..............._........... ................... ................................................. .................... ........... . ....... ......................................................................................................................... .................... ...._.......................................................................................................... ......................................................................... ........... ......... ..... ......................................................... ........... ...... . .... . . .. ... ..... ........ Estimated Cost ..1,....., l>.c►•.•• .................. 5337 PLUMBING APPLICATION Apph<ation No. 6120 on the ho t side of Street No. -.181 Owner ....—O Plumb:�ffice Filed of The Bwl&ogI�pector F P h_ 15 19-7-9 INNS XCINDI . No person shall emsavct, add do or alter sty portion of the drainage system of any bm-l&sg (except to repair leaks) until a P it is gcomed by the Building Inspector. Application No. 6120......... permit No. ...5.3 3.7.................. .............. TO THE BUILDING INSPECTOR of the TOWN OF SOUTH WINDSOR, CONN. ..hereby make application to perform plumbing according to detailed description below. All provisions of the Rules for Sanitation, By-Laws, Sections 33 to 47 inclusive, shall be complied with whether specified herein or not. South Windsor, ................... C:/................ ................... 19'�.... Sign here ... .... ............................ ................................... Address ........... -tr_1 .................. ........ 6-�4. Location .... ....... ........... ................. ............................................................. side o ............. ............................................................. Street Natureof Building ...... ...... .......................................... How many stones .. .... ............................................................................ .................... ....................................... Owner ........('?..'AU X . ...... Address................................... ....... ess........- ...... Architect ............ .................................................................................... Address ....................................................................................................................... Builder ...... ........................................................................... Address ................................................................. ................................................... Plumber .... ......... .............................................................. Address ...Y............ ........ �..(.................................... DRAINAGE CESSPOOLS, How many J 4L..'................. Where located .. .... .... .................... ............ Are they water tight . ......... J_ ............................. Of what materia, a they built ....... ...................................... Size of pipe from house to ces�/L / . ............. Kind of pipe ...CZ.. .................................................................................... MAIN DRAIN IN CELLAR, Ma ter'.eZrI ...... *7........ . Diameter-'Z......................................................................................................... Above or below cellar bottom .. .._4u--"****'*" '*"***** ...... .......'- SOILPIPES, Material . ..... ...-L.....:/.............................................. Diameter ZZ. ....................................................................................................... WASTEPIPES, Material . ....... ....... . ............. . Diameter ..... ............�?................................................. .............. TRAPS,Type proposed to use is .. ....... ........ ..... .. . .. ... ....................................................................................................................................... RAINWATER LEADERS, where do they run to .. .. .. . .. .................................................................................................................. REFRIGERATORWASTES, where do they run to .. .... .... ............................................................................................. .............................. TANKOVERFLOWS, where do they run to .. ....... ........................................................................................................................ FIXTURES WATER CLOSETS, How many ................. ......................... Where located ................................................................. Distance from trap to vertical soil pipe .................. ................... Pattern ......... .. ........................... WASHTRAYS, How many ... ................................................. Where located . ......... .............. ............................................... SINKS, How many ........................................................................................ Where located .. .... .......................................................................................... BUTLER'S SINKS, How many ....................................................... Where located... ............................................................................................... REFRIGERATORSINKS, How many....................................... Where located ................................................................................................. LAVATORIES, How many .............. ........................................... Where located ./z� ............................................................ BATHTUBS, How many................/..................................................... Where located .......:?....................................................................................... URINALS, How many ....... ................................................................ Where located .. ............................................................................................... Are water closets and urinals to be local vented If not, is there a window in outer wall ofroom where same are to be located ........ .. .. .................................................................................... ................................................ Estimated Cost ....,l G. .. ............... ....... PERMIT # Application For 6064 4963 xc DEPARTMENT DECISION - o Heating Permit cAPPLICATION IS HEREBY: DEPARTMENT OF LICENSES AND INSPECTIONS N � �APPROVED ❑ DISAPPROVED ` TOWN OF SOUTH VVINDSOR Cd 4/26/79 r k 00 W DATE EF SPECTOR A LICATIONS MUST BE PRINTED OR TYPED. BEGIN WITH NUMBER ONE OIL W I� O ! - C ^� 1. LOCATION OF JOB 181 s~ Q i NO. f BEET Cd 4 f [ LOT NO. FLOOR APT. NO. PE � O N C 2` OWNER Cd � 3 sI ADDRESS 0 4.PHONE art � f, APPUCANT ad cc o 4 s, ADDRES 43 7.PHONC���� 3 s. LICENSE NO. 6 -51 0 w f, EXPIRATION DATE OF LICENSE /G ' y c� .a 10. ESTIMATED COST sti ^ 11. IS THIS A CONTRACT COST? ❑ YES0 be as A 12. FEE ENCLOSED :- Permit 10624 ° 53 4Hi is. TYPE OF ILDINC: b R[f10[MTIAL ❑ COMMERCIAL _O R cis O 14. TYPE OF JOB: ❑ INDUSTRIAL ai 3 n JMGINAL ALTERATION INSTALLATI N ❑ ADDITION REPAIR APPLICATION FOR HEATING PERMIT (C atinued from Reverse Side) 11. LOCATION OF JOB NO. � STREET FLOOR A".N . 12. TYPE OF INSTALLATION: E3�OIL BURNER ❑ ELECTRIC ❑ VENTILATION ❑ SPRINKLER ❑ GAS BURNER ❑ STACK ❑ INCINERATOR ❑ MISCELLANEOUS IDEIITIFT SIZE c-2 SIZE SIZE 13. OF TANK �� OFCTANKN OF FILL OF VENT ` 14. B.T.U. EQUIP. AT REGISTER FURNACE MA AND NO. AT BONNET FIRING RATE BOILER OR FURNACE MAKE AND NO. B.T.U. OR SQ. FT. NET B.T.U. OR SQ. FT. GROSS FIRING RATE FLOORS TO BE HEATED NEW OR OLD BUILDING INSULATED — YES OR NO TYPE OF WALL INSULATION ROOF OR CEILING INSULATION AVG. SYSTEM WATER TEMP. B.T.U./SQ. FT./HR. EMISSION INDOOR-OUTDOOR TEMPERATURE DIFFERENCE °FAHRENHEIT MAKE OF RADIATION: BASEBOARD. COPPER CONVECTORS, OR C.I. RADIATION. OUTPUT PER SECTION OR LINEAL OF RADIATION. SO. FT. OR B.T.U. DESCRIPTION OF WORK 2r�s 15. TO BE DONE: 1e. HEAT LOSS SCHEDULE. (TO BE INCLUDED FOR ALL JOBS). ROOM SIZE wINDOwi AREA - SQUARE FEET e.T.U. e.T.U. f DISTRIBUTION INSTALLED AND DOORS VOLUME TOTAL TOTAL ROOM NO' GROSS GLASS 6ETALL CEILING FLOOR CU.FT. AT 70•F CORRECTED t j L MAD. REGISTER L W N AND WALL SG (INFILT.) TEMP' TO • O 1-O TYPE AND SIZE SG. FT. OR LEADER SIZE c DIFF. F f St R FREE AREA //I /v 6 a a� (/ 7 ` o196 Uu 0 0 92a a 0-0 7 0 ,v/� /o � g 6x' .� 3 �� 00� 3oU=714�v 1--401) _17oo /P(,p o 0 2-)- (p 0 ? G Z 7 o o 13oo :gloV iota //600 ;?2ko 02 3 / / Uo pw aoo 00 z 6 b ov --&V Jbo 7te 0 8 6, ��d U o ' TOTALS A. HEAT LOSS FROM BUILDING S y B.T.U./HR. B. DOMESTIC HOT WATER DEMAND B.T.U./HR. C. PIPING.OTHER THAN NORMAL B.T.U./HR. ALLOWANCE FOR HEAT VALVE �OFF�FUEL (A B C) FACTOR 17. ELECTRICAL WORK BY: � `�'��fi& NAME ADDRESS SUBCONTRACTORS AND is. THEIR TRADES ALL WORK COVERED BY THIS APPLICATION HAS BEEN AUTHORIZED BY THE(OWNER) OR (AGENT) OF THIS PROPERTY AND WILL BE DONE IN STRICT ACCORDANCE WITH THE BUILDING CODE. APPLICATION TO BE COMPLETELY FILLED IN. J%';7 2 DATE SIGNATURE OF APPLICANT I = B= R CALCULATION SHEET 1503 (Modern Method) Q � Copyright 1977 by The Hydronics Institute OWNER ADDRESS / rn ��- Roo " eSIGN TEMPERATURE DIFFERENCE 6� F. DATE COL.A COL.B COL.C COL.D COL.E COL. F L COL.G K 1 ROOM Ix 7 'C � `S I' A '- /`'I����� S 0/% 6 a r.6 Design Water Temp. d O H L W H L W H L W H L W H L W OM MENSIONS, FT. 1 3 ODIEX EXPOSED WALLS, FT. Q 7 //I s /G 7 �/�', /6 OZ� /G 7 a /, 7 Radiat 7 IV/ BTUH pn Selected LENGTH �0 4 WINDOW AND OUTSIDE DOOR AREA U. 0-71 3 0" BTUH BTUH BTUH BTUH BTUH 5 WALL CONSTRUCTION �j ROOM LIN.FT.OF (Table 9, Line 3 x H) ,�6 goo O'®0 � 6 0 700 yao TOTALS RADIATION 6 TYPE OF GLASS FROM LINE 12 SELECTED (Bottom of table used for Line 5) 7oo 0 0 '1 0 0 OZ� 7 CEILING CONSTRUCTION C --Q Q _7 (Table 91 L x W) , '' B FLOOR CONSTRUCTIONt D (Table 9, L x W or Lin. Ft.) ,67 E A00 9 COLD PARTITION CONSTRUCTION F Q (Table 9, L x H) G f 3 Y'd 3 10 c 1 Wall(With Openings) C3 I0 J6(? a 0 P160 3 H 3i f1aC1 , =o C� 2 Walls(Wit hOp nings) �X rUOr � 3 Walls(With Openings) or Ent. Hall 11 TOTAL BTUH AT 70F TEMP. DIFFERENCE �• 3 /a , �o o =� © ,� 1 /c2 T J 12 TOTAL BTUH AT DESIGN TEMP. DIFFERENCE JT /0 () K L Q COL.A COL.B COL.H COL. 1 COL.J COL. K COL.L TOTAL BTUH TOTAL 1 ROOM 1 OF BUILDING RADIATION AT SELECTED O H L W H L W H L W H L W H L W DESIGN TEMP.° 2 ROOM DIMENSIONS, FT. U 7 ',1r)- i DIFFERENCE 3 LENGTH EXPOSED WALLS, FT. Q /3 4 WINDOW AND OUTSIDE DOOR AREA LL ' BTUH BTUH BTUH BTUH BTUH 5 WALL CONSTRUCTION *INCREASE BATHROOM (Table 9, Lin 3 x H) 3 TOTAL 20% 6 TYPE OF GLASS (Bottom of table used for Line 5) oc0 7 CEILING CONSTRUCTION tFOR CONCRETE FLOOR ON (Table 91 L x W) GROUND OR FILL AT GRADE LEVEL, USE LINEAR g FLOOR CONSTRUCTIONt FEET OF EXPOSED EDGE (Table 9, L x W or Lin. Ft.) 9 COLD PARTITION CONSTRUCTION (Table 9, L x H) 10 c 1 Wall(With Openings) C C ,;.2 1 2 Walls(With Openings) 2 X " 3 Walls(With Openings) or Ent. Hall a 11 TOTAL BTUH AT 70F TEMP. DIFFERENCE' 12 TOTAL BTUH AT DESIGN TEMP. DIFFERENCE i This f rm is available from The Hydronics Institute, 35 Russo Place, Berkeley Heights,N.J. 07922 FORM 1503 ESTIMATE QUANTITY ITEM AMOUNT Boiler No. Net I=B=R Rating or Net SBI Rating* Oil or Gas Burner or Stoker, with Controls Oil Tank, Pipe and Fittings Combustion Chamber or Stoker Hearth Pump Thermostat Low Limit Control Reverse Control Extra Controls --Draft-Regulator Flour Control Valve Pressure Reducing Valve Relief Valve Air Cushion Tank ®ornestic Waier Heater and Tank Mixing Pipe, Valves, Fittings, Hangers Pipe Covering Heating Units (Radiators, Baseboards, Convectors) Rodiaitor Enclosures Sets -- Radiator Brackets Radiator Valves Radiator Union Elbows Radiator_Air Valves Main-Air Vents Floor and Ceiling Plates Smoke Pipe Foundation Electric Wiring Pounds — Asbestos Cement Paint Freight and Cartage Labor Incidentals Total Cost Overhead Profit Bid *Net 1=B=R Rating or Net SBI Rating of Boiler should equal or exceed the total heat loss f the house plus pr per allowance for d mestic hot water TO THE R ING INSPECTOR of the APPLICATION FOR Irolim PLAN EXAMINATION AND OF COS BUILDING PERMIT IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. o I• AT (LOCATION) I 'Fumbk 8mejk— ^a- ZONING DISTRICT LOCATION (NO.) (STREET) OF BETWEEN AND BUILDING (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE II. TYPE AND COST OF BUILDING`= All applicants complete Parts A — D �o A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use 1 ❑ New building Residential Nonresidential 2 Addition(It residential, enter number 12❑ One family 18❑ Amusement, recreational of new housing units added, if any, in Part D, 13) 13❑ Two or more family — Enter 19❑ Church, other religious number of units— — — —-i 20❑ Industrial 31in Alteration (See 2 above) 14 ❑ Transient hotel, motel, 4❑ Repair, replacement or dormitory — Enter number 21 ❑ Parking garage 5❑ Wrecking (1/multifamily residential, of units ——————— — -i 22❑ Service station, repair garage enter number of units in building in 15❑ Garage 23❑ Hospital, institutional Part D, 13) 16❑ Carport 24❑ Office, bank, professional 6❑ Moving (relocation) 17 •Other — Specify d`m 25❑ Public utility 7 ❑ Foundation only 26 0 School, library, other educational B. OWNERSHIP (�'� `�`� 27❑ Stores, merconfile 8 K Private(individual, corporation, r 28❑ Tanks, towers nonprofit institution,etc.) 5 �1 `•'�C 29❑ Other — Specify e 9 ❑ Public(Federal, State, or local government) C. COST (Omit cents) Nonresidential — Describe in detail proposed use of buildings, e.g.,food processing plant, machine shop, laundry building at hospital,elementary 10. Cost of improvement,,,,,,,,,,,,,,,, U� school, secondary school, college, parochial school, parking garage for, department store, rental office building, office building at industrial plant. To be installed but not included If use of existing building is being changed,enter proposed use. in the above cost a. Electrical...................... b. Plumbing ...................... /9 00 c.Heating, atr-vanditfeaing......... lO 0 6 d. Other(elevator, etc.)............ 11. TOTAL COST OF IMPROVEMENT s �� III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — L; for wrecking, complete only Part J, for all others skip to IV. E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS 30❑Masonry(wall bearing) 40 Public or private company 48• Number of stories............... 31 1g] W d frame 41 ❑ Private(septic tank, etc.) 49• Total square feet of floor area, q t:>A- all floors, based on exterior �j►� 32❑ Structural steel dimensions ................••..• /''a? , 33❑ R inforc d concrete H. TYPE OF WATER SUPPLY 34❑ Other — Specify 42 Public or private company 50. Total land area, sq. ft. ........... 43❑ Private(well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed ....................... 35❑ Gas Will there be central air 52. Outdoors....................... 36dR Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY 37 El ctricity 44❑ Y s 45 y'"t' N 53. Number f b dr ms.............. 38❑ C al 39❑ Other— Specify Will ther b an elevot r? 54. Number f Full.......... 46❑ Yes 41�1 N bothr ms Partial....... t t NOTES and Data — (For deportm nt us ) IV. IDENTIFICATION — To b compl t d by all applicants Name Mailing addr ss — Number, street, city, and State ZIP cod T I. No. Owner or -AAer bencteA -T�lnhle Sr&tk A, Lessee 90--41 7 2. f�I-r, )an-e 014,4teld Contractor �f 3. Architect or Engineer The owner of this building and the undersigned agree to conform to all applicable laws of this jurisdiction. Signatur app icant •p„I Address Appli tion d t 00 NOT WRITE BELOW THIS LINE V. PLAN REVIEW RECORD — For office use Plans Review Required Check Plan Review Date Plans By Date Plans By Notes Fee Started Approved BUILDING PLUMBING $ MECHANICAL $ ELECTRICAL OTHER VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Permit or Approval Check Date Obtained Number By Permit or Approval Check Date Number By Obtained BOILER PLUMBING CURB OR SIDEWALK CUT ROOFING ELEVATOR SEWER ELECTRICAL SIGN OR BILLBOARD FURNACE STREET GRADES GRADING USE OF PUBLIC AREAS OIL BURNER WRECKING OTHER OTHER VII. VALIDATION Building Permit numb r 17611 Bui Iding Permit issued Feb. 24 19 82- Bui Iding Permit Fee $ 54.00 pprov ed b 0 ta,/r/ ZONING DISTRICT FRONT SIDE - . SIDE YARD REAR YARD NOTES IX. 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Value $8 P 900.00 Permit N® 12 611 on the side of Tumblebrook Drive Street Street No. 1 8l Owner Peter Dengeni s Applicant Frank D. Zito CERTIFICATE OF OCCUPANCY ISSUED: Date No. Fee Paid $ CLASSIFICATION Basement recreation room, storage, bedroom BUILDING PERMIT i N° 12611 0MCB of i 'i THE BUILDING INSPECTOR of the fSouth Windsor,Town o Conn. i South Windsor, Conn. —Fab, 24 i to gerfifg, That Frank D. Zito is hereby granted permission to Basement recreation room* storage, bedroom i at estimated value AMM O AA on the side of 1$1 Tatmblebrook Drive Street on land owned by Peter Denis Said Work to be as described in Application N12911 and to conform to specifications and plans filed with said Application, and Building By- Laws of THE TOWN OF SOUTH WINDSOR. Issued Feb. 24 . 6) Building Inspector. Streets and sidewalks, obstructed by ezcavations or building materials, must be guarded by barriers during the day and by both barriers and colored lights by night. SECTION 1343, GENERAL STATUTES OF CONNECTICUT: "When any person shall place or keep building materials, or any obstacle in any highway (or any sidewalk) either with or without a license therefor from the city or borough in which such highway may be situated, he shall pay said city, t wn or borough all costs and damages which it :ball sustain, or be compelled to reason therefor" I YP �~�-�� aye A "v- INSPECTION REPORT Permit # a6' Job 1 Footing 2 Foundation 3 Framing 4 Wiring � �~ 5 Plumbing; I,f--��r� 6 Heating 7 Lathing 8 C.O. 7611 ELECTRICAL APPLICATION Application No. 8723 on the l side of L,J rlOrJ Street aw Street No. Owner-, Elcctrictan FILED INS OFFICE OF i The Building,Inspector Fed. 24�'- 19 82 INSPECTION. "3-No Electrical Work shall be started until a Per- mit is granted by the Building Inspector. in New Buildings no wiring shall be started until the plumbing and heating pipes, and the fire stops (if of wood) are installed, without a special permit from the office of the Building Inspector. 1 d' APPLICATION FOR PERMIT TO DO ELECTRICAI, WORK. No. ........ .8. ...... ...... Permit No. ... ... . 611 TO THE BUILDING INSPECTOR of the TOWN OF SOUTH WINDSOR, CONN. 1............ hereby make application to. perform Electr cal Work according to detailed description below. All provisions of the Rules for Electrical Installation, Section 48, Building By-Laws, shall be complied with whether specified herein or not. South Windsor, Conn., ..... ,, "l�~ 19 Sign here `�.. ' ..�..... C' z's �� Oct` Address ............. ... ..... ...........�.............._.... �+Q � n Location / /.......,��.�K �..... ► �� .... �•.. Side of ... . . .... ..... ........................ ......... ................................ Nature of Building ... . ... How many stories .........0 ............................................ ................. New or old Building l How many families .......0.....Ct.................................................................... Kind of Installation How many Stores .................................................................................................. Owner �, Tle, ,. .... .°...... �°It�.>...�,�........ ....._... ... . . Address .____.3...... ,_....�2. Architect .......... ... Address . . . .. .. .................................................. J Builder ....... ..... .�1 Q MF's.�! .. . Z44�0..... . ...... Address .. . ... .......... ................................. _._._..... ..... .... dress `� ...� `v° Electrician �..�).���. ...... .�......[� !.. .. 4�1i.(� .� . (.�...: ....✓.....,.,�........f..'�...�'".l�!.��........... ...'T't Size of Main Wires ... ..Z..... .............................. No. of Light Loops .. . .. Q ...... No. of Heat Loops . ..... No. of Power Loops ......................... No. of Light Outlets rC..1.. No. of Heat Outlets . No. of Power Outlets ...........3............... NoP of Light Circuits .... ....�...... ..... No. of Heat Circuits .. No. of Power Circuits . No. of Sockets No. of Heat Receptacles No. of Motors ......... .. . No. of Panels ......................... ..... ...... . .. .. .. Size of Heat Circuit No. of Power Receptacles HIV .. . .. .. No. of Switches . ....... .............. .. . . Total Wattage .... .. ...... Size of Power Circuit .. . . . Total Horsepower No. of Straight Electric Fixtures ....... . ... .. . ................ .. No. of Combination Fixtures .... No. of Receptacles .............28......... ......... ....... .... ...... No. of Cord Drops ...... ........... .............................................. .............. Remarks: For othor kind of Installation .................. ` .. /..............Z...g.....`l..T!..`" .......... .............. e e //*� le'S e QC7e""PV / k,,l 0 'el:;� ......� �J...o. ................0.............. J.s:1. .. .......... '��P.. ................................................................................................ ......................................................�..,....... �...... ........... ........ .... . . ..... ................................................ ............. ....... . . ... ........... . Estimated Cost .... ;`4,�....�dA....6. ...... 5907 PLUMBING APPLICATION No. 6696 on the _..._..._. aide of _........_......_. Tumblebrook Drive -qft Street No. 181 Owner ._Peter DeRenis ply _..Gary Benware Filed in Ofic of The Bwldrmg Inapocaor Feb. 24 ig 82 IN 1C VWN. ............. No person Shall ooas- Ir f t, add to or abe r aay portion of the &abap syaaem of my bml&og (except to repair belts) wag a Pe is Sra ood by the Building Inopomr. a 0 6 3 5 ,94 Application No. ...........6.68.6.............. Permit N . . ..5.9.0.7............... ............. TO THE BUILDING INSPECTOR of the TOWN OF SOUTH WINDSOR, CONN. hereby make application to perform plumbing according to detailed description below. All provisions of the Rules for Sanitation, By-Laws, Sections 33 to 47 inclusive, shall be complied with whether specified herein or not. ............. ............ South Windsor, 19 ..?;2. Sign here-14... ....... . ... . ...... Address .................................................................... ........................................ Location ........ .. .. side of .............................................................. Street Nature of Building . .............................................. . How many stories ... .................................. Owner .......pw��,e ....... 4,-,7---e 5..................... . Address -/,*-/......�7 Xeg'C'..x..ze................................ Architect .................................................I.... ...I.........................................I............ Address .......................................................................................... .................... Via,.v Builder ............................................ Address -7...A., .......1401.......119 Plumber ..........................I....... Address DRAINAGE CESSPOOLS, How many Where located ......................................................................... Are they water tight ...... ........ ....... ......... Of what materials are they built .......................... ........ Size of pipe from house to cesspool Kind of pipe .......... . ............. ............................................................. MAIN DRAIN IN CELLAR, Material ....... Diameter ........./Y............................................................................................. Aboveor below cellar bottom . . .... .......................... . . . ............I...................................................................................................... SOILPIPES, Material . E,. .............. .. ......... Diameter ................................................................................................... WASTE PIPES, Material - -- .185 ............................................................... .............. .. ............. .... Diameter 14 TRAPS,Type proposed to use is . . P. . ........ ....................................................................................................................... RAINWATER LEADERS, where do they run to . ................................................................................................................ REFRIGERATORWASTES, where do they run to . ... .. .............................................................................................. ............................... TANKOVERFLOWS, where do they run to . ... . ................................................................................................................. FIXTURES LL WATER CLOSETS, How many ... ............./.......... . ....... Where located .... . ............................. Distance from trap to vertical 30il pipe ................... ................... Pattern . . .................................................................................... WASHTRAYS, How many ... . ............................................. Where located ..................................................................................... SINKS, How many ....................................................................................... Where located .. .. .......................................................................................... BUTLER'S SINKS, How many ........................................................ Where located. .................................................................................................. REFRIGERATOR SINKS, How many.. ................................... Where located ............................................... ................................................. LAVATORIES,How many . ................................Z.......................... Where located ........... ......................................... ffJ.et..i BATHTUBS,How many.... ...............I.................. Where located .........Iz Ax.Ar.."a.'rexr.--10................................. URINALS, How many ....- - ....... . ............................................... Where located ......... ......................................................................................... Are water closets and urinals to be local vented Xx 5 - . . If not, is there a window in outer wall ofroom where same are to be located ......... . . .... ................................................................................................................................... Estimated Cost ........ ............... 8329 ELECTRICAL APPLICATION Application No. 9735 on the side of Tiimh1 Phronk nriVF' Street Street No. 181 Owner Peter D'Engenis Electrician M i l can P 1 c)u f f FILED IN OFFICE OF The Building Inspector April 13 19 R4 INSPECTION. m No Electrical Work shall be started until a Per- mit is granted by the Building Inspector. In New Buildings no wiring shall be started until the plumbing and heating pipes, and the fire stops (if of wood) are installed, without a special permit from the office of the Building Inspector. Electrical Permit Na. ....��...... .f......................._ Master License No. ...... �..3.!..�7 ................ TOWN OF SOUTH WINDSOR Building Permit INO. Zev.. BUILDING DEPARTMENT Date Filed ..... /V/.ff...... . .................................. Date Final Approval ....... ........... .......................... APPLICATION FOR ELECTRICAL WORK Electrical Inspector JOB LOCATION: ��/ �cl� ,C ^��`�K.. '� JOB OWNER: t ........... /�1 G- lS......................................... Sideof . Between . .... . .. ....... ........ ........ . and ................................................................................. Name of Building Owner P am' .�� �J&d-,"...�!-5................ Address ....���... Uty/3Cr,f3ti,01V�'D :.................. If work is for Lessee—Give name Address ................ .... ..... ......................... ........ ......................... Building now occupied as (unless new) 10 �75 14=W.;:�/�..Z— No. of family units now ..e9 .... ... Building to be occupied as ....... .. .. .... .... . .... ..... . .. I....... ...... Number of family units to be ........ ...................... Is this work included in a Building Permit? /�!O. ...... Permit Fee .. .......... .. ..... .. ....... ............................. .........................._..... (If no Building Permit) Permittee �Li°iV C I d��� ��'• Business Address 1 F=D / �Ycu —�U. ,�/ �Telephone ..... COST OF INSTALLATION �7-s.�D� . ........ L.!!,.. ����i5No&De9�cr... .s::...v�g.......................................... ...... ............ TO BE FILLED OUT BY PERMITTEE TO BE WIRED EXISTING APPLIANCES Number of light outlets to be installed Number of convenience outlets to be installed Number of present Appliance Circuits ...... ...................... ............. Number of switches to be installed Do these include Range ❑ Water Heater ❑ Number of appliances to be installed "02, ... (as listed below) Dryer ❑ Air Conditioner ❑ Oil Burner ❑ TYPE RATING NO. Dish Washer ❑ Gas Burner ❑ Range Well Pump ❑ Elec. Heaters ❑ Range Top . . . . . . Oven . . . . . . . . REMARKS: Water Heater . �' C ��-e? / '1- Clothes Washer . . . . Clothes Dryer Dish Washer . . . . . . Air Conditioning Motor Oil Burner Motor Gas Burner . . . . . . Circulator Motor . . . . Attic or Large Fan , , , Well Pump . . . . . . Electric Heat . . . . . Other . . . . . . . Number of new Lighting Circuits . . . . ............................. Number of new Appliance Circuits . . . .........A—.............. Number of Heating Circuits . . . . . . ............................. Number of Motor Circuits . . . . . . . .._...........—...-- Size of present service ....../. 19.. ......._............................_............ _.... _ Size of service to be ......, 'o! ..t... ........_..........................._..___ _---- B iIdnII�V""'A �t-Z,s_9 SPECTIO1 APPLICATION FOR BUILDING PERMIT a a r C Plumbing HVAC Date: Sprinkler 181 TUMBLEBROOK DRIV Electric Estimated Cost $ Zoning Permit Fee $ �a Affidavit NO. 18004 Occupancy Fee $ Eng. Dept. COMPLETE RED BOXED AREAS. Fire Dept. TYPE OR PRINT ONLY Total Fee $ Health Dept. SIGN ON REVERSE SIDE. Approved for CO: (Additional Cost) $ TO BUILDING DEPARTMENT, TOWN OF SOUTH WINDSOR, CT The undersigned, h reb appli s to do work according to the following specifications: Job Location Lot No. Side of Street Zone Applicant Q�r 0.l S � Tel. # �� k-f a-0 Address a V_)Ck r A S4. cO Zip a 6 dk Lic.# STREET CIT Owner Q �� S ddress -e I' ArchitectLa,C ---Address — Q r e ILE Size New Area: Ft. Front Overall Ft. Deep Overall Total Area #Garages Lavatories No. of Families No. of Stories Construction Bathrooms Rooms 1st 2nd 3rd Size of Lot Dist. frp m Street Line Dist. from Side Str et Line Pur se of this Permit a e laCe , 0 e 6(I i' 4o r C.1 City ater Well ❑ Septic ❑ Sewer �C Approved by Date T`3/ BD1A 11/88 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 lin s,sid yard lin s and required distances f om all other zones and is located in a zone in which this building and its use is allowed. Signed - I hereby apply for a Certificate of Occupancy for the work described in this application for permit. Signed —DO NOT WRITE BELOW THIS LINE— INSPECTION RECORD � Footing C FramingA Foundation Fireplace/Chimney Insulation Plumbing Permit# Inspections: HVAC Permit# Inspections: Electrical Permit# Inspections: Sprinkler Permit# Inspections: GARDNER Et PETERSON ASSOCIATES 676 OLD POST ROAD-TOLLAND, CONNECTICUT 06084 c� W ovV PAQCEL. A • �� p�2aPo5E0 1 '1. Z 1 Ai 337.E �SG.T O 333.6 i54.1 35A.G 3s�•� � 49 '4 M M Q i 3 5 2.0 \3 A Tw 3 5 4.1 ' u V 24 11 14 7 1kV•�7h�. 3st 3s • �� 24 jst•o .152•IL ti•b s s•s �� _ 3�44.4 3sz•9 asz.b 50 � � 3s� •� 352.5 •. Tv MF3�..'EgROOK �Q ��i� MORTGAGE SURVEY Minn `•��OF CQev LOT # 13 TIMBER RIDGE SECTION III ••''•��,��it 0.c-�Fc+ TOWN OF SOUTH WINDSOR, CONNECTICUT ;'••�';��a�" "4oy;n N I hereby certify to Savings Bank of Manchester that ILNo. 4395 the location of the building as shown is substantially =RF0/s r'Itc 00 010,0 correct and that there are no zoning violations of the "° IMEr°a same. L.S. # 4395 April 20, 1979 PROFESSIONAL ENGINEERS LAND SURVEYORS ITI Or ZONING C 01VINLiA;�CE 'AUG 3 1 1989 Proposed buildi>>g(s), use(s) and/or structurefs) as shown on this p!:,n app--i;(s) to be in South Windsor Corsiorrrr,-once wilit h cr.l reY�,: S,D:1-,J1 y,/; ,f�.- ;r QUILDING DEPARTMENT 1-e0T--;1Qti0►1s. Var»a,nces a+id except;,D;ls may apply.,, Date 3 Zoning E:�f;;rc-�riaon.t Off`cer 10 iris :i. 1 i dN OF SOUTH WINDS This certm,d P,-t C-is pl-n Ind sp^cific-•tlons are true copies of the proposed building or aiterations to be erected at ee, togcthtf :mendrnent - t c• � filed with pl,n and 1 ,grr,, to con pl, �t Building ,rid A,te 1_,ws aid 31,ch r issued by the uuilding Dep rtm•nk d rI ;;c of this application and_LLnal issuance f t permit. Signed Coz I This plan is approved subject to th• c-,VIi,)n a orders and ordin,.nces regulating bi ildmp .',,id complied with Conditianalty Approved T s il_d with ,Building Inspector (Cller: Dato Bectric# APPLICATION FOR BUILDING PERMIT Plumbing# 181 TUMBLEBROOK DRIVE pat : IZIIS/9�' AC 25789 Sprinkler# N0' FIUin� 5 PR Estimated Cost 90 D Buil 7Mk�� COMPLETE RED BOXED AREAS Permit Fee $ TYPE OR PRINT ONLY Occupancy Fee $ �ida"'t SIGN ON REVERSE SIDE Appr.for CO. I Total Fee TO BUILDING DEPARTMENT,TOWN OF SOUTH WINDSOR,CT (Additional Cost) $ The undersigned hereby applies to do work according to the following specifications: Job Location 18 -'VMA Lot No. Side of Street Zone Applicant r o04,.�1 Tel.# SL e" W 6 y Address 12--r^i-y St f,H • Zip ato Lic.# Sal9 / Owner z Address S�•.^...c Architect Address Sq. Ft.New Area: 1st FI. 2nd FI. 3rd Fl. Total New Area #Rooms #Lavatories #Bathrooms #Garages Purpose of this permit: lea 9� 0VP-- t K1i f.^s s ^S(Lr. City Water ❑ Well ❑ Septic System ❑ Sewer ❑ Ins. H.O. S.P. Cert. Area I Basement Garage Approved by < 1 Date 12J)VV Use Group instruction Type R•v6ed 1197 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 building and its use is allowed. Signed bx, t�� I hereby apply for a Certificate of Occupancy for the work described in this application for the permit. Signed DO NOT WRITE BELOW THIS LINE INSPECTION COMMENTS Electric# APPLICATION FOR BUILDING PERMIT Plumbing# 181 TUMBLEBROOK DRIVE Dat HVAC # �_ 26335 Sprinkler# FINAL APPROVAP Estimated Cost Building -7 23 ff - COMPLETE RED BOXED AREAS Permit Fee $ �4''� Engineering TYPE OR PRNT ONLY Occupancy Fee $ Affidavit SIGN ON REVERSE SIDE Appr.for CO. Total Fee $ 2 TO BU ILDM DEPARTMENT,TOWN OF SOUTH WNDSOR,CT (Additional Cost) $ The undersigned h reby applies to do work according to the following specifications: Job Location 8/ rym&"R&O i( DRrilE Lot No. Side of Street Zone Applicant A((T'RW Al tAl 127L S K-S. Z6&j Tel# -- 9-iTe)0 Address 40 EPMKr-,r = ,' S ¢' G rip. PAO 7q Lic.# Owner ;,ri Address Z t� Architect Address Sq.Ft.New Area: 1st FL 2nd FL 3rd FL Total New Area #Rooms #Lavatories #Bathrooms #Garages Purpose of this permit: I(� eiL'l'0L1a T� 1ermwx -1,e- SaSE Dr j/z /O,00 2�2 City Water ❑ Well ❑ Septic System ❑ Sewer ❑ Ins. H.O. S.P. Cert. Area Basement Garage Approved by �� Date *Zv Use Group Construction Type R.v6ed 1197 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 Alf any alteration in the plans or specifications of the Building for which this permit is asked,and agree that this building is to ted t roper distance from all street lines,side yard lines,and required distances from all other zones and is located in h this b it a it se is owed. Signed I hereby apply for a Certificate of Occupan r the work described in this application for the permit. Signed DO NOT WRITE BELOW THIS LINE INSPECTION COMMENTS DEPARTMENT DECISION PEF.M[IT# APPLICATION FOR HVAC PERMIT IoPS3 Application is hereby: TOWN of SOUTH WINDSOR BUILDING DEPARTMENT Bld P # 7fAPPJ3j,007xV0PE-:D::) 1540 SULLIVAN AVENUE 2,a 644-2511 ext.230 2±- ;-7 Date Building Inspector Application must be printed or typed Location of job Street No. Street Lot No. FEE SCHEDULE Floor Apt.No. $0 - $11000 - $12.00 Over $1,000 $12.00 per$1,000 OWNER F or any fraction thereof ADDRESS. OWNERS PHONE# APPLICANT 0,0,01 OWN S ADDRESS ESTIMATED COST $ 0 IS THIS A CONTRACT COST? psi V YE NO j FEE ENCLOSED $ 12 01 RCO TYPE OF JOB: Original Installation L--'Alteration/Addition Repair Revised 11/95 APPLICATION FOR HVAC PERMIT(Continued from reverse side) TYPE OF SYSTEM TYPE OF BUILDING HEATING ✓ RESIDENTIAL A/C COMMERCIAL VENTILATION INDUSTRIAL HEATING STEAM LOW PRESSURE LIMIT LBS. HIGH PRESSURE LIMIT LBS. HYDRONIC WARM AIR UNIT RADIANT HEATER EXISTING RADIATION ADDITIONAL RADIATION TOTAL RADIATION DESIGN TEMP. OUTSIDE F INSIDE F DIFFERENCE F TOTAL HEAT LOSS(BTUH) (HEAT LOSS SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL HEATING EQUIPMENT (INCLUDING MAKE MODEL NO.) TA GROSS HEATING CAPACITY (INPUT-BTUH) NET RATING (OUTPUT-BTUH) TYPE OF FUEL OIL-GPM GAS-INPUT ELECTRIC-KW OIL TANK SIZE&LOCATION INSIDE ✓OUTSIDE CAPACITY 2.D IS- LPG TANK CAPACITY AIR CONDITIONING DESIGN TEMP. OUTSIDE F INSIDE F DIFFERENCE F TOTAL HEAT GAIN(BTUH) (HEAT GAIN SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL COOLING EQUIPMENT (INCLUDING MAKE&MODEL NO.) TONNAGE COOLING CAPACITY(BTUH) 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 THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONN.BUILDING CODES IN THE PERFORMANCE OF SUCH WORK. STATE LICENSE-NO.NAME&TYPE SIGNATURE OF APPLICANT PHONE NO. �A r- DATE `-) q A