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HomeMy WebLinkAbout14 Shadbush Lane B N n-. SPECTIONS: APPLICATION FOR BUILDING PERMIT P I umjing HVAC Date: Spri I e r 14 Shadbush LANE Electric Estimated Cost y � Zoning Permit Fee $ Affidavit NO. 17748 Occupancy Fee 3 Eng. Dept. Fire Dept. COMPLETE RED BOXED AREAS. Total F $ •�� Health Dept. TYPE OR PRINT ONLY Approved for CO: SIGN ON REVERSE SIDE. (Additional Cost) $ TO BUILDING DEPAR MENY, WN OF SOUTH WINDSOR, CT The undersign#d jereby applies to do work accordin to the follow pecifications: Job Location 1 ofIfo. Side of Stree Zone U` Applicants GdT -Tel. # vim. 6 Address?1Ci �f G' - s- 1J�1 / f�^� ,.4�If p au 6 Lic.# STREET CITY STATE Owner ! Address S.�Al 6� Architect Address fon4�cb Size New Area: Ft. Front Overall krt. Deep Overall Total Area #Garages No. of Families No. of Stories Lavatories Construction �b Bathrooms Rooms 1st X-2nd-?-3rd Size of Lot Dist. from Street Line .301 Dist. from Side Street Line Purpose of this Permit Sr^jQ[.0 otot P1 a.-j City Water Well ❑ Septic ❑ Sewer �C Approved by Date 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 lines,side yard lines and required distances from all other zones and is located in a zone in which this building and its use is allowed. eo Signed I hereby apply for a Certificate of Occupancy for the work described in this a licatio for permit. c Signed —DO NOT WRITE BELOW THIS LINE— Footing Framing ��^ C INSPECTION RECORD � Foundations s—� Fireplace/Chimney Insulatio�n � Plumbing Permit# 3 Inspections: <Jo� HVAC Permit# 77 Inspections: �S Electrical Permit# 1 QO � Inspections: Sprinkler Permit# Inspections: w-*a' a•-•.. , zaa'7'P>. r C.. .a,i,fy e','a`�".'j�w'9y';{.r , < s BUILDING INSPECTION DEPARTMENT SOUTH WINDSOR, CONNECTICUT FEE PAID: $3.00 CERTIFICATE OF OCCUPANCY ZONE: DATED 10/3 1989 This is to certify that 14 Shadhush Lane Erected under permit No. 177AR conforms substantially to the requirements of the building ordinances and the zoning regulations of the Town of South Windsor and is hereby approved for occupancy as indicated below. Approved for Occupancy— Single family dwelling -- Lot # 33 uilding Official Notice:ff this certificate is lost or destroyed, a duplicate should be obtained immediately from the Building Department. Any change or extension of the use herein approved requires a new certificate of occupancy. CERTIFICATE OF OCCIPANCY CHECK LIST / �f Sr Applicant Mannarino _ Certificate of occupancy r Y 7 Address Bldg. Permit No. "7-7 4 g' Lot No. 33 Date Submitted 9-27-89 Project Victorian Woods Reviewed By Date As required in the Zoning 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. 2. Finish grading per approved building permit plan. 3. Site work; i.e. trees, shrubs, dumpsters, required parking 4. Utility location a. sanitary sewer b. foundation drain c. electrical & telephone d. water e. other _ 5. Appropriate certification 0 ruWin 16. Bonding n�Sc A fad^ Sewer Permit No. Pavement Excay. No. COMMENTS: J Gam+- WJAJ ,¢ v,r�s C.y�c✓s a/� � G BUILDING PERMIT CHECK LIST Applicant Building Permit No. /�7Y4f �/ Address 3p ,� ,� , Un;f ,g_q, s, w m6o. Date Submitted /';f ZZ Mel Lot No._,* S3 s tiactb"s 4 Reviewed by I Project v,4,,-,.,, "/0oC& Date In accordance with the 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 : Approved Denied N/A ✓ 1. Name, address & phone number of owner/ applicant. 2. Name address & hone numb er ber of plan preparer. 3. Zoning information - i.e. zone, open space, floodway, etc. 4 . Plot plan at 1" = 40 ' scale. —j� a. Subdivision reference, abutting properties, etc. b. Easements of record. c. Lot description, bearings, distances, / building lines, area, etc. d. Contours, existing & proposed, 1 or 2 ft. interval where appropriate. ✓ e. Building location with dimensions. Elevations of proposed finish floor, garage floor & center line of road at driveway. f. Elevations of gravity drainage systems, sanitary & foundation drain at the / house and the street.g. Tentative utility location gas, electric, water, etc. h. Title block with name and address of preparer, date appropriate certification, live seal and signature. 5. Sedimentation and erosion control. 6. Special Planning & Zoning, Inland/Wetlands considerations. (Plans on file w/Town Clerk) BUILDING DEPT. PZC IWA/CC WPCA OTHERS COMMENTS: COY r 0-le S ?Z)&U&01t o � s �L 1540 SULLIVAN AVENUE • SOUTH WINDSOR, CONN. 06074 R.coN AREA CODE 203/644-2511 DATE: May 10, 1991 --- TOWN OF SOUTH WINDSOR BUILDING DEPARTMENT Joyce M. Samiotis 14 Shadbush Lane South Windsor, CT 06074 TO WHOM IT MAY CONCERN: Re: 14 Shadbush Lane South Windsor, CT.. This office has observed that the construction activity I referenced below is in progress at the above noted location. Our files indicate that no building and/or zoning permit has been issued to allow the referenced construction. _ Please terminate all construction activity and contact this office as soon 'as possible to make arrangements to obtain the necessary permits . Your cooperation will be appreciated. Very truly yours, I O` G� I James A. Emery Assist.Building Official Construction Activity: Wading Pool no permit J cc: John McCahill, Zoning Enforcement Officer l 1 Ast•►s •.e �' � � M CAM .O�,.� =:�'• oavver •Rows �VJ a C "I J •� a ..}=r r�« ,r �•+G= air ' ' �''• . � .40 �EccE o� B,doo.c >72 •sue - s.di s...•rsss'�f�f .'• =c'l✓•or 33• _ i i S.ry t! �...t✓ !; �ooa 177 A 7G•S rr bOA.Slu ate.A4oll / 1t 1 �_ '!•a.y e Z= 41 1 1.4 A Jodi( pep / n f6 ' IsAb •��� V" 77. 90 r� fiat 401"ve MH)B /VG V/OLA TiONS 71.31 /AVE ,BEEN 5�►++.1�1?�, 79 4( Zvi e. Vj c;0�.►� s MAP PREPARED BY: 9,�•7-89 � M E X 0 R A N D U X TO: Louise Evans, Chairman, Planning & Zoning FROM: John E. McCahill, Zoning/Wetlands Enforcement Officer DATE: March 15, 1991 RE: Swimming pools as an accessory use at Victorian Woods (DA- 15) It has come to my attention that a small swimming pool has been r- placed on the property at 14 Shadbush Lane (see attached) . Before taking enforcement action I would like to know if the Planning and Zoning Commission considers this an acceptable accessory use and whether or not the building envelope applies to such use. If pools are allowed and the building envelope does not apply, what limits are we to impose with regard to location? Thank you for your attention to this matter. JEM/pmm cc: Marcia A. Banach, Director of Planning John R. Collins, Chief Building Official i I PERMIT # DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT pv,Dq i s Application is hereby : TOWN OF SOUTH WINDSOR f E APPROVED DISAPPROVED BUILDING INSPECTION DEPT. 644-2511 Ext . 230 Application must be printed or typed. Date Building Inspect 1 . LOCATIOF JOB 1-04 14 s� - FEE SCHEDULE No . Street i ' $ 0 - $19000 - $10. 00 Floor Apt . No. Over $19000 - $10 .00 p e r $1 ,0 0 0 or 2 . OWNER fraction thereof ' 3 . A D D R E S S ,52- C'T /�}(/�i�/r/E c�'�//j� l 4 . APPLICANT Z?L'!Gc-J" C /� 5 . ADDRESS ,.570 6 . ESTIMATED COST $ 7 . IS THIS A CONTRACT COST Ae s No 8 . FEE ENCLOSED 7711f 9. TYPE F BUILDING: RESIDENTIAL COMMERCIAL 10. TYPE OF JOB : Original Installation Alteration/Addition/Repair BD 3A 11/88 APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side) 11. LOCATION OF JOB NO. STREET APT. NO, 12 . TYPE OF INSTALLATION Axi 13 . SIZE OF MAIN FEEDER — 15'4E-ie 14. NO. OF LIGHT LOOPS 15 . NO. OF HEAT LOOPS 16. NO. OF POWER LOOPS 17 . NO . OF LIGHT OUTLETS cw� 18. NO . OF HEAT CIRCUITS 19 . NO . OF POWER OUTLETS 20. NO. OF CONVENIENCE OUTLETS 5-0 21 . NO. OF HEAT CIRCUITS 22 . NOo OF POWER CIRCUITS _ 23 . NO. OF LIGHT CIRCUITS 24. SIZE OF HEAT CIRCUITS 25 . NO . OF MOTORS 26 . NO. OF PANELS / 27 . TOTAL WATTAGE 28 . NO. OF POWER FEEDERS 29 . NO . OF SWITCHES 30. A/C LOAD 31 . SIZE OF POWER FEEDERS 32 . NO. OF FIXTURES 02-0 33 . TOTAL HORSEPOWER 34 . NAME OF SUBCONTRACTORS AND THEIR TRADES 35 . REMARKS AND FURTHER DETAILS : LICENSE NO. SIGNATURE OF APPLICANT DATE PHONE NUMBER ... a, i...'h77 n 7^ ! i 9 . Si 4i Lot, No. � Building Permit Temporary Seryice Permanent Service Pursuant to Permit No. 11 AC-M This Certifies that the Electrical Work for which the above named Permit was granted has been duly inspected and is hereby approved. OwnerA Electrician 1, i Street ( � ` ('9CIA Building Inspector PERMIT NO. DEPARTMENT DECISION A P P L I C A T I O N F O R APPL ATION IS HEREBY: PLUMBING PERMIT APPROVED DISAPPROVED TOWM OF SOUTH WINDSOR BUILDING INSPECTION DEPT. 644-2511 Ext. 230 Y DATE PLUYtAG INSPECTOR Application must be printed or typed. 1. LOCATION OF JOB: 'II/ AD N s 3 . 2. OWNER: Y" 1csYo-, \ -,.[�� 3. ADDRESS:a"13C FEE SCHEDULE 0 - $1,000 - $10.00 4. APPLICANT: T Over $1,000 - $10.00 5. ADDRESS: per $1,000 or Fraction Thereof 6. EST. COST: $ Jo 7. IS THIS A CONTRACT COST? YES NO 8. FEE ENCLOSED: S 9. TYPE OF B ILDING: PRESIDENTIAL COMMERCIAL 10. TYPE OF VJZB: �RIGINAL ALTERATION INSTALLATION ADDITION REPAIR BD 2A 11/88 APPLICATION FOR PLUMBING PERMIT (Cont. from Reverse Side) C3usH 11. LOCATION OF JOB: GENERAL PLUMBING 12. KIND OF INSTALLATION: {yJ ?�� �,c��1C� 13. SIZE OF MAIN DRAIN 14. NO. OF TOILETS j 15. NO. OF URINALS STYLE 16. NO. OF BATHTUBS 1 16A. NO. OF SHOWERS N 17. NO. OF LAVATORIES 18. NO. OF SINKS 1 19. DISPOSAL. 1 19A. DISWASHER JJ 20. NO. OF CONDUCTORS SIZE 21. NO. OF STACKS SIZE 22. AREA OF ROOF 23. NO. OF CATCH BASINS 24. NO. OF FLOOR DRAINS 25. NO. OF OTHER FIXTURES KIND 26. ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW? �S 27. SIZE OF WINDOW 2)>2) 28. IF NO WINDOW, WHAT KIND OF VENTILATION IS THERE? 29. SIZE OF DUCTS 30. SEWER OR SEPTIC TANK? 31. SIZE OF WATER MAIN \! 31A. SIZES OF WATER PIPING & RISERS 32. REMARKS AND FURTHER DETAILS WATER HEATER 33. TYPE �.( + �� 34. MANUFACTURER \ TANKS SAFETY DEVICES TEMPERATURE 35. CAPACITY d �q 5� 39. RELIEF VALVE 36. TEST PRESSURE LBS. 40. MANUFACTURER 37. WORKING PRESSURE LBS. 41. PRESSURE RELIEF VALVE QS 38. TYPE 42. MANUFACTURER 5 LICENSE NO. bAT SI NATURE w APPLICANT PHONE NO. FOR OFFICE USE ONLY APPLICATION FOR HVAC PERMIT DATE: 6 —0 (NO. '7,5 77 ) TOWN OF SOUTH WINDSOR EST.COST: BLDG. PERMIT NO. 7qo? 1540 SULLIVAN AVENUE FEE SOUTH WINDSOR, CT 06074 FEES: 644-2511 — Ext. 230 _ $ 0 — $19000 — $10.00 Jul IRD,BU S/� 1—�N� $1000 or fraction LOCATION OF BUILDING �33 ' thereof — $10.00 ne � 6T- WNER ADDRESS TOWN PHONE NO. H AC CONTRACTOR ADDRESS TOWN PHONE NO. TYPE OF SYSTEM: HEATING TYPE OF BUILDING: RESIDENTIAL A/C COMMERCIAL VENTILATION BUSINESS INDUSTRIAL IF HEATING: STEAM LOW PRESSURE LIMIT LBS. HIGH PRESSURE LIMIT LBS. HYDRONIC _ WARM AIR UNIT RADIANT HEATER (INCLUDING WOOD/COAL BURNING STOVE) TYPE OF FUEL: OIL-GPM GAS IN-PUT ELECTRIC KW WOOD COAL OIL TANK - SIZE & LOCATION: INSIDE OUTSIDE CAPACITY LPG TANK - CAPACITY EXISTING RADIATION ADDITIONAL RADIATION TOTAL RADIATION DESIGN TEMP. OUTSIDE 0 OF INSIDE_ ) OF DIFFERENCE 0D OF TOTAL HEAT LOSS (BTUH) _(HEAT LOSS SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL HEATING EQUIP ENT (INCLUDING MAKE & MODEL NO.) : AM-TZ GROSS HEATING CAPACITY (INPUT-BTUH) () NET RATING (OUTPUT-BTUH) IF AIR CONDITIONING: DESIGN TEMP. OUTSIDE °F INSIDE OF DIFFERENCE OF TOTAL HEAT GAIN (BTUH) (HEAT GAIN SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL COOLING EQUIPMENT (INCLUDING MAKE & MODEL NO.) : TONNAGE COOLING CAPACITY (BTUH) IF VENTILATION: DESCRIBE ALL AIR-HANDLING EQUIPMENT (INCLUDING KITCHEN EXHAUSE EQUIPMENT) : TOTAL SIZE OF SYSTEM (CFM) FRESH AIR INTAKE (CFM) (PLAN MUST ACCOMPANY APPLICATION) The undersigned hereby applies for a permit to perform the following work and is to comply with all local ordinances and State of Conn. Building Codes in the performance of such work. FURTHER DESCRIPTION OF WORK: S 1 -o s STATE LICENSE - NAME & TYPE # DATE SIGNATI OF APPLICANT P OVED DATE BD 4A 11/88 = B= R CALCULATION SHEET 1503 (Modern Method) Copyright 1977 by The Hydronics Institute OWNER ADDRESS DESIGN TEMPERATURE DIFFERENCE F. DATE COL.A COL.8 COL.C COL.D COL.E COL.F COL.G 11 ROOM cr O H L W H L W H L W H L W H L W Design Water Temp. 2 ROOM DIMENSIONS, FT ~ _ V BTUH per F t of 3 LENGTH EXPOSED WALLS, FT. Q Radiation Selected 4 WINDOW AND OUTSIDE DOOR AREA LL BTUH BTUH BTUH BTUH BTUH 5 WALL CONSTRUCTION ROOM LIN.FT.OF (Table 9, Line 3 x H) TOTALS RADIATION 6 TYPE OF GLASS FROM LINE 12 SELECTED (Bottom of table used for Line 5) 7 CEILING CONSTRUCTION C (Table 9, L x W) g FLOOR CONSTRUCT10Nt (Table 9, L x W or Lin Ft) E 9 COLD PARTITION CONSTRUCTION F (Table 9, L x H) G 10 1 Wall(With Openings) O =0 e; H 2 Wails(With Openings) -x CS 3 Walls(With Openings) or Ent Hall eJ 1 11 TOTAL BTUH AT 70F TEMP DIFFERENCE' 12 TOTAL BTUH AT DESIGN TEMP DIFFERENCE K COL A COL B _—COL.H - COL. I— COL J -_` — COL. K COL.L TOTAL BTUH TOTAL OF BUILDING RADIATION 1 ROOM AT SELECTED O H L W H L W H L W H L W H L W DESIGN TEMP.* DIFFERENCE 2 ROOM DIMENSIONS, FT 3 LENGTH EXPOSED WALLS, FT Q 4 WINDOW AND OUTSIDE DOOR AREA J LL BTUH BTUH BTUH BTUH BTUH 5 WALL CONSTRUCTION *INCREASE BATHROOM (Table 9, Line 3 x H) TOTAL 20% 6 TYPE OF GLASS -- ----------- --- --- ----- --- ----- ----- -------- -- (Bottom of table used for Line 5) tFOR CONCRETE FLOOR ON 7 CEILING CONSTRUCTION GROUND OR FILL AT (Table 9, L x W) GRADE LEVEL,USE LINEAR B FLOOR CONSTRUCTIONi _ 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) — =0 2 Walls(With Openings) -x _ J 3 Walls(With Openings) or Ent Hall 11 TOTAL BTUH AT 70F TEMP DIFFERENCE' 12 TOTAL BTUH AT DESIGN TEMP DIFFERENCE This form is available from The Hydronics Institute, 35 Russo Place,Berkeley Heights,N J 07922 FORM 1503 I V J , ARGO CALCULATION SHEET OWNER � r 1 � � •• 'C.- ADDRESS �'' '� I I � "� DATE i i ) DEALER 3 r -' orKIND OF BUILDING �� �J CHIMNEY SIZE CONSTRUCTION: WALL WINDOWS ROOF OR CEILING BASEMENT HEIGHT: ABOVE GRADE BELOW GRADE DESIGN WATER TEMPERATURE DESIGN TEMP. DIFF COL.1 2 3 4 S 6 7 8 9 10 11 12 13 14 13 16 17 is ROOM SIZE WINDOWS AREA•SO. FT. FLOOR vc L r E TOTAL TOTAL fASEDCAMOS AND DOORS Is[E MOTs/ ACCESSORIES GLASS NET WALL CEILING AT sO► coRRECTED WATER LENGTH ROO11M Num$ER GROSS 0 1 L TEN.. TO TEMP ^w L W H ow AR[A WALL + G DIF►. fi�� ENCLOSURE FIN I. R S I.0 MISC. f,=s _ics IF TUBE - I/ 1 0 , 0 7 0 5 . TEN. OIFF. .T. ., r7c ;�. I loco00 o0 10.0o a100 33/0 911 o o 61 0 0 00 $5 70 /6 'r a � � o y a < 30 �: 3� = �y b 00 /.xo ado 310o 00 �' �0 l r: s �c 0 0 �IF� � 13 l� �' 2 00 00 00 /Go0 0 3 c 10 400 4200 1100 /iA 00 G ' yy IT A 7 b 3900 Sop 300 oC 0o )3 IN 00 Liro 0 AD o 1106 A900 0�00 6 �- c?, o 3 0 5 6 o0 0 0 r q oo It00 Iz6o 3 , 1_ v 00 00 oo ©o a430 M Iggo 1300 loco- n 00 00 ��30 N DL y qIr aoo / 00 1.260 3 NOTE: FOR c NCRET[FLOOR ON GROUND OR FILL AT GRADE LEVEL.USE LINEAR FEET OF E:ro$tD EDSE. TOTALS FOR ALL OTHER FLOOR$USE SQUARE FEET OF AREA. V V Electric# APPLICATION FOR BUILDING PERMIT Plumbing# 14 SHADBUSH LANE HVAC # Date: Sprinkler# No. 23958 FINAL APPROV LS Estimated Cost $ 5� Building COMPLETE RED BOXED AREAS Permit Fee $ r 2 Engineerin 1 TYPE OR PRINT ONLY Occupancy Fee $ ln� — Affidavit SIGN ON REVERSE SIDE Appr.for CO. Total Fee $ /7 TO BUIL EPARTMENT, TOWN OF SOUTH WINDSOR,CT (Additional Cost) $ The and rsigned hereby applies to do work according to the following specifications: Job Location 19 S 6u5b 1, Lot No. Side of Street Zone Applicant Ga r Tel. # �j C.� �- d(p L(q Address L-0 ' ds Zip 07L Lic. # Owner eV Address 14 5'tqCc.A by5Ln Lavi-c S• Ldi,-,-td-Sor L7— Architect Address Sq. Ft. New Area: 1st FI. 2nd FI. 3rd A. Total New Area #Rooms # Lavatories #Bathrooms #Garages Purpose of this permit: v SS 1"Olg0, eI a e e C4.-S CA C v+q W City Water 27 Well 0 Septic System ❑ Sewer Use Group y Construction Type Area / Basem nt Garage Approved by Jo!z- Date j ? Revised 6/95 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 a zone in which this building and its use is allowed. � Signed 4a, P � I hereby apply for a Certificate of Occupancy for the work described in this application for the permit yl Signed -- DO NOT WRITE BELOW THIS LINE -- INSPECTION COMMENTS Inspection / Approval Date By Appl Code Description Due Whom Code Comment ------------------------------------------------------------------------------- 96-23958-B 850 E10 FINAL 04/29/97 JFH A GARAGE CIRCUIT B10 FINAL 04/29/97 JFH D EXPOSED INSULATION B03 FRAMING (ROUGH) 05/29/97 JFF D NO ACCESS LEFT CARD B09 OTHER 05/30/97 JFH PROGRESS B10 FINAL 07/07/97 JFH A GARAGE/APPROVED FOR CO & CLOSEOUT 97-14255-E 100 i DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT PEER Application is hereby: TOWN of SOUTH WINDSOR BUILDING DEPARTMENT Bldg P APPROVED 1540 SULLIVAN AVENUE X 351q 4 r 644-2511 ext. 230 Date Building Inspector Application must be printed or typed Location of job .5ko,ci lo L)SJ-1 LCt y-1 Street No. Street Lot No. FEE SCHEDULE Floor Apt. No. $0 - $1,000 - $12.00 Over $1,000 IR $12.00 per$1,000 OWNER (n 6 'r or any fraction thereof ADDRESS J Jag S Io L S CT 0(0®7 OWNERS PHONE# APPLICANT �C;t✓ l ] \\ e N ` ADDRESS [ Lf ,5��C�16 L)5 L g LaLun e-- f S Fq j Cam . ESTIMATED COST$ 006 op C IS THIS A CONTRACT COST? Vol ,�° YES NO yr ' FEE ENCLOSED $ 6 ®a TYPE OF JOB: OR-Co Original Installation Alteration/Addition/Repair Revised 11/95 APPLICATION FOR ELECTRICAL PERMIT(Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A RESIDENTIAL BUILDING PERMIT APPLICATION YES / NO BUSINESS ASSEMBLY CURRENT USE AND OCCUPANCY MERCANTILE EDUCATIONAL FUTURE USE AND OCCUPANCY INSTITUTIONAL FACTORY STORAGE ENGINEER'S NAME PHONE GARAGE MIXED USE ADDRESS CITY STATE ZIP (Other please specify) TYPE OF INSTALLATION/WIRING METHOD SIZE OF MAIN FEEDERS AND RATING OF WIRE USED 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 F. NUMBER OF HEAT CIRCUITS NUMBER OF A/C CIRCUITS SEPERATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED. DESCRIPTION OF WORK c I V,C L) L i:- -e(�,tz Ct1& -c © 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. d�_P 1�1uY l cf A It-A NAME STATE LICENSE NO. TYPE SIGNAIW6F APPLICANT PHONE NO. /,0 G - 6 DATE I136I q7