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HomeMy WebLinkAbout136 Murielle Drive W O I� eTO THE BUELDING INSPECTOR 1 �3 APPLICATION FOR 1 of>1:6 PLAN EXAMINATION AND TOWN OF SOUTH WEN DSM COW BUILDING PERMIT IMPORTANT — Applicant to complete all items in sections: 1, 11, III, IV, and IX. O • NING AT (LOCATION) �� 'et ' C o DISTRICT LOCATION (NO.) (STREET) OF BETWEEN AND BUILDING (CROSS STREET) (CROSS STREET) `'� LOT SUBDIVISION LOT J BLOCK SIZE CA 11. TYPE AND COST OF BUILDING — All applicants complete Parts A — D 3Z A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use T 1 M New building Residential Nonresidential 2 ❑ Addition(If residential, enter number 12 M One family 18 ❑ Amusement, recreational of new housing units added, if any, 13❑ Two or more family — Enter 19❑ Church, other religious in Past D, 13) number of units— — — — 20❑ Industrial 3 ❑ Alteration (See 2 above) 14 4❑ Repair, replacement ❑ Transient hotel, motel, 21 ❑ Parking garage P P or dormitory — Enter number 5 ❑ Wrecking (If multifamily residential, of units ——————— — -i ❑ 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, mercantile 8 X 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 2.D 0�av processing plant, machine shop, laundry building at hospital, elementary 10. Cost of improvement,,,,,,,,,,,,,,,, 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 $C_A.-� ®�©• 4 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 F�7- 30❑Masonry(wall bearing) 40 F" Public or private company 48• Number of stories................ ��= 49 Total square feet 31 Wood frame 41 ❑ Private (septic tank, etc.) . floor area, all floors, based on exterior IZj�Qr. 32❑ Structural steel dimensions .................... ;TTo 33❑ Reinforced concrete H. TYPE OF WATER SUPPLY _ I 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....................... 1 4 360011 conditioning? •..•. L. RESIDENTIAL BUILDINGS ONLY 37 Electricity 44❑ Yes 45 X] No 53. Number of bedro MS........ 13 38 ❑ Coo I 39❑ Other— Specify Will there be an elevator? 54. Number of Full.......... t 46❑ Yes 47 ANo bothro ms l Partial....... NOTES and Data — (For department use) IV. IDENTIFICATION — To be completed by all applicants Name Mailing addr ss — Number, street, city, and State ZIP code Tel. No. Owner or Lessee �- • r Who �6.CcJiwJOSe� O�vO 7 2. t to Contractor 3. oN��,e Architect or Engineer The owner of this building and the undersigned agree to conform to all applicable laws of this jurisdiction. Signature of a plicant Address Application date 9 r QikfxLlc 2_(C r n 1� ��cvelo�c lA�a 7s- r�1 DO NOT WRITE BELOW THIS LINE V. PLAN REVIEW RECORD — For office use Plans R view R quired Check Plan Review Date Plans B Date Plans B Notes Fee Started y Approved y BUILDING PLUMBING $ MECHANICAL $ ELECTRICAL $ OTHER $ VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Permit or A rova I Check Date Number B Permit or Approval I Check Date Number B pp Obta ined y pp Obtained Y 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 P rmit numb r 9947 Bui Iding Permit issu d Aug. 30 19 77 Bui Iding P rmit F $ 120.00 Approved by: t TITLE VIII. Z.JNING PLAN EXAMINERS NOTES DISTRICT USE FRONT YARI SIDE fARD SIDE YARD REAR YARD NOTES IX. 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Est. Value �$. Permit -NQ 9,947 on the side of Lot Dr. Street Street No. 136 Owner Chane 1 Hi 11 Dev. Co. Applicant 1 Dev,. Co. CERTIFICATE OF OCCUPANCY ISSUED: Date No. 5013 Fee Paid $3.00 CLASSIFICATION Dwelling BUILDING PERMIT NT -_9-947 OFFICE OF THE BUILDING INSPECTOR of the Town of South Windsor, Conn. Aug. 30 77 South Windsor, Conn. 19 Chapel Hill kDev. Co. ig4ia is fit (Certify, That Dwelling is hereby granted permission to .00 at estimated value of $ Lot #45 Murielle Drive on the side of Street on land owned by Chapel Hill De v. Co. Said Work to be as described in Application 10247 No. and to conform to specifications and plans filed with said Application, and Building By- Laws of THE TOWN OF SOUTH WINDSOR. Aug. 3 � 7 7 A gn 42 y i •} uildi 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 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, town or borough all costs and damages which it shall sustain, or be compelled to reason therefor." Permit I& f7f TOWN OF SOUTH WINDSOR SOUTH WINDSOR, CONN. I Permit No 5013 I Certificate of Occupancy I l S C+ Y that the at N in the of South Windsor, Connecticut, has I been erected and completed in accordance with the Building Code and Zo ' _ gulatio i the Town of South Windsor, and is hereby appr9pio for occupan9r. Building Inspector � s Owner, Builder .,Fee Paid 37 Date _ �✓ 19 T TO THE BUILDING INSPECTOR This will Certify that the Property Identified below has been Inspected and M is Engine ring Criteria for Certificate of Occupancy. b 6Z 141�1s 77 Engin ring Approval Dat �k r N/ F ALBERT M. 8t ANN CORMIER 108 106 10 I 1 \ ' + I 112 114 _ d 0' to E 97.96 _ 120 LOT 45 r-- 1 1 20,045.18 SO. FT. w� \ O cV LOT II \' 0.46 Ac. ` tp N \ LOT 44 W � m � \ 122 0 N�� \ rug►11� ' 1 N. ,y 40 BUILDING LINE — Foundation Foundation located as shown no 70?'11.t ' o violations. Q= 13-0 - I I 5 21 L=63 a ✓� 48 116.0_0 _ S I I -48' -38��W HYD. SAN. — 8 W T E 1101 M ' 200'- Soy SAN. SEWER SAN. M.H. ` MURIELLE , DRIVE • 112 -�! I16 L:y roperty of CHAPEL =1 DEVELO�NT INC. , of -:5 lawielle Drive: South Windsor, Conn. EMIL W. LUC-E ASSOCIATES N0. REVISIONS DATE SCALE I"�4: bATE .10/1.7/77 CONSULTING ENGINEERSbui It 5 OAKLAND ROAD DRAWN AVH ;, CHECKE ,ah ,+ SOUTH WINDSOR. CONN. 203-644-2802 PROJECT SHEET R CERTIFIED SUBSTANTIALLY CORRECT - DECREE OF ACCURACY f--�-A-2 -, V E Y O R 6 2 9 3 ' EMANUEL W. LUCEK CONN. REG. LAND SURVEYOR 14 6353 QQ I' ELECTRICAL APPLICATION Application No. 6660 on the side of Lot #45 Murie l le Dr. Street Street No. 136 Owner 'Chapel Hill Day, Electrician Gilles LaRoche l le FILED IN OFFICE OF The Building Inspector Oct. 13 19 77 INSPECTION. ry 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 ,tops (if of wood) are installed, without a special permit from-the office-of the Building Inspector. APPLICATION FOR PERMIT TO DO ELECTRICAI. WORK. No. ....6660.......................................... Permit No. ...............635 3............. TO THE BUILDING INSPECTOR of the TOWN OF SOUTH W INDSOR, CONN. ... ............ 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., etaer �............................ 1J77. Sign here .: ....t ..... ,....aJ. '" k.. ... Address 24....Whiting...Road.,Ea.st....Hartf:ord.._.... Location ...ott...45....Maal-el....wive........................................ ... Side of ............ .................................................................................................................. Residential 1 Natureof Building ...................................... ................................ ................ How many stories ................................................................................................. Newor oId Building .......................... ................................. .... ........ ... How many families ................._.................1._.........._.........._................_........... Kindof Installation ................Cu ro4me-c................................. ..... How many Stores ................................................................................................ Chapl....)il........................................Dper�- ..............................................626' E11ig on, Road.,_...S...�,iOwner ...... .. , .............__............... e .... :... __....Architect ................................................................... ... ....................................... Address ............................................................................_.........._... ......_.._._..__....... Builder ........5... ... .......Gonatr tlon................................... ..... Address .......626-Eningtan-Road,.... ..IL...._............ ford Electrician ........dill:es....La..........................cYielTe........................................... Address ? .... ........................ ....... ...... . .. Size of Main Wires .... 2 AL'" No. of Light Loops ...................... .............. No. of Heat Loops ....................... .. ....... . No. of Power Loops .......................__._...._.... No. of Light Outlets ...........i9... ........... No. of Heat Outlets ............ .. ... . .. No. of Power Outlets ..................................... NoO of Light Circuits ...............q................ No. of Heat Circuits ...... ..... ...... . ......... No. of Power Circuits ............... ................ No. of Sockets ......................... .... ................ No. of Heat Receptacles ... .... ... .. .. No. of Motors ...................................................... No. of Panels ......... .........t...............1........... ... .. Size of Heat Circuit ................... ............. No. of Power Receptacles ...................... �� No. of Switches c�...7............X... ......... .. Total Wattage ...................................................... Size of Power Circuit ................ . Total Horsepower ............ ......................... . No. of Straight Electric Fixtures ..........I......./............................... No. of Combination Fixtures ....... .... ............................. ... .......... No. of Receptacles .......................�q.... .................................... . . ........... No. of Cord Drops .............................................................................................. Remarks: For other kind of Installation .................N...EU1..... C1UE ............. ............................................................................... ........................................................................................................... ............................... ..............._............................................................................................................................................. ... ............................................................................................................ .............................. ............................................................................................................................................................................ .............................................................................................. ........................................................................................................................................... .............. ...................................................... Estimated Cost ...........M%.......00........................... 5091 PLUMBING APPLICATION - - . N6, 5879 on the...&2 S 2'—'— - —mi&aE Lot #45 Suet Street NO. 136 Owner L Plumber UA•4 A, Filed in Office of The BvW'm�g Aug. 31 19_7 7 DWEr"DIL ................................. ......................... ............................ No person AA cmaract, am 0 or alder asy portion of the drainage system of any bwl&og (ezapt to repair 66) until a Pemk is grayed by the Budding Inspector. Application No. .......5..8.7.9................... Permit N . ......59.91............... .. ......... .. ...... ... TO THE BUILDING INSPECTOR of the TOWN OF SOUTH WINDSOR, CONN. 4--'.t----.....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. P1,2v SouthWindsor . ............................................................................. 19 Sign here ...... ........... ....... . Address ..:�,�-O... A,A C.14,-V... .......A..........S-1.1.... Location .................. ..............(' -7—. . z// '4!�- .V ............. side of ...........P9. . ... .................. Street Natureof Building ........... ............................................ How many stories . ............. .................................................................... Owner C-h...A. Y IAt. ......P.E.-.4�............. ...... Address .6.,94....... ...;...e.0... ...... "......... Architect .............................................................................................................. Address ....................................................................................................................... Builder ............ ................ ....... .......................... ............................................... Address ..................................................................................................................... Plumber -C.-i--R.......LA. .... .4. --'1W.....y.......................................... Address &.4........RJA........ DRAINAGE CESSPOOLS, How many . ....... ............................... ............... . Where located ..................................................................................................... Are they water tight . . . ........................................................................ Of what materials are they built ...................................................... Sizeof pipe from house to cesspool ............................................ Kind of pipe ................. ..................................................................................... MAIN DRAIN IN CELLAR, Material ........(f... Diameter ...........//.../01...................................................................................... Aboveor below cellar bottom ............................. I........... .. ...........................................................................................................................I.......... /I I " SOILPIPES, Material . ... ..............................of..s-f................ Diameter & -a.....*..........?../r ...... WASTEPIPES, Material .............. ...........Ael................ Diameter .... ......... ......3.1................................................................. TRAPS,Type proposed to use is ........................ .... .......I.................................................................................................................................. RAIN WATER 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 ./f.r. -/.S...4. &..-xn. ..4......4/...2.................................. Distance from trap to vertical soil pipe ........................................ Pattern . ... . .................... ................................................................... WASHTRAYS, How many ........................................................ Where located .. .. ........................................................................................ SINKS, How many .............................................t.......................................... Where located ......... .................................. BUTLER'S SINKS, How many ........................................................ Where located. ........ ......................................................................................... REFRIGERATOR SINKS, How many .. ................................... Where located .................................................................................................... E'w LAVATORIES,How many ...... ......... Where located .... .......................................................7........................ BPTH TUBS, How many.......I......./........... ..................... Where located. ... .... 4— JALAWW many ......................./............... ...G.,................. Where located ..................................................................................................... Are water closets and urinals to be local vented - ...... . . .. If not, is there a window in outer wall of room where same are to be located ........ .. .......................................................................................................................I................ Estimated ...Cost/ 1. .0-,-"v If.. .(c.X?'.O............. PERMIT # Application For 4908 4707 DEPARTMENT DECISION Heating Permit W ° o 3 APPLICATION IS HEREBY: DEPARTMENT OF LICENSES AND INSPECTIONS N +' KI APPROVED ❑ DISAPPROVED I TOWN OF SOUTH WINDSOR o911� 9 00 DATE CI In CTOI&F APPLICATIONS MUST BE PRINTED OR TYPED. BEGIN WITH NUMBER ONE BEL W O � to � ,d 1. LOCATION OF JOB o w 136L,�►etle NO. STREET cd ° y .5 � rn LOT NO. FLOOR APT. NO. 0 O [J 4.0 rye. I l l e y 2. OWNER d ° S. ADDRESS L 0 le 1 ( ry L +U Iy beo 3 r) 1 IV d S O(2 4.PHONE Cn S. APPLICANT 6) VIA I I e a� d o go s. ADDRESS h lA d 1 A� In/dsa� 7.PHONE 99 1(`111 Q B. LICENSE NO. 5 33 O 6 g 1 7 a 4S 43 B. EXPIRATION DATE OF LICENSE " a to. ESTIMATED COST s 1 1 0 O y- 0 d - O 4-) -40 eq 11. IS THIS A CONTRACT COST? ❑ YES ❑ NO be Permit #9947 I a. FEE ENCLOSED s �i O - � v c� 13. TYP"F BUILDING: a� RESIDENTIAL ❑ COMMERCIAL +' 14. TYPE JOB: INDUSTRIAL 3 cc ORIGINAL ❑ ALTERATION r--i INSTALLATI N ADDITION REPAIR APPLICATION FOR HEATING PERMIT (Continued tr m ReN me side) 11. LOCATION OF JOB C b I' 1 NO. STREET FLOOR AFT.NO. 12. TYPE OF INSTALLATION: OIL BURNER ❑ ELECTRIC ❑ VENTILATION ❑ SPRINKLER ❑ GAS BURNER ❑ STACK ❑ INCINERATOR ❑ MISCELLANEOUS nn IDENTIFY/ SIZE 13. OF TANK �DD Cr /� OF TANKU/V OxQ Gl�a C>I�J / OF FILL ,� OF VENT 14. B.T.U. EQUIP. AT REGISTER FURNACE MAKE AND NO. UPAL+712— AT BONNET FIRING RATE BOILER OR FURNACE MAKE AND NO.L78C 113 Fk B.T.U. OR SQ. FT. NAET vU B.T.U. OR SQ. FT. GROSS FIRING RATE Iv FLOORS TO BE HEATED NEW OR OLD BUILDING e UJ INSULATED — YES OR NO TYPE OF WALL INSULATION ROOF OR CEILING INSULATION XgE:!— 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. SQ. FT. OR B.T.U.12E&Q fJ4fL ,0,4LZ D A-7 .440 /7i// A/ZF7— DESCRIPTION OF WORK 15. TO BE DONE: 16. HEAT LOSS SCHEDULE. (TO BE INCLUDED FOR ALL JOBS): R OM SIZE WINDOWS AREA - SQUARE FEET e.r.u. e.T.u. D AND DOowS VOLUME < DISTRIBUTION INSTALLED NO. < TOTAL TOTAL r ROOM L W N AND W GROSS GLASS NET WALL CEILING FLOOR CU. AT ao•F CORRECTED �j� RAD. REGISTER WALL to (INFILT.) TEMP. TO F F pa TYPE AND SIZE $0. FT. R LEADER SIZE F,C DIFF. •F F m d FREE AREA 75< TOTALS A. HEAT LOSS FROM BUILDING 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 OF FUEL (A B C) FACTOR 17. ELECTRICAL WORK BY: NAME ADDRESS SUBCONTRACTORS AND Ia. 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. -2 7 c DATE NATURE OF A►►LI i I =B=R CALCULATION SHEET 1503 Copyright 1965 by the Institute of Boiler and Radiator Manufacturers OWNER —_ _— ADDRESS _ -_ DESIGN TEMPERATURE DIFFERENCE F. DATE COL. A - COL. B COL. C COL. D- COL. E COL. F COL. G ROOM 1 ROOM _ —�- U A �� • FROML TOTALS 12 SELECTED O w W H L W H L W H L W H L W H L W 2 ROOM DIMENSIONS, FT. ~ 0] �L ___ U Q --- 3 LENGTH EXPOSED WALLS, FT. Q 0 Z 1 L L L C 4 WINDOW !,ND OUTSIDE DOOR-AREA _ - -LL -- - -- !-_ -_ -- BTUH _ BTU BTUH BTUH BTUH D- ,��- 5 WALL CONSTRUCTION --- �-�- - --- - - E 6 TYPE OF GLASS 7 CEILING CONSTRUCTION F 00 8 FLOOR CONSTRUCTION t G 9 COLD PARTITION CONSTRUCTION — H_ ��OQ 4 10 11 O ONE WALL(WITH GLASS OR EXTERIOR DOOR) IL~ TW O WA L LS " -- -- — - I 42 �LTHREE_WALLS Oli ENTRANCE= HALL " - -_ - 3:3 I D - - -- --- J F12_ TOTAl,,BTIJH AT70FTE'�1F1.DIFFERENCE• //To fAL HTUH AT DESIGN TEMP.DIFFERENCE K F--_� - COL. A COL. B COL. I♦ COL_1 /- --_ COL_J COL. K COL. L L 1 ROOM 13 R- c ,I L A Li g O w w H L W H L W H L W H L W H �dj W 0., 2 ROOM DIMENSIONS. FT F- 0 mTOTAL BTUH TOTAL U Q - OF BUILDING RADIATION 3 Q LENGTH EXPOSED WALLS, FT. n" z — ----_' _ Z AT SELECTED 4 WINDOW AND OUTSIDE DOOR AREA DESIGN TEMP. -- _ -- - DIFFERENCE BTUH.---- BT H BTUH BTUH BTU 5 WALL CONSTRUCTION - 6 TYPE OF GLASS 0 —742 a 7 CEILING CONSTRUCTION — *INCREASE BATHROOM TOTAL 20% 8 FLOOR CONSTRUCTION? / goo COLD PARTITION CONSTRUCTION t FOR CONCRETE FLOOR ON GROUNDOR FILLAT GRADE - _ _ _ LEVEL, USE LINEAR FEET '0 J p ONEWALL(WITH GLASS OR EXTERIOR DOOR) /t v OF EXPOSED EDGE a ?tivO WA L LS z THREF_WALLS OR ENTRANCE HALL • 11 TOTALBTUHAT70F TEMP.DIFFERENCE* 12 TOTAL BTUH AT DESIGN TEMP.DIFFERENCE / This form is available from The Hydronics Institute (Formerly The Institute of Boiler and Radiator Manufacturers) 35 Russo Place, Berkeley Heights, N.J.07922 FORM 1503 Copyright 1965, by the Institute of Boiler and Radiator Manufacturers. Form 1503 E S T I M A T Z q,,oUANTITY ITEM AMOUNT Boiler No. Net I=g=R Rating or Net S81 Rating* Oil or Gas Burner or Stoker, with Controls j Oil Tank, Pipe and Fittings Combustion Chamber or Stoker Hearth Pump ' Thermostat Low Limit Con*rol Reverse Control Extra Controls IDraft Regu'.=for ! Flow Confrol Vaive Pressure Reducing Valve 0 �i— Relief Volvo � Air Cushion Tank + Damestic_Vlater Heater and Tank Mixing Valve �� { Pipe, Valves, Fittings, Hangers Pipe Covering .1 Herfing Units (Radiaio-s, Baseboards, Convectors) Radiator Enclosures I Sets -- Radiator Brackets j Radiator Valves Radiator Union Elbows Radiator Air Valves Main Air Vents Floor and Ceiling Plates Smoke Pipe Foundation Electrsc Wiring Pounds — Asbestos Cement Paint Freight and Cartage Labor Incidentals I w Total Cost Overhead ' Profit Bid *Net I=B=R Rating or Net SBI Rating of Boiler should equal or exceed the total heal loss of the house plus proper ailowance for domestic hot water Electric# APPLICATION FOR BUILDING PERMIT Plumbing# 136 MURIELLE DRIVE HVAC # �_ 25159 Dot Sprinkler# FIK APPR V Estimated Cost $ D a v, Building COMPLETE RED BOXED AREAS Permit Fee $ , a� Engineering TYPE OR PRNT ONLY Occupancy Fee $ Affidavit SIGN ON REVERSE SIDEAppr.for CO. Total Fee $—J—qlb TO W U)PAIG DEPMTMB4,TOWN OF SOUTH WINI)SOR,CT (Additional Cost) $ The undersigned hereby applies to do work according to the following specifications: Job Location 134i /�z6 n /l/1. lot No. Side of Street Zone Applicant Tel# 4:� Address/ZD' 2 'p 66OZ Lic.# Own r Y Address I e,W—,�M 5�VA Architect Address Sq.Ft.N w Area: 1st Fl. 2nd Fl. 3rd Fl. Total New Area #Rooms Lavatories #Bathrooms #Garages Purpose of this permit: S' a&z v 1 # l City Water ❑ Well ❑ Septic System ❑ Sewer ❑ Ins. H.O. S.P. Cert. Area Basement Garage Approved by J 4C Dat 06AP Use Group Construction Type Rrv'sed 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 y alteration in the plans or specifications of the Building for which this permit is asked,and agree that this building is to t the proper distance from all eet lines,side yard lines,and required distances from all other zones and is located in ich i III Signed 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