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Home My WebLink About16 Locust Street Application No. 3980 Permit No. 3720 TO THE BUILDING INSPECTOR of the TOWN OF SOUTH WINDSOR, CONN. t__3 hereby make application for a permit to (erect (nak��1*�tiall a building according to the following detailed statement of the specifications and plans herewith submitted. (Draw a line through word "erect" or words "make alteration to" as the case may require.) All provisions of the Building By-Laws (Sections 2 to 32 inclusive) shall be complied with in the execu- tion of this work whether specified herein or not. South Windsor, Conn., ttf ......a............. 194.1... F Sign here . .. .............. .. ................... Address .Q.. ... u f Location? side of? t,Z..Gt..G+.. ................... `=............................... Nearest cross street? ..... .. . .. ..............................................................Street No. . : .......... .......... . ............... 11 No. .. ..r�.! .... . f Owner of land is� �+�4/. G��'�1�►. '.0 Address -�,�.�..71.... �`..�.�..�.............................. d* Ownerof buildin is? . �`'..... ................... ......................................Address .. ... .. ... ................. ..................... ..... ........................ ' r Architect is? ...t,411d....... .. ./... ..................Address.P�it�... aol ��... �.�-.c ....... ....... ilder is. /. �P... Address /V/jf Dimensions of building?,%;% YZ4 Feet front? ... ,D.$f. .. Feet rear? -:57. .......... Feet deep. . 0. Extreme height to highest po' t of roof? f ....... .. No. of stories in height? .... .0... . Purpose of building is? ... ... ..,U).E.- ... ./& .................No. of stores? ...... .................. ...................................................................... Howmany families? ... � ........_....................................No. of roon s? ... . ...... 7..... . .......................................................... If Distance from street line is? .. .141elv........,........................from building line is? ...... ........ ..... . .......................... ... .. .... ADDITIONS AND ALTERATIONS (Give Brief Description) Ja ................................................... ... .. ...........a'?f E".......0 ... .. ....... ,e�g�.�............... . ..............� ...................................................... ....... .............................. ........................ ................................................... Map No. If of steel frame, what is exterior construction? . What kind of columns used? .......... .. Size of columns used? What length of columns used? . How protected? What kind of beams or girders? .. ..... . . . Size of beams or girders? Longest span of beams or girders? These rest on? . Roof construction is? ....................Roof covering is? The floors are of ...... construction and are calculated to carry a safe load of lbs. per square foot. (See Section 14, Building By-Laws.) BRICK CONSTRUCTION. Of what material will walls be constructed? . ....... . .. . ...... .... ...................... Compositionof mortar? . ............. ... ...................... ...... ..... . ..... .. ......... ...... ............. ......... ... ......... . Height and Thickness of Walla Height Stories Front Walls Side Walls Rear Walls Partition Walls Basement, ................................ .......................................................................... ................................................................................................................... .. .................................................. 1st Story ........................... ............................................................................................................................................... . .. .................................. . 2nd " ..........................................._................................................. ............................................................................ ... ...... .......... ..................... ........ ............ ... ................. ...... . 3rd " ......................... ..................... ............................... ............... .......................................... ......................................... ,............................. ... ...... .. ...... . ........... .. 4th " ................ ... ............._.............................._......................... ...................... ................... . ................................................. .... ........ ...... ....... ... 5th 11 ................................ ................ _.......................-...... ................. ........... .......................... ,............................ ...................................... ....................... ... .......................................... 6th " ... .............. . ................._...................................................................................... ................................... .. .................................... ......................... .................................................. 7th ........................... ... ...... ................................ .............. ............ . ........................ ,................ . . . . ........ ................ ............................ ............... ............................. 8th Is ..............................................._..............................-...... ............... .... .. ............ .. ....., . ..... ... ...... . .. ... .......... .. ................ ..................... 9th " ............................_................................................... ......... ... ............... .. ... .. ....... ......I .. ................. ............... ............................. loth " Material.of Front? If stone, what kind? Thickness of Ashlar? .......Thickness of Backing? Backed up with what? Arches or lintels over openings? WOOD CONSTRUCTION. Give Size, Longest Span and Distance Between Centres, of Joists, Girders and Columns JOISTS I GIRDERS OOLUMNS Floors Size Longest Span Centres Bridging I Size Longest Span Centres Size Lengib Centres 1stFloor ..... .... .......7.f........................ ...... ........ 2nd " . .................. ....................... 3rd 4 ....... . ............. .......................................................... .............. ................-1'**"'**** ... ...................................... . ................................... ....................... Size of outside studs? Distance on centres? . Size of sill? . � 0- ....... .. ... .... ....... -.4.............. Size of rafters? Distance on centres?..........WO/419 ................... Size of late? ........ . .. .. .. ............. Size of ledgers or girts? ........................ ............................................Size of deck rafters? ... ................................................................ ............... Distance on centres? .............. ....................................................................Size of studs in bearing partitions? ......-4.4141.F. ........ MISCELLANEOUS C'0-� P Style of roof, flat, pitch, Mansard, or hipped? ........ Fireplaces? ..........0......................................... Material of roof covering? ... ..... . I 0.4,4.4t. .....Material of Cornice? ...77y........... ....�.rl... ........................... How is building heated? 761,. ........ ........Lining of flues? �..... .. .. ......... .............. Thickness of shell of Rues? ........... ./...op.......................................Any tkny elevators or lifts? ................ ... ...... ................... ...................... What kind? How many? . . Any hoistways? . . ........ ........ .... How protected? . ......... .. .. ...... ........................ . ..............Total Value of Building ......o..o.......15........................ When will work be commenced? . . . 1!2/....... .0e ....... ................................................... ................. The applicant warrants that the lot for residential purposes, shown on a plot plan accompanying this application, conforms to the zoning regulations of the Town of South Windsor. Town of South Windsor since 1949. Applicant 3720 BUILDING APPLICATION Application No. ... ...989.................................................... East onthe ... ............ ... ....... ...... . .......... side of .... .. ........Locus.t. St. Street. Street No, ..16 ... Lot #24 . Owner Leo & J.a.Ck...Lei.chtne.r Applicant Same . . ...... CLASSIFICATION Dwelling 501-x28t . ......... ......... Permit issued on above Application. Date, Oct.16.1 19 61 r, TOWN OF SOUTH WINDSOR BUILDING PERMIT Date 0 c t. 16,9 1961 Fee Paid s 64-tOO Est. Value $.16.s 000 Permit N9 3720 on the E as t side of Locust St. Street Street No. 16 Lot #2h Owner Leo &, Jack Leichtner Applicant Same jF CERTIFICATE OF OCCUPANCY ISSUED: I Date 6 No. 2248 x E Fee Paid $ 3.00 d r CLASSIFICATION Dwelling 501x281 f BUILDING PERMIT No 3720 OFFICE OF THE BUILDING INSPECTOR of the Town of South Windsor, Conn. South Windsor, Conn. Oct.1610 19 61 T4to to ter Terttf1j, That Leo & Jack Leichtner is hereby granted permission to Dwelling 50rx2$t at estimated value of on the La®t side of Locust `3t. Lot #24 Street on land owned by Leo & Jack Leichtner Said Work to be as described in Application No. 3960 and to conform to specifications and plans filed with said Application, and Building By- Laws of THE TOWN OF SOUTH WINDSOR. Issued Oct. 16 19 61 Building 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 No. 3 TOWN OF SOUTH WINDSOR SOUTH WINDSOR, CONN. Permit NQ 2248 Certificate of Occupancy THIS IS TO CERTIFY that the �-G� Z 71r/6 at No. rr ��`��.��• in the Town of South Windsor, Connecticut, has been erected and completed in accordance with the Building Code and Zoning Regulations of the Town of South Windsor, and is hereby approved for occupancy. Building Inspector ,60wner, Builder L Fee Paid Date , 19 f. s&cr - Lot numbers refer to map entitled, ItSubdivisioLi 'lap, Graham Par':, Property of Windsor Construction CorF. , Graham & Hayes Roads, So. 4indsor, �,��►�: . , Scale 1" a 401 November 23, 1960 Certified Substantially Correct, Morton S. Zino `.I.. — J.'� I oo . o 0 i fI Q i � v N I � I i a 4 __ t r rr.� I� f LOCUST STREET PROPOSED LAYOUT �ci 0��F�. Leh:UST STY,011T SOUI'H WiNiDSOI�, CU^v�J�CTIC'JT r I hereby c rtity that this y x m �1 map is substantially c rrect * *! and no zoning regulati ns �� Na 2931 SCALE In . �i,' , kV I.1G, 19G have been vi lated. `��r fo `�� MORTON S. FINE, C.E.—L.S. LAN ' HARTFORD� CONN. 1445 OIL BURNER OR FUEL STORAGE APPLICATION Application No. 1456_ Permit No. on the East side of Locust S t. Street Street No. Lot #24 Owner Leo Le i chtn e r Application Same CLASSIFICATION Federal O. Permit Issued on Above Application Date 11-21-61 19 Fee Paid $ Permit ##3720 4 ' 4" TOWN OF SOUTH WINDSOR APPLICATION TO INSTALL RANGE AND FUEL OIL BURNERS EQUIPMENT AND TANKS PERMIT N 1445 DATE 11 17101/ The undersigned hereby applies for a permit for the installation of range and fuel oil burners, equipment and tanks of the f owing description Address Z1st floor 2nd floor 3rd floor Character of Building: Frame Brick Owner of Burner A Owner of Building Lessee or Tenant— RANGE BURNERS Capacity of Tank at Range in cellar outside Name of Range Burner _ Purchased from POWER BURNERS Name of Fuel Oil Burner Model Number w Purchased from Z&d-t J414Z� F Name of Tank Gauge of Tank- Where is Tank Located �` fEl. Size of Tank — Size of Motor 119f Size of Wire — Will other heating equipment be installed? If so, by whom Name of Party Making Installation _ Address 02. Jr Electrician A e Address Signed APPLICANT All provisions of Ordinances of this Town Regulating Oil Burner Eq ipment and Fuel Storage (Sections 1-23 in- clusive) and Underwriters' Code applicable to the subject matter of same shall be complied with in execution of thiss work whether specified herein, or not. Estimated Cost $ �0 Application for Permit received 11—7—61 and Permit No. 1445 issued 11-21-61 Permit #3720 aalter H. TC:.urnham Permit Fee Paid _ Approved BUILDING INSPECTOR Application No. 4.295 Permit No. 40350 TO THE BUILDING INSPECTOR of the TOWN OF SOUTH WINDSOR, CONN. hereby make application for a permit to (erect ( to) a building according to the following detailed statement of the specifications and plans herewith submitted. (Draw a line through word "erect" or words "make alteration to" as the use may require.) All provisions of the Building By-Laws (Sections 2 to 32 inclusive) shall be complied with in the execu- tion of this work whether specified herein or not. South Windsor, Conn., f l/. ......... 19...4�,G VA C,C. u Z Z-v Sign here .. .../ ........... ............... .�c�G u5 �T-............. ... Address ../� ... ........ . ............................................. .... Location? /& T....... ...sid� e of,� ..................................................................................... Nearest cross street? ...... .............Street No. ...... Lot No. ............. .. ... ..... . Owner of land is? .....Add" .. .....6. - =. Owner of building is? f// .................... `'`............................Address _f.............................^................................"e........... ...... . ......................`.`' A itect is? ....... .. `...........................................`.`. . ......................Address ..................... ................... ............ ....... .. ....... Builder is? . L�H .......s.1. A G. .(! z 2.............Address .!�. . �e�G r l i 5 ................... ....................*..C...-.............. ........... Dimensions of building? .. ......... Feet front? . ..... . Feet rear? ...... . .. ..... Feet deep? Extreme height to highest point of roof? ...... .. . ............ No. of stories in height? . Purposeof building is? .. .... ..........................................................No. of stores? .... ............. ........ ....................... ................................ Howmany families? .................................................................................No. of rooms? ... ........... . .... ..... ........................................ .............. Distance from street line is? . .. .. ........ ....................from building line is? . ... ....... .... .. ..... ... .......... ADDITIONS AND ALTERATIONS (Give Brief Description) /=/0 l,5/4 ...... .........A...D.L?..............�1.............e-AI/Z4.T.01,?J ,ff R.7771.42Y' ....... .... ....�'. .o. .... ....................... ................................................................................... ..... ...................................... ............. ........... ............................................ ........._...... ................................ .......... . ..................... ........ . .......... .......... .... ................................ Map No. If of steel frame, what is exterior construction? What kind of columns used? .............. Size of columns used? What length of columns used? ... How protected? What kind of beams or girders? Size of beams or girders? Longest span of beams or girders? . . ..... These rest on? .. .. . ........... Roof construction is? ....... ... ...... ................................... .....Roof covering is? The floors are of construction and are calculated to carry a safe load of lbs. per square foot. (See Section 14, Building By-Laws.) BRICK CONSTRUCTION. Of what material will walls be constructed? .. . . .. ... . . .............. Compositionof mortar? . ............. .... ........... . ............. .. ....... ............. ..... ............ ......... .... .......... ...... Height and Thickness of Walls Height Stories Front Walls Side Walls Rear Walls Partition Walls Basement, .................................I........................................................................ .............................................. ............................................................................................ ............................... ... 1st Story ... ....................... .............................................................................................................................. ..................................................................... ............... ... ... . ... ........... 2nd " ........................ ..................................................... ..... .......................................I.............................................. ......... .......................................... ... ............ 3rd " .................. .... ....................... ................................................. .............................................. .......................................... ...................... .. ... ... .......... . ...... .. ........ 4th 'I ............. ........ .. . .................................................................. ..................................... ................................................................................. 5th Of .............................. .. ................................................................................... ...................................................................................................................... .. .......................................... 6th a' .................................................................................................... .................................................................................................................................................... 7th ............................ ....................................................... ....................I..........................r.................... ..... ....... .......................... ................................. ................................... 8th ....................................................................................... .......................... .............................. ....... ........... .............. ......... ........... .................. ....................... 9th da .............................................................10th................;'....... . ... .. .. ........ ...... . .. ....... ................ .. ........ ....... Material.of Front? ..If stone., what kind? Thickness of Ashlar? ....Thickness of Backing? Backed up with what? Arches or lintels over openings? WOOD CONSTRUCTION. Giv Size, Longest Span and Distance Between Centres, of .foists, Girders and Columns JOISTS GMDEB$ MUM Floors Size Longest Span Centres Bridging Size Longest Span Centres Sire Length Centres 1st Floor .i�a ...... .... .............. .................................. ........... .... . ........._.. ...._......................................................... ................._ ...._.........._ . ._................. go ............... .............................................................................. ......................... ................._ _.._......................__.._... ....._....._..._..... .........._.............._......_. ...................... 3rd " 4 ....��.... ............ .................. _....._.... _................_............. _..._...... _......_.... _.........._. Size of outside studs? ............. ......... ........ Distance on centres? ................... ....................... Size of sill? ......................................... ..... Distance on centres? ?Size of rafters. .................. .... ........ ................................... Size of plate. ..................................................... Size of ledgers or girts? ................... .. . .............................................Size of deck rafters? .................................................................... ............... Distance on centres? ............ .............. ....... .......................................Size of studs in bearing partitions? ................................................ MISCELLANEOUS Style of roof, flat, pitch, Mansard, or hipped? . .. Fireplaces? ...................................................... Material of roof covering? . ....................... ................... . ......Material of Cornice? ............... ............................................................ Howis building heated? . . .. .....................................................Lining of flues? .. ................................................... ... ... . .............. Thickness of shell of flues? ...... .............................................. .......Any elevators or lifts? ...................... ...................... ....... ..................... What kind? How many? .. . . Any hoistways? . ...... .. .. .......... . How protected? . . .. . . ..... . .... . . .................... ................Total Value of Building ......... • .... .................................. L�� When will work be commenced? ...........'0- .. f,�1 The applicant warrants that the lot for residential purposes, shown on a plot plan accompanying this application, conforms to the zoning regulations of the Town of South Windsor. Town of South Windsor since 1949. Applicant 4035 BUILDING APPLICATION 4295 ApplicationNo. ....................................................................... on the ................ .... .. . . ......... ...... .. side of Locust St. .. ........... .. ..... ...... . ... ....... Street. Street No, 16 Ralph Saccuzzo Owner Applicant Same .. ... CLASSIFICATION Finish recreation roon. , add .............. lavatory,,...partition room. ......... ......... Permit issued on above Application. July 190 62 Date, 19 . . TOWN OF SOUTH WINDSOR BUILDING PERMIT Date July 19, 19 62 Fee Paid $. . ...0 Est. Value $. 0 0.0 0 Permit Nd 4035 on the side of Locust St. Street Street No. 16 Owner Ralph Sac cuz zo Applicant Same CERTIFICATE OF OCCUPANCY ISSUED: Date No. + Fee Paid $ CLASSIFICATION Finish recreation room, add lavatory,partition room. BUILDING PERMIT N° 4035 OFFICE OF THE BUILDING INSPECTOR of the Town of South Windsor, Conn. South Windsor, Conn. July 190 19 62 94is to to Tertif1j, That Ralph Saccuzzo Finish recreation rooip add lavatoryspartition is hereby granted permission to room, at estimated value of $ 500.00 on the side of 16 Locust St. Street on land owned by Ralph Saccuzzo Said Work to be as described in Application No. 4295 and to conform to specifications and plans filed with said Application, and Building By- Laws of THE TOWN OF SOUTH WINDSOR. Issued J-4y 19,0 62 19 Building 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." TO T BUILDING INSPECTOR of the APPLICATION FOR ,�,O� OF S�OI)'I'H C+O� PLAN EXAMINATION AND BUILDING PERMIT z IMPORTANT — A nt to complete all items in sect s: 1, $1, 111, IV, and IX. ZONING DISTRI • AT (LOCATION) " LOCATION (NO.) (STREET) OF BETWEEN AND (CROSS STREET) BUILDING (CROSS STREET) LOT SUBDIVISION LOT 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(It residential, enter number 12 ,One family 18❑ Amusement, recreational of new housing units added, if any, 13❑ Two or more family - Enter 19❑ Church, other religi us in Part D, 13) number of units- - - - -i 20❑ Industrial 3 ❑ Alteration (See 2 above) 14 Transient hotel, motel, ❑ 21 ❑ Parking garage 4❑ Repair, replacement or dormitory — Enter number 5❑ Wrecking (If multifamily residential, of units ------- --� ❑ Service station, repair garage enter number of units in building in 15❑ Garage 23❑ Hospital, institutional Part D, 13) 24❑ Office, bank, professional 6 Moving (relocation) 16❑ Carport ❑ 17❑ Other - Specify 25❑ Public utility 7 ❑ Foundation only 26❑ School, library, other educational B. OWNERSHIP 27❑ Stores, mercantile 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................ ��'� .0' 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 u in the above cost c a. Electrical...................... b. Plumbing ...................... l c.Heating, air conditioning......... t d. Oth r(elevator, etc.)............ f r, 11. TOTAL COST OF IMPROVEMENT 3 ge 02 ` III. SELECTED CHARACTERISTICS OF UI DING — For new buildings o add► tons, c plete Parts E — L; for wrecking, comp to only Part , 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 ❑ W ad frame 41 ❑ Private(septic tank, etc.) 49• Total square feet of floor area, all floors, based on exterior 32❑ Structural steel dimensions .................... 33❑ Reinforced concrete H. TYPE OF WATER SUPPLY 34❑ Other - Specify 42❑ Public or private company `� Total land area, sq.ft. ........... 43❑ Private(well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES 51. Enclosed ...................... F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 35❑ Gas Will there be central air 52. Outdoors........................ 36❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY 37❑ El ctricity 44❑ Yes 45❑ No 53. Number f b drooms.............. 38❑ C al 39❑ Oth r- Specify Will th re be on elevator? 54. Number f Full.......... 46❑ Y s 47❑ No bathrooms Porfiol........ NOTES and Data — (For deportm nt use) IV. IDENTIFICATION — To be completed by all applicants Nam Maili address — Number, str t, city, and State ZIP cod Tel. No. 1. Owner or / T 4py o LesseeT 2. Contractor w 3. Architect or Engineer The owner of this building and t-he undersigned agree to conform to all applicable laws of this jurisdiction. Signature of applicant A441ress Application date Zx 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 Approva I Check Date Number B Permit or Approval I Check Date Number By Obto ined y pp 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. 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Value $. 100.00 permit N° 10595 on the aide of Locust Street Su Street No. 16 r Owner Robert Fisher ` Applicant Robert Fisher CERTIFICATE OF OCCUPANCY ISSUED: i Date No. i Fee Paid $ CLASSIFICATION Wood burning stove BUILDING PERMIT NO 10595 OFFICE OF THE BUILDING INSPECTOR of the Town of South Windsor, Conn. South Windsor, Conn. Nov'e Z 5 19 78 9#1z to to Cerfifg, That Robert Fisher is hereby granted permission to Wood. burning Stove at estimated value of $ on the side of 16 Locust Street on land owned by Robert Fisher Said Work to be as described in Application No. 10895 and to conform to specifications and plans filed with said Application, and Building By- Laws of THE TOWN OF SOUTH WINDSOR. Issued 1978 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." DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT TOWN OF SOUTH WINDSOR PERMIT# Application is hereby: �(a3q BUILDING DEPARTMENT APPROVE 1540 SULLIVAN AVENUE Bldg.Permit# 644-2511 ext. 230 ate Building Inspector Application must be printed or typed Location of Job: FEE SCHEDULE // Y k $0-$1,000=$13.00 Street No. Street Lot No. Over$1,000= $13.00 per$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANT t�/S' G�' �d • APPLICANT ADDRESS 36l9ee G � G1` 06 0/7 APPLICANT PHONE# 9 —O�G N OWNER If.— T l$✓1 to'C, W SF / q OWNER ADDRESS o &07 f OWNER PHONE 6 C ESTIMATED COST$ 45 75 0 'U IS THIS A CONTRACT COST? 0 Yes )I(A10 f FEE ENCLOSED$ QU TYPE OF JOB: SOR-COAKrew--Mstallation 0 Alteration/Addition/Repair Revised 8/99 APPLICATION FOR HVAC PERMIT (Continued from reverse side TYPE OF SYSTEM: TYPE OF BUILDING: ,05EEATING IDENTIAL ❑A/C ❑COMMERCIAL ❑VENTILATION ❑INDUSTRIAL HEATING ❑ STEAM LOW PRESSURE LIMIT LBS. HIGH PRESSURE LIMIT LBS. IRONIC ❑ WARM AIR ❑UNIT RADIANT HEATER EXISTING RADIATION ADDITIONAL RADIATION TOTAL RADIATION DESIGN TEMP. OUTSIDE OF INSIDE OF DIFFERENCE OF TOTAL HEAT LOSS(BTUH) °F(HEAT LOSS SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL HEATING EQUIPMENT(INCLUDING MAKE&MODEL NO.) 'r .7 GROSS HEATING CAPACITY(INPUT—BTUH) NET RATING(OUTPUT—BTUH) �O4L4'C)� TYPE OF FUL ,ifOIL—GPM e r011,TANK LOCATION :❑INSIDE❑ OUTSIDE CAPACITY ❑ GAS—INPUT LPG TANK CAPACITY ELECTRIC—KW AIR CONDITIONING DESIGN TEMP.OUTSIDE OF 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) VENTILATION DESCRIBE ALL AIR HANDLING EQUIPMENT(INCLUDING KITCHEN EXHAUST EQUIPMENT) TOTAL SIZE OF SYSTEM(CFM) FRESH AIR INTAKE(CFM) (PLANS MUST ACCOMPANY APPLICATION) FURTHE ESCRIPTION OF WORK S114_,e� �� THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE PERFORMANCE OF SUCH WORK. 5 ( c-'r- :5o .�,'�> 2,2 CONTRACTORS LICENSE NO. TYPE STATE SIGNATURE OF APPLICANT D �'� O