HomeMy WebLinkAbout1340 Main Street Elecrr►c# APPLICATION FOR BUILDING PERMIT
Plumbing# 1340 MAIN STREET
HVAC # 49A Date: Op— 2_?�>
Sprinkler# 6 2
FINAL APPROVALS Estimated Cost $ SDUO
Building /t Z COMPLETE RED BOXED AREAS Permit Fee $ �
Engineerin ::5/� TYPE OR PRINT ONLY Occupancy Fee $ ,3
Affidavit / -? SIGN ON REVERSE SIDE
Appr.for CO. / Z f Total Fee $
TO BUILDING DEPARTMENT, TOWN OF SOUTH WINDSOR,CT (Additional Cost) $ — —
Th undersigned hereby applies to do work according to the following specifications:
Job Location 3 "Q i n %SIL' Lot No. Side of Street Zone
Applicant Cr'o Ss" zu l"Ijees . a:7�c' Tel. # (F1o4—807/—9 94 7
Address 7 Y Mery-vu) % Ila ri d1l e.-71 Zip 0(o Q Lic. #
Owner .L kAddress 13 3D t4a'y!L S. Wj-ndsor
f I,
Architect 0—r-ossen et--5 Address I?q 14eM —r ( pa?
Sq. Ft. New Area: 1st FI. /3 3 2nd FI. //.a +-Va 3rd FI. WA- Total New Area
#Rooms # Lavatories / #Bathrooms 3 #Garages �"?
c
Purpose of this permit: ` ��
City Water Well 0 Septic System 0 Sewer X
Use Group 4 Construction Type YArea 7-57 4 / Basement S Garage �(p
Approved by Date i
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 tke 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
I hereby apply for a Certificate of Occupancy for the work described in this application drthe permit
Signed �-�
-- DO NOT WRITE BELOW THIS LINE --
INSPECTION COMMENTS
Location of Job: AFFIDAVIT IT Additional Fee S -0-
State of Connecticut
ss.South Windsor
County of Hartford
l Owner
I of ��v� A
Eeai�aster
nd r Permit No. 23466 issued by th ilding Department of the Town of South Windsor being
duly sworn,make oath and say that the actual cost of the completed work authorized under said pe it did not
exceed the most current accepted BOCA value of$ 16 5 ,S 0 0,,0 Q .
Signed `c-e—
Subcribed and sworn to before me this day of A.D. 19 9(;
Estimated Cost$ ] 6 5# R 0 n_ n n
Difference: $ -0-
Notary Pub k 3/
I �
Inspection / Approval Date By Appl
Code Description Due Whom Code Comment
-------------------------------------------------------------------------------
96-23466-B 145,000
B01 FOOTING 08/22/96 JFH A
B02 FOUNDATION 09/04/96 JFH A TAR FOUNDATION & FOOTING DRAINS
B03 FRAMING (ROUGH) 10/11/96 JFH A
E03 ROUGH 10/11/96 JFH A
P03 ROUGH 10/11/96 JFH A
H03 ROUGH 10/11/96 JFH A
B04 INSULATION 10/25/96 JFH A
E01 SERVICE 10/30/96 JFH A RELEASED
B10 FINAL 12/20/96 JFH D NOT READY
B10 FINAL 12/23/96 JFH A APPROVED FOR CO (BLDG DEPT ONLY)
ENGINEERING DEPT OK WITH BOND
96-9817-P 6,500
96-9590-H 11,900
96-14128-E 2,400
Total Est Value 165,800
Dwelling 2,974 121,696.08
Basement 1,356 16,814.40
Garage 564 6,993.60
Smoke Det 7 525.00
BOCA Value 165,012.86
Difference (787.14) --l� —
r
afSITE COMPLIANCE CHECKLIST
TOWN of SOUTH WINDSOR, CONNECTICUT
1340 MAIN STREET LOT_# Reviewed By.,T �tt�
Bering)
CROSSEN BUILDERS INC Date Reviewed pprove /
174 MERROW ROAD,TOLLAND,CT Reviewed By Planning)
BP_#_23466_ Ph_# (860) 871-2987 Date Revie / ZApprove /Denied
Date Submitted 12/20/96 IOR C olf **
As required in the Zoning and/or Subdivison Regulations, no Certificate of
Occupancy shall be issued until grading plans have been complied with and
approved by the Town Engineer. The minimum requirements shall include:
Approved Denied N/A
�� . 1. Approved building permit plan
OWL _ 2. Finish grading per approved
building permit plan
3. Site work; i.e. trees, shrubs,
dumpsters, required parking
4. Utility location;
_ a. sanitary sewer/septic system
b. foundation drain
C. electrical & telephone
d. water
e. other
_ 5. Sewer connection charge paid
6. Appropriate certification
7. Bonding
8. Planning & Zoning/
Inland Wetlands Considerations
Sewer Permit No. 115
Pavement Excavation No.
COMMENTS:
• D
'_W4-14e.ve- ar ?J C)
SITE COMPLIANCE CHECKLIST
TOWN of SOUTH WINDSOR, CONNECTICUT
1340 MAIN STREET LOT_# � Reviewed By (Engineering)
CROSSEN BUILDERS INC Date Reviewed ov /Denied See �,--w---,"
174 MERROW ROAD,TOLLAND,CT Reviewed By (Planning)
BP_# 23466 Ph_# (860)871-2987 Date Revie & k ppro /Denied
Date Submitted 08/07/96 ***** FOR BUIL NG PERMI *****
In accordance with the Zoning and/or Subdivision Regulations, prior to the
building of any structure on a lot, a Topographic Plot Plan shall be submitted
for approval. The minimum requirements shall include:
Approved Denied N/A
1 . Name, address & phone number of owner/applicant
2. Name, address & phone number of plan preparer
3. Zoning Information - i.e. zone, open space,
floodway, etc.
4. Plot Plan at 1" = Ael- scale z o
a. Subdivision reference, abutting properties, etc.
b. Easements of record
c. Lot description, bearings, building lines,
distances, area, etc.
d. Contours, existing & proposed, 1 or 2 ft.
interval where appropriate ,
e. Building location with dimensions.
Elevations of proposed finish floor, garage
floor & centerline of road at driveway
f. Elevations of gravity drainage systems, sanitary
& foundation drain at the house and the street
�-r g. Tentative utility location (gas, water,
electric, septic system, etc. )
h. Title block with name and address of preparer,
date, appropriate certification, live seal and live
signature consistent with the Board of Registration
requirements. (P.E. & L.S. )
iv 5. Sedimentation and erosion control
6. Special Planning & Zoning, Inland/Wetlands
considerations (Plans on file w/Town Clerk)
COMMENTS:
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TOWN OF SOUTH WINDSOR
STAFF SITE CHANGE
FOR SITE & SUBDIVISION
GENERAL: Cow ��lad
a ] n
CHANGE ORDER CONTACT PERSON 1� t" Phone JNo. e/ 7��'0�9( �,
AddressAlitiltt%l G�J .
116 Oki
Site Narje /� N < - &Z No.
Owner ° Phone No.
C=15'60
ContractorCr7f?.SjPKJ
Signature of OwnerC&2ajo Date: a
Signature of Design Engr. — ate:
CHANGE: (Describe location and nature o chan e. nc1ude
Four (4 ) copies of plan/profile of Change. )
E(_J IA t N krE FTpeaN& t>eiN-7N ou rzi.71T-- Pj .
Reason for Change: (Why is change required)
kavKA, :cn M*A�vkNli'j FLA%t e7 wNtil-
weA�h*i ►t) "ry Of
�ruI fv n,►u c ►%► Sor+ s `c Nl /'
APPROVALS: (As Re uir d) / -EKe 1`5 VV Ajvt R K/9„/
Dir. Of Planning Date: lL f6
Town Engineer Date: /Z�Z��,�
Dir. of Public ks Date:
� 0�e',� 7�5
x eOO56Date: Z Z
ST FF COMMEN :
v
White - Town Engineer Yellow - Applicant
Pink - Director of Planning Goldenrod - Engineering Department
v
PERMIT
/`
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT 42z
Application is hereby : TOWN OF SOUTH WINDSOR
BUILDING INSPECTION DEPT.
APPROVED DISAPPROVED 1540 SULLIVAN AVENUE
644-2511 Ext . 230
a e A�r�c- ng In pector Application must be printed or typed
1. LOCATION OF JOB
d
1340 Main Street
FEE SCHEDULE No . Street
j 1 N/A
$ 0 - $19000 - $10.00 Floor Apt . No.
Over $10000 - $10.00
p e r $1 ,000 or 2 . OWNER Crossen Builders, Inc.
fraction thereof
3. ADDRESS D4 Merrow Road
Tolland, CT 06084
j 4. APPLICANT Pearce Electric, Inc.
5, ADDRESS 42 Mechanic Street
Danielson, CT 06239
6, ESTIMATED COST $ 29400.00
7 , IS THIS A CONTRACT COST X
Y a N
8 . FEE ENCLOSED $
9. TYPE OF BUILDING :
X RESIDENTIAL COMMERCIAL
10. TYPE OF JOB :
X Original Installation
Alteration/Addition/Repair
Rn 3A 11/88
APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side)
11 . LOCATION OF J O B 1340 Main Street
NO. STREET APT. NO ,
12 . TYPE OF INSTALLATION Wiring of New House
13 . SIZE OF MAIN FEEDER 4/0 SEU Aluminum
14 . NO . OF LIGHT LOOPS 8 15 . NO. OF HEAT LOOPS 1
16 . NO . OF POWER LOOPS 3 17 . NO. OF LIGHT OUTLETS 24
18 . NO . OF HEAT CIRCUITS 1 19 . NO. OF POWER OUTLETS 10
20 . NO. OF CONVENIENCE OUTLETS 56 21. NO. OF HEAT CIRCUITS 1
22 . NO , OF POWER CIRCUITS 3 23 . NO. OF LIGHT CIRCUITS 8
24. SIZE OF HEAT CIRCUITS 20 AMP 25 . NO. OF MOTORS N/A
26 . NO . OF PANELS 1 27 . TOTAL WATTAGE
28 . NO . OF POWER FEEDERS N/A 29 . NO. OF SWITCHES
30 . A/C LOAD N/A 31. SIZE OF POWER FEEDERS N/A
32. NO . OF FIXTURES 24 33. TOTAL HORSEPOWER 2
34 . NAME OF SUBCONTRACTORS AND THEIR TRADES
NONE
35 . REMARKS AND FURTHER DETAILS :
102988 10-08-96
LICENSE NO. GNATURE OF APPLICANT DATE
PHONE NUMBER: 860-774-4135
INSPECTOR DATE 1.3o TIME -"-�
LOCATION +4cJ /v A
= _INSPECTION: CODE: RESULT(D/
BUILDING:
-_ ELECTRICAL: F� �
: PLUMBING:
HVAC:
OTHER:
f
4
'a
PERMIT ":0.
9YI7
DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT
Application is hereby :
TOWN OF SOUTH WINDSOR
APP DISAPPROVED BUILDING INSPECTION DEPT.
1540 SULLIVAN AVENUE
(� �( e7o�; 644-2511 Ext. 230
a e Building Inspector Applications must be printed or typed
1. LOCATION OF JOB:
1340 Main Street
FEE SCHEDULE 2. OWNER: Crossen Builders, Inc.
$ 0 - $1 ,0 0 0 - $10.0 0 3. ADDRESS: 174 Merrow Road, Tolland CT
Over $19000 - $10.00 06084
p e r $1 ,0 0 0 or 4. APPLICANT: Hany Brothers, Inc.
fraction thereof
5. ADDRESS: 170 West Main St.
Rockville, CT 06066
6. EST. COST: $ 6500.00
7. IS THIS A CONTRACT COST? x YES NO
8. FEE ENCLOSED: $ r.76 _ .00
9. TYPE OF BUILDIN
x RESIDENTIAL COMMERCIAL
10. TYPE OF JOB:
x ORIGINAL ALTERATION
INSTALLATION ADDITION
REPAIR
BD 2A 11/88
APPLICATION FOR PLUMBING PERMIT (Cont. from Reverse Side)
11. LOCATION OF JOB: 1340 Main St.
GENERAL PLUMBING
12. KIND OF INSTALLATION: all plumbing 13. SIZE OF MAIN DRAIN 4"
14. NO. OF TOILETS 4 STYLE 1.6 15. NO. OF URINALS STYLE
16. NO. OF BATHTUBS 2 16A. NO. OF SHOWERS 1 17. NO. OF LAVATORIES 4
18. NO. OF SINKS 1 19. DISPOSAL x 19A. DISWASHER x
20. NO. OF CONDUCTORS SIZE 21. NO. OF STACKS 1 SIZE 3"
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? & fan
27. SIZE OF WINDOW
28. IF NO WINDOW, WHAT KIND OF VENTILATION IS THERE? fan
29. SIZE OF DUCTS 30. SEWER OR SEPTIC TANK? )B0060[ Sewer
31. SIZE OF WATER MAIN 31A. SIZES OF WATER PIPING & RISERS 3/4" copper
32. REMARKS AND FURTHER DETAILS all plumbing for new residence
WATER HEATER
33. TYPE electric 34. MANUFACTURER State
TANKS SAFETY DEVICES
TEMPERATURE
35. CAPACITY Rn rj31 39. RELIEF VALVE 3/4" Watts
36. TEST PRESSURE 350 LBS. 40. MANUFACTURER Watts/ 100XL T & P
37. WORKING PRESSURE LBS. 41. PRESSURE RELIEF VALVE
38. TYPE 42. MANUFACTURER
203726 10/3/96 G �
LICENSE NO. DATE SIGNATURE OF AP LI T
PHONE NO. 872-4706
DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT P R1VIIT#
s
Application is hereby: TOWN of SOUTH WINDSOR
BUILDING DEPARTMENT Bldg Permit#
PROVE 1540 SULLIVAN AVENUE
u 4 644-2511 ext. 230
I/q —
Date Building Inspector Application must be printed or typed
1
Location job
13 l Vic.►w S
Street No. Street Lot No.
I
FEE SCHEDULE
Floor Apt.No.
$0 - $1,000 - $10.00
Over $1,000
$10.00 r$1000
Pe OWNER
or any fraction thereof
ADDRESS cl
OWNERS PHONE#
ci�
APPLICANT � w, 5 C\/►G le �-P c�
j OW N
SADDRESS �, ����► I � 1� �`k Ue
40% f �4
I�J 1141%
j C/) ESTIMATED COST $ / 9( v
C IS THIS A CONTRACT COST? ✓
"3 YES NO
l� ,A" C► FEE ENCLOSED $
OR-CO TYPE OF JOB:
Original Installation
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 7 a F DIFFERENCE--w- F
TOTAL HEAT LOSS(BTUH) S` utiv
(HEAT LOSS SHEET MUST ACCOMPANY APPLICATION)
DESCRIBE L HEATING EQUIPMENT (INCLUDING MAKE&MODEL NO.)
w�c. ►
GROSS HEATING CAPACITY (INPUT-BTUH) NET RATING (OUTPUT-BTUH) G,- c 0
TYPE OF FUEL
OIL-GPM GAS-INPUT ELECTRIC-KW
OIL TANK SIZE&LOCATION
INSIDE OUTSIDE CAPACITY LPG TANK CAPACITY
AIR CONDITIONING
DESIGN TEMP. OUTSIDE g0 F INSIDEJF DIFFERENCE F
TOTAL HEAT GAIN(BTUH)
(HEAT GAIN SHEET MUST ACCOMPANY APPLICATION)
DESCRIBE ALL COOLING EQUIPMENT (INCLUDING MAKE&MODEL NO.)
TONNAGE COOLING CAPACITY(BTUH) (Tz--O
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 , d-- C • y L,1J L, L
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.
3 3 I :'I�► C t�•c� Le s
STATE LICENSE-NO.NAME&TYPE SfGNATURE OF APPLICANT
1j
PHONE NO. 5t G 0 ` `I)L cl DATE 1(3 r 1\f - )
�" '' -o a � `� '* ' O��r�-„�r"v�'�-'a���r����,.�•r�1.:`�-s��,"•\� _�I"V '��` 1/►''�/ 'r'� '�
62.1
Y y
- - W r - " ''J =b�.. _- ~rj_._"`;?_ R.,-..;«;,j' .-- ....:;.+'7Fht.;' �.wr''` _ •• �r C`.-'.�. = ,
' - - COOYrlght 1977 by The Hyaronics Institute
1 = B = R CALCULATION SHEET 1503 (Modern Method) - _ b a_ 9L
S ADDRESS 0, ' f'� DESIGN TEMPERATURE DIFFERENCEI3LF. DATE
OWNER COL.a
COL.A COLS COL.D COL. CO +f
J t•�• P a5
I ROOM. E W N L W H t W
W Oatyn Water Ttmp.
O H L H t: H L - - -
STUN per Foot of
Z ROOM DIMENSIONS,FT. U Z Radiation Selected
3 LENGTH EXPOSED WALLS,FT. �' _
4 WINDOW AND OUTSIOF-DOOR AREA
STUN STUN - STUN STUN
STUN
^ l O O r'1 0 J 0 O �f�0 O TOTALS RADIATION
S WALL CONSTRUCTION (!� / !r
_ (Table 9,Line 3 x M) � �1 D� FROM LINE 12 SELECTED
6 TYPE OF GLASS 3660 0 Z�6 ��v
(Bottom of table used for Line S) C �00
7 CEILING CONSTRUCTION `� I "'� •�- D D
(Table 9,L x W) ! D
b FLOOR CONSTRUCTIONI `^� 9a o (O 0 I aD I �O 0 )00 E I O
I (Table 9.L x V.*or Lin. Ft.) (� F Z O d
9�COLD PARTITION CONSTRUCT ON �� �00
(Table 9,L x H) So 0-
1 10i 1 Y1elt{W,th Cpeningsl �� !��
oU 00
( 9 Wa's IMJ1th ODenings) CX •fr✓
= 3 weI1s,w1tn Ooenings) or Ent.Hall �U t 2-0 0 --+ v QV
� •sc'o �b
TO-A_ _," AT 70F TEMP. OtFFERENCE' � %� 00 c 61 00 �
K
— - _ L AT DESIGN T-N4p 01FrERENCE L
aC?
ICOL.B COL. COL.1 COL.J COL:K COL.L TOTAJIBTUH TOTAL
COL.A I, OF BUILDING RADIATION
C. !s'/"` AT SELECTED
I I aoOM C DESIGNTEMPr•
O H L H L W H W H L �/ H L W DIFFERENCE
I
2i ROOM DIMENSIONS, FT.
a
3 LENGTH EXPOSED WALLS, FT.
LL r
AI WINDOW AND OL;TSIDE DOOR AREA
STUN STUN BTUH BTUH STUN i *INCREASE BATHROOM
5 v%ALL CONSTRUCTION I,^ 2 R O �D D o 0 Q TOTAL 20%
b I (Ta1i 9, Line 3 x H) V /V / _ o r,
61 TYPE OF GLASS I / D 0 , L O v 0(So n G
tto- of table used for Line 5) r tFR CONCRETE FLOOR ON
ROUND OF FILL A7
i 7 I CEILING CONSTRUCTION .� - GRADE LEVEL,USE LINEAR
I
(Table 9 L x W) FEET OF EXPOSED EDGE
I g r-LOOR CONSTRUCTION? 4sL j Q �O [� 1 0
k7able 9. L x 1h or Lin FL)
,; P RTITION CONSTRUCTION
— -- _-_ --: -_ n p I Z o� i c I �Td
-his'or- s e.a e:�'e irc-r Tre-vc'on,cs first tote,35 Russo Place,Berkeley Heights,N.J.07922
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I B = R CALCULATION SHEET 1503 (Modern Method) Copyright 1977 by The HydrOMCS Institute
f4ef; N TEMPERATURE DIFFERENCE—2-0 F. DATE
OWNER CC-OSSLA ADDRESS /-?4(
t9 - 0 1--1 SIGI.M COL.G
COL.A JCOL.8 CO .C COL. COLA E CO
I ROOM CC mamr C Design Water Temp.
0 H L W H L W H L W H L IN
I I W H L I
Z-
2 STUN per Foot of
1 ROOM DIMENSIONS,FT. la 1 27, Radiation Selected
31 LENGTH EXPOSED WALLS. FT. < 2L z 3
41 WINDOW AND OUTSIDE DOOR AREA U.
STUN STUN STUN STUN STUN
51 WALL CONSTRUCTION 0 C) Room LIN.FT.OF
0
(Table 9.Lima 3 x H) 700 go 0 <0 700 TOTALS RADIATION
161 TYPE OF GLASS q60 "? 0 0. 360, FROM LINE 12 SELECTED
(Bottom of table used for Line 5) ?&& I 7-0o C *2?0 o
-7 CEILING CONSTRUCTION L)-Y I 0 I Z'& 0 1 '� 0 ZX) e,)
(Table 9,L x W) 30
81 FLOOR CONSTRUCTIONt E
(Table 9,L x A'or Lin. FL) F
9 COLO PARTITION CONSTRUCTION 2'� 0
(Table 9.L x H 70 0 1
10 1 Wall(With Openings) '0/9 1
2 1 2 0C
2 Waits(Wit Openings) X '02,7
1 3 Wells(With Openings)or Ent.Hall Y-7
1 TOTAL BTUH AT 70F TEMP, DIFFERENCE* 0 .37oo Z K
A
1 12 TOTAL BTUH AT DESIGN TEMP. DIFFERENCE
L
COL.A COL.9 ,COL: I
COL. COL. COL.K COL.L TOTAL BTUH TOTAL
I \ 1 t------ OF BUILDING RADIATION
C AT SELECTED
I ROOM '41-1 Z-- DESIGN TEMP.0
0 H L [ W H L I W, H L W H LW H L DIFFERENCE
21 ROOM DIMENSIONS,FT. 171 1 71 Y
31 LENGTH EXPOSED WALLS,FT, Q7
41 WINDOW AND OUTSIDE DOOR AREA U.- - --&I
BTUH S+UH BTUH STUN BTUH
I *ir4CREASE BATHROOM
51 WALL CONSTRUCTION
(Table 9,Line 3 x H) 10� 2-0 0 20 0 TOTAL 20%
61 TYPE OF GLASS 0 L_) '70 C,
(Bottom of table used for Line 5) .5 IFOR CONCRETE FLOOR ON
I I CEILING CONSTRUCTION GROUND OR FILL AT
GRA LEVEL.USE
(Table 9,L x W) 6 FEETDE OF EXPOSED EDGE LINEAR
81 FLOOR CONSTRUCTIONt
(Table 9,L x W or Lin.Ft)
9 COLD PARTITION CONSTRUCTION
(Table 9,L x HY
10 1 Wall(With Openings) p
ZZ 2 Wells(With Openings)
3 Wells(With Openings)-0-r Ent.Hall
I TOTAL BTUH AT 70F TEMP. DIFFERENCE* L--C-
12 TOTAL STUN AT DESIGN TEMP. DIFFERENCE FORM. 1503
This form is available from The Hydromics Institute,35 Russo Place,Berkeley Heights,N.J.07922
HOME OCCUPATION FORM
Minor ZEO Approval Date ' ASSESSOR'S USE ONLY:
Major PZC Approval Date Home Occupation Type
Expiration Date Code
Name -Ja&6 Lga— Q X- V7
Address of proposed occupation: i 4 b A J i in �C � 1�
Telephone! -"0— . ^.Lit Zone A
Description of Occupation:
�i'C7'C't�}�1 e nc�Q -►c' �ll�..a,'1CSZ� ��-� A. PROPOSED SIGN
Please use the boxes or an attached sheet to provide the following:
1. Attach copy of plot plan if applicable. -
2. Use box A (or attach sketch)to draw proposed signage . 1
3. Use box B (or attach sketch) to draw the floor plan of the home
occupation area.
4. Architectural elevations for any proposed additions or modifications
must be provided.
B. FLOOR PLAN ( Basement 1st Floor 2nd Floor)
Floor area of dwelling I I W)
Floor area of home occupation u 1.
%of floor area b Q
Iq4 Rq ,
I have read the regulatio regarding home occupations and intend to comply with said regulations. I understand I
must notify the Plannin D alment ' w ' ' n termination of this occupation at this address.
Signature of Applicant �• TDate 0/ lQ
Signature of Home Owne , Date
White = Assessor ellow = ApplicanY Pink = Street File