HomeMy WebLinkAbout1512 Main Street 3b
a r TO THE BUILDING INSPEMR
of the APPLICATION FOR
PLAN EXAMINATION AND
�Ol)'[H � ��COW PLAN
PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, III, IV, and IX. O
7 d 1�' ZONING
/�/I
• AT (LOCATION) /R r j r 0 7 I/ 'y a DISTRICT
LOCATION (NO.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
II. TYPE AND COST OF BUILDING — A11 applicants complete Parts A — D
�o
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use
1 be New building Residential Nonresidential
2 ❑ Addition(It residential, enter number 12® One family 18❑ Amusement, recreational
of new housing units added, if any,
in Past D, 13) 130 Two or more family - Enter 190 Church, other religious
3 � Alteration (See 2 above) number o/units- - - - -� 200 Industrial
14❑ Transient hotel, motel, 21 ❑ Parking garage
4❑ Repair, replacement 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 230 Hospital, institutional
Part D, 13) 16 Carport 24❑ Office, bank, professional
6 0 Moving (relocation)
7 � Foundation only 17❑ Other - Specify 25❑ Public utility
26❑ School, library, other ducational
B. OWNERSHIP 27❑ Stores, mercantile
8 ❑ Private(individual, corporation,
28❑ Tanks, towers
n npr fit 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................ 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 3 / coo
III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — L;
for wrecking, complete only Part J, for all others skip to IV.
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS
30❑Mas my(wall bearing) 40 Public or private company 48• Number of stories................
31 ® Wood frame 41 Private(septic tank, etc.) 49• Total square feet of floor area,
all floors, based on exterior ^ 47
32❑ Structural steel dimensions .................... a,(
33❑ Reinforced concrete H. TYPE OF WATER SUPPLY
Public or private company Total land area, sq.ft. ........... QO d
34❑ 42Other - Specify /�
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.......................
c nditioning?
36❑ Oil L. RESIDENTIAL BUILDINGS ONLY
37 LzWElectricity 44[Des 45❑ No 53. Numb r of b drooms..............
38❑ C al
39❑ Oth r- Specify Will th re be an levator? 54. Number f Full..........
46❑ Y s 47❑ No bathrooms /
Partial........
NOTES and Data — (For department use)
IV. IDENTIFICATION — To b completed by all applicants
Nam Mailing address — Number, street, city, and State ZIP cod Tel. No.
1.
Owner or
Lessee
z. S' j4azlsa, G - �791 -
Contractor p.
3.
Architect or
Engineer
The owner of this building and the undersigned agree to conform to all applicable laws of this jurisdiction.
Signature f applicant Address Application date
r
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Revi w R uired Check Plan Review Date Plans B Date Plans B Notes
9 Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
P rmit or Approva I Check Obtained Number By Permit or Approval Check ObtDa ned ate Number By
BOILER PLUMBING
CURB OR SIDEWALK CUT ROOFING
ELEVATOR SEWER
ELECTRICAL SIGN OR BILLBOARD
FURNACE STREET GRADES
GRADING USE OF PUBLIC AREAS
OIL BURNER WRECKING
OTHER OTHER
VII. VALIDATION
Building
P rmit numb r 10972
Bui Iding
P rmit issu d .July 20 19 79
Building
Permit Fe $ 426.00
Approv by:
TLE
NOTESVill. ZONING PLAN EXAMINERS
FRONTDISTRICT
SIDE YARD SIDE YARD
REAR YARD
NOTES
IX. SITE OR •T PLAN For Applicant
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TOWN OF SOUTH WINDSOR
BUILDING PERMIT
Date July 20 , 1979
Fee Paid $42 6.00 Eat. Value $.71,000.00
Pernut N2 10972
on the aide of
Main Street
Street No. 1512
Owner John G. Murphy
Applicant Richard S. Kelley
CERTIFICATE OF OCCUPANCY ISSUED:
Date
No. 5496
Fee Paid $ 3.00
CLASSIFICATION
Dwelling
BUILDING PERMIT
N? 109'72
OFFICE OF
THE BUILDING INSPECTOR
of the
Town of South Windsor, Conn.
South Windsor, Conn. July 20 1979
9 j;�t j,�[ to (ferfifg, That RSK Cnntra tors Inc..
is hereby granted permission to Dwe 1 l iM
i
i
at estimated value of $ 71 000L.00
on the side of 1512 Main Street on land
i
owned by John G. Murphy
i
Said Work to be as described in Application
No. 11272 and to conform to specifications and plans filed with said Application, and Building By,
Laws of THE TOWN OF SOUTH WINDSOR.
Issued Jtilw 20 ,.' 19 790
By ding 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 Pmon, :ball Pim
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."
I
INSPECTION REPORT
r
Permit # Job Zsf �
1 Footing14--,k"r7'�
2 Foundatio
3 Framing ,? 71
V� � g
4 Wiring "" �— - ' R.
5 PlumbingF — ,Q6-71
6 Heating 1dZ9eZ,47
7 Lathing -
8 C.O.
i
i
Permit No. TOWN OF SOUTH WINDSOR
SOUTH WINDSOR, CONN.
i
i
Permit U .5496
I Certificate of Occupancy
THIS IS TO TIFY
at No. in the of South Windsor, Connecticut, has
i
been erected and completed in accordance with the uilding Code and Zoning Regulations of
the Town of South Windsor, and is hereby'approved for occupancy.
f ,
I
ui In nspector
i
O ner, Builder
Date 19 .
�
� Fee Paid � '
6892
ELECTRICAL 'APPLICATION
Application No. 7897
on the side of
Main Street
Street No. 1512
Owner RSK for John Murphy
Electrician Alan Petersen
FILED IN OFFICE OF
The Building Inspector
Aug. 28 lq 79
INSPECTION.
e
M No Electrical Work shall be started until a Per-
mit is granted by the Building Inspector.
In New Buildings no wiring shall be started
until the plumbing and heating pipes, and the fire
stops (if of wood) are installed, without a special
permit from the office of the Building Inspector.
APPLICATION FOR PERMIT TO DO ELECTRICAI. WORK.
No. . ....78.9.7..... .. ......
Permit No. . ...6.8.9 2... .. . .
TO THE BUILDING INSPECTOR
of the
TOWN OF SOUTH WINDSOR, CONN.
hereby make application tc1 perform Electr cal Work according to detailed description below. All
provisions of the Rules for Electrical Installation, Section 48, Building By- , shall be gcoied with
whether specified herein or not.
South Windsor, Conn., ' 1J Sign here
Address �.(�, . .........
Location ) Side of ..
Nature of Building /� � � .C! How many stories . ......... ........ .. ...................................... .. ................
New or old Building .. How many families ........................! ........................................... ..............
Kind of Installation How many Stores ... ......................... ...................................................................
Owner ... ...... . V _... ... . . Address _...._..........._.._..... _....._......
Architect Address . . .. ....... . ..... .. ..................................................
__..__....._....._._....
Builder ... .9.S l<... ..... 0 r!C4�!l. .��ss .. ./��SGt/PZ ............06`4LO
Electrician ..1(..t.r66X.. '6 Address .. ... . ..... ..............................................................................._....._ ...
Size of Main Wires .. 0ll uAt.-I IT6 v
No. of Light Loops . �. ... No. of Heat Loops .. .. No. of Power Loops
No. of Light Outlets 1....`.. No. of Heat Outlets . . No. of Power Outlets ................ .......... .
NoO of Light Circuits v.. .... .. ..... No. of Heat Circuits . No. of Power Circuits .
No. of Sockets No. of Heat Receptacles No. of Motors
No. of Panels ................. . /..... . . . . Size of Heat Circuit No. of Power Receptacles
No. of Switches . ..... . � Total Wattage Size of Power Circuit ..
Total Horsepower
No. of Straight Electric Fixtures .. .. . No. of Combination Fixtures ....
No. of Receptacles ....................... .. .... .. 6....................... . No. of Cord Drops ..... ...................... ................ ............ . .... ... ..
Remarks: For other kind of Installation .. . ...................... ................... .. ............ ... .... ................................ ...... ........ ..... .. . .......... .............
........................................................................................... ... ..... /t.� ��l,C .........1 �r'e. �........�.a�
' ............................................ ............... ..................... ........... ......... ... ........................... . ._................................. .................................................. �= �
........... ............................................... ....................... .......
...............
Estimated Cost ...
54b0
PLUMBING APPLICATION
gppmQ Noy 6 243
on the---- L-kL2 - side of
Street No. _ -222���c
Owns hsi
Piumber ALI-Zlw—
Filed in Office of
The &n1dmg Iaspecmc
Aug. 15 1979
n��oso�r.
No person.shall construct; add to or alder army
portion of the drainage sym m of any boil&g
(except to repair leaks) until a Permits granted
by the Building Inspector.
Application No. ............... Permit No. .................
TO THE BUILDING INSPECTOR
of the
TOWN OF SOUTH WINDSOR. CONN.
.... .. ........... .....hereby make application to perform plumbing according to detailed description below. All
provisions of the Rules for Sanitation, By-Laws, Sections 33 to 47 inclusive, shall be complied with whether
specified herein or not. .................... .d 7 �f
..... .. ........... .. 97!�... Sip r>e ). Z. ..
.y................. .......
South Windsor,
Address ZO?... .. .....6...
Location ...................... .............................................................. side of ......... ......................................................... Street
Nature of Building .......................... How many stories .. ...........ft:2..................................................................
Owner ...................................... Address . .. IL--.e.............................................
Architect ...... ............................................................................... Address .....................................................................................................................
Builder . .... ... .......... .... .......... .................................0................................... Address ......................................................................................................................
Plumber ... Address 10-2.06"Atr . .... ................................
DRAINAGE
CESSPOOLS, How many 7..................... ..... ........ - Where located ............................................................
Are they water tight .......................... ......................................... Of what materials are they built ....................................................
Size of pipe from house to cesspool ... ..... ........ Kind of pipe ............. ................................................................................
MAIN DRAIN IN CELLAR, M .......................................................I.........................................
...Mat Diameter .......z/../(
. .4.4�
Aboveor below cellar bottom .. .. . ... ........ ..................I.....................................................................................................
SOILPIPES, Material .. .......................... Diameter ..........................................................................................
WASTE PIPES, Material . . ........ .....6S...... Diameter LL................................................... ..............
TRAPS,Type proposed to use is ...... - ... .. ....................................................................................................................................
RAINWATER LEADERS, where do they run to . . ..........................................I......................................................................
REFRIGERATORWASTES, where do they run to .. ... .... ....................................................................... ....................... ...............................
TANKOVERFLOWS, where do they run to .. ...... ............. ........................................................................................................
FIXTURES
WATER CLOSETS, How many ...............1 3
................. Where located ....... ..f.............................................
Distance from trap to vertical soil pipe .................. ..................... Pattern .. .. . . .......... . ...................I.........................................
WASHTRAYS, How many .... ............................................... Where located . ......................................................................................
SINKS, How many .. ................. .................../.......................................... Where located ........................................................
BUTLERSSINKS, How many ........................................................ Where located,.. ..........................................................................................
REFRIGERATORSINKS, How many...................................... Where located ...................................................................................................
LAVATORIES, How many .....................3..................................... Where located ..................................................................................................
;
BATH TUBS, How many ........................c2-
-................................................ Where located 4.... ..............
URINALS, How many ...... ................... ......................................... Where located .....................................................................................................
Are water closets and urinals to be local vented If not, is there a window in outer wall
ofroom where same are to be located . ....................................................................................................................................
Estimated Cost 4R... ... . ..........
5489
PLUMBING APPLICATION
mli ation No. 6271
on the ......_... -"of
Street No.
owtur
Plumber--22&� "L&
Filed in Office of
The Buldiog Lrpecoor
Sept 27 ig 79
No person shall coostroct, add to or aher any
portion of the drainage system of say 6ul&ng
(except to repair lealrs) until a Pkrmit is Smawd
by the Building Inspector.
Application No..........6 2.... ... .............. Permit No. 5 4 8.9.....................
TO THE BUILDING INSPECTOR
of the
TOWN OF SOUTH WINDSOR, CONN.
��....... .....hereby make application to perform plumbing according to detailed description below. All
provisions of the Rules for Sanitation, By-Laws, Sections 33 to 47 inclusive, shall be complied with whether
specified herein or not.
South Windsor, .................... .." .` .................................. 197��..... Sign here ... ........ .. . .
Address: C�.?....... .......... ... �.
Location .. .................... ................................................................. side of -__X':1 A-4,sA..r............................................................... Street
Nature of Building ...... ....................... How many stories ........�........
Owner ...........IPS./.�..........-t'�..'. ............. ............................................... Address ..,,�......�C/.�Gk/1..�................................................
Architect ..........."............................................................................................ Address........................................................................................................................
Builder .........,... ......................... ....................................... Address ......................................................... ........................................................
Plumber ZZW. - ............... Address.... :.... ..'`1 .................................
DRAINAGE
CESSPOOLS, How many .........................`--.................................... Where located ....................................................................................................
Are they water tight . ......................................................................... Of what materials are they built ........................................................
Size of pipe from house to cesspool . .................�'.�..'.................. Kind of pipe ....644*7,44,4''?. ....................................................
...
MAIN DRAIN IN CELLAR, Material Diameter ...............:.............................................................................................
Aboveor below cellar bottom .. ..... . .....................................................................................................................................................................................
SOIL PIPES, Material . .......................... Diameter .....4`..#........3....................................................................................
WASTE PIPES, Material .. .. .. .. Diameter ..... .......... .�..:-.....�.1........................... ..........................................
TType proposed t .. .......... .. ... . ........ ........ ......... .......... ..................................................................
RAPS, YP P P� d o use is .... ................ ........ ...... ....... ......
RAINWATER LEADERS, where do they run to . ................................................................................................................................................
REFRIGERATOR WASTES, where do they run to ................................................................................................................... ...............................
TANKOVERFLOWS, where do they run to . . ... . ................................................................................._....................................................
FIXTURES
WATER CLOSETS, How many ................. ................ ..... Where located ... .. ................................................................. ........
Distance from trap to vertical soil pipe ......................................... Pattern ... ...............................................................................................
WASHTRAYS, How many ............................................................ Where located .. ...............................................................................................
SINKS, How many .................................................. ................................... Where located .. ,fi
BUTLER'S SINKS, How many ........................................................ Where located,.....................................................................................................
REFRIGERATOR SINKS, How many....................................... Where located ....................................................................................................
LAVATORIES,How many..............................3.............................. Where located ......................................................................................................
t-z
BATHTUBS,How many............................ ................................ Where located ......I......::�. .... .............. ................................................
URINALS, How many ........ .. ................................................ 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 .............. . .. ...............................................................................................................................................
Estimated Cost (,1.V................
D�
TO THE B ING INSPECTOR
of the APPLICATION FOR
PLAN EXAMINATION AND
T'� w BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, III, IV, and IX. O
ZONING •,
I• AT (LOCATION) Z& DISTRICT
LOCATION (NO') / (STREET)
eli
,/ CI v t1w4� u�
OF BETWEEN AND ou
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE !/
N
II. TYPE AND COST OF BUILDING — A11 applicants complete Parts A — D
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use �
1 ❑ New building Residential Nonresidential
2❑ Addition(if residential, enter number 12❑ One family 18 ❑ Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13❑ Two or more family — Enter 19❑ Church, other religious
number of units— — — — -- 20❑ Industrial
3 ❑ Alteration (See 2 above) 140
Transient hotel, motel,
4 El Repair, replacement or dormitory — Enter number 210 Parking garage
5❑ Wrecking (1/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[W Other — Specify 25❑ Public utility
7 ❑ Foundation only 26❑ School, library, other educational
B. OWNERSHIP jr c 27❑ Stores, mercanfile
❑ 7 x r 29❑ Tanks, towers
8 Private (individual, corporation,
2 Other — Specify
n nprofit institution,etc.)
9 ❑ Public(Federal, State, or
local g vernment)
C. COST ^(Omit cents) Nonresidential — Describe in detail proposed use of buildings,e.g., food
processing plant, machine shop, laundry building at hospital,elementary
10. Cost of improvement................ S 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. Oth r(elevator,etc.)............
11. TOTAL COST OF IMPROVEMENT Is 1Z n
III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — L;
for wrecking, complete only Part J, for all others skip to IV.
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS
30❑Masonry(wall bearing) 40❑ Public or private company 48• Number of stories................
31 ❑ Wood frame 41 ❑ Private (septic tank, etc.) 49• Total square feet of floor area,
all floors, based on exterior
32❑ Structural steel dimensions ....................
33❑ Reinforc d concrete H. TYPE OF WATER SUPPLY
34❑ Oth r — Specify 42 E] Publicor private company `-+0• Total land area, sq. ft. ...........
43❑ Private(well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed ......................
F. PRINCIPAL TYPE OF HEATING FUEL 1. TYPE OF MECHANICAL
35❑ Gas Will there be central air 52. Outdoors.......................
96❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37❑ Electricity 44❑ Yes 45❑ No 53. Number f bedr me..............
38❑ C al
39❑ Oth r— Specify Will there be an el vat r? 54. Number of Full..........
46❑ Yes 47❑ No bathr me
Partial........
NOTES and Data — (For department use)
IV. IDENTIFICATION — To b compl t d by all applicants
Name Mailing addr ss — Number, street, city, and State ZIP cod Tell. No.
Owner or
Lessee
2.
Contractor
3.
Architect or
Engineer
Th owner of this building n t-he undersigned agree to conform to all applicable laws of this jurisdiction.
Signature f applic t Address Application dot
i4� I
DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Revi w R uired Check Plan Review Date Plans B Date Plans B Notes
q Fee Started Y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
P rmit or Approval I Check Date Number B Permit or Approval I Check Date Number By
pp Obtained Y pp Obta fined
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 12720
Permit number
Building
Permit issued MAy 24 19 82
Bui Iding
P rmit Fe $ 3.00
proved by
T
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i -
S f
TOWN OF SOUTH WINDSOR
BUILDING PERMIT
Date May 24 , 19 820
Fee Paid $. 3.00 Eat. Value $125 9 00
q�
Permit No 12720
on the aide of
Main Street
Street No. 1512
Owner R i c harti Good
Applicant R i chard Good
CERTIFICATE OF OCCUPANCY ISSUED:
Date
No.
Fee Paid $
CLASSIFICATION
Shed 8' x 12'
i
BUILDING PBRbffr
i
OFFICE OF
N° 12'720
THE BUILDING INSPECTOR
of the
Town of South Windsor, Conn.
South Windsor, Conn. MaT2 4 .
94is is to Certify, That Rlr-lhard Good
j is hereby granted permission to Shed 8 x 12
at estimated value of
on the side of 1512 Main Street on land
Richard Good
owned by - -
Sa; A to be as described in Application
No,13020 and to conform to specifications and plans filed with said Application, and Building By-
Laws of THE TOWN OF SOUTH WINDSOR.
Issued May 24 120
a
uilding 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."
MAIN STREET
r" i
1 0
' 150,
9
1 W tn
+ ELEVATIONS -yam �' 45 ULLVATIONS }
FIRST FLOOR - 49' (L �. ` dA�AG PROPMED r -
cf
BASEMENT 40.8 j 4 `\` •�`, RESIDENCE /� ,
LI
Z -1 f.6.w 2.a0e F-
lil E N TRA ty11 N. _-lL--
U FAMILY ROOM '' 0
ir
Q -
111 +3$ .o � �-�! _a- �_ SCALE IN FEET
20 0 20 40
30.000 000 SQ. FT ' Q
4 _� _�-
a clot,NfC 1
Z _ 4 L `� '
STOUGHTONs
BROOK
9 '-y¢Qr
NOTES:
PROPERTY OF
1 . SURVEY DATA FROM SO, WINDSOR N/F JUDSON A• AND KATH LEEN B. JOHN G. MURPHY , 91 TIFFANY RD .
1
TOWN CLERK'S OFFICE RECORDS. BANCROFT EAST HARTFORD . CT .
2 . TOPOGP.APHY FROM METROPOLITAN
DISTRICT MAPPING. APRIL 1979 PREPARED BY:
LORD-WOOD. LARSON ASSOCIATES , INC
3. POTENTIAL WETLAND r/ ENGINEERS , SOU m \.A'INDSOR C-r
6
TOT BUBMIDING
d the APPLICATION FOR
TOWN CIF SOUR! WIIrDSM COM PLAN EXAMINATION AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, It, III, IV, and IX. O
/�^ ZONING
I• AT (LOCATION) 151
`Y1 1 A AI'y�r `JT DISTRICT��
LOCATION (NO.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D
�o
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use �
1 ui
❑ New building Residential Nonresidential
223 Additi n(1f residential, enter number
12 One family 18❑ Amusement, recreational
/new bousing units added, if any, 13 Two or more family — Enter 19 E] Church, other religi us
in Part D, 13) number of units— ———-�
3 ❑ Alt ration (See 2 above) 20 Industrial
14❑ Transient hotel,motel, 21 ❑ Parking garage
4❑ Repair, r placement or dormitory — Enter number
5❑ Wr citing (it multifamily residential, of units ——————— ——► 22❑ Service station, repair gerag
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 ❑ Foundati n only
/1 l 26❑ School, library, other educati nol
B. OWNERSHIP l� x 3� 27❑ Stores, merconfiI@
8 fiZ� Privets(individual, corporation,
213❑ Tanks, towers
nonpr fit institution,etc.) 29❑ Other — Specify
9 ❑ Public(Federal, State, or
I cal g vernment)
C. COST (Omit cents) Nonresidential — Describe in detail proposed use of buildings, .g., fo d
processing plant, machine shop, laundry building at hospital,elem ntary
10. C at of improvement,,,,,,,,,,,,,,, I school, secondary school, college, parochial school, parking garage f r,
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. El ctrical...................... v
b. Plumbing ......................
c.Heating, air conditioning.:k.0...
d. Other(elevator, etc.)...JY.0 ....
11. TOTAL COST OF IMPROVEMENT = 1al000•00
I11. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — L;
for wrecking, complete only Part J, for all others skip to IV.
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS
30 LJ Mao my(wall bearing) 40 Public or private company 48• Number of stories...............
31 W d frame 41 N 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 C] Publicor private company �• Total land area, sq.Ft. ...........
43 JK Private(well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed .......................
35❑ Ges Will there be central air 52. Outdoors........................
36❑ Oil c nditl nine? L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 N
❑ Yes 45 0 53. Number f bedrooms..............
30 Coal
39❑ Oth r— Specify Will there be an levetor? 54. Number of Full..........
46❑ Yes 47 EQ No bethroome
Partial........
IV. IDENTIFICATION — To b compl t d by all applicants
Mailing address - Number, street, city, and State ZIP code Tel. No.
Owner or (~
Lessee LQ
2. ST AV,F-LL I JR. 63, GARDEN H IRT O R CT. .S)t C�-i
Contractor
OroiU� 6yy-I6�11
3.
Architect or
Engineer
Th owner of this building and the undersigned agree to conform to all applicable laws of this jurisdiction.
Signature of applicant Address Applicati n date
. 3.� (� .�owo�a.►. C 10 t 9 qb
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans R view Re uired Check Plan Review Date Plans B Date Plans B Notes
q Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Ob wined Number By Permit or Approval Check obDa t�d Number By
BOILER PLUMBING
CURB OR SIDEWALK CUT ROOFING
ELEVATOR SEWER
ELECTRICAL SIGN OR BILLBOARD
FURNACE STREET GRADES
GRADING USE OF PUBLIC AREAS
OIL BURNER WRECKING
OTHER OTHER
VII. VALIDATION
Building
P rmit numb r yS�
Bui Iding
P rmit issued hZI 19 We/
Building -,��'✓,
Permit Fe $
A� rove y:
T-11-1\
ITLE r-4. TH
TOWN OF SOUTH WINDSOR
BUILDING PERMIT
Date Sept, 26 1986
Fee Paid $.7.2...0 0 Est. Value $.12 ..0 0 0
Pert No 15456
on the aide of
Main Sty
Street No. 1512
Owner Richard/Joan Good'
Applicant M_ G_ T o r t-a r _1 1 i , a r_
CERTIFICATE OF OCCUPANCY ISSUED:
Date
No.
Fee Paid $
CLASSIFICATION
Arld i i-i nn
BUILDING PERMIT No 15458
OFFICE OF
THE BUILDING INSPECTOR
of the
Town of South Windsor, Conn.
South Windsor, .onn Sept. 2 5 q0
ig#iz is to Crrtifij, That M.G.Tostarelli, Jr.
is hereby granted permission to Finish basement and 12' x 30 addition
to rear of dwelling
at estimated value of
on the side of 1517 Main Street on land
owned by Richard and Jean Good
Said Work to be as described in Application
Nil 575F and to conform to specifications and plans filed with said Application, and Building By-
Laws of THE TOWN OF SOUTH WINDSOR.
Issued Sept. 25 _ 1506
" 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."
INSPECTION REPORT
Permit Job
1 Footing
2 Foundation
3 Framing
4 Wiring
5 PlumbingL L
6 Heating
7 Lathing
8 C.O.
. l
_ MAIN STREET
150, 9
c
L'@
• -0- -444 N
AA7
ELEVATIONS . } tf,EVATIONs
FIRST FLOOR a PROPdSED '7
BASEMENT AO-S' � dA,RAG
411 RESIDENCE -
Z `\ ---r-
o \ E N TRANCE TO YINFAMILY ROOM "
H
-3 _ G _ -------' U SCALE IN FEET
' 34.000 SQ. FT _ Q 20 0 20 .0
46 CON�y fC
ST OUGHT ONS
OK ' Lfie
ti
BRO
-�
9 '-if%0l
NOTES: PPOAEATY OF:
1. SURVEY DATA FROM SO• WINDSOR N/F JUDSON A. ANId KATHLEEN 6. JomN G. MURPHY. 91 TIFFANY RD
TOWN CLERK'S OFFICE RECORDS. 13ANGROP T EAS r HART r-ORD CT .
2 . TOPOGP.APHY FROM METROPOLI rAN ,
DISTRICT MAPPING. APRIL 1979 PREPARED BY
i LORD-WOOD , LARSON ASSOC IA r E S INC.
1, POTENTIAL WETLAND �- i ENGINFFRS SOU r-1i W/INnSOA CT
r•
9471
ELECTRICAL APPLICATION
Application No. 10 9 A 2
on the side of
I'da i n $tMt
Street No. 1 53 2
Owner Richard rand
Electrician Michael Malinquagaio
FILED IN OFFICE OF
The Building Inspector
11/21 19 86
INSPI CrION.
m No Electrical Work shall be started until a Per.
mit is granted by the Building Inspector.
In New Buildings no wiring shall be started
until the plumbing and heating pipes. and the fire
stops (if of wood) are installed, without a special
permit from the office of the Building Inspector.
Electrical Permit No. .......2Y21..........
Master License No. Aq. �.... .............
TOWN OF SOUTH WINDSOR Building Permit No. ......................
BUILDING DEPARTMENT Date Filed .. --.111142-112��.......................................
Date Final Approval .................... ...........................
APPLICATION FOR ELECTRICAL WORK
Electrical Inspector
'.2....../414�/A/........JOB LOCATION: ...7.......................... JOB OWNER: ... .........................................................................................................
. Side of ......... ........ ....... . ......... Between ................. ....................................................... and .........................................................................
Name of Building Owner ..............6:... 0..... ......... Address ... ...;z...........M..A.11v...5.7.......S.e...&V,
........ ... ..... ......... ... ..... ........ .........
If work is for Lessee—Give name .... . . .. .......... .......... .. ................... ..... Address .................................................................................................
Building now occupied as (unless new) ................ ....... . .. No. of family units now ..................................
Building to be occupied as........... . . ................. ......... . .............. ....... ...... .......... ........ Number of family units to be .................................
Is this work included in a Building Permit? Permit Fee ............... ............. .................................
(If no Building Permit)
/61/f/,--FFD
Permittee I-VI f-4,11V6-V,4Q,-1d1usiness Addresses.-2..</?.Q5'S..........PiZ..... Telephone .............................
COST OF INSTALLATION: ...... ...................... ................................. .......
TO BE FILLED OUT BY PERMITTEE
TO BE WIRED EXISTING APPLIANCES
Number of light outlets to be installed . . ............ .... ........
Number of convenience outlets to be installed Number of present Appliance Circuits ...................................................
Number of switches to be installed . . . ....... ......... ........ Do these include Range ❑ Water Heater
❑
Number of appliances to be installed . . . ..............................
(as listed below) Dryer C] Air Conditioner ❑ Oil Burner ❑
TYPE RATING NO.
Dish Washer ❑ Gas Burner F1
Range . . . . . . . . Well Pump ❑ Elec. Heaters E:]
Range Top . . . . . .
Oven . . . . . . . . REMARKS:
Water Heater
Clothes Washer /V
Clothes Dryer . . . . .
Dish Washer . . . . . . ✓ AP
Air Conditioning Motor
Oil Burner Motor . . . . 24 5 c-
Gas Burner . . . . . .
Circulator Motor . . . .
Attic or Large Fan . . .
Well Pump . . . . . .
Electric Heat . . . . .
Other . . . . . . . . I
Number of new Lighting Circuits . . . . ...........................
Number of new Appliance Circuits . . . ...........................
Number of Heating Circuits ...............
Number of Motor Circuits . . . . . . . .
Size of present service ............... . .. ..........................................
Size of service to be ............................................
BEAT LOSS ESTIMATE SHEET (SHORT FORM) .
For Use With F.P.E. Heat Loss Calculator (SHORT FORM)
JOB R/Cb*,^wD boa 0 ADDRESS 43 12 1'1,#I� So
CONTRACTOR /4-IA-41,11/ G-G.,(o /D /dl6 DATE /i
CONSTRUCTION DATA: Sidewalls I3 q
Notes: Ceilings
Floors �• S ��
GLASS �D v f3 !,, ,....1� k S 5
DOORS
1. ROOM,�jDD�
3�x i z-- WALL -
EQUIPMENT SELECTION: GLASS
H ater s - DOOR o
Controls + or
P-pl Alirs TOTAL HEAT LOSS y
2. ROOM AREA _
WALL = >
EQUIPMENT SELECTION: GLASS =
Heaters DOOR =
Controls + or
TOTAL HEAT LOSS-
3 ROOM AREA =
` WALL_GLASS
EQUIPMENT SELECTION:
Heaters DOOR =
Controls + or
TOTAL HEAT LOSS
4. ROOM AREA _
WALL =
EQUIPMENT SELECTION: GLASS =
Heaters DOOR =
Controls + or
TOTAL HEAT LOSS
S. ROOM AREA
WALL
EQUIPMENT SELECTION: GLASS =
H aters DOOR = _
Controls + or -
TOTAL HEAT LOSS
3 -
7197
PLUMBING APPLICATION
m&adm No, 6267
on the of
........ Sft
&Mft 140.
Plunam j/ S 5
Filed in Offia of
The &Uum Iarpecoor
Dec. 4 ig
4 II�ICy W
.................
No person"D comas, add ft w altar mW
portion of the draimp wmm of any bwl&mg
(emzpt to repair lealm) uo& a A is gmmd
by the Building Inqmaw.
Application No. ........� .7.................. Permit No. .................
TO THE BUILDING INSPECTOR
of the
TOWN OF SOUTH WINDSOR. CONN.
hereby make application to perform plumbing according to detailed description below. All
provisions of the Rules for Sanitation, By-Laws, Sections 33 to 47 inclusive, sha be c lied wj;k whether
specified herein or not.
inclusive, sh be lied whether
South Windsor, P0..!/ 19 .914ign here ......... . .... ............. . ...... .. ..................................
Address .......... ...................... .............. ............. .........................................
. ... ...... ...
Location side of ........ ........................... ................................. .. ....... . ..... Street
Nature of Bui ding S...z.DA............................ . How many stories .. ....... ............. .... .....L.c ......
Owner ....gle, ................................. ..... Address .IS.1d. ......
Architect ......... .... ....... ................ Address ... . .......... ... ...... ............ .........................
ir c Ll
... ...........
Builder M ............................. ........... Address... 77z
e 0 -7/r
,1 c
Plumber 0.1 . .a. .. ........'5..... ......................................... Address /0...74 PC. ....:�44.....
DRAINAGE
CESSPOOLS, How many Where located . .. ............ .......................................................................
Are they water tight .. .... Of what materials are they built .. ...........................
Size of pipe from house to cesspool . ........ Kind of pipe ... - .. ............................................................................
MAIN DRAIN IN CELLAR, Material W.47 S Diameter ..................................................................... ........... ...........
Aboveor below cellar bottom .. 0440w.......... . . . . ............I......................................................................................................
SOIL PIPES, Material 14135. .... ...........I.... .... .. Diameter ...3..........2 .........t
.. ...... ........................................................
WASTE PIPES, Material Diameter .......5..............5...................5............................................................
TRAPS,Type proposed to use is .. ................................................................................................................................
RAINWATER LEADERS, where do they run to . . . . .. ........I....................................................................................................
REFRIGERATORWASTES, where do they run to . .. .. ........ ................................................................................ ...............................
TANK, OVERFLOWS, where do they run to . . .. ... .......................................................................................................
FIXTURES
WATER CLOSETS, How many . .. .......... ...... ....... ......... Where located . .................................................................................
Distance from trap to vertical soil pipe ........................................ Pattern ........ . ........ . ............................................................
WASH TRAYS, How many . I.. ...................... . .... Where located ..................... . .. . ....................................
SINKS, How many ... ............. ............................................................... Where located .................................. ...... ......................................
BUTLERSSINKS, How many ....................................................... Where located. ..............................................................................................
REFRIGERATOR SINKS, How many. ................................... Where located ............... ..............................................................................
LAVATORIES, How many .............................................................. Where located ....................................................................................................
BATHTUBS,How many ....................................................................... Where located ....................................................................................................
URINALS, How many ...................... ............................................... Where located ....................................................................................................
Are water closets and urinals to be local vented . . If not, is there a window in outer wall
ofroom where same are to be Irated ....... . .. . ............... ...............................................................................................................
:"�b -f Estimated Cost .4. ............ .......
30 010
_ a
DEPARTMENT DECISION PERMIT# zt -
APPLICATION FOR HVAC PERMIT
S:90
Application is hereby: TOWN of SOUTH WINDSOR
BUILDING DEPARTMENT Bld 't#
AYBufl D 1540 SULLIVAN AVENUE
644-2511 ext. 230
2 m
Date ding Inspector Application must be printed or typed
Location of job
I Z O Zs tyvi I N
Street No. Street Lot No. ;
FEE SCHEDULE
Floor Apt.No.
$0 - $1,000 - $12.00
Over $1,000
$12.00 per$1,000 OWNER a001�M fl it
or any fraction thereof
ADDRESS S P1 M G
OWNERS PHONE# Z Sq— 5&5 8
APPLICANT t 4 6 L-L (Yl.V S vC A
w N sF ADDRESS SZ -L7>fto" 3t wyk
00
ESTIMATED COST $ S Z
C IS THIS A CONTRACT COST?
Vol A%w YES NO
l� M C1 FEE ENCLOSED $ aCe
�S�R C�� 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 F DIFFERENCE F
TOTAL HEAT LOSS(BTUH)
(HEAT LOSS SHEET MUST ACCOMPANY APPLICATION)
DESCRIBE ALL HEATING EQUIPMENT (INCLUDING MAKE&MODEL NO.)
GROSS HEATING CAPACITY (INPUT-BTUH) NET RATING (OUTPUT-BTUH)
TYPE OF FUEL
OIL-GPM GAS-INPUT ELECTRIC-KW
OIL TANK SIZE&LOCATION
INSIDE OUTSIDE CAPACITY LPG TANK CAPACITY
AIR CONDITIONING
DESIGN TEMP. OUTSIDE F INSIDE F DIFFERENCE F
TOTAL HEAT GAIN(BTUH)
(HEAT GAIN SHEET MUST ACCOMPANY APPLICATION)
DESCRIBE ALL COOLING EQUIPMENT (INCLUDING MAKE&MODEL NO.)
TONNAGE COOLING CAPACITY(BTUH)
VENTILATION
DESCRIBE ALL AIR HANDLING EQUIPMENT(INCLUDING KITCHEN EXHAUST EQUIPMENT)
TOTAL SIZE OF SYSTEM(CFM) FRESH AIR INTAKE(CFM)
(PLANS MU 'I`ACCOW P ON)
r FURTHER DESCRIPTION OF WORK. Z
THE UNDERSIGNED HEREBY PLIES FORIT TO PERFORM THE WORK DESCRIBED AND IS TO
COMPLY WITH ALL LO C�ESND STATE OF CONN.BUILDING CODES IN THE
PERFORMANCE OF SUCH WORK.
3o pS-1 - 1?6�a 1�1�
STATE LICENSE-NO. NAME&TYPE SIGNATURE OF APPLICANT
PHONE NO. pZ3- -3 3 0 DATE
r n
Hall & Muska Oil
Division of George T.'Taylor&Son,Inc.
■ — The Energy Savers —
HEAT P.O.Box 348, 152 Broad Brook Road
COMPLETE HOME COMFORT Broad Brook, Cr 06016
(860)623-3308 Fax(860)623-1356
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INSPECTOR �C DATE TIME
LOCATION
INSPECTION: CODE: RESULT(D/A) :
BUILDING F36 5
C
ELECTRICAL:
PLUMBING:
xvAc:
f
�
OTHER:
Electric# CORRECTED 10/0 8 APPLICATION FOR BUILDING PERMIT
plumbing# 1512 MAIN STREET
HVAC # 25592 Dot ' 8
Sprinkler# �-
FINAL
OV Estimated Cost =�--
V COMPLETE RED BOXED AREAS Permit Fee $_
EngineerTYPE OR PRINT ONLY Occupancy Fee $
Affidavit E SIDE
Appr.for CO. SIGN ON REVERS mmmwdl Total Fee $ jZM
TO BIAIDWG DEPARTMENT,TOWN OF SOUTH WWDSOR,CT (Additional Cost) $
The undersigned hereby applies to do work according to the following specifications:
Job Location 2 Lot No. Side of Street_Zone
Applicant (V 6 Tel#
6
Address I0�1 r 0 k S e 'p 8 Lic.# J1 I U V-9 42-3 44'�-
Own r 14 y 16 ryo 0D W/N Address 15 Z N
So ,4
Architect Addr J A&
Sq. Ft.N w Area: 1st Fl. 2nd Fl. 3rd Fl. Total New Area
#Rooms #Lavatories #Bathrooms ges
Purpose of this permit: - r A I>D C 4(#(A A/ l
% OtY W r ❑ Well ❑ Septic System 0 Sewer ❑
Ins. H.O. S Cert._ Area Basement Garage
Approved by Date g Use Group Construction Type
R•vked 1197
I hereby agree to conform to all the requirements of the Laws of the State of Connecticut and the Ordinances of the Town of
South Windsor and to notify the Building Inspector of any alteration in the plans or specifications of the Building for which this
permit is asked,and agree that this building is to ed the proper d' from all street lines,side yard lines,and required
dista from all other zones an is located in i h is build' a it is
Signed
I hereby apply for a Certificate of Occupancy for the work descnbed in this application for the permit.
Signed_
DO NOT WRITE BELOW THIS LINE
INSPECTION COMMENTS
Inspection / Approval Date By Appl
Code Description Due Whom Code Comment
-------------------------------------------------------------------------------
98-25592-B 975
B05 FIREPLACE/CHIMNEY 02/05/99 DCJ A
B10 FINAL 09/23/99 JFF A APPROVED FOR CLOSEOUT
Elkmc# /G SG APPLICATION FOR BUILDING PERMIT
Plumbing# 1512 Main Street
HVAC # 27168
Dot : 7 O 4
Sprinkler# NO'
FINAL O Estimated Cost $ `Z. 50
BuildhVo X COMPLETE RED BOXED AREAS Permit Fee $ i 3
EngineerTYPE OR PRINT ONLY Occupancy Fee $ 5
Affidavit SIGN ON REVERSE SIDE
Appr.for CO. Total Fee
TO BUILDISIG DEPARTMENT,TOWN OF SOUTH WWSOR,CT (Additional Cost) $
The undersigned hereby applies to do work according to the following specifications:
Job Location / 5 /2- A/I mi -:�T Lot No. Side of Street Zone
Applicant D!TV10 0-0 0 h w Tel#• `7 W 9
Addr ss t 5 ( Z-- AAn t o 3'r Zip Lic.#
Own r 1)t1I 10 6&6)) W IA) Address j 1 L yVW t oU S r
Architect Address
Sq.Ft.N w Area: 1st FI. 2nd FL 3rd FL Total New Area
#Rooms #Lavatories #Bathrooms #Garages
Purpos of this permit: R Ofi )V 6 —Z-7U S 1�?' 11 Q?V
City Water ❑ Well ❑ Septic System ❑ Sewer ❑
Ins. H.O. Cert. Area I I Basement Garage
Approved by Date 7171 0 U Use Group Construction Type 2G
Revs«i 1/97
I hereby agree to conform to all the requirements of the o he State of Connecticut and the Ordinances of the Town of
South Windsor and to notify the Building Inspector of ny aRerati n in the plan spec ications of the Building for which this
permit is asked,and agree that this building is to ocat the ro istan ro street . s,side yard lines,and required
distances from all other zones and is located in wh' h s buil g n s u
Signed
I hereby apply for a Certificate of Occ cy f the dew' in thi a lication for the permit.
Signed
DO NOT WRITE BELOW THIS LINE
INSPECTION COMMENTS
Inspection / Approval Date By Appl
Code Description Due Whom Code Comment
-------------------------------------------------------------------------------
**-27168-B 250
B10 FINAL 10/18/00 JFF A WITH OWNER
B10 FINAL 10/18/00 JFF A CLOSED OUT.
[DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
Application is hereby.
TOWN OF SOUTH WINDSOR PERMIT#
BUILDING DEPARTMENT A0 IF(O
APPRO 1540 SULLIVAN AVENUE Bldg.Permit#
644-2511 ext. 230
yY
mg Inspector
Application must be printed or typed
FEE SCHEDULE Location of Job:
$0-$1,000=$13.00 Street No. Street Lot No.
Over$1,000=
$13.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT
APPLICANT ADDRESS /S j Z
APPLICANT PHONE# `-S-GI S�D SO
00.11111111
11 �.q OWNER U/
y OWNER ADDRESS /Z Al07
#� [•► OWNER PHONE Z if—5*45
ESTIMATED COST$ .15�0
V
IS THIS A CONTRACT COST? 0 Yes alio
Y FEE ENCLOSED$ k0jO—
�� TYPE OF JOB:
O Original Installation
13 Alteration/Addition/Repair Revised 8/99
a
APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
BUILDING PERMIT APPLICATION? ❑ YES ❑ NO
❑RESIDENTIAL
❑BUSINESS CURRENT USE AND OCCUPANCY
❑ASSEMBLY
❑MERCANTILE FUTURE USE AND OCCUPANCY
❑EDUCATIONAL
❑ INSTITUTIONAL ENGINEER'S NAME PHONE
❑FACTORY
❑ STORAGE ADDRESS
❑ GARAGE
❑MIXED USE 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 Z
NUMBER OF SWITCHES NUMBER OF OUTLETS
NUMBER OF LIGHT FIXTURES NUMBER OF HEAT CIRCUITS
NUMBER OF A/C CIRCUITS
SEPARATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED.
DESCRIPTION OF WORK
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS TO
COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE
PERFORMANCE OF SUCH WORK.
CONTRACTORS LICENSE N . STATE
SIGNATURE OF APPLICANT DATE