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1658 Main Street (2)
Application No. 6394. Permit No. .6124 TO THE BUILDING INSPECTOR of the TOWN OF SOUTH WINDSOR, CONN. hereby make application for a permit to (eKc._ make alteration o 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., •.... ............ 19.1a. ... Sign here ............... .. . ....... ... ............... �t,.s.. Address .. ....................... ........... .... Location? . .... ... .................. .....................................................................side of? .......... ..................................................... - Nearest cross.street? .. .................Street No. . .................... Lot No. ............................. . -: Owner of land is? Address cQ :.......•3Q., ............... 1- Owner of building is? .. ✓ Address ... ..... ...................................................................................... ' Architect is? ... Builderis? . ....................._..........................Add ress .......................`..� ...............................................................��.......... : 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) � .. ..................... ..'............. . ...........-..... .............................................................................................................................._......... 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? . ... ... ...... . . ............ ..... .... ........... ......... .... ..... Composition of mortar? . ............ Height and Thickness of Walls Hefgfit Stories Front Walla Side Walls Rear Walls Partition Walls Basement, ........................ ................._..._............_.........._...._...._..................... ........._.........................._....................................................................................................................................... ... 1st Story ................................ .............................._....._............................................................................................................................................................ ........... ...... .............................. ... .. ..... 2nd " ............................................._........................................................................................._......r...................................... .......... ........................................... ... ............... ....... 3rd " ......................._......................................................................I..................................._................................................................. �....................... ....................... .......... .............. ..... .... . ..... 4th " ........................... ..........._..................................................... ...................................................................................................................... .............. .... ........ ... .... . . ...... ..... 5th " ....................... .......... ............_. ................................................... ......................................... .........._.................................. ................................................. ................................................ 6th " .... ................ ................._................_.......................................-......................................................................................................................................................................._................ 7th " _......................._......... ......... ........................................................ ............. ....I....................... I.................. ... .. ............................................................ .................................................. 8th Of ........................................._.............................................................. ........................... ..........., .................... ......... ........... ....... ................ . .................... ...................... 9th " ......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. Give Size, Longest Span and Distance Between Centres, of Joists, Girders and Columns Jots" (;=DIM COLUMNS Floors Size Longest Span Centres Brldging Size Longest Span Centres Sim ImV* Centres 1st Floor a.....as.... .............. .................................. ........._.. .......................................................... ._........_. _........_�..... Via.....,,..... ............. ............................................................ ............ ........................ _.........._. ........ __.._ ................_.... _ 4 ....��.... ............. ................................. ................... ...................... ........_.. .............................. ._.._.... ..._........._.. Size of outside studs? ....................................... Distance on centres. .................... Size of sill? Size of rafters? .......................... ....... Distance on centres?......... .................................. Size of plate? ..................................................... Size of ledgers or girts? ......... ........ . . .........................................Size of deckrafters? ................................................................... ............... Distance on centres? Size of studs in bearing partitions. MISCELLANEOUS Style of roof, flat, pitch, Mansard, or hipped? ..... .. ... ............................ Fireplaces? ....................................................... Materialof roof covering? .............................. ............. . . .....Material of Cornice? .................................................................................... How is building heated? . ..... ......................Lining of flues? .. .... . .. .. ............. Thickness of shell of flues? . ............ ............................... ...................Any elevators or lifts? ................................................... ...................... What kind? How many? ... . . Any hoistways? .. ......... .... . ......... ............. . .......�,.�1,1�. How protected? ... .. . . ............... ....... . ...................... .. .............Total Value of Building ......... ............................. m When will work be commenced? ... 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 6124 BUILDING APPLICATION ApplicationNo. ..63.94........................................................ east onthe ........................................................ .............. side of Main St. ........... ... ..... ....... .... .. . .. .......... ...... ... Street. Street No, ..... .165 8 ... .. . .... ... Owner Robert. ..L.av ey.. Same Applicant .. .... CLASSIFICATION Install rear entrance door with roof over same, . ............ ........ Permit issued on above Application. 9-5-67 Date, 19 .. Ov Swum NVIND" . j BUILDING PBRUIIT v Date Sept.5, 16 Fee Paid 2.©0 fiat. Value $. .154.01 ;e Permit 6124 s a s t Side of on the - ma in Sal et x 1658 Street No. .; y Owner Robert Lavey Applicant Same CERTIFICATE OF OCCUPANCY ISSUBD Date y v ' No. = t . . Fee Paid $ V ` CATIO Install rear entranoe door With roof over same, BUILDING PERMIT N° 6124 OFFICE OF THE BUILDING INSPECTOR of the Town of South Windsor, Conn. South Windsor, Conn, 3e»t`%* 1967 94is to to Terfif1j.9 That R aber t Layey is hereby granted permission to install rear sntraws door with roof over same. at estimated value of $15() 0 C) on the east side of Main St, #1658 Street on land owned by Robert LgVeY Said work to be as described in Application No. 6394 and to conform to specifications and plans filed with said Application, and Building By- Laws of THE TOWN OF SOUTH WINDSOR. Issued 890*5 s 1967 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." Application No. 73310 Permit No. 7030 TO THE BUILDING INSPECTOR bf the TOWN OF SOUTH WINDSOR, CONN. Vk hereby make application for a permit to 44teet- (make alteration 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 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., ?.. .... ./................ 19.......°. Signhere ........... ........ .......... .................................................. ................... Address ... l 6.s~.�......�.�..�"' .S..... ............. Location? . ... ... ..........I.............. . .........................................side of? .................................................................................................................... Nearestcross street? ...... ...... ................... ...... .................................Street No. ... .. . ........... . .............. Lot No. .. ....... .............. . s s_ 2st Ownerof land is? .............. .......... . ..........................Address .....�........... ..............................`:`:"......�.�`..- ............. ...... Owner of building is? ..� . ... ..........Address �..6. '� 7'd �7`— .................................................................. Architectis? ........ .. . ................................................ .......................Address . ..................................................... ................ ........... ................... Builderis? ..... ....................°'.....................................`°...............................Address .............. .... [...........................................`r.............................. ........... �z� Dimensions of building? .. Feet front? ....... Feet rear? ..... . ... ..... Feet deep? .. Extreme height to highest point of roof? ...... .. .... ........... No. of stories in height? . .. .. cam p Purpose of building is? .... .. .. .........................................................No. of stores? .. ................ ...... Howmany families.xn......... ................................No. of rooms? .... .......... .............. ........................................................... Distance from street line is? . .. ...... . .............................from building line is? . .... ....... .... ADDITIONS AND ALTERATIONS (Give Brief Description) C , '..........................................- .. .,..........�............�L:`:.`�.!- .... r.................. ........... ....... ................. -.................................................................................................................................... ................ . .............................................. ............................................... .. . ....... ....................... ... ........ .... ..... ......... .... ..........._.................... 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 He*bt Stories Front Walls Side Walls Rear Walls Partitlon Walls Basement, ............................ .........__......................................................................._........._................_..__.........._....................... ................... .............. ........................................................... 1st Story ... .................... ............................................................................................................................................... . ...................................... . ....... ......... ...... .................... 2nd " ... ........................ ........._......._.........._...................... ........._.................................................................... .. ......... ..................... .... .............. .. .............. . ...... .. 3rd " ....................._...... ............_...................................................... .......................................... ..................................... ,................................... .......... .. ...... .. ........ ..... ............. 4th . ........ .... .. . .........._...................................................... ............................................,......................................._................................. ............. ........ ... .. ............ . 5th ................... .... .............. ........................._....... ................ ........... ......................... ,........................_.. .................................... ....................... . ............................................ 6th is ... .. ........ .............. ......_................._......................................................... .... .........................._.......... ... ........... ................ ....... ........... ........ ......................................... 7th " ... .................... .. . ........................................ . ........... ..... ..... .. . ..... ........ .. . . ........................ .... ...... ..... ........ ... .............................. 8th so ............................................._.... ........................_....... .... ....... ........ .. .... .. ........., ....... ......... ..... . ... ..... ... ............. ...................... 9th ....lOt.... 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 Joists.. Girders and Columns JOISTS GISDIMS COLUMNS Floors Size Longest Span Centres Bridging Size Longest Span Centres Size long h Centres 1st Floor aria....;�.... .............. .................................. ............ ...... ........_.._ .................................. .................. .............. _..........__ _........_.....� ..tea.....,,..... .............. .................................. .................. ............_.. _................. . _....._.._.. __.._ ___....._...._ 4 .... ..... .............. ..... ................... .............._...._........._.. ....._. _...___ _...._...... ...._. r. Size of outside studs? .....'�......?j.;�.... ....... Distance on centres? ..............�.`.. ................. Size of sill? .......... ....' ... �� /c Size of rafters? .... ...X.. ............ Distance on centres?.......... .... .................. Size of plate? ........ '� .•Z.......... ................................... Size of ledgers or girts. ... ................. Size of deck afters? .. ............�....................................... ............... Distance on centres? ' ' 2 ................................. ..............................................Size of studs in bearing partitions? ........................ ........................ MISCELLANEOUS Style of roof, flat, pitch, Mansard, or hipped? . ... ............................ Fireplaces? ........................................................ Material of roof covering? .......�`. 'J...............X....I.. ........Material of Cornice? ..................................... ... ................... How is building heated? . .. .. ....Lining of flues? . .......... Thickness of shell of flues? . ......... ..................................................Any elevators or lifts? ........................... ............................. ...................... What kind? . ........ ... ....... How many? .... .. Any hoistwa How protected? � ......•• � .... .... . . ... ................. .................... ... ................Total Value of �tilding .. .... .,,�� ®.(�.......�.--� t \ When will work be commenced? . . +. !0... .................................... . .......... ................. 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 7030 BUILDING APPLICATION 7.330Application No. .. ......... .................................................... east onthe ... .............. ............. ... . ........... ................ side of Main St. .. . ........ ......... . .. ....... ..... Street. 1658 Street No, .. ..... . .. . .. . ......... Owner . .Robert W... Lavey. . Same Applicant CLASSIFICATION Close in existing porch to make permanent rooms and bath. . ............ ......... Permit issued on above Application. Date, 5-2.5-- 19 .7.0 i i TOWN OF SOUTH WINDSOR BUILDING PERMIT Date May �5' 19 70 Fee Paid $ . 12.00 Est. Value $.1500.00 Permit N° 7030 i i on the east side of Main St. Street Street N0.1658 Owner Robert W. Lavey Applicant Same CERTIFICATE OF OCCUPANCY ISSUED: Date No. 3 962 Fee Paid $ 3.00 CLASSIFICATION Close in existing porch to make permanent rooms and bath. BUILDING PERMIT N° 7030 OFFICE OF THE BUILDING INSPECTOR of the Town of South Windsor, Conn. South Windsor, Conn. My 25' 19 0 94io to to Terfif1j, That Robert We Lavey is hereby granted permission to Cloy© in existing porch to make pemanent rooms g.nd bath - at estimated value of 1500.00 on the east side of Main Ste #165 8 Street on land owned by Roburt W. Lavey Said work to be as described in Application No. 7330 and to conform to specifications and plans filed with said Application, and Building By- Laws of THE TOWN OF SOUTH WINDSOR. a May 25, �r 70 Iss-- d /y 19 „x uil g 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 # �� G Job 1 Footing i/- q- 7,0 2 Foundation 3 7! 3 Framing 3 - 2- 7 4 Wiring ��J 6 -i7- 71 5 PlumbingC��S—//— 72 6 Heating 7 Lathing 8 C.O. ,� � , I Permit No. 4 � TOWN OF SOUTH WINDSOR I SOUTH WINDSOR, CONN. I I I ' l\I Permit d. 3962 I Certificate of Occupancy I I I THIS IS TO CF4RTIFY th it th I at No/ 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. II 1 j Building Inspector r Owner, Builder I Fee Paid 0• Date 19 Permit No. TOWN OF SOUTH WINDSOR SOUTH WINDSOR, CONN. Permit N� 3962 i i Certificate of Occupancy THIS IS TO CERTIFY that the— at No. "f 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. I Building Inspector I • I Owner, Builder I Fee Paid4i 0 Date 19 JOV I I 4821 ELECTRICAL APPLICATIOR Application No. .....5132 ........5.1....32....................................................................... on the .....e.a.s.t.................... ................. ... ............... side of ... ....... ... .. ...... . Main St.. ... . .... ....................... ............... .. Street Street No. .1658. ... . ..... ....... .. ........... ..... .. .......... Owner RobertLavey . ......... ......... ......... ... ........... ... Electrician H.D.Lane FILED IN OFFICE OF The Building Inspector .... ........ ...4.-2.97.71.1.. .... ........ ... ... Wsprkviow. ............................................................................................................................................ ................................................................................................................................................. .............................................................................................................................................. AwNo 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. f APPLICATION FOR PERMIT TO DO ELECTRICAI. WORII. 5132 No. .. ......... .... ....... .. ... Permit No. . . .. TO THE BUILDING INSPECTOR of the TOWN OF SOUTH WINDSOR, CONN. ................. hereby make application M perform Electr cal Work according to detailed description below. All provisions of the Rules for Electrical Installation, Section 48, Building By-Laws, shall be complied with whether specified herein or not. South Windsor, Conn., ............ — ... . .. --,.,....,... ��....'.1.... 7/ .9. .... ....... 19.2,1. Sign here .......................... ir . =:.,._ ..... ........... Address %...3......... ..... 0 l � .f.�° .!.........1 Location ..................... ..c... ...................... ............... .............. ............ Side of ............ .....................�. -.:..........5�..�............ Natureof Building . ................................... ...... How many stories ............................................................................... ................. Newor old Building ................................... .............................. ........... . How many families ................................................................................................ Kindof Installation .................................... . ......................................... . How many Stores ..................................................................................................... Owner ..��..crll6..le- . ..v ' ... ).6.,'Y � //.y................2............................................ �..... .............. Address .. Architect ................................................ ... .... .. .. ..... ... .......... .......... ... Address ... .............. ..........................9................................._............................. Builder . 'LEL '1v�i.�....J '� i .; ....I I........ ...... .............. Address .. . ......... ....... .. ......... ................. ............. ................................ Electrician DAVIS H. LANE . Address .... ................................................................................................ . ................................................................. ... .................................. . .. ........ 1080 AVEE;Y STREET WAPPING, CONAzeORCMIn Wires .. ...................................................... No. of Light Loops ...................... No. of Heat Loops .. . .. .. No. of Power Loops f No. of Light Outlets ................... . ......... No. of Heat Outlets . . . . . .. . . No. o Power Outlets u ets .................. ... ...... No. of Light Circuits ........... .. ......... ..... 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 ....................................... ...... .............. .... . ...... No. of Cord Drops ...... ... .. ... ..................... ... ... ....... ........ .. Remarks: For other kind of Installation ...... ...........,,�........ . .... ....... .. ...../,..... .r ................. ... ........... ..... ....... .,........... ......... ................................ .... .... ... ........... .............._................................ . ...................................................... ....... .......I.. .... ......... ............................................................................................................ ...... .................... ........................................................................................................................ ..................................................................................................... .............................................................................................. .............. . ...... .. . ..... ........... .. Estimated Cost ............o u �'.............. ................... 17 PLUMBING APPLICATION Appiicaaon Noy on the............._...._ - aide of ........................................ Street No. . ... Owner ....___...._. Plumber .......___ Filed in O$ice of The Building Iaapoctor _.... 19 III CTmq. No penm AA crostnw, add w or alter mW portion of the drainage systenn of any boildmg (except to repair leaks) until a Plermit is wed by the Building Inspector. Application No. .......... Permit N . ...................................... 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, ................Q.... ...'.::�..��............... 19 1..... Sign},ere ......t .....:.... Address ......./......... �..... .. ... .. ............57'� 11/ Location .......................................... ................................................................... side of ...................................................................................................... Street Natureof Builc ng ....... � � ''.. ............................................ How many stories .. ................................. .. ................. ................................ r p.,�. ,� Owner ..................t� ... . �..................... Wit....... Address ..... ........ ).. ......................�- 1................ Ne ArchitectAddress ................................ �.................. ..................... Builder �— / �" ` Address ..J.( 4. Plumber ...................................................................................................................... Address ....................................................................................................................... DRAINAGE CESSPOOLS, How many ............... ................................ .................... Where located ............1. .......-. ............................................................. Are they water tight ................../.. Z.._.................................................. Of what materials are they built........ ..... .....h.•�1.L- Size of pipe from house to cesspool ............L�.............................. Kind of pipe ............... .... .................................-.......................................... MAINDRAIN IN CELLAR, Material ; �...,.... Diameter .....................�...�.�.................................................................... Aboveor below cellar bottom ........... t.T...4.. ..... ....................................................................... ..... ...................................................................... SOILPIPES, Material .. .... ... ...�'...1..: ....................... ............... Diameter ............. �..... .......................................................................... WASTEPIPES, Material ........((' ................................... Diameter ..............�..,................................................................................. TRAPS,Type proposed to use is .... ........ ................. .. ... ... .......................................... .................,11....................... .............................................. f— _> RAIN WATER LEADERS, where do they run to .................. 117:.............. .........................................:.................... ..................................... REFRIGERATORWASTES, where do they run to ........ ... .......................................................................................... ........ ............................... TANKOVERFLOWS, where do they run to .. .................................................................................................................................... FIXTURES WATER CLOSETS, How many . . .............. . ... Where located .... r Distance from trap to vertical soil pipe ........................................ Pattern ................ .. ...... ....................................................... WASHTRAYS, How many ............................................................. Where located . . . ........................ ...... ............................................... SINKS, How many ............... ... ................................................................ Where located . ... ........... ....... ..........:................................................. BUTLER'S SINKS, How many ........................................................ Where located .................................................................................................. REFRIGERATORSINKS, How many ....................................... Where located ................................................................................................ LAVATORIES, How many ................................................................... Where located .................................................................................................... BATHTUBS, How many ............................ .......................................... Where located .................:............,.........A...........::.............................................. URINALS, How many .................. ......................................................... Where located ........ .......................................................................................... Are water closets and urinals to be local vented ,y-��' If not, is there a window in outer wall ofroom where same are to be located . ....... . ... .................................................................................................................I................ Estimated Cost...... 2 . v . ab ..................................................... ';s. �',. : -` _ \z•, 't -_ _ f q.a:�, ,Y. _ 4 `3:3 46 Application No. ...... ............ . ....... pennk No.' ..............•w. TO THE BU I DING INSPECTOR of the ` TOWN OF SOUTH WINDSOR, CONN. . ....... hereby make application for a permit to (erect (make alteration 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 case may requires) All provutoM of the Building By-Law: (Sections 2 to 32 inclusive) fall be complied with in the eucu- tion of this work whether specified herein or not. South Windsor, Conn., ................... ..31 19 _,�► 4 Signhere .......( .. .. ...... ......._...... ................... Address .............................................. ......... . ........._...... "At&AAA Location? 11—E.............. . .......... ...............side-of? .......�. ............................................................... Nearest cross street? .................. ..�lr ............... .Street No. . ... ......... Lot No. ........... M...'....... . .. Ownerof land is? � Address........... ............................................ ........................................................................................... ..................... Owner of building is? '�.............................................Address Architectis? .. ..... ............... ...................................................... ......................Address ... .............. Builder is? . . ..... ........507 ......................................._.........._._.._.......................Address Dimensions of building? .. ... ...........Fat front? ............. Feet rear? ............... ........... Feet dap? . Extreme height to highest point of roof? ...... .... ... ............ No. of stories in height?....... .... . Purposeof building is? ..................................................................................No. of stores? ......................... ..................................................... ...... Howmany families? . ..............................................._._.............................._.No. of room.s? .... .................... ..................................... ....... .. ............. Distance from street line is? ... ........... ... .....................................from building line is? . ..... ....... ADDITIONS AND ALTERATIONS (Give Brief Description) ........... ............... .. ... ......... ................................. ....................�.............�........................ .. ................. ..................... ............................. e......................... .............. .. .... ........ .. ....................................... ................... .................... ................. ... ........ ...................................... ...... t ..... �,. .�.. Map No. 3 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? . .... .... .... ............I..................... ..... Compositionof mortar? . ......... . . ......... ........... .......... .. .... .............. .............................. . ...... ...... ... ... Height and Thickness of Walls Height Stories Front Walls Side Walls Rear Walls Partition Walls Basement, __....... .........1st.Story.............. ................................. ...................................................................... .................... ................................ . .. .................. . . ................................................................................................................................................. ... .................................. ......... ....... .. ...... .......... 2nd " ...................... ..............._.................._........._...... ....... ............................................................................. ..... .. ......... ....................... . .............. .... ................. ...... .. .......... . 3rd " ................. . .. .... ................................................. ............. ........................................ .......................................... ,..................... . . ... ...... .......... ........... .... .... .... 4th " .. ............. . . .................................................. ... .... ..................................... .....,.............................................. ................... .. ........... ...... 5th 11 6th " .._................................. ... ......... _. ........ .. ..... .................................. .... ... ......... ..... .......................................................................................... 7th " ........... .. ........ .. ... .... .............................. . ............. ........... ................... ,............ .... .. ..... .......... ............................ . ............................................. 8th " ......................... ............_........ ............................. .. .. .... .... ... ............. . ..................... 9th " ...................................... ......10t. ...... . . .......... .. ...... ....... ............... ... ........ ............ Material.of Front? ..If stone, what kind? Thickness of Ashlar? .Thickness of Backing? Backed up with what? Arches or lintels over openings? "k, , -4 N Y 7-wo"OD, CONSTRUCTION G m, Sim, -1.6agoal"o 1W AC401tra'"d Ah" of i4W Jown Long"& 8P.Mvestm awgiog am on idngft Omdm WE Floor ..................... ... itw....;; .............. ............. sin Of outside studs?.......................................... Distance on centres? ................................................. of I"? ...................................... Size of rafters? ........................................... Distatwe on centres?................................................... Size of plate? ..... ................................ Size of ledgers or girts? ................................................................................SiU of deck rafters? .........I........I.............................................. studs in Distance on centres? ..............................I.........................................................Sin of .............................................. MISCELLANEOUS Style of roof, flat,pitch,Mansard,or hipped? ........ ........... ..... .................................... Fireplaces? ........................................................ Material of roof covering'. .......................................................... ...........Material of cornice? ....................................................................................... Hw is building heated? ............... ...........................................................Lining of flues? ... ............................................................................... .............. Thickness of shell of flues? ........................................................................Any elevators or lifts? ........................................................... ..................... What kind? ............. ............. ... ............ How many? ........ Any hoistways? ...................... ........................... How protected? ..... ......... ..................................................... .................Total Value o uilding .. .... ............. ........... ........ K5). Whenwill work be commenced? ....... .. ................................................................................................................................ ................. 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 7678 BUILDING APPLICATION Application No. ....79 7.8................................................... on the ........east ....... Main St. .... ........... Street. 1658 Street No, . . . . . ......... Owner . ... Robert Lavey ... .... . . .. Applicant S ame CLASSIFICATION Convert existing porch into extension for kitchen 6tx10t and add room 61x8t . .......... ......... Permit issued on above Application. Date, . 5-26-72 19 . . . 4. TOWN OF SOUTH WINDSOR BUILDING PER UT Date May �5, 19 72 Fee Paid $. 4.'.00 Est. Value ,$.400.00 �4 p� Permit y p 7678 , 4. on the east aide of Main St. Street Street No. 1658 Owner Robert Lavey Applicant Same CERTIFICATE OF OCCUPANCY ISSUED: Date No. Fee Paid $ CLASSIFICATION Convert existing porch into ex- tension for kitchen 61x101 and add room 61x81 . 1 A BUILDING PERMIT N° 7678 OFFICE OF THE BUILDING INSPECTOR of the Town of South Windsor, Conn. South Windsor, Conn. May 26 1972 94'to to to Ter#tfu, That Robert Lavey is hereby granted permission to Convert existing porch into extension for kitchen 61x101 and add room 61x81 . at estimated value of $100-00 on the east side of Main S t. #165 8 Street on land owned by Robert Lavey Said work to be as described in Application No. 7978 and to conform to specifications and plans filed with said Application, and Building By- Laws of THE TOWN OF SOUTH WINDSOR. Issued May 26.9 i9 72 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 CONNECT I C UT: "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 compeller: to reason therefor." H Qct PTO THE BUILDING INSPECTOR of dim APPLICATION FOR TOWN OF SOUTH W94DSM MW PLAN EXAMINATION AND BUILDING PERMIT z IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O ZONING • AT (LOCATION) A DISTRIC ' LOCATION (NO.) (STREET) OF BETWEEN AND BUILDING (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE V1 II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D —I �v A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use rn rn 1 EP-New building Residential Nonresidential 2❑ Addition(1/residential, enter number 12❑ One family 113❑ Amusement, recreational of new housing units added, i/any, Enter 19 Church, other religious in Part D, 13) a 13 Two or more family -number of units- - - - -► ❑ 20❑ Industrial 3 ❑ Alteration (See 2 above) 14 l t l t t h i Transenoe , motel,❑ 21 ❑ Parking garage 4❑ Repair, replacement or dormitory - Enter number 5❑ Wrecking (1f multifamily residential, of units ------- --- 22❑ Service station, repair garage enter number of units in building in 15❑ G�ge 23❑ Hospital, institutional Part D, 13) 6❑ Moving (relocation) 16 arport 24❑ Office, bank, professional 7 ❑ Foundation only 17❑ Other - Specify �- 25❑ Public utility 26❑ School, library, other educational B. OWNER P �'` N �E�a 14— 27❑ Stores, mercantile 8 Private (individual, corporation, 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................ S JrQv •pt 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 $ 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❑M s my (wall bearing) 40❑ Public or private company 48• Number of stories............... 0 31 ood frame 41 ❑ 49. Total square feet of floor area, Private(septic tank, etc.) all floors, based on exterior 32 Structural steel dimensions .................... 33❑ R inf rced concrete H. TYPE OF WATER SUPPLY 34❑ Other - Specify 42❑ Public or private company 50. Total land area, sq.ft. ........... 43❑ Private(well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES F. PRINCIPAL TYPE OF HEATING FUEL 1. TYPE OF MECHANICAL 51. Enclosed ....................... 35❑ Gas Will there be central air 52. Outdoors....................... %❑ Oil c nditi ping? L. RESIDENTIAL BUILDINGS ONLY 37❑ El ctricity 44❑ Yes 45 No 53. Number f bedrooms.............. 38❑ C al 39❑ Oth r- Specify Will there be an elevat rVN 54. Number f Full.......... 46❑ Yes 47 bothr ms Partial........ NOTES and Data — (For department use) IV. IDENTIFICATION — To b completed by all applicants Name Mailing address — Number, street, city, and State ZIP code Tel. No. Za vz /�S`� -f a C3 2 Owner or �OZ ;-a� Lessee 2. &AA Contractor 3. Architect or Engineer The owner of this building and the undersigned agree to conform to all applicable laws of this jurisdiction. Sign" a of applicant Address Application date aJ-,- S 74-- 7,� b4-OO NOT WRITE BELOW THIS LINE V. PLAN REVIEW RECORD — For office use Plans R view Required Check Plan Review Date Plans By Date Plans B Notes Fee Started Approved y BUILDING PLUMBING MECHANICAL ELECTRICAL OTHER VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Permit or Approva I Check Date Number By Permit or Approval I Check Date Number B Obta ined Obtained y BOILER PLUMBING CURB OR SIDEWALK CUT ROOFING ELEVATOR SEWER ELECTRICAL SIGN OR BILLBOARD FURNACE STREET GRADES GRADING USE OF PUBLIC AREAS OIL BURNER WRECKING OTHER OTHER VII. VALIDATION Building 8698 Permit number Building Permit issued Nov. 19 74 Bui Iding Permit Fee $ 4. 00 Approved by: 1 � Tf LE VIII. ZONING PLAN EXAMINERS NOTES DISTRICT USE FRONT YARD SIDE YARD SIDE YARD REAR YARD NOTES IX. SITE OR PLOT PLAN — For Applicant Use ,. ,_ °�..e--s-4�v �` ?"�t Y "'§�• '_i t .,.�"� 3,. 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Value $. .50.0,00 Permit NO 8698 on the side of Main Street Street No. 1658 Owner Robert Lavey Applicant Robert Lavey CERTIFICATE OF OCCUPANCY ISSUED: Date No. Fee Paid $ CLASSIFICATION Storage Shed BUILDING PERMIT N-1 8 6 9 8 OFFICE OF THE BUILDING INSPECTOR of the Town of South Windsor, Conn. South Windsor, Conn. Nov' 6 19 74- t to to Terttf1j, That Robert Lavey is hereby granted permission to Build storage shed for tractoro at estimated value of $ 500 00 on the side of 1658 main Street Street on land owned by Robert Lave' Said Work to be as described in Application No. 8998 and to conform to specifications and plans filed with said Application, and Building By- Laws of THE TOWN OF SOUTH WINDSOR. Nov* 6 00 19 74 Issue � QF ildi 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 compeller: to reason therefor." PA/Al/ INSPECTION REPORT Permit Job 1 Footing '- 2 Foundation 3 Framing 1-2-If-7*,- 4 Wiring 5 Plumbing 6 Heating 7 Lathing 8 C.O. 2-1700oo9 CIA 00", Page S TOWN OF SOUTH WINDSOR, CONNE CTICUT HISTORIC DISTRICT COMMISSION CERTIFICATE OF APPROPRIATENESS Ctf. No. Date Issued i ?7(/ This certificate of appropriateness is issued for work described in application for Certificate ofjAppropriateness Number dated f n property located at Location of Property Owner C; Person doing work )12 This certificate is issued under the conditions hereinafter indicated: J,,:"-�Application approved as submitted --- Application approved with stipulation(s) or Modification(s), as noted below: Comments: I Signed: --- Clerk, Historic Dist. Comm. This block for Building Inspector use only. This certifies that the work herein described has been completed in compliance with the terms specified. Attest Date of inspection Building Inspector Date Page 5 TOWN OF SOUTH WINDSOR, CONNECTICUT HISTORIC DISTRICT COMMISSION CERTIFICATE OF APPROPRIATENESS Ctf. No. J Date Issued ?X- This certificate of appropriateness is issued for work described in application for Certificate of Appropriateness Number 2 dated / S r,C on property located at Location of Property Owner --�� T Person doing work —�- This certificate is issued under the conditions hereinafter indicated: Application approved as submitted --- Application approved with stipulation(s) or Modification(s), as noted below: Comments: 74 e� 117 ,Signed:, --- Clerk, istoric Dist. Comm. This block for Building Inspector use only. This certifies that the work herein described has been completed in compliance with the terms specified. Attest Date of inspection Building Inspector Date TO THE BUILDING INSPECTOR of dw APPLICATION FOR PLAN EXAMINATION AND TOWN OF SOUTH W COS BUILDING PERMIT IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O 1 b"S 6 M A ) J �Q� ZONING �_�D • AT (LOCATION) 1� 1 'v 1� " DISTRICT LOCATION I (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 �v A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use M 1 ❑ New building Residential Nonresidential 2 F' Addition(1/residential, enter number 12❑ One family 18❑ Amusement, recreational of new housing units added, i/any, 13❑ Two or more family — Enter 190 Church, other religious in Part D, 13) number of units— — — — •-jo- 20❑ Industrial 3 ❑ Alteration (See 2 above) 14 Transient hotel, mote , ❑ T i h ll 21 ❑ Parking garage 4 ❑ Repair, replacement or dormitory — Enter number 5 ❑ Wrecking (If multifamily residential, Of units ——————— — --10. 22 ❑ 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) 7 ❑ Foundation only 17 Other — Specify 25❑ Public utility 26❑ School, library, other educational B. OWNERSHIP 27❑ Stores, mercantile 8 Private (individual, corporation, l r 28 ❑ Tanks, towers nonprofit institution, etc.) 29❑ Other — Specify 9 ❑ Public (Federal, State, or local government) X 20 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,,.,....,,••,,,• 1:zi,�oO 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 S 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❑ 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 F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed ....................... 35❑ Gas Will there be central air 52. Outdoors........................ 36❑ Oil conditi ping? L. RESIDENTIAL BUILDINGS ONLY 37❑ Electricity 44❑ Yes 45❑ No 53. Numb r of bedro ms.............. 38 ❑ Coal 39❑ Oth r— Specify Will there be an elevat r? 54. Number of Full.......... 46 0 Yes 47❑ No bathr oms Partial........ NOTES and Data — (For department use) IV. IDENTIFICATION — To be completed by all applicants Name 1 r Mailing addr ss — Number, street, city, and State ZIP cod T I. No. LAPOwner or 0(002-8 Lessee 2. 'h .t, Gt�• Contractor 3. Architect or Engineer F T F Th own r of this building and the undersigned agree to conform to all applicable laws of this jurisdiction. Signature of applicant Address Applicati n date s Yr. eeZZ2 �- 00 NOT WRITE BELOW THIS LINE V. PLAN REVIEW RECORD — For office use Plans R vi w R quired Check Plan Review Date Plans By Date Plans B Notes Fee Started Approved y BUILDING $ PLUMBING $ MECHANICAL $ ELECTRICAL is OTHER Is VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Permit or Approval Check Date Number By Permit or Approval I Check Dote Number B Obtained Obta ined y BOILER PLUMBING CURB OR SIDEWALK CUT ROOFING ELEVATOR SEWER ELECTRICAL SIGN OR BILLBOARD FURNACE STREET GRADES GRADING USE OF PUBLIC AREAS OIL BURNER WRECKING OTHER OTHER VII. VALIDATION Building Permit numb r __ 9621 Building Permit issued Dpc_ 7 19 76 Bui Iding Permit Fee $ 4-Qn Approved by: 1 ' ICY., TITLE VIII. ZONING PLAN EXAMINERS NOTES DISTRICT USE FRONT YARD SIDE YARD SIDE YARD REAR YARD NOTES IX. SITE OR PLOT PLAN — For Applicant Use 71 N TOWN OF SOUTH WINDSOR ' r BUILDING PERMIT Date Dec. 7 , 19 76. 400 Fee Paid �$. . Est. Value $. .500.00 Permit NO 9621 on the side of Main Street Street No. 16 S 8 Owner Robert Lavev Applicant Barbara Lavev CERTIFICATE OF OCCUPANCY ISSUED: Date No. Fee Paid $ CLASSIFICATION Lean-to BUILDING PERMIT IC* ' S 6 21 OFFICE OF THE BUILDING INSPECTOR of the Town of South Windsor, Conn. South Windsor, Conn. Dec• 7 19 76 94ifta i'a to T erflo f ji, That Robert Layey is hereby granted permission to 40' x 24' Lean-to added to existing garage* at estimated value of on the side of 1658 Main Street - Street on land owned by Robert- Lave-v Said Work to be as described in Application No. and to conform to specifications and plans filed with said Application, and Building By- Laws of THE TOWN OF SOUTH WINDSOR. Issued Doc• 7 :ldin'g 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 dry, town or borough all costs and damages which it shall sustain, or be compeller: to reason therefor." AV7� 7?`Z:a�-,4�39 �le/K INSPECTION REPORT Permit #9Zc;7-1 Job r 1 Footing 2 Foundation r-- 3 Framing 4 Wiring 5 Plumbing 6 Heating 7 Lathing 8 C.O. Beoric# APPLICATION FOR BUILDING PERMIT Plumbing# 1658 MAIN STREET HVAC # 24890 Date: IhAe Sprinkler# No. FIM P Estimated Cost $ s s�.� BuildiM COMPLETE RED BOXED AREAS Permit Fee $ 7 Z ov i TYPE OR PRINT ONLY Occupancy Fee $ Affidavit SIGN ON REVERSE SIDE Appr.for CO. Total Fee $ 74 w TO BUILDWG DEPARTMEW,TOWN OF SOUTH WNDSOR,CT Additional Cost) $ The undersigned hereby applies to do work according to the following specifications: Jo6 Location_ 14" A4.,w ,41� Lot No. Side of Street Zone Applicant woeiwe �. /,c- Tel# (220 711-C,LVY Addr ss it t AAa Zip &0P Z- Lic.#_ oo,-0 3 S Z.,P Own r_ 4 A"r L.of-IJEY Address /,f9 i �Na 4, �/r_ 9-4l r Ai••a.vx Ace 4r oz o Architect Address Sq.Ft.N w Area: lst Fl 2nd Fl 3rd Fl Total New Area #Rooms #Lavatories #Bathrooms #Garages Purpose of this permit: jE - ,� City Water ❑ Well ❑ Septic System ❑ Sewer ❑ Ins. H.O. Cert._ Area Basement Garage Approved by Dat O Use Group Construction Typ R*vW 1/97 I hereby agree to conform to all the requirements of the Laws of the State of Connecticut and the Ordinances of the Town of South Windsor and to notify the Building Inspector of any alteration in the plans or specifications of the Building for which this permit is asked,and agree that this building is to be located the proper distance from all street lines,side yard lines,and required distances from all other zones and is located in which this building and its use is allowed. Signed I hereby apply for a Certificate of Occupancy for the work described in this application for the permit. Signed DO NOT WRITE BELOW THIS LINE INSPECTION COMMENTS DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT PERMIT# TOWN OF SOUTH WINDSOR Application is hereby: BUILDING DEPARTMENT APPROVED 1540 SULLIVAN AVENUE S✓ (� 644-2511 ext. 230 Bldg.Permit# Date Building Inspector Application must be printed or typed FEE SCHEDULE Location of Job: /6 �� �/1• i�' 95,r9&-&7- $0-$1,000=$13.00 Street No. Street Lot No. Over$1,000= $13.00 per$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANT APPLICANT ADDRESS / 7(ram 51)41 -rY mi APPLICANT PHONE# I OW N S�'4 OWNER OWNER ADDRESS ' r Q 4% OWNER PHONE C � *. U ESTIMATED COST$ `6,670 i IS THIS A CONTRACT COST? AkYes 0 No ' s G FEE ENCLOSED$ ��•OR C�� TYPE OF JOB: O 0 New Installation /�Alteration/Addition/Repair Revised 8/99 i 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 SERVICE `-2W;d. SIZE OF MAIN CONDUCTORS &P0M;.al e NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS NUMBER OF PANELS REMOTE DISCONNECT REQUIRED? ❑YES ❑NO NUMBER OF LIGHT CIRCUITS 4f NUMBER OF POWER CIRCUITS 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 IV 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. Z % CONTRACTORS LICENSE NO. TYPE STATE SIGNATURE OF APPLICANT ,1�' DATE 0 INSPECTOR IS- "� DATE lt ir7 TIME LOCATION INSPECTION: CODE: RESULT(D/A) : (o W a BUILDING: ELECTRICAL: PLUMBING: HVAC: OTHER: