HomeMy WebLinkAbout141 Lisa Drive 6_r
3,
4,
TO THEBUILDING INSPECTOR :
of the APPLICATION FOR
IrOVM OF SOUTH WIPWSM COS PLAN EXAMINATION A N D
J-
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, III, IV, and IX. O
ZONING •
• AT (LOCATION) j �� �-I sa �1-I ve DISTRICT r
LOCATION (NO.) (STREET)
OF BETWEEN 1 c.a AND
BUILDING ( OSS STREET) (CROSS STREET)
LOT E5
SUBDIVISION QIJV14a61r1 V, �ST. S LOT BLOCK SIZE ZX I(v9 X ...�.�.►
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D
A. TYPE IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
1 New building Reside ial Nonresidential
2 Addition(IJ residential, enter number
❑ 12 One family 18 ❑ Amusement, recreational
of new housing units added, it 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) 14 ❑ Transient hotel, motel,
21 ❑ Parking garage
4❑ Repair, replacement or dormitory — Enter number
5 ❑ Wrecking (IJ multifamily residential,
of units ——————— — —► 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)
17❑ Other — SpeciJy 25❑ Public utility
7 ❑ Foundation only
26❑ School, library, other educational
B. OWN SHIP 27❑ Stores, mercantile
8 Private(individual, corporation, 28 E] Tanks, towers
7
nonpr 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,,,,,,,,,,,,,,,, 97 000 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 e
a. Electrical...................... Q/T�� ?kAN A T
b. Plumbing ...................... �+
c. Heating, air conditioning.........
d. Other(elevator, etc.)............
11. TOTAL COST OF IMPROVEMENT $ 9
-7.0001
III. SELECTED CHARACTERISTICS OF BUIL ING — 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 0 SEWAGE DISPOSAL J. DIMENSIONS
30❑ sonny(wall bearing) 40 Public or private company 48- Number of stories................
31 D Wood frame 41 ❑ Private (septic tank, etc.) 49• Total square feet of floor area,
all floors, based on exterior
32❑ Structural steel dimensions .................... 1 l
33❑ Reinf rc d concrete H. TYPE F WATER SUPPLY
t 50. Total land area, sq.ft. ...........
34❑ Other — SpeciJy 42 Public or private company
43 ❑ Private(well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES h
F. PRINCI AL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed ....................... oC...•
35 s Will there be central air 52. Outdoors.......................
36❑ Oil conditioning?
L. RESIDENTIAL BUILDINGS ONLY
37❑ EI ctricify 44❑ Yes 45 N 53. Number f bedr ms..............
38❑ C al
39❑ Oth r— Specify WIII th to be an I vator?
54. Number f
Full..........
46 El Yes 47 N bothr me partial......
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
I. J r C o607q 222-0 25
Owner or
Lessee
2. zz
Contractor
3.
Architect or
Engineer
The owner of th' building and the undersigned agree to conform to all applicable laws of this jurisdiction.
Si ature of a li ant Address Application date
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Re uired Check Plan Review Date Plans B Date Plans By Notes
9 Fee Started y Approved
BUILDING
PLUMBING
MECHANICAL
ELECTRICAL
OTHER
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval I Check Date Number B Permit or Approval I Check Date Number B
pP Obtained y pp 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
Vil. VALIDATION
Building
Permit number b b
Building
Permit issued 7T_//. 19
Building
Permit Fee $ 522.00
CD 3 .00
5 2 5 .0O Appro d b
TITLE ,
TOWN OF SOUTH WINDSOR
BUILDING PERMIT
Date 13 19 8
Fee Paid $. . . .,522.00 Est. Value $.87,000.00
Permit N° 16065
on the side of
Lot # 65 Sveet.
Street No. 141 Li--a T)riue
Owner aax t M111 Real ty,T;g c.
Applicant -Itain- Basques
CERTIFICATE OF OCCUPANCY ISSUED:
Date
No. 8248
Fee Paid •00
CLASSIFICATION
Single family dwelling
BUnDLNG PERMIT
N° 16065
I �
OFFICE
Q��Q Oi-Q
THE BUILDING INSPECTOR
of the
I \
Town of South Windsor, Conn.
South Windsor, Conn. 1987
94is 'to to (fertif-u, ThatDarrRMdt7jo .
is hereby granted permission to
at estimated value of 901). 0/�
y
on the side of Lot fb-i 141 Lian 1iriva Street on land
owned by SAMS sus above
Said Work to be as described in Application
No. 163b3 and to conform to specifications and plans filed with said Application, and Building By-
Laws of THE TOWN OF SOUTH WINDSOR.
Issued 1987
IT-U J%
rA Mj"q
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."
I
Fri- ,.1N�• Permit #
Electrician 797
Heating Contr. S'-&). 'PI.MQ. 4 14 Tq. # 6cr 31
Plumbing " OA R L.Tonl '-2ETTLiFM-0)1&7z # 7 Yff6
Oil Burner #
Certificate of Occupancy #d??
Sewer Permit �v.i 3�-�
`5�"`9/e FAM
INSPECTION REPORT E►-�
Permit # Job JD
1 Footing DA i �� A �"n/c- /�T.Y/Er✓ i
2 Foundation
3 Framing
4 Wiring - � �av-.fl rr el 4
5 Plumbing 7 �� ejq J._ 3—anl� �TT
�_6 Heating �Q S=Lt, Mgr.
:t8C-1...
thing. I of �O D
f ,Permit No. % ` TOWN OF SOUTH WINDSOR
SOUTH WINDSOR, CONN.
Permit N® 8248
Certificate of Occupancy �f
THI TO CERTIFY thane 4k,' T t.� -t��r (_
at No 17 i �� - <�- tin.the Town of �outh Windsor, Connecticut, has
been erected and completed in accordance with the uilding Code and Zoning Regulations of.,
the Town of South Windsor, and is hereby approve o/r upanc .
e
r Building Inspectiir
I .
Owner, Build r
Fee Paid , Date ! !025 19 F jr
. BUILDING PERMIT CHECK LIST
Applicant g
Cam- Permit No.
� Building
Address L- Date Submitted
Lot No, Reviewed by
Project Date
In accordance with the subdivision Regulations , prior to the building of
any structure on -a lot, a Topographic Plot Plan shall be submitted for
approval. The minimum requirements shall include :
Approved Denied N/A
1. Name, address & phone number of owner/
applicant.
2. Name, address & phone number of plan preparer..
3. Zoning information - i.e. zone, open spacer
fl oodway, etc.
v 4 . Plot plan at l" = 40 ' scale.
a. Subdivision reference, abutting
properties , etc.
b. Easements of record.
C. Lot description, bearings, distances ,
building- 1 ines, area, etc.
d. Contours, existing & proposed, 1 or 2 f{
—"'— —"'— interval where appropriate.
e. Building location with dimens ions .
Elevations of proposed finish floor,
garage floor & center line of road at
—' '—'— driveway.
f. Elevations of gravity drainage systems ,
—' sanitary & foundation drain at the
house and the street.
g. Tentative utility location gas, e.lectri,
water, etc.
h. Title block with name and address of
preparers, date appropriate c rtificatior.
' live seal and signature.
S . Sedimentation and erosion control.
6 . Special Planning & Zoning, Inland/Wetlands
considerations . (Plans on file w/Town Clerk)
BUILDING DEPT.
PZC
IWA CC
WPCA
OTHERS
Permit 4 A7R7
ELECTRICAL APPLICATION
Application No. 11293
on the side of
Lot # 65 Street
Street No. 141 Lisa Drive
Owner JMJ Construction Co.
Electrician Richard Barrett
FILED IN OFFICE OF
The Building Inspector
7116 19_87
INSPECTION.
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 Are
stops (if of wood) are installed. without a special
permit from the office of the Building Inspector.
Electrical Permit No. Ct ��7
...................................._
Master License No.
TOWN OF SOUTH WINDSOR Building Permit No. .................
BUILDING DEPARTMENT Date Filed -.. �.. ..... �.7
_ ... ...................................
Date Final Approval ................... ...........................
APPLICATION FOR ELECTRICAL WORK
Electrical Inspector
CC5),s� C,
ATION JOB OWNER: ...
JOB OG 1. 11..:. Between G ..
5...-) Side of ......� ........ .......... . and .............. ...................... ......................
Name of Building Owner s ....CQ- LSt.......... J Address ..,... I..S..�....... . 1.X..... ..... ............._....................
Ifwork 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 ' a Building Per ? �? . Permit Fee .. ...... ... .......r............... ..............................................................................
.....
(If no Buildi Per(m-i� &q>7
Permitte C . Business Address �V.. -1 � x... elephone .� �
COST OF INSTALLATION: . ... ... ��` QU....L�....... ......................................................................................................................................................
_.
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 ❑ Air Conditioner ❑ Oil Burner ❑
TYPE RATING NO.
Dish Washer ❑ Gas Burner ❑
Range . . . • • • • • Well Pump ❑ Elec. Heaters ❑
Range Top . . . . . .
Owen . . . . . . . . REMARKS: `
Water Heater . . . . W (( L,4_ Q S P42r
S
Clothes Washer . . . . 9 1
Clothes Dryer . . . . . . -S,
Dish Washer . . . . . .
Air Conditioning Motor . .
Oil Burner Motor . . . .
Gas Burner . . . . . .
Circulator Motor . . . .
Attic or Large Fan , , ,
Well Pump . . . . . .
Electric Heat . . . . .
Other . . . . . . . .
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 b-e ................................ .A- r��r... . . _.___.
e-7i
PLUMBING APPLICATION
Application w 714-5-
on the ......_.........--
Side of
_... o ...W/ _...._
Street No. ......�
1
Plumber .&.R L Z2L)- R
Filed in Office of
The Bu;l&mg Impactor
qd i9e-7
..................................
...............................
......................................
No person shall oomtroct, add to or abet MW
portion of the dm*p qju= of ay bu&&g
(except to repair lea6) until a Bptm t is owned
by the Building Ins amw.
APPLICATION FOR PLUMBING PERMIT (Continued from R v rse Side)
TOWN OF SOUTH WINDSOR, CONN.
11. LOCATION OF JOB
NO. STREET FLOOR APTAO.
GENERAL PLUMBING
,/� 9 L
12. KIND OF INSTALLATION 13. SIZE OF MAIN DRAIN I
14. NO. OF TOILETS _.STYLE /�� �T./� 15. NO. OF URINALS STYLE
16. NO.OF BATHTUBS 17.NO.OF LAVATORIES _ 18. NO.OF SINKS 19. NO. OF WASHTUBS
20. NO.OF CONDUCTORS — SIZE 21. NO. OF STACKS.1_SIZE
22. AREA OF ROOF 23.NO. OF CATCH BASINS — 24. NO. OF FLOOR DRAINS
25. NO. OF OTHER FIXTURES , KIND _� we /
26. ARE TOILET COMPARTIMENTS VENTILATED TO OUTER AIR BY A WINDOW?_ 27. SIZE OF WINDOW
28. IF NO WINDOW, WHAT KIND OF VENTILATION IS THERE?
29. SIZE OF DUCTS 30. ARE SEWAGE AND WATER FACILITIES AVAILABLE?
SIGNATURE ~ - ADDRESS .S�Z T��r����� ✓f' L�'Ll�
LICENSE NO. 20,ZO" ESTIMATED COST TELEPHONE
OWNER r ADDRESS
WATER HEATER
31. TYPE z 32. MANUFACTURER
TANK SAFETY DEVICES
33. CAPACITY �'� 37. TEMPERATURE RELIEF VALVE I o 4
f l0 �_r 38. MANUFACTURER_ �����-f
34. TEST PRESSURE_35. WORKING PRESSURE !7�>
U//! 39. PRESSURE RELIEF VALVE
J
36. TYPE xl�'4 J f l"'-,- f 40. MANUFACTURER J�l/
ALL WORK COVERED BY THIS APPLICATION HAS BEEN AUTHORIZED BY THE OWNER OF THIS PROPERTY
AND WILL BE DONE IN STRICT ACCORDANCE WITH THE BUILDING CODE.
CZQ�CD962 ATE SIGN j RE OF LICANT
::7445)6 PERMIT #
Application For
• °' DEPARTMENT DECISION 4931
Heal Permit
APPLICATION IS HERESY: DEPARTMENT OF LICENSES AND INSPECTIONS
❑ OISAPPROYEO
O APPROVED TOWN OF SOUTH WIN DSOR
.9 �
W A/ OATg cuar wwACTOw A►KKATION. 0091 .t V8WT99 ON TT►.N. •[CHI WIN MYM.[w ONE ones
•p '
.� 1. LOCATION OF JOB
.T
LOT NO. /LOON AST. N0.
O
s. OWNER ��- ram• // �R lT
S. ADORES:
7L� 4.tNONE
S. APPLICANT
7 T yr
O. ADDRESS
�.PHONE
g
•. LICENSE NO. �/ U
•. EXPIRATION GATE OF LICENSE
10. ESTIMATES COST • �d U.o o
*+ It. IS THIS A CONTRACT COSTT
� a
02. FEE ENCLOSED
ts. TYPE OF SINLDINQ
OEf10E11T1AL ❑ C MNENCIAL
+� V IC. TYPE F SOS: ❑ INOYSTNIAL
►�y /�� ONICINAL n AFLTENATION
Jr C IN/TA11■T/AY , I sHf11TIffM
"AiCkfION iOit Al"lli G kLAkil" 64")
11. LOCATION OF JOB 'O c' Li 4 d J ' ✓`�
NO. STSSR /L+OOt WT.MO.
IL TYPE OF INSTALLATION: ❑ OIL BURNER ❑ ELECTRIC ❑ VENTILATION ❑ SFNNUU
GAS BURNER ❑ STACK ❑ moNERATOR MISCELLANEOUS
LOCATION SIZE
13. OF�TANK OF TANK OF FILL
14. B.T.U. EQUIP. AT REGISTER FURNACE MAKE AND NO. AT BONNET FIRING RATE
BOILER OR FURNACE MAKE AND NO. =,�. 6'424-.._B.T.U. OR SO. FT. NET '�' ^'B.T.U. OR S0. FT. GROSS — FIRING RATE
FLOORS TO BE HEATED_-/L)o NEW OR OLD BUILDING. INSULATED — YES OR NO
TYPE OF WALL INSULATION ROOF OR CEILING 12-1"1".1-6 INSULATION ��t..•%.r
AVG. SYSTEM WATER TEMP. >moo `� B.T.U./SQ. FT./HR. EMISSION
INDOOR-OUTDOOR TEMPERATURE DIFFERENCE rl`ev 'FAHRENHEIT
MAKE OF RADIATIO A OA COPPER/CONVECTORS. OR C.I. RADIATION. OUTPUT PER SECTION OR LINEAL OF RADIATION. S0.
FT. OR &T.U.
TO
OF WORK
�Y -� /�(�
is. BE DONEr �/r rl �i/ L��/V �J
01
t NGT LOW,SCHEDULE. (TO BE.INCLUDED FOR ALL JOBS):
Room uss w�MOOws AREA - SO LL
UAItE FEET �•T•�• IL T.LL DISTRIOUTI N INSTAED
AMo OOOas woLu�i ,�„ TWAL.
` w . i
woor wo. OLAM wR w Ce1las P60M GU.PT. AT W p ;` wwo.
III *Or: Tvpn AND use owas sL)es.rwnnwR
site
� ` INOM16T.
so. /T. pane wwt.
TOTALS
A. HEAT LOSS FROM BUILDING B.T.UJHL
B. DOMESTIC HOT WATER DEMAND —B.T.UJHR.
C. PIPING. OTHER THAN NORMAL LT.UJHR.
ALLOWANCE FOR HEAT VALVE OF FUEL (A B C) FACTOR
,,. aEeTIacAL WORK BY•_
NAMs Asomm
SUBCONTRACTON AND
is. THEIR TRADES
ALL WORK COVERED BY THIS APPLICATION HAS BEEN AUTHORIZED BY THE (OW- I OR (AGENT) OF THIS PROPERTY AND WILL
BE DONE IN STRICT ACCORDANCE WITH THE BUILDING CODE ^
PLICATION TO BE COMPLETELY FILLED IN. ��" /
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B N d n9 SPECTIONS: �� c4s,,e a; APPLICATION FOR BUILDING PERMIT
Plumbing
HVAC 141 LISA DRIVE Date: a
Sprinkler
Electric Estimated Cost $ DSO°n
Zoning
Permit Fee$
Affidavit NO. 20079 Occupancy Fee $
Eng. Dept. COMPLETE RED BOXED AREAS. Total Fee $ /o "=
Fire Dept. TYPE OR PRINT ONLY
Health Dept.
Approved for CO: SIGN ON REVERSE SIDE. (Additional Cost) $
TO BUILDING DEPARTMENT, TOWN OF SOUTH WINDSOR, CT
The undersigned, hereby applies to do work according to the following specifications:
Job Location `� Lot No. Side of Street Zone
Applicant
Z. Tel. # C� -62f-2
Address .�®a�`�� .f tdZ.V4rohF Zip 2"q � V Lic.#
STREET CITY STATE
Owner Address /!,'// 41�4 �&
Architect Address
Size New Area: Ft. Front Overall Ft.Deep Overall Total Area #Garages
Lavatories
Size of Lot Dist. from Street Line Bathrooms Rooms 1 st 2nd 3rd
Purpose of this Permit 7-0 Co ti c , or i X/ a 17-0,,f dG 61 4%A/9-0
City Water 0 Well D Septic 0 Sewer 0
11
Use Group A-A Construction Type lv
Approved by Date �� BD1A 11/88
I h reby agr a 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 Budding for which this permit is asked,and
that this building is to be located the proper distance from all street lines,side yard lines and required di nces from all other zo an is
located in a zone in which this building and its use is allowed.
Signed
1 hereby apply for a Certificate of Occupancy for the work described in this application for permit.
Signed
—DO NOT WRITE BELOW THIS LINE—
INSPECTION RECORD
Footing Framing
Foundation Fireplace/Chimney Insulation
Plumbing Permit# Inspections:
HVAC Permit# Inspections:
Electrical Permit# Inspections:
Sprinkler Permit# Inspections:
Inspection / Approval Date By Appl
Code Description Due Whom Code Comment
-------------------------------------------------------------------------------
92-20079-B 550
B10 FINAL 03/16/93 JFH A CLOSE OUT
Total Est Value 550
REINO E. HYYPPA a ASSOCIATES
CIVIL ENGINEERS 5 LAND SURVEYORS
GLASTONBURY, CONN.
(6;6,
'I
2254
I ,
65 A PL ism F\ ;
�r°Q°Sej rrJ.
(kv �cofi
r-5-2-• �c
LOT FIL-E TITLED,
gopEN S CU
R.CE . W'41��Qw,A;'JO ZONE
PLOT PLAN SECTIa 13 k� �K�T�Bti ;`
E5TAT E5 -%UT H
RnNo E. H"FPA t Assoc]A► F-S 5004-E
o w i80;8� I�..
111_40' DaTE:e,-� MAP-85 PREPARED FOR
SHEET Z O F 9 SHEET S REv.
..- INC
DART HILL REALTY
CERTIFIED ,,UBSTAN
TIALLl CDRRECT SOUTH WINDSOR, CONN.
SCALE'. C%40' ()ATE' -7- t- �
,i
V
JUL l 1992
south Windsor
BUILDING DEPARTMENT
F `"• amllnrlments stated in appfic
!"1"'c •�rYrf ! aw,a to c ornply with Y
_,tte 13WS ana ;uch orders is
S tta. '!"Ifding p„puwmAnt during p•n
µPPJJCa16dn and fin issuance of a 'a
a'.n le approved subject to the conctitiol, r"
s Fund —11nances regulating building shy,- :e
Ww d with.
-'-crklatonarly Approw4 These fcled
Owidlnr, 9nspector,
IYO' VV 79
Q64VICAT{ON OF ZONING COMPLMN!
Proposed bullding(s), use(s) and/or structure(
R wbst o as shown oa this plan appear(s) to be i r l
31+=D conformance with current South Wind 1.
8 1 Iregulations. Variances and special exception;:
tnay apply.
Date -r L o 1f L Z
ng Enforcement C",M
FuNAL INSPE NS: °�!�
Building a A LICA OR BUILDING PERMIT
Plum
HVA 141 LISA DRIVE Date:
Sprinkler
Electric i Estimated Cost $ 2 y°y
Zonin Permit Fee$ -10
Affidavit NO.
20790 Occupancy Fee $ -2
Eng. Dept. COMPLETE RED BOXED AREAS. Total Fee $ `�
Fire D pt. TYPE OR PRINT ONLY
Health Dept. SIGN ON REVERSE SIDE.
Approved for CO: (Additional Cost) $
TO BUILDI PARTMENT, OWN OF SOUTH WINDSOR, CT
The undersigned, hereby applies to do work according to the following specifications:
Job Location - I S Lot No. Side of Street Zone
Applicant Tel. #
Address / -= �a.�l rr LJ Ste' C_ Zip v t ®74 Lic.#
STREET CITY STATE
Owner Address S A M
Architect Address
Size New Area: Ft. Front Overall Ft. Deep Overall Total Area #Garages
Size of Lot Dist. from Street Line LavatoriesBathroo s Rooms 1st 2nd 3rd
Purpose of this Permit ,Z.v.ir,!g c t ZA7': oZ y
City Water 0 Well 0 Septic 0 Sewer 0
Use Group Construction Type LC
Approv d by Date ? Z� BD1A 1 1/88
iAlAl����
I hereby agree to conform to all th requirements of th 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
that this building is to be located the proper distance from all street lines,side yard lines and required di nces from a Ipper zo an is
located in a zon 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 ermit.
Signed
—DO NOT WRITE BELOW THIS LINE—
INSPECTION RECORD
Footing Framing
Foundation Fireplace/Chimney Insulation
Plumbing Permit# Inspections:
HVAC Permit# Inspections:
Electrical Permit# 1 Inspections:
Sprinkler Permit# Inspections:
Inspection Approval Date By Appl
Code Description Due Whom Code Comment
-------------------------------------------------------------------------------
93-20790-B 2,400
B10 FINAL 08/17/93 JFH D NO GATE MOTOR CORD LENGTH
B09 OTHER 08/30/93 JFH PROGRESS
B09 OTHER 08/31/93 JFH SENT LETTER
B10 FINAL 08/31/94 JFH A APPROVED FOR CO
93-12691-E 50
w 'R � S�CtA7ES K,
VE..1}. f ! t `Y"i.-!, .4* `x4•a`'� "'6:'+'4- `{�''e+'s31:.' ��'�-I`IN ' fir^„�gg ,�,�.:s'a�_.�a �;kS _ �; ti� 'e'�
;a t-,�. ,� ,�•„r,n' -i>r,` �' � ,,,l,,r>, '"J,.,• a�° ��^;�j_
h rz� :,�e a." ,y.•' �' d CONK
;A� ';-,: • ,}'_�; .� ,7.'{ .*4r at :y�, - 'a .n ., •,v,r' 'iyi-.- ..:q; ,y .,,v?.4 �4" ..� ',•Tr- t'"• 'xt-. ,�,'^n..,i'.r,�,;:a�'s.3 .'._^?t.�
STONBuRY.
}F� A �F w y°��-'a i r'�` -i� kk � Ley.-'ti•
I "
tF3 10 2,Z SQ" E 1 t
1 _
65 RE .F r
64 I ts", '
O
Ir1 0
Z 38
00
' c �
. ,�,_� yam• �' W 9c 1
Sr
'1 Stall
"^ L
r '
i
LOT LINES FROM MAP OW FILE TITLEO,
*OPEN SPACE 5IJeDIVISION A-30 ZONE
PLOT Pf:AIV 5EC1I0f.1 5 MOUNTAINVIEW
ESTATES 5OUTH WIND:5ORl C0wN'rBY
RnNo E.H'"PPA f ASSOCIAtES SCAJ-F
r=40* DATE:6_Z3-85 MAP No.180-66-IL
SHEET Z. OF 9 SHEETs Rfv. 2 z.%-8.o PREPARED FOR
HllLL ' .REALTY, ,-lN,, ,DART .
s,NT �c.Y ct�zREcT SOUTH WI NDSOR, 'CO�1N
`CFJZTI D T I l
Ft E �r .SUBS � ,� ','`
Jr•V!+`t'��..�i4, 'Sf n.��lf,.SR_'d ,�. -.+ tY• ,•f-�v��''�" ���-.x: +` .- � ,. ���ara ,�� ,` w7T <i.i�a"i¢'"�"'-�Ir .,,�T;�3�u�>s�''a'.�.�.n. ��. �p►��x ���� yxC
AtJ x:M .�+"r s� '"�tr 4�e;, ryY,{'l,'y`•,,i*na�,i, '� - t'" a� ".5CAL ` ��' ��� +'-r'••af_:+a'( r/�.'.�f- ♦ !"4 •� * �+
�r � �� �,�. � ��_, ,�a .' �. _I,"^..��� ,�'.`.`� �'r -a. .� it a#, .a " •+ .� ��� i
� N'-9..r a � k-� � � t .� ,�}'�f• :.'�'.+.ram;Y:�-i"�-s:dt�'�1ae _{Y�S�'�.,.n�"�,� ..�,�` m" ;p' "y�'. � � p,�'� L i
•dw �
Y Ye
J U l 2 1 1993
South Windsor
BUILDING DEPARTMENT
fhls certlir d th A i- plan ,rd ^;tl,�ns.,re trite
�npi,�s of the proposed building nr to be
-rected at
t�t SSA 9 4:-V s
tng,ther with amendments stated in application as+
filed with plan and 1 agree to comply with all zoninr
Ruilding and state laws ana snch orders as shall I,
issued by the Building Department during e r
of this application and final iss ante a b din>_
permit.
Signed ✓
This plan Is approved subject to the conditio.i that
orders and ordinances regulating building shall be
c^r pilod with
Condition.ilr Approve These filed with
_i
dit;g Inspect r Clerk
t'
' a v 7 �
Oate t � No.
CERTIFICATION OF ZONING COMPUANCE
2q Proposed building(s), use(s) and/or structured
as shown on this plan appear(s) to be in
conformance with current South Windsc
regulations. Variances and special exception
may apply.
Date
Z ing Enforcement Cff;^Ar
PERMIT u
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
Application is hereby : TOWN OF SOUTH WINDSOR
BUILDING INSPECTION DEPT.
APPROVED DISAPPROVED 1540 SULLIVAN AVENUE
- 644-2511 Ext . 230
ate ru Inspector Application must be printed or typed
1 . LOCATION OF JOB
FEE SCIIEDULE No . Street
$ 0 - $19000 - $10.00 Floor Apt . No.
Over $1 ,000 - $10.00
per $1 ,000 or 2 . OWNER L►-�'�P.��,Q �,�f
fraction thereof
3. ADDRESS
CT 71
4. APPLICANT
5. ADDRESS
6, ESTIMATED COST $
7 . IS THIS A CONTRACT COST
Ye No
8. FEE ENCLOSED $
-��7yO
9. TYPE OF BUILDING:
RESIDENTIAL COMMERCIAL
10. TYPE OF JOB :
Original Installation
Alteration/Addition/Repair
RD 3A 11/88
APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side)
11 . LOCATION OF JOB
NO. STREET APT. NO ,
12 . TYPE OF INSTALLATION lk"'�l�
13 . SIZE OF MAIN FEEDER
14 . NO. OF LIGHT LOOPS 15 . NO. OF HEAT LOOPS
16. NO . OF POWER LOOPS 17 . NO. OF LIGHT OUTLETS_
18 . NO . OF HEAT CIRCUITS 19 . NO. OF POWER OUTLETS
20 . NO. OF CONVENIENCE OUTLETS 21. NO. OF HEAT CIRCUITS
22 . NO. OF POWER CIRCUITS 23 . NO. OF LIGHT CIRCUITS
24. SIZE OF HEAT CIRCUITS 25 . NO. OF MOTORS
26 . NO . OF PANELS 27 . TOTAL WATTAGE
28 . NO. OF POWER FEEDERS 29 . NO. OF SWITCHES
30. A/C LOAD 31. SIZE OF POWER FEEDERS
32. NO . OF FIXTURES 33. TOTAL HORSEPOWER_
34. NAME OF SUBCONTRACTORS AND THEIR TRADES
35 . REMARKS AND FURTHER DETAILS :
y
LICENSE NO. SIGNATURE OF APPLICANT DATE
PHONE NUMBER:
September 69 1993 =27
�m
Jahn F. Hagan SEP 9 1993
Assistant Building Official
Town of South Windsor South Windsor
1540 Sullivan Avenue BUILDING DEPARTMENT
South Windsors CT 06074
Dear Mr. Hogan:
Thank you for your memo dated August 30ths regarding obtaining
a certificate of Occupancy for the recent above ground pool
erected on my property located at 141 Lisa Drive.
As a father of two young childrens I am always concerned when there
appears to be an unsafe condition. I have every intention
of complying with State and Town Codes. That's why I obtained a
building permit to make sure the installation was done
properly.
However: I must correct you on your comments of your visit
on August 17th stated in your memo. You never told me I had
two weeks to complete repairs. As a matter of fact, I told you
directly that we were away on vacation the next two weekendss
ands that when I return I will call you when the repairs
were completed.
We discussed three items needed completion for a CO:
* Shorten the electrical pump card to three feet
* Run PVC internally to the junction box and cover
* Put gate around fold up ladder or remove ladder and
close up pool .
The first two items have been completed. As we have discusseds
I will be building a deck in the spring which will have
a latched gate as required by code. In the meantimes the
pool ladders which had remained locked and posing no
safety hazards has been removed and the pool will be
prepared for winter close shortly.
In the springs I will complete the deck with an access gate
prior to the pool being opened and obtain the final CO as we
discussed. I will consider this matter closed until the
Spring of 1994. Thank you for your concern and understanding
of this matter.
Sincerely!
1 .
Gerald A. Daseel
141 Lisa Drive
s
s �
v
1540 SULLIVAN AVENUE SOUTH WINDSOR, CONN. 06074
AREA CODE 203/644-2511
,��SOR•CO��
August 30, 1993
Mr. Baseel
141 Lisa Drive
South Windsor Conn. 06074
Dear Mr. Baseel;
You are hereby notified that the following condition exists on the
property referenced above:
State Statute 29-265
Type of violation:
I stopped by your home yesterday to check the progress on the gate
for your pool ladder and the other violations you have. I had asked
you to complete the repairs to your pool installation with in two
weeks of my last inspection which was August 17 , 1993 . I gave you the
option to close your pool until you meet all code requirements . \
\
I will remind you again that you are in VIOLATION of your building
permit. When the permit was issued you signed that you under stood
all that was required for the installation of your pool and that you
had received our pool hand out. A Certificate Of Occupancy is
required by State Statute 29-265 which states it is unlawful to use a
pool without a Certificate Of Occupancy.
You have an unsafe condition that not only is a hazard to you and
your family but to your neighbors as well . All of this adds up to
extra liability for you as the home owner.
Corrective action required:
Please contact this office on or before September 9, 1993 . If the
required repairs are not done by this date I will turn this matter
over to the town attorney for further action.
If you have questions regarding this matter, call me at 644-2511 ext.
232 between 7 : 30 & 9 : 00 am or 12:30 & 2:00 pm.
Very truly yours,
. Hogan, Assistant Building Official
CTFD m+ArL -Pa93-JV-?--9�s
UMM STARS POSTAL SON=
OM ICML MISS
WIMHOW
_ MNr
AiM�M�is =r
PdrAL7Y'ON PINNATE
■wM ,.moo It e6w USE;SS00
MOW.
=I um p "Ift's'now.sddrsss,end aP Cods in the MOM below.
TO Building Department-Town Of South Wii
1540 Sullivan Avenue
r
8 : Compho item re d 1 and 2 when additional services aesired, and complete items
Put your addraes in the"RETURN TO"Spas on the reverse side.Faihne to do this will prevent this
tcard bumm radmrtoCradommalTmumfollowmaservices
.T� n,oslaa Rm you thenam�of the person delivered
are ava s ons po a er
for ea x es for additional samloo(s)requested.
1. R Show to whom delivered,,d and addressee's address. 2. O R(Extra c `chM�livery
3. Article Addressed to: 4. Article Number
Mr . Baseel P 293'143-985
141 Lisa Drive T of Service:
U South Windsor, GT Rpisterod ❑Insured.. 0 6 0 7 4 ®Certified ❑COD
❑ Express Mail ❑form Rhandise
Always obtain s*mft s of addresses
or agent and DATE DRIVERED.
I- FOoliverV
re -Addr r i 8. Add's Address(ONLYand fee paid)
re -Agent
.
PS Form 3811,Mar. 1988 +► LLS.GLA.d 1988-212-865 DOMESTIC RETURN RECEIPT
Bu Ad1ngNSP CTI s: APPLICATION FOR BUILDING PERMIT
Plumb'
HVA Date: IT
Sprinkler 141 LISA DRIVE
Electric Estimated Cost $ q,
Zoning 21450 Permit Fee$ /a -
Affidavit NO. Occupancy Fee $
Eng. Dept. COMPLETE RED BOXED AREAS. k-0
Fire Dept. Total Fee � /
Health Dept. TYPE OR PRINT ONLY
Approved for CO: SIGN ON REVERSE SIDE. (Additional Cost) $
TO BUILDING DEPARTMENT, TOWN OF SOUTH WINDSOR, CT
The undersigned, hereby applies to do work according to the following specifications:
Job Location Z411 Zl,rd 166wa' Lot No. Side of Street ZZone
Applicant Tel. #
Address A4 ✓4r al X/^o,f,,d Cr Zip 007 V Lic.#
STREET CITY STATE
Owner Address
Architect Address
Size New Area: Ft. Front Overall Ft. Deep Overall Total Area #Garages
Lavatories
Size of Lot Dist. from Street Line _Bathrooms Rooms 1 st 2nd 3rd
Purpose of this Permit ,10 4&�Q /J6c k dAl Oyiva "�2197_ QP fe=f;
City Water 0 Well 0 Septic 0 Sewer 0
Use Group Construction Type
_jV(4c Approved by Date at BD1A 11/88
I h reby 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 th 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 z and is
located in a zone in which this building and its use is allowed.
Signed
-
I hereby apply for a Certificate of Occupancy for the work described in this application for permit.
Signed
—DO NOT WRITE BELOW THIS LINE—
INSPECTION RECORD
Footing Framing
Foundation Fireplace/Chimney Insulation
Plumbing Permit# Inspections:
HVAC Permit# Inspections:
Electrical Permit# Inspections:
Sprinkler Permit# Inspections:
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PL_oT PLAN 5Ec.TICXj 3 MOUNTASNViEW
ESTATES SOUTH YIIINDsOR,CDWN'MBy
Re►No E.H Npm i ASSMIAIES.5CALE
V=40r DATE:6-m-85 MAP NO.180-65"L'
SHEET 2 OF 9 SHEETS REv. PREPARED FOR
HILL ' REALTY -INC.DART .
1 TANT!Ali`! CORRECT s SOUTH •.WI NDSOR, 'CON N.
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D (giggly
MAY 2 i 1994
South Windsor
BUILDING DEPARTMENT
TO THE BU-101,1Z �!PT. TOWN 7 --';M WIMSOR
This certified that this plan and sp_c+:it tions are trut
4opies of the proposed building or aitcratinns to br
erected at
together with amendments stated in applic.•tv,n
filed with plan and I agree to comply with all zone..
Building and state laws and such orders as Sh.I ..,
issued by the Building Deportment during u
of this application and f al is ce o a b, .o r
permit.
Signed ✓ __
This plan is approved subject to the condition ondition i
orders and r-rdmances regulating b.•iiding shad
complied with.
Conditionally Approved These�wltii
Building Inspector 7 C.lk rt
Date No
ZONING COMPLIANCE
Proposed building(s), use(s) and/or structure(s)
as shown on this plan appears to e .
conformance with current So th b .n
regulations. Variances ands Winds.-,,
exceptions
may apply,
Dates ����f y
Zoning Enforcerr3Lr,t 0 `'--r
Electric# APPLICATION FOR BUILDING PERMIT
Plumbing# 141 LISA DRIVE
/go/
HVAC # Date: ANo. �3 9 6 6
Sprinkler#
FINAL PPRO Estimated Cost $
Building t , COMPLETE RED BOXED AREAS Permit Fee $
'
Engineer g[ 9 TYPE OR PRINT ONLY Occupancy Fee $
Affidavit SIGN ON REVERSE SIDE
Appr.for CO. Total Fee $ fz—
TO BUILDING DEPARTMENT, TOWN OF SOUTH WINDSOR,CT (Additional Cost) $
The undersigned hereby applies to do work according to the following specifications:
Job Location ��/ ZISA Lot No. Side of Street Zone
Applicant C-6'44-10 /d. -Tel.# �yS�.1'1?�►1'�
Address i4n1W Zip Q Lic. #
Owner e,,PAc is d. Address
Architect Address
Sq. Ft. New Area: 1st FI. 2nd A. 3rd A. Total New Area
#Rooms # Lavatories #Bathrooms #Garages
Purpose of this permit: A7'J7- C,4.a /�/�PCz�7 r. V14✓1T lAb RFC!i6C��
City Water C Well 0 Septic System ❑ Sewer 0
Use Group Construction Typ N ? Area / Bas m nt Garag
Approved by Date ,]o
Revised 6/95
I hereby agree to conform to all the requirements of the Laws of the State of Connecticut and the Ordinances of the Town of
South Windsor and to notify the Building Inspector of any alteration in the plans or specifications of the ing for which this
permit is asked,and agree that this building is to be located the proper distance from all s reet line ide and lines and required
distances from all other zones and is located in a zone in whi this b i its u s allow
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
i
Electric# APPLICATION FOR BUILDING PERMIT
Plumbing# uo;t��) 141 LISA DRIVE
HVAC # Date:
Sprinkler# No. 26175
FIEngimHAL 01/ Estimated Cost �In
Buildi COMPLETE RED BOXED AREAS Permit Fee
TYPE OR PRWT ONLY Occupancy Fee $ 5
Affidavit I N ON REVERSE so
Appr.for CO. 1 E - ITotal Fee $ 12E5.e_
TO BUILDING DEPARTMENT,TOWN OF SOUTH WWSOR,CT (Additional Cost) $
The undersigned hereby applies to do work according to the following specifications:
Job Location 141 U 5Or 0"-` Lot No. Side of Street Zone
Applicant OU,n ra v I V- Tel# b y Y S-53Z
Addr ss 7 V4,YQ . Zip o Lic.# S Z3-2 4:>
Owner g 0,s S � Address I Ll USA 0 r:
Architect Address
Sq.Ft.N w Area: 1st FI. 2nd FI. 3rd FL Total New Area
#Rooms I #Lavatories #Bathrooms #Garages
Purpose of this permit: —,b won A W xi j-' ��ak ae--" Renuo►—
City Water Well ❑ Septic System ❑ Sewer
Ins. H.O. Cert. Area I Basement Garage
Approved by OE Date Use Group Construction Type
R•vs.d 1/97
rn�
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 ' tance from all street lines,side yard lines,and required
distances from all other zones and is located in is this building an its se is allowed.
Signed
I hereby apply for a Certificate o ancy for the wo escribed in this application for the permit.
Signed
D T WRITE BELOW THIS LINE
INSPECTION COMMENTS
_ _ s
w
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PLOT PLA 4 SEC.TIOdJ 3 MWNTAANYIEW
ESTATES 5ouTH WINOs.oRfCbwN•0BY
Retmo E.H"Pm 4 AssmlA1 Es•5ca.F
r--40' OATE:643-85 Mw NO.180'66-IL-
SHEET 2 OF 9 SHEF-TS Rfv. 2 21-W PREPARED FOR
.. _ DART HILL ' .REALTY, N.C.
� CORN. N.SOUTH WINOSOR,RECT
aU�S ANTIALII CRCERTIFiED :
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• _ p {� a. ., r�.- "i�3..s�.•.i••.� �d�",u ai'�',,+-��i's♦ �`�'{tint••- ~ '.``��n;. �1.ri.'q�i•'�'r, ��^, ��.•.�L.; -ti•-•
• ,-"+���s";rs+t.alret,i''.:�•` --;'*3'',11�s�����''J.•'�:ter` _v�j.ice.}• - •+^�- m• _-`r�►+'-�'.� t.•'�'i�- ,i+�+` �••': i } } ic• a• �
TO THE 3ME)ING DEPT. TOWN OF SOUTH WINDSOk
This certified that this plan and specifications are true
copes of the proposed building or alterations to b•
:,rected at
`//D440, _ Street
trtgether with amendments stated in application any
piled with plan and i agree to comply with all zoning
<uiiding and state laws and such ord*rs as shall b
issued by the Building Department during pendent%
't this apphca on and final issua NK
permit.
iigned
!his plan i app oved subject to the condition that
irdtrs and or ' antes regulating building shall be
complied with
Conditionally Approved These filed with
Building Inspector clerk
Patti —- " 11
LGKI rtGAFIUN OF ZONING COMPLIANCE
proposed building(s), use(s) andror struc:ture(s`
show," on this plan appe y-(s) tr) be, i;
.Iiformance with cu:ren' . .-i Wind
,;ulations. Variances and spu,,,-�1 exceptior-i
ay aWly-
Ale -rZZrWJ
Enf r ment Officer
`/kl Z
DEPARTMENT DECISION PERMTT'#
APPLICATION FOR ELECTRICAL PERMIT I L-5tl
I w
Application is hereby: TOWN of SOUTH WINDSOR g e #
BUILDING DEPARTMENT
DEPARTMENT
I Bid
PROVED 1540 SULLIVAN AVENUE
q9 Q3 4",4— , 644-2511 ext.230
Date Building Inspector Application must be printed or typed
Location of job
Street No. Street Lot No.
FEE SCHEDULE Floor Apt.No.
$0 - $11,000 - $12.00
Over $1,000
$12.00 per$1,000 OWNER 4��AS-4e-Z-
or any fraction thereof ADDRESS ZI5g A-
j �Dso,e, (/-7
OWNERS PHONE#
APPLICANT
Ste`''4t ADDRESS
Jq
4(
ESTIMATED COST$
IS THIS A CONTRACT COST?
YES NO
FEE ENCLOSED
TYPE OF JOB:
0 -C jDriginal Installation
Alteration/Addition Repair Revised 11/95
APPLICATION FOR ELECTRICAL PERMIT(Continued from reverse side)
TYPE OF BUILDING
IS THIS APPLICATION ASSOCIATED WITH A
RESIDENTIAL BUILDING PERMIT APPLICATION YES / NO
BUSINESS
ASSEMBLY CURRENT USE AND OCCUPANCY
MERCANTILE
EDUCATIONAL FUTURE USE AND OCCUPANCY
INSTITUTIONAL
FACTORY
STORAGE ENGINEER'S NAME PHONE
GARAGE
MIXED USE ADDRESS
CITY STATE ZIP
(Other please specify)
Mumma
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 7 YES/NO
NUMBER OF LIGHT CIRCUITS NUMBER OF POWER CIRCUITS
NUMBER OF SWITCHES -9 NUMBER OF OUTLETS -�
NUMBER OF LIGHT FIXTURES Z.
NUMBER OF HEAT CIRCUITS NUMBER OF A/C CIRCUITS
SEPERATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED.
DESCRIPTION OF WORK
,G2�1/�t��i oOe„ �•y� �/� - FGt3S� ���;/�or�. �s:�r4c ,Z-�3i�c�rFL-
N�iec�a�r��i
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS
TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONN.BUILDING COD S IN THE
PERFORMANCE OF SUCH WORK. ,
NAME STATE LICENSE NO. TYPE SIGNATURE CANT
PHONE NO. �/" �3F DATE G �x 9
RMT
[DEARTMENT DECISION APPLICATION FOR PLUMBING PERMIT PE3
pplication is hereby: TOWN of SOUTH WINDSOR
BUILDING DEPARTMENT Bldg Permit#
APPROW 1540 SULLIVAN AVENUE
644-2511 ext. 230
h6lding Inspector Application must be printed or typed
Location of job
F It 7L�11 Lt-SA 0 Ify
Street No. Street Lot No.
FEE SCHEDULE
Floor Apt.No.
$0 - $1,000 - $12.00
Over $1,000
$12.00 per$1,000 OWNER Z7�./.,Q y B S c.c L
or any fraction thereof
ADDRESS � Y j L.! SA DR
6�7�
OWNERS PHONE# .6 4-/L/
APPLICANT Mt ke NA
0 N $S ADDRESS eww-�... Q.e�6 ka
At :4 P.
rdwd.CT
ESTIMATED COST$ b b+
C IS THIS A CONTRACT COST?
VIA V YES NO
C► FEE ENCLOSED $
TYPE OF JOB:
OR-Co Original Installation
_ Alteration/Addition/Repair
Revised 10/96
APPLICATION FOR PLUMBING PERMIT(Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
RESIDENTIAL BUILDING PERMIT APPLICATION YES / NO
BUSINESS CURRENT USE AND OCCUPANCY
ASSEMBLY
MERCANTILE FUTURE USE AND OCCUPANCY
EDUCATIONAL
INSTITUTION
FACTORY ENGINEER'S NAME PHONE
STORAGE
GARAGE ADDRESS
MIXED USE
CITY STATE ZIP
(Other please specify)
TYPE OF INSTALLATION bVA e/Z SIZE OF MAIN DRAIN
NO. OF TOILETS STYLE NO. OF URINALS STYLE
NO. OF BATHTUBS NO. OF SHOWERS NO. OF LAVATORIES
NO. OF CONDUCTORS SIZE NO. OF STACKS SIZE
AREA OF ROOF NO. OF CATCH BASINS NO. OF FLOOR DRAINS
NO. OF OTHER FIXTURES KIND
ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW YES/NO
SIZE OF WINDOW IF NONE C.F.M. OF VENTILATOR
SIZE OF DUCTS SEWER OR SEPTIC TANK
SIZE OF WATER MAIN SIZE OF WATER PIPING&RISER
WATER HEATER
TYPE-Am iv"Z MANUFACTURE
TANKS SAFETY DEVICES
TEMPP-RATURE
CAPACITY S RELIEF VALVE ,
TEST PRESSURE WORKING PRESSURE 75 PRESSURE RELIEF VALVE l/
TYPE MANUFACTURER Lnm_1T-<
DESCRIPTION OF WORK
15�t��� 90 L 9,4 S L.r� fcA
R
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS
TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONN. BUILDING CODES IN THE
PERFORMANCE OF SUCH WORK.
cT :2 aL s $ P - I
NAME STATE LICENSE NO. TYPE SIGNATURE OF APPLICANT
PHONE NO. 2 c s 3 DATE -7 Z 1 -y q