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Home My WebLink About189 Farnham Road Application No. ....... 2 SS. ..... .... ....... Permit No. ......22.9.a....... ....... TO THE BUILDING INSPECTOR of the TOWN OF SOUTH WINDSOR, CONN. We hereby make application for a permit to (erect ( -11 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., . May...................................... 19....5.8. Signhere ................................................................................................................ Address ................................................................................................... ................. Location? South Farnham Road ..... ........................... ....... ...............................................................side of. ........................................................................................................................ Nearestcross street? ........ . ..... ............................................................Street No. .. ......................... ............. Lot No. .............2.3............ . Owner of land is? I.R, Stich. Associates...„.........Address ......6.1..1....New..Paxk..Ave.nu.e.,..W..Ht;fd.. Owner of building is? I.•R.Stich.Assokiates........Address ... ..61.1...New..Prk..Avenue.,..W...Htfd.. Architectis? . .. Address . .................... ................................................... ............................... Builder is? .. Manchester Builders, Inc.............Address ........6.11....New..Parlc..Ave:nue,..W...Htfd... ................ ............ Dimensions of building?24. 6x40., 8 Feet front? . . . .. _._Feet rear? ...... ... ......... Feet deep?.. Extreme height to highest point of roof? .... 141...... .. No. of stories in height?-. l • ? Dw.ell in Purpose of building is. .... .. ... ..............�....g...................................No. of stores? .. ............... ... .. .......................... ................................ Howmany families? .. ...............n.e............................................................No. of rooms? .... .. ........ .... ..... .................................... .............. Distance from street line is? . 45`.. .............. ..................from building line is? .. . ADDITIONS AND ALTERATIONS (Give Brief Description) .. . . .............................................. .......................................................... ................................................... ..................... ........................ -' ...................................................................................................................... ..................... .. .............. .................................. ....... .................... .... ................................... i � y .c a �� 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? . ... ... ...... ......... ......................................................... Roofconstruction 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 Wi11 walls be constructed? .. .................. ..................... ......... .......- .. . ............................................................................... ................. Composition-of mortar? . ..................... ......................................................................................................................................................................................... Height and Thickness of Walls Height Stories Front Walls Side Walls Rear Walls Partition Walls Basement ..............................................!............................................................. ...................................................................................................................................................................................................... 1st Story ........................................I..................................................................................................................... .................................................................................................................................................... 2nd " ...................................................................................................................................................................................................... ........................................................................................................ -3rd .............................................................................................................................................................................................................. I.....................................I........... ....................I................................. 4th do .......................................................................................................... .................................................................................................................................................................... .................................. 5th .......................................................................................................... ..............................................I...................................................................;......................................................I............................ 6th 96 ..................................................................................................................................................................................................................................................................................................................... 7th 44 .................................................................................................. ......................................................................................................................................................................................................... 8th 's ..................................................... ................................................. ................................................. ........................................... ......................................................................................................... 9th 11 ..............................................................10th........................................... ................ ... ................. .................. ........I................ ...................... ................................................................................. r Material of Front? ......................... ........... . .......... ..............................If stone, what kind'.? ...... . .. . ................. .... ........ . .......... Thickness of Ashlar? .......... ..................................... .. .......................Thickness of Backing? . .......... .. ................ . ........................ Backed up with what? .. ....... . ... . .... ... . . . ... Arches or lintels over openings? WOOD CONSTRUCTION. Give Size, Longest Span and Distance Between Centres, of Joists, Girders and Columns JOISTS GIRDERS COLUMNS Floors Size Longest Span Centres Bridging Size Longest Span Centres Size Length Centres 1st Floor 12'8" 1611 lx3 x8 8' _-- 4" 71 8t 2nd....... 8.... ........_ ............8.................... .................. ............ .............." .. ........ ............................................................................. ........................ ...................._.._......................................................... .........._......................._�.. ......................... 3rd 4 ..... ..... .............. ................................... _.. .............. Size of outside studs? .. .2x4. ..... ............ Distance on centres? .....16.!.P........ ..... Size of sill? ..... 6............................ Size of rafters? 2x6 Truss. Distance on centres?.... .. ................V............. Size of plate? ...............`x`............................ Size of ledgers or girts? ... .. -"" Size of deck rafters? ............. -w w w Distance on centres? Size of studs in bearing partitions? ..........."..-.'�.�.�..................... .......... MISCELLANEOUS Style of roof, flat, pitch, Mansard, or hipped? pitch Fireplaces? ......Non.e................................ Material of roof covering? 21.O1b.,.....Aaph.alt . ....Material of Cornice? ...Wood.G.,. ,....G�a� .t.e.r.s............... How is building heated? a s...... ............. .. ..........................Lining of flues? .. ..8x 12...T e r r. ..G.4t.a .......... 9 1 . .T r t ? .............. ....�.�.............. ....... ......Thickness of shell of flues? .. C.......4 ....c. nder...Any elevators or lifts. ................ block What kind% .. .. ....... ... How many? ............ Any hoistways? --"w- How protected? -7 7.......... ................... .................Total Value of Building ........ ...............-....:.....'....... ....I............ Whenwill work be commenced? .. . ...... ............ ..........................................................................I................ The applicant warrants that the lot for residential purposes, shown on a plot plan accompanying this appli- cation, has 20,000 square feet, or more, and at least 100 foot frontage on a Town road shown on a map of South Windsor showing Town Roads dated December 1949, or on any other roads officially/accepted by the ✓ ' f Town of South Windsor since 1949. �- �`� �' ° --�`L < < i ��C �� Applicant 22o5 BUILDING APPLICATION Application No. ........25.55................................................... South - ' on the .................................................................................. side of .lo' .....................Fa. h. ..... rnam R. . d ................................ Street. ..................... ....... . StreetNo, ..............L.ot...............-#.23......................................................... I. R. Stich Assoc. Owner ..... ................................................................................... Applicant ...........Same .... . ............................................................ CLASSIFICATION .Dwe1l.in .....2.4..1 6"XZt.O..'..8" ..................... . . . ................ . .............. .. .................................................. .................................. ....................... ................... ............................... Permit issued on above Application. Date, ..........June....1 l..s....... 19....��8 if TOWN Ur SOUTH WINDSOR BUIDII4G PERMIT "401"10-- , Y 4, Vate June 11 195 Fee Paid $...40...00 Est. Value $...109000 :gar '` periA X9 2295 on the mouth side of Rd s Frnhara Street p y Street No Lot23 Omer R. Stich Assoc. Applicant Same CtRTIFICATE OF OCCUPANCY ISSUED: Date - �-3 5 -, may No. If , r e` Fie Paid $ 3.00 CLASSIFICATION Dhre 11 n 2 1 6"x 0 f 8" g— - m BUILDING PERMIT NY 2295 OFFICE OF THE BUILDING INSPECTOR of the Town of South Windsor, Conn. South Windsor, Conn. Jun® 11 19 58 Tots is to (ferttfil, That T• R. St i eh Aja llne- is hereby granted permission to Dwelling 24 f �,"40 t 8" at estimated value of 10 00Q0 on the South side of Farnham Fd.l Dot #23 Street on land owned by 1. rL. Stich Azzoc. Said Work to be as described in Application No. 2555 and to conform to specifications and plans filed with said Application, and Building By- Laws of THE TOWN OF SOUTH WINDSOR. Issued June 11, 19 58 ' Building Inspector. Streets and sidewalks, obstructed by excavations or building materials, must be guarded by barriers dur- ing 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 Permit No. . ........... TOWN OF SOUTH WINDSOR SOUTH WINDSOR, CONN. Permit N? 1345 Certificate of Occupancy THIS IS TO CERTIFY that the A at No. e4 h a A" in the T n of South Windsor, Connecticut, has been erected and completed in accordance with the Building Code and Zoning Regulations of the Town of South Windsor, and is hereby approved for occupancy. BUILDING INSPECTOR OWNER, BUILDER Date Fee Paid ��,., 119 I �1 � -Tij - i i it f _c 2 r� r FAF tJ HAM Rog, D Lot numbers refer to map entitled, "Subdivisi n Map, Farnham Estates, Property of I Re Stich Associates, Inc., Rye Street, South Windsor, Conn., Scal 1" • 4019 Sept. 190 1957, Sheet 6, Certified Substantially Correct, Morton S. Fine, C.E. & L.S." COO �NFG J, �� r ON S. .01 � ` PROPOSED LAYOUT I hereby certify that this o 5' �, � ��► FARNHAM ESTATES map is substantially c o r- * FARNHAM ROAD 2' SOUTH WINDSOR rect and no zoning regula- � p No. 931 0 �� • CONNECTICUT tins have been violated . '"�,�, �,,C SCALE-�. 1 = 401 JULY 14, 1958 uN�s� MORTON S. F�I�F, C.E. -:.S. HARTFORD, CONN. �j. TO THE BU DING INSPEMR of the APPLICATION FOR PLAN EXAMINATION AND � �TH WSOR,COS. BUILDING PERMIT z IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O ZONING • AT (LOCATION) DISTRICT LOCATION (NO. (STREET) OF BETWEEN AND BUILDING (CROSS STRE ) (CROSS STREET) � 4SUBDIVISION � A LOT BLOCK SIZE N II. TYPE AND COST OF BUILDING — A11 applicants complete Parts A — D A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use 1 ❑ New building Residential Nonresidential 2❑ Addition(It residential, enter number 12�ne family 18❑ Amusement, recreational of new housing units added, if any, 13❑ Two or more family — Enter 19❑ Church, other religious in Part D, 13) number of units— — — — --► 20❑ Industrial 3 ❑ Alteration (See 2 above) 14❑ Transient hotel, motel, 21 E] Parking garage 4❑ Repair, replacement or dormitory — Enter number 5❑ Wrecking (If multifamily residential, of units ——————— —i 220 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) ��Q/ n4 17M Other — Speci/y ❑ Public utility 7❑ Foundati n only Lhl ❑ School, library, other educational B. OWNERSHIP PG^�} I/Z❑ Stores, mercantile TZ / ` �R r�� o4�l�r� 28 ❑ Tanks, towers Privat (individual, corporation, dC( Qp [ �28 n npr fit institution, etc.) ,�` 3� 6/$' 9❑ Other — Speci/y 9 ❑ Public(F deral, State, or local g v rnment) C. COST (Omit cents) Nonresidential — Describe in detail proposed use of buildings,e.g., food 4:* processing plant, machine shop, laundry building at hospital,elementary 10. Cost of improvement................ �1 school, secondary school, college, parochial school, parking garage for, department store, rental office building, office building at industrial plant. To be installed but not included If use of existing building is being changed,enter proposed use. in the above cost a. Electrical...................... b. Plumbing ...................... c.Heating, air conditioning......... d. Oth r(elevator, etc.)............ ��yy�� 11. TOTAL COST OF IMPROVEMENT �5 - 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❑ Reinf rced concrete H. TYPE OF WATER SUPPLY 34❑ Oth r — Specify 42❑ Public or private company �• Total land area, sq.ft. ........... 43❑ Private(well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES 51. Enclosed ....................... F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 35❑ Gas Will there'be central air 52. Outdoors........................ 36❑ Oil c nditi nine? L. RESIDENTIAL BUILDINGS ONLY 37❑ Electricity 44❑ Yes 45❑ N 53. Number of b dr ms.............. 39❑ C a l .� 39❑ Oth r— Specify Will there b an elevat r? full.......... 54. Number f & 46 ❑ Yes 47❑ No bathrooms I F . al....... NOTES and Data — (For department use) IV. IDENTIFICATION — To b completed by all applicants Name Mailing address — Number, street, city, and State ZIP cod Tel. No. 1. '//- % Owner or Lessee 2. Contractor 3. Architect or Engineer The own r of this building and the undersigned agree to conform to all applicable laws of this jurisdiction. $i nature applicant Address Application date Ak*)4j eq DO NOT WRITE BELOW THIS LINE V. PLAN REVIEW RECORD — For office use Plans Review R Plan Review Date Plans Date Plans BY Notes quired Check Fee Started By Approved BUILDING PLUMBING MECHANICAL ELECTRICAL OTHER $ VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Permit r A rova I Check Date Number B Permit or Approval I Check Date Number By Pp Obtained Y pp Obta ined 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 II. VALIDATION Building P rmit numb r 12904 Bui Iding P rmit issued Sept. 14 19 82 Building P rmit Fee $ 4.00 Approved by: TLE „;_ NOTESVill. ZONING PLAN EXAMINERS FRONTDISTRICT I L REAR YARD IX. SITE OR • Applicant ■�ari........... ..•.............................................m..w.........•..a.....■.. a asa■/t�.��.rar■a...rra•I..ra�.ja.. r a.1...•a�.•rr■.• sneer are•...■ `" rasue. 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'ss�e=s ;:= ==3:== ::"se: 'sa: ss a:s�:Ee _ijl:'s_:::a;=:a:a sa•'s:s:';s;::::s:':::s:s:isa:s::�::=::==::e:i:i=:i:s:m:s=s:::sess:a:�:s::'sesEs:ss:::s:s:�::::e::::::=a.::s:::�:':::cc::e's:::::s::::=:::::::::E:Es:s::csmEass::�:9::e=s:aa:ss:s:aes �:�s:=s=: :�p= ;:s�"usa=:: s.: a s MEN Osseo unnnnuminmum : : : :" :::: :: ss sses : 6 s = � .fi: _ s ■ ssp += sa:n:•::�_ ! saluj i _ " = �r■as � � i_ � = ::la iara rer. ; u 1N::l:.=:: . : as. :na.r : .. a•■. ■ see■: msseas:anC mass : ass■. : ■ rp s� a'° i"sssaa: z= : p:::::_ss::m __::: .:m:=s=:l::sl sesame:=a=::m:::m:snm:mm:as:m:::mm:aim■aaa::::::::■aaa::aaa:::m::::m::::l::=s:::=O:=:.212 :M Usss:sa =:sass:=rim:::s::s=: ---------------::::_:::::::----------- mil--------- - e:::ee------s:;;;a----------------- TOWN OF SOUTH WINDSOR BUILDING PERMIT Date Sept. 14 , 19 82 Fee Paid $. 4.00 Eat. Value $. .5.QQ•00 Pe"'lit N° 12904 on the aide of Farnham Road Street Street No. IS 9 Owner Wi l I-J-aan Wi 1 san Applicant William Wi 1-s on CERTIFICATE OF OCCUPANCY ISSUED: Date No. Fee Paid $ CLASSIFICATION Re-roof dwelling and add deck a BUILDING PBRNIIT oMCa of N° 12904 THE BUILDING INSPECTOR of the Town of SouthWindsor, Conn. South Windsor, Conk. SeR t. 14 . i 94is to to Certify, That 0 1 1 1 am Wil ann is hereby granted permission to Re—roof—roof dwelling — add deck in rear n f dwelling i at estimated value of 000-00 i on the side of 189 Farnham Rnad Sat-et on land owned by William T. Wilson son Said Work to be as described in Application No.13204 and to conform to specifications and plans filed with said Application, and Building By- Laws of THE TOWN OF SOUTH WINDSOR. Issued Sett . 14 CIO f> Building ns dor. Streets and sidewalks, obstructed by euavations or building materials, must be guarded by barrios 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 rason therefor." Electric# APPLICATION FOR BUILDING PERMIT Plumbing# 189 FARNHAM ROAD HVAC # Date: S rinkler# No. 2 5 9 2 3 P FINAL APPROVALS Estimated Cost $ r4"� Building -1�t COMPLETE RED BOXED AREAS Permit Fee $ Engineering TYPE OR PRINT ONLY Occupancy Fee $ Affidavit SIGN ON REVERSE SIDE Appr.for CO. Total Fee $ TO BUILDING DEPARTMENT,TOWN OF SOUTH WINDSOR,CT (Additional Cost) $ The and rsign d hereby applies to do work according to the following specifications: Job Location '�cl -1pe`r-n V c-L� �j Lot No. Side of Street Zone Applicant ti'�&r-\p tie l o,yc, k-PS10 Tel.# Address l S5�1 'Fc— :--r\V�,� 2 k Zip C)t„()'-1 4c. # Owner Address Architect Address Sq. Ft.New Area: lst FI. 2nd FI. 3rd Fl. Total New Area #Rooms # Lavatories #Bathrooms #Garages Purpose of this permit: \j. '�-� �% S� �f'D : lP c-k City Water 2 Well 0 Septic System El Sewer J Use Group Construction Typ Area / Basem nt Gartme, , Approved by Date Rw..d 6195 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/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 the permit Signed -- DO NOT WRITE BELOW THIS LINE -- INSPECTION COMMENTS Inspection / Approval Date By Appl Code Description Due Whom Code Comment ------------------------------------------------------------------------------- 99-25923-B 1,500 B01 FOOTING 04/01/99 DCJ A B10 FINAL 05/07/99 DCJ A APPROVED FOR CLOSEOUT i r . Sectric# /(fly{ APPLICATION FOR BUILDING PERMIT Plumbing# 18 9 FARNH�M ROAD WAC # 26355 Date: 51 pta- q Sprinkler# NO' FINAL R hmaf sf Buildi COMPLETE RED BOXED AREAS Permit Fee $ 12 TYPE OR PRINT ONLY Occupancy Fee $ ffid°`"t �� SIGN ON REVERSE SIDE Total Fee $ Appr.for CO. 17 TO BUILDM DEPARTMENT,TOWN OF SOUTH WINDSOR,CT (Additional Cost) The undersigned hereby applies to do work according to the following specifications: Job Location V� ]& r`,a -RA Lot No. Side of Street Zone Applicant .-C :E",�CA-Vrt�,e Tel# 8 0 Address Zip 4Lic.# Owner -N1 Svc- -e2 Address �En Architect Address Sq.Ft.New Area: 1st FI. 2nd FI. 3rd Fl Total New Area #Rooms #Lavatories #Bathrooms #Garages Purpose of this permit: L>0 'C O O` City Water ❑ Well ❑ Septic System ❑ Sewer Ins. H.O. S.P. Cert. Area Basement waoe ,,,_, � � Approved by Date 21 23 Use Group 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 2-- I hereby apply for a Certificate of Occupancy for the work in this application for the permit. Signed DO NOT WRITE BELOW THIS LINE INSPECTION COMMENTS Inspection / Approval Date By Appl Code Description Due Whom Code Comment ------------------------------------------------------------------------------- 99-26355-B 300 E02 UNDERGROUND 08/04/99 JFF A WITH OWNER E10 FINAL 08/04/99 JFF A WITH OWNER B10 FINAL 08/04/99 JFF A WITH OWNER APPROVED FOR CO & CLOSEOUT 99-16402-E 100 t a �r 1 M _ { r Y i a a >� y ' f Location j Building Permit# ZL 3 S4 SWIMMING POOL REQUIREMENTS: This list is not all inclusive,please refer to pool packet. A 48"barrier will be provided to protect the pool access. Including a temporary fence for inground pools prior to filling. Access gates will be self closing and self latching(if less than 54"high they shall be on the pool side and be protected within 18"of release mechanism). Doors providing direct access to the pool shall either have an alarm, a self closing self latching device 54"above the floor, or a safety cover over the pool. No receptacles within 10' of pool. (locking type receptacle for pool equipment must be at least 5' from pool and GFCI protected). All metal parts of pool structure, fixed metal parts within 5' of pool,pump motors, filter casings and metal electrical equipment shall be bonded with a minimum#8 solid copper wire. Convenience GFCI receptacle shall be provided between 10' and 20' from pool. Trench depth for 20 amp. circuit to pool equipment shall be 12"minimum. REQUIRED SWIMMING POOL INSPECTIONS: The following is a list of inspections that need to be performed prior to the continuation of work to complete the swimming pool. We require 24 hours notice for inspections. Requests for inspections can be made by calling the Building Department at 644-2511 ext. 230. 1. TRENCH AND BONDING-Electrical trench depth verification and bonding of pool and metal appurtenances including metal reinforcing for gunite pools. 2. FINAL ELECTRICAL-Location of equipment and GFCI protection. Convenience outlet provided. 3. FINAL-Swimming pool access protection must be provided before pool can be used. Each swimming pool installation requires a Building and an Electrical permit. Additional permits and inspections are required for pool decks. I have read and understand the requirements listed above. S' ed Date —7 DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT P q6 z. DEPARTMENT is hereby: TOWN of SOUTH WINDSOR BUILDING DEPARTMENT Bldg Permit# f IT 1 1540 SULLIVAN AVENUE ;(C5 '712 7 14e) APPRO 644-2511 ext.230 Dle Vding Inspector Application must be printed or typed Location of job Xr"-�,� Street No. Street Lot No. FEE SCHEDULE Floor Apt.No. $0 - $1,000 - $12.00 F-Str I vN Over $1,000 $12.00 per$1,000 0 or any fraction thereof ADDRESS OWNERS PHONE# APPLICANT 0* S� ADDRESS ESTIMATED COST$ 0 IS THIS A CONTRACT COST? „'� ` YES NO FEE ENCLOSED $ OR-CO TYPE OF JOB: Original Installation Alteration/Addition Repair Revised I VV5 APPLICATION FOR ELECTRICAL PERMIT(Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH 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) mamma 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 NUMBER OF OUTLETS NUMBER OF LIGHT FIXTURES NUMBER OF HEAT CIRCUITS NUMBER OF A/C CIRCUITS SEPERATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED, DESCRIPTION OF WORK W m 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. NAME STATE LICENSE NO. TYPE SIGNATURE OF APPLICANT PHONE NO. 5 Z, S `� DATE ? - L - / 7