HomeMy WebLinkAbout153 Gail Lane THE B Il�TG
0 INSPECTOR .
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APPLICATION FOR
of the PLAN EXAMINATION AND
'DOWN OF Soum cow BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
��� . ZONING
I• AT (LOCATION) A& 0aw".1.0 DISTRICT
LOCATION (NO.) (STREET) �/�
• AND444"� �(CR ' X Il�•S�
OF BETWEEN (CROSS STRE )
BUILDING (CROSS STREET) LOT ao�t3
ff,J*7 X ' 7
SUBDIVISION'PLIM� /' djOLLEV #041'" 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 �
1 KNew building Resid ntial Nonresidential
2❑ Addition(It residential, enter number 12 One family 18❑ Amusement, recreational
o/new housing units added, if any, 13❑ Two or more family — Enter 19❑ Church, other religious
in Part D, 13)
number of units— — — —-i 20❑ Industrial
3 ❑ Alteration (See 2 above) 14❑ Transient hotel, motel,
21 ❑ Parking garage
4❑ Repair, replacement or dormitory — Enter number
5❑ Wrecking (if multifamily residential,
of units ——————— ——! �❑ Service station, repair garage
enter number of units in building in 15❑ Garage 230 Hospital, institutional
Part D, 13) 16 ❑ Carport 24❑ Office, bank, professional
6❑ Moving (relocation) 25❑ Public utility
17❑ Other — Specify
7❑ Foundation only 26❑ School, library, other educational
B. OWNERSHIP 27❑ Stores, mercantile
8 Private (individual, corporation, 28❑ Tanks, towers
nonprofit institution,etc.) 29❑ Other — Specify
fit-❑ Public(Federal, State, or
local governmertit)
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. C st of improvement................ civ'/ 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 Ports 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
48. Number of stories................
30❑Masonry(wall bearing) 40MPublic or private company
41 ❑ Private(septic tank, etc.) �• Total square feet n floor area,
31�Wood frame p all floors, based on exterior
32❑ Structural steel dimensions .....................
33❑ Reinforc d concrete H. TYPE OF WATER SUPPLY
34❑ Oth r — Specify
42�Public or private company `�• Total land area, sq.ft. ........... ��8 G
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........................
e nditi ping?
96❑ Oil L. RESIDENTIAL BUILDINGS ONLY
37❑ El ctricity 44❑ Yes 45 12!�N 53. Number f b dr ms..............
39❑ C al
39❑ Other— Specify Will th re be an el vator? CAI
54. Number f
46❑ Yes 47 2�Na bathrooms
NOTES and Data — (For department use)
IV. IDENTIFICATION — To b compl t d by all applicants
Nam Mailing address — Number, street, city, and State ZIP code Tel. No.
1. 4U9`
Owner or
Lessee .0% t+Amb
/St_A1 Q
2. f it owl 1'
Contractor t(
3.
Architect or
Engineer
The owner of this building and the undersigned agree to conform to all applicable laws of this jurisdiction.
nature pplicant Address 0 Application date
0:4,
V I &4"Tm- .4
DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Revi w R quired Check Plan Review Date Plans By Date Plans By Notes
Fee Started Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit r Approval Check Date Number B Permit or Approval I Check Date Number By
Obta ined y pp Obtained
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 12860
Bui Iding
Permit issued Aug. 12 19 82
Bui Iding �yy 402.00
P rmit Fee $ jffO§3ff "
Appro d by:
aA
af-i
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NOTESVill. ZONING PLAN EXAMINERS
DISTRICT
FRONT YAR
SIDE - . SIDE YARD
REAR YARD
IX. SITE OR •T PLAN For Applicant
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_ / d
TOWN OF SOUTH WINDSOR
BUILDING PER UT
Date Aug• 12 , 19 82
Fee Paid g.402.00 Est. Value . 6 7,,,000
Permit No 12860
on the side of
Lot #8 4 Gail Lane Street
Street No.
153
Jean Marc Jac ue
Owner 4 s
Applicant Jean Marc Jacque s
CERTIFICATE OF OCCUPANCY ISSUED:
Date
No. 6077
Fee Paid $ 3.00
CLASSIFICATION
Dwelling
z
z
m
0
BUUDING PERMIT
N° 12860
OFFICE OF
THE BUILDING INSPECTOR
of the
Town of South Windsor, Conn.
South Windsor, Conn. AU&- 12
94to to to gertif-g, That JM-W Co r.s♦,..,st „_
is hereby granted permission to Die 11 Ins
i
i
at estimated value of
on the side of Let #S4 Ga i 1 I.&no- Street on land
owned by JM Tacatta s
Said Wn rk to be as described in Application
ISU460 and to conform to specifications and plans filed with said Application, and Building By-
Laws of THE TOWN OF SOUTH WINDSOIL
Issued AA,0 12 52
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."
SECTION REPORT
INS
Permit # o
t
ting
` 4
i'
ndation <
Fr ming
W ing
-4
5"PI mbing
ting
hing
8 C O �
Permit No. f 4 TOWN OF SOUTH WINDSOR
SOUTH WINDSOR, CONN.
Permit N o 6077
Certificate of Occupancy
CERTIIFY that the ems.
f J
at o r in the;Town of South Windsor, Connecticut, has
be c d and completed in accordance with tthe Bu' ing Code and Zoning Regulations of
the �n pf South Windsor, and is hereby appred occupancy_
Building Inspector
�wner, Builder
Fee Paid - Date ` l '�1�f.- R.�•� 19 ��""
i
REINO E. HMPA do ASSOCIATFS
Civil Engineers
Glastonbury, Conn.
GA I L LANE
N s-Lch 1a1;
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T=tS.00' 112
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Fot*4OA3t0M LOCATED AS SV%OWN 10-119,St /i ar
,NOTE: Lot lines from map on file in
Town Clerk's Office entitled, "Plot Plan
Section_ S Pleasant Valley Hanes
South Windsor, Conn."
Scal 1"• Ito' Date q-'Lq-%o A-2p BONE.
Map No 220-78-12- By. F ei no E.
Ayyppa t* Ass asakes C1as}on6ory, Cony,.
P f2 PAR E iD FCC Q 1 hereby certify that this rnap and survey were prepared in PLEASANT' VALLEY WOME5
accordance with the standards of a Class A-2 survey as defined
In the existing Code of Practice for Standards of Accuracy of 5O UTH W I NDSQQ1 C C)W N.
lurveys and Maps, adopted by the Connecticut Association of
LaM Surveyors, Lie. SCALE 11#=40' p GTE
1
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S $4
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7783
ELECTRICAL APPLICATION
Application No. R 8 A 4
on the side of
T of #8_4 Ca i 1 T.ane Street
I
Street No.
Owner JM J C9p_St-r1_Ct1nr.r3,-
Electrician Cri pps Electric
FILED IN OFFICE OF
The Building Inspector
Oct. 7 ig 82
INSPECTION.
13r No Electrical Work shall be started until a Per-
co mit is granted by the Building Inspector.
0�/� 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
ZZi permit from the office of the Building Inspector.
z
M
a
APPLICATION FOR PERMIT TO DO ELECTRICAI. WORK.
No. 1194
Permit No. . .....}.78 3....... . .
TO THE BUILDING INSPECTOR
of the
TOWN OF SOUTH WINDSOR, CONN.
hereby make application tcx perform Electr cal Work according to detailed description below. All
provis ons of the Rules for Electrical Installation, Section 48, Building By-Laws, shall be complied with
whether specified herein or not.
South Windsor, Conn., 19RgSign here �---T✓�r - �-!"��"
��
f 07 Address &4 5jc-)P)h .!. ..:_.... �/J
Location h. .. . Q S l Side of .. . az,
I. La./v.......... ..... ......... ..............
Nature of Building ... .. .... !4S .�.�..� How many stories ........... ....� ........................................ ................
New or old Building How many families /v . _ . ..........................................................................................
L
How many Stores
Kind o! Installation .. ...L,.... C. .�.�...C.. . . ..................................................................................................
Owner V..m .�...... . �..t (-JC I.V.,'1 Cb Address �,a(�.. �L....I...l...�. _��_..�_ _...... � "t!
ArchitectAddress ... . ........... .. ................................................__..__ _._....
m J. ....c 0 n.54,r U 4'vl1. .CoAddress ��`�.
Builder �. I �.n. ..a._.... W
T
.....
Electrician L ,1'.A..� �. .L.G..Lr�.( 1 t,... ... ... . .. Address5..... ....,,.. ....C�...4.1...!'1........ .-.s.T. ._..lC....2!.vd) J
Size of Main Wires .. .. .'�......
No. of Light Loops .. .. �.: No. of Heat Loops . ...... No. of Power Loops ..........................
No. of Light Outlets �..� No. of Heat Outlets . .. No. of Power Outlets ................. ...........
NoP of Light Circuits . . ..cam-.... . .... 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 Cord Drops ............... ..... .......... .................. ......
No. o! Receptacles ...........� p �.. ..�. ..
Remarks: For other kind of Installation .. .. l t.J 1..0 e.d......... .�.D l.(.�..t.n........... ... •. �� 7..Q.....���.....
�—
........................................................................ ..... ......... .. ............................... ..............._.......... .................................................................. ..... ...... . .
.................................................................................................................................................... ..................................................................................................................................... ... .. .. .
...................................................................... .......... ........ .. .. ...... .............................................................. . ..... . .................. ..... . ... . .. .. .. . ...... .......... .
Estimated Cost 4
w 6021 �. .
PLUMBING APPLICATION
gpp]caf,Noy 6800
on the _..___ side of
_............ Lot 84 Gail Lane Sit
Street No. ._._ 15 3
Owm . .JMJ Construction
plumber So. Windsor Plb. & Htg.
I
Filed in Office of
The Bdd&mg
Oct. 27 � 8
r
i
..............
Co ............._............
....
�„.: No peaoa shall coestintot, add m or abet ay
portion of the aysu m of aay bul&eg
(ezeept to repair leaim) uaod a Plermit is gmood
by the BuMng Inq)am r.
m
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a
Application No. M-N...................... Permit No. ..................
TO THE BUILDING INSPECTOR
of the
TOWN OF SOUTH WINDSOR, CONN.
hereby make application to perform plumbing according to detailed description below. All
provisions of the Rules for Sanitation, By-Laws, Sections 33 to 47 inclusive, shall be complied with whether
specified herein or not. -
South Windsor, 13 ... .... . 19 A? Sign here ..... t. ........
Addrew ./f1..... rvy......;.. ... .......
Z4.17...'�c...................... Street
.. ......... ...
Location -Z-( . . ............................................... side of
Nature of Building /fei.,744.,,.rc-a.. ............. How many stones .. ................ ........................... ..................................
Owner ............. .................... Address r ...........
Architect ............ ....... .................. ................... Address ... ...... .............................................................................
ItIf V I -
Builder . ...................... ................................ .......... Address ................. ... . .. .............. ....... . ................................ .........
Plumberj.�.�k 7-//.AJ'A' �6 m'.z.t....Ifl. ................... Address /00. -.4q,4........I'a...q.............r ...
DRAINAGE
CESSPOOLS, How many Where located .... ...... . . ........................................................................
Are they water tight . . ... ..... Of what materials are they built .................... ........
Size of pipe from house to cesspool Kind of pipe .............................................................................
MAIN DRAIN IN CELLAR, Material Diameter .................... ...............................................................................
Aboveor below cellar bottom - ..- --66claw... - - . ... . ... .........................j....................................................................................
SOIL PIPES, Material . .. .....A/41-ril(.... .. ... Diameter . ..... ...........................
WASTE PIPES, Material PAS Diameter ......... .....................................................................................
TRAPS,Type proposed to use is - . ...... . .. .. .............................................................................................................................
RAINWATER LEADERS, where do they run to . .. . ... .... ..................................................................................................................
REFRIGERATORWASTES, where do they run to .. ... ... ............................................................................................... ...............................
TANKOVERFLOWS, where do they run to . ..............................................................................................................
FIXTURES
WATER CLOSETS, How many .... ..........3...... .. . ......... Where located -.-rwo......4ievn.l .... ...j) F
Distance from trap to vertical 30ilpipe ....................................... Pattern .. ............... ...............................................................
WASHTRAYS, How many . .. ... ................................... ... Where located . ......... .........................................................................
SINKS, How many ..........................................................I........................... Where located ...... .............................................
BUTLER'S SINKS, How many ....................................................... Where located.. ................................................................................................
REFRIGERATORSINKS, How many . .....j............................. Where located .................................................................................................
LAVATORIES,How many ............................................................. Where located -&0...JPL QA ....OWE
BATH TUBS, How many ...........................................I......................... Where located .........Setan.-d......Flo.,9.K...........................................
URINAW-1 6w ......... ... ... . ................./........................ Where located .......&eeAA1..d....... ...........................................
Are water closets and urinals to be local vented If not, is there a window in outer wall
ofroom where same are to be located ........ Y5?...................................................................................................................................
Estimated Cost Q..Q..............
3 N N V%'Zo
,
Heat loss schedule must be complete for all jobs. System guaranteed to heat all rooms to 800 in zero weather.
Dwellings exceeding 1260 sq. ft. to be heated shall have two or more zones controlled by separate thermostats.
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APPLICATION FOR HEATING PERMIT (Continued tr m Revene side)
11. LOCATION OF JOB Z,, r `► 1: F
NO. STREET FLOOR AFT.NO.
12. TYPE OF INSTALLATION; ❑ OIL BURNER ❑ ELECTRIC ❑ VENTILATION ❑ SPRINKLER
GAS BURNER ❑ STACK ❑ INCINERATOR ❑ MISCELLANEOUS
IDENTIFY
SIZE LOCATION SIZE SIZE
13. OF TANK OF TANK OF FILL OF VENT
14. B.T.U. EQUIP. AT REGISTER FURNACE MAKE AND NO. AT BONNET FIRING RATE
BOILER OR FURNACE MAKE AND NO. &i? 681irl' B.T.U. OR SQ. FT. NET vov B.T.U. OR SO. FT. GROSS FIRING RATE
FLOORS TO BE HEATED a NEW OR OLD BUILDINGAflt.' INSULATED — YES OR NO Ye
TYPE OF WALL W000 6!!A �f INSULATION f 66,641 ROOF OR CEILING L`e.A., INSULATION
AVG. SYSTEM WATER TEMP.__,160 B.T.U./SQ. FT./HR. EMISSION
INDOOR-OUTDOOR TEMP DIFFERENCE d" 0 °FAHRENHEIT
MAKE OF RADIATIO BAS PER CONVECTORS, OR C.I. RADIATION. OUTPUT PER SECTION OR LINEAL OF RADIATION. SQ.
FT. OR B.T.U.
DESCRIPTION OF WORK y /
15. TO BE DONE; dk _ c Z
0• T h d J'"" L/ ,
16. HEAT LOSS SCHEDULE. (TO BE INCLUDED FOR ALL JOBS).
Roots slzE WIN
Dows AREA - SQUARE FEET B.T.U. B.T.U. 1-D
AND DOOR voLUME TOTAL TOTAL N F DISTRIBUTION INSTALLED
L
ROOM NO. GROSS GLASS NET WALL CEILING FLOOR CU.FT. AT 70•F CORRECTED J j 4 RAD. REGISTER
L W N AND Q TEMP. TO f; TYPE AND SIZE OR LEADER
SIZE < WALL TO (INFILT.) DIFF. •F O a 3O. FT. FREE AREA
TOTALS
A. HEAT LOSS FROM BUILDING B.T.U./HR.
B. DOMESTIC HOT WATER DEMAND �y C4 B.T.U./HR.
C. PIPING, OTHER THAN NORMAL B.T.U./HR.
ALLOWANCE FOR HEAT VALVE OF FUEL (A`B C) FACTOR
17. ELECTRICAL WORK BY; L J a &✓C 4 1
NAME ADDRESS
SUBCONTRACTORS AND
te. THEIR TRADES
ALL WORK COVERED BY THIS APPLICATION HAS BEEN AUTHORIZED BY THE (OWNER) OR (AGENT) OF THIS PROPERTY AND WILL
BE DONE IN STRICT ACCORDANCE WITH THE BUILDING CODE.
APPLICATION TO BE COMPLETELY FILLED IN. r ��
DATE SIGNATURE "AI CANT
CA
HEET
- ARGO f �_ - --
� . ADDRESS
�L � --Leif -
` _ _.�s 1... --- _3 iC'ND OF
of,_ISTRI.�CfiroN WALL
on
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Is to 13 60
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- �_ .. • - -. _, . -- -_ - _max w''=.`: _ - - - ._ _ _•`'� _ -
- mow? :s, - -' ,. _ � -4..._-�' �7>� - __ -_ � -- .. - _ .s-..--" '•{'* "y�g� �`=+c.S'�".-`,ySi"" `+A.,,y.•.�-T
FINAL INSPE TIo /f SS APPLICATION FOR BUILDING PERMIT
Building C�t
Or
Plumbin
HVAC 153 GAIL LANE Date:
Sprinkler
Electric Estimated Cost $ 600,00
Zoning 19488 Permit Fee$ Zn
Affidavit NO. Occupancy Fee $
Eng. Dept. 4
Fire D pt. COMPLETE RED BOXED AREAS.TYPE OR PRINT ONLY Total Fee $ -,In
pt �-
Health De .
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 Q o 1AA a mg A /P4 D S 19 j Tel. # -;�g'9-OY/V
Address S3 i ZAn e S. U)LndSOf C4 Zip 0 D1V Lic.#
TREET CITY STATE
Owner 1 �A `� ddress �.5- LtJ�vr�So✓-
iL I hl D
Architect Address
Size New Area: Ft. Front Overall Ft. Deep Overall Total Area #Garages
Lavatories
No. of Families No. of Stories Construction Bathrooms Rooms 1st 2nd 3rd
Size of Lot Dist. from Street Line Dist. from Side Street Line
Purpose of this Permit
City Water ❑ Well ❑ Septic ❑ Sewer ❑
Approv d by Dat 3
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 o her zones and is
located in a zone in which this building and its use is allowed.
� P
Signed
-
I hereby apply for a Certificate of Occupancy for the work described in this application for permit. CJ
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:
IMIHO E. HrMA do ASSOCIATES
Civil Enginee ra
Glastonbury, Conn.
GA1 L LANE
/n .�=��00'00' Id=Zq.a►q'
T r tS.00' N 41A
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ri� �Z• N ' 1• W� 110
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No ZONING V1oLAT1oN5 ' �'
FOUNDAX%0N LOCATED 45 51-W wN to-Z9.1at TZ
T vP�
1%4
.VOTE: Lot lines from map on file in
Town Clerk's Office entitleds "Plot Plan +
Section- 5 Pleasant Valley Homes 1 -
South Windsor.. Conn."
Scal 1"= 40 I Date
-Map No 220-78-IQ By. R ei no E. A-20 MON E.
KYYppa t-- Associakes Gta,stohb"rYI Conn. -
Pf2EPARED FOR
t hereby certify that this rnap and survey were prepared in PLEASANT VALLEY =
accordance with the standards of a Class A-2 survey as defined • A LY �--�� 1....5
in the existing Code of Practice for Standards of Accuracy of SO UTH WINDS" 0 Q1 C Ott N,
Purveys and Maps, adopted by the Connecticut Association f
Lend Surveyors, Lir. SCALE 1"=40'
� _ a--
C�NNE�
0
South Windsor,
BUILDING DEPARTMENT
may
Date 7
Zonaing Enforcement Off;
Icer
1,n 4d, �
J9 4
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1540 SULLIVAN AVENUE - SOUTH WINDSOR, CONN. 06074
R.Go��,� AREA CODE 203/644-2511
DATE: August 23, 1991
TOWN OF SOUTH WINDSOR
BUILDING DEPARTMyNT
Ralph A. & Pamela J. Lindsay
153 Gail Lane
South Windsor, Connecticut 06074
TO WHOM IT MAY CONCERN:
Re: 153 Gail Lane
South Windsor, CT.
This office has observed that the construction activity
referenced below is in progress at the above noted location.
Our files indicate that no building and/or zoning permit has
been issued to allow the referenced construction.
Please terminate all construction activity and contact this
office as soon .as possible to make arrangements to obtain the
necessary permits .
Your cooperation will be appreciated.
Ve u o rs
John R. Collins
Chief Building Official
Construction Activity:
Deck
cc: John Mc Cahill, Zoning Enforcement Officer
Electric# APPLICATION FOR BUILDING PERMIT
Plumbing# 153 GAIL LANE
HVAC # Date: 2Co
Sprinkler# No. 25912
FINAL APPROVALS Estimated Cost $ e
Building 415� COIMIPLETE RED BOXED AREAS Permit Fee $ oa
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) $
Th undersigned hereby applies to do work according to the following specifications:
Job Location /S 3 !2 r L L 4 Ai L- Lot No. Side of Street Zone
Applicant 4" Py vjef^- `— en—s AvIne— Tel.# 75 dl 3
Address (�&/ _ �'.® CL Zip l Lic. #
Owner Address
Architect Address
Sq. Ft.New Area: lst FI. 2nd FI. 3rd FI. Total New Area
#Rooms # Lavatories #Bathrooms #Garages
Purpose of this permit:
4fh
City Water [7- Well 0 Septic System ❑ Sewer
Use Group Construction Type Area / Base ent a
Approved by qk Date I
Revised 6/95
I hereby agree to conform to all the requirements of the Laws of the State of Connecticut and the Ordinances of the Town of
South Windsor and to notify the Building Inspector of any alteration in the plans or specifications of the Building for which this
permit is asked, and agree that this budding is to be located er distance from all 'nes, side yard lines and required
distances from all other zones and is located in a zone ' which t 's b ildi and its a is allowe .
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