HomeMy WebLinkAbout105 Country View Drive (4) 3
TO THE ]BUELDING INSPECTOR
of the APPLICATION FOR
lrovm OF SOUTH WWADSOIlk CXOW PLAN EXAMINATION AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, III, IV, and IX. _
O
I• AT (LOCATION) x ZONING ,.
DISTRICT an
LOCATION (NO.) L
(STREET) Q 5A'I 0k9 O
OF BETWEEN AND // TV ^1G..
BUILDING (CROSS STREET) (CROSS STREET)
SUBDIVISION �� r �a- LOT �� p
BLOCK SIZE
11. l_O.Ada S
11. TYPE AND COST OF BUILDING - A11 applicants complete Parts A - D
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use M
1 EZ New building Residential Nonresidential
2❑ Addition(I/residential, enter number 12 XC One family 18❑ Amusement, recreational
o/new housing units added, i/any,
in Part D, 13) 13❑ Two or more family - Enter 19❑ Church, other religious
3
number of units- - - --� 20❑ Industrial
Alteration (See 2 above) 14❑ Transient hotel, motel,
4❑ Repair, r placement 21 E] Parkinggarage
or dormitory - Enter number
5❑ Wrecking (1/multifamily residential, of units ------- - - 22❑ Service station, repair garage
enter number of units in building in 15 g Garage 23❑ Hospital, institutional
Part D, 13)
16 ❑ Carport 24❑ Office, bank, professional
6 El Moving (relocation)
17❑ Other - Specify 25❑ Public utility
7 ❑ Foundati n only 26❑ School, library, other educational
B. OWNERSHIP 27❑ Stores, merconfile
8 Rj Privat (individual, corporation, 28❑ Tanks, towers
nonpr fit institution,etc.) 29❑ Other - Specify
9 ❑ Public(Federal, State, or
local g v rnment) - .
C. COST (Omit cents) Nonresidential - Describe in detail proposed use of buildings,e.g., food
processing plant, machine shop, laundry building at hospital,elementary
10. Cost of improvement,,,,,,,,,,,,,,, S L 0400 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. El ctrical......................
/L Ir S
b. Plumbing ......................
c.Heating, air conditioning.........
d.Other(elevator,etc.)............
11. TOTAL COST OF IMPROVEMENT G L o co
III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — L;
for wrecking, complete only Part J, for all others skip to IV.
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS
30❑Mas my(wall bearing) 40 Q Public or private company 48• Number of stories................
tz
31 W d frame 41 ❑ 49. Total square feet of floor area,
Private(septic tank, etc.) all floors, based on exterior
32❑ Structural steel dimensions .................... 7 Z
33❑ R inforc d concrete H. TYPE OF WATER SUPPLY
34❑ Other - Specify 42 S Public or private company 50. Total land area, sq. ft. ........... 11, 1760
43❑ Private(well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed .......................
35❑ Gas Will there be central air 52. Outdoors........................
111111111:99 oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 El ctricity 44❑ Yes 45® N 53. Number of b dro ms.............. 3
38❑ Cal
39❑ Oth ►- Specify Will there be an I vator? Full..........
54. Number f
46❑ Y s 47® N bathrooms partial........
NOTES and Data — (For department use)
IV. IDENTIFICATION — To b complet d by all applicants
Name Mailing addr ss — Number, street, city, and State ZIP cod Tel. No.
1. +�U
Owner or ilo 7aAaaic CoArm
Lessee
2. 5a
Contractor
3.
Architect or
Engineer
Th own r of this building and the undersigned agree to conform to all applicable laws of this jurisdiction.
Signatur of applicant Address AvoP. Application dot
r Rd coriN 4 c od i ///t/lq3
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plan Review Date Plans Date Plans
Plans R vi w R quired Check Fee Started BY Approved BY Notes
BUILDING
PLUMBING $
MECHANICAL $
ELECTRICAL is
OTHER Is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approva I Check O Date bta ned Number By Permit or Approva I Check Obt Date
a ned Number By
BOILER PLUMBING
CURB OR SIDEWALK CUT ROOFING
ELEVATOR SEWER
ELECTRICAL SIGN OR BILLBOARD
FURNACE STREET GRADES
GRADING USE OF PUBLIC AREAS
OIL BURNER WRECKING
OTHER OTHER
VII. VALIDATION
Building
Permit numb r 13014
Building
Permit issued Nov. 23 19 82
Building
Permit Fee $ 372.00
rove b e
L
JE' -0
NOTESVill. ZONING PLAN EXAMINERS
FRONTDISTRICT
SIDE - . SIDE YARD
REAR YARD
NOTES
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J
TOWN OF SOUTH WINDSOR
BUILDING PERMIT
Date Nov. 2 3 , 1982
Fee Paid $.3 7 2..00 Eat, Value $. .6.2.,.000
Pit N° 13014
on the aide of
Lot #11 Country View Dr. Sty
Street No. 105
Owner T & M Builders
Applicant Ray Litchfield
CERTIFICATE OF OCCUPANCY ISSUED:
Date
No. 6999
Fee Paid $ 3_00
CLASSIFICATION
Dwelling
BUILDING PERMIT
N° 13014
OFFICE OF
THE BUILDING INSPECTOR
of the
Town of South Windsor, Conn.
South Windsor, Conn. Nov. 23 19 8 2
ir#ija be to (fP1`ftfv, That I & M biilding
is hereby granted permission to Eve l l i ng
at estimated value of .00
on the side of Lee- 411 C0-untrT114614 Dri396 Sweet on land
owned by
Said 11,10-r-k to be as described in Application
No. 13114 and to conform to specifications and plans filed with said Application, and Building By-
Laws of THE TOWN OF SOUTH WINDSOR.
Issued Nom 2,T 19 8 2.
'4wding Inspector.
excavations or building materia must be guarded by barriers
Streets and sidewalks, obstructed by ding ls,
during the day and by both barriers and colored lights by night.
SECTION 1343, GENERAL STATUTES OF CONNECT I CUT: "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."
Welltng - Lot #11 Cty.View Dr. 11/23/82
T' & M Builders
105 Country View Drive Permit # 13014
Electrician
Milton C. Plouff 7860
Heating Cont
Plumbing it Norman Lutzen # 6095
Oil Burner #
Certificate of Occupancy # 6222
Plot plans apprd. per Engr.
S
INSPECTION EPORT
Permit # Job
1 Footing ; I—��,_�
2 Foundation
3 Framing
4 Wiring
5 Plumbing
6 Heating
7 Lathing
8 C.O. /,%7
P rnut No. �--� ` TOWN 6F SOUTH WINDSOR
o� SOUTH WINDSOR, CONN.
Permit N9 6222
Certificate of Occupancy
TH S TO C IFY that the
at No. .� � the T of South Windsor, Connecticut, has
been erected and comp ted in accordance with the Buil ing Code and Zoning Regulations of
the Town of South Windsor, and is hereby appro d f ccup
v"
` Building Inspector
eer, B er
19 C7
p
Fee Paid /' _
OPEN SPACE
� t
s OT 47? -29' w
LOT AREA
189900 S.F. �•... •
ar.
iw _
LOT 10Wam s ..-' l" 12
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♦w�+wrw�rs����iw�w�www ww.��..��.w..•r,.���.���..•�•ram.
RFFFAF�c�• AS BUILT
Plat PIan,Country View Or.
Country View Estates,Photo One LOT
Property Of TaM Widin9 Co. Country View Estates
South Windsor, Conn.
Nov, 1980 Rev. 3-26-81 i"=40` South Wirl
S� Com.
Certified Class A-2 By :
A. R. Lombardi Associates, Inc. PROPERTY OF T8M BULDING CQ
/ HERESY CFR77FY THIS MAP APR IL 12, 1983 ' SCALE, I'•4 Q'
LY C IQ/QE�T.
Robert T. Dayton, CorW LA. 8157
A PPR O V
E D
TOWN OF
SoUT"H WINDSOR
ENGINEERING DEPARTMENT
DATE;
SIG.: 3
-----
7860
ELECTRICAL APPLICATION
Application No. 8971
on the side of
Lot 11 Country View rStreet
Street No. 105
Owner T & M Rili I d1 derS
Electrician Milton C. Plouff
FILED IN OFFICE OF
The Building Inspector
Jan. 24 19$—
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 fire
stops (if of wood) are installed, without a special
permit from the office of the Building Inspector.
1 �
APPLICATION FOR PERMIT TO DO ELECTRICAI. WORK,
No. .. .... ....R.9f9 ..8.9 71
Permit No. . 7860
TO THE BUILDING INSPECTOR
of the
TOWN OF SOUTH WINDSOR, CONN.
��. . hereby make application tcq perform Electr cal Work according to detailed description below. All
provisions of the Rules for Electrical Installation, Section 48, Building By-Laws, shal be corn ied with
whether specified herein or not.
South Windsor, Conn., teY IY 17 19 P3 Sign here • .• •.••••...••.•
Address
Location 77e. Side of
Nature of BuildingG3 i L- How many stories ..... v.
. . ........................................... .................
New or oId Building r�!
How man �
y families ............................... ......................................
Kind of Installation ./ �! � How many Stores
Owner ....../...... .. ./..✓...��f!.1-�� `''�-..�-.`.�... ....... .... .. Address ..��'! .. .. ...... G.s'�'.t'.!�`..lr�J1/....._....._......
ArchitectAddress . ..... ..... .. ................................................
Builder Address �/7`lyc ... ................ ...................
_...._....._ .... ....
Electrician .L Dill.... ...� !C? Add ss .7! .. ....... ......................................................................
_._...
Size of Main Wires .. ...G..................................
..l.....L.............._
No. of Light Loops ... ... . ...... No. of Heat Loops .. ..,.. No. of Power Loops ........................._._..........
No. of Light Outlets No. of Heat Outlets . No. of Power Outlets ................. .......... .
Nob of Light Circuits ..... .. .... ... ... No. of Heat Circuits se
. No. of Power Circuits ..
No. of Sockets Q!��� No. of Heat Receptacles No. of Motors ......... . ..
No. of Panels .............. �
ice,t . . Size of Heat Circuit 0. No. of Power Receptacles
No. of Switches ... ... v.. Total Wattage �, 00. .... . Size of Power Circuit ..
Total Horsepower
No. of Straight Electric Fixtures ..... No. of Combination Fixtures ...
Y
No. of Receptacles ........... ..... .... ... ............................. . No. of Cord Drops ... .. .............. ..I...... .......... .. ... ....... ... .... ..
Remarks: For other kin
d of Installation ..�/���'�r 4r�'/`t�f���7�� � 5 •�`'� r'' �
oycice./G f1� 7yi . ........... ..............._.... .................................................................................. .. ..
......................................... .......... ......................... .................. ..... ... .... ................. _... .......................... ........................................... ................... .
.............................................. � ......... ...... ....
A
Estimated Cost .,, ........................ .
THERMA-RAY HEATING SYSTEMS HEAT LOSS CALCULATION
511--e
DATE PHONE
CUSTOMERBLDR.
y
JOB 7-**/ L/loq/V-t-78-
INSULATION
WALLS CEILING FLOOR BETWEEN FLOORS DOORS GLASS I SLAB INSUL. ARCHITECT
DESIGN TEMP DEGREE DAYS HEAT LOSS HEAT INSTALLED LOCAL ANNUAL ELEC. COST(AVERAGE) ANNUAL OPERATING COST(APPRX.)
ROOM F ba tom
A
DIMENSION C
T
AREA AREA AREA AREA AREA AREA AREA AREA AREA AREA
HEAT LOSS WATTS WATTS WATTS WATTS WATTS WATTS WATTS WATTS WATTS WATTS
R
SOURCE OR LOST OR LOST OR LOST OR LOST OR LOST OR LOST OR LOST OR LOST OR LOST OR LOST
S VOL. VOL. VOL. VOL. VOL. VOL. VOL. VOL. VOL. VOL.
CEILING +r�
SQ. FT. J
FLOOR
S Q.FT. Iw
INFILTRATION
ROOM VOLUME (
C U.FT.
G ROSS
WALL SQ. FT.
GLASS less less less less less less less less less less
SQ. FT. I I I to
OUTSIDE DOOR less less less less less less less less less le
VENTED FAN
FIREPLACE
NET WALL ,� /��
SQ. FT. /
TOTAL Q
HEAT LOSS Q
TOTAL WATTAGE
INSTALLED � e
so
ESTIMATOR . . . . . . . . . . . . . . . . . . . . . . . . . . . COMPANY NAME & ADDRESS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
THERMA-RAY HEATING SYSTEMS HEAT LOSS CALCULATION
DATE PHONE
CUSTOMER
JOB _ ' r i ;� c-z4) BLDR.
INSULATION WALLS CEILING FLOOR BETWEEN FLOORS DOORS GLASS I SLAB INSUL. ARCHITECT
DESIGN TEMP DEGREE DAYS HEAT LOSS HEAT INSTALLED LOCAL ANNUAL ELEC. COST(AVERAGE) ANNUAL OPERATING COST(APPRX.)
r lit
ROOM F
DIMENSION C ". t. 1 r y - �' ) • "� �� K / ��•, •j
T
AREA AREA AREA AREA AREA AREA AREA AREA AREA AREA
HEAT LOSS R WATTS WATTS WATTS WATTS WATTS WATTS WATTS WATTS WATTS WATTS
SOURCE OR LOST OR LOST OR LOST OR LOST OR LOST OR LOST OR LOST OR LOST OR LOST OR LOST
S VOL. VOL. VOL. VOL. VOL. VOL. VOL. VOL. VOL. VOL.
CEILING r• ,,i 8� 4j 1 • 3
+SQ. FT. &. 5 it� 1,�I p%, 1 I
�`
FLOOR ,k : ,� J . 1 � 3 yea
d'x ° '�� + �1 r `� '
C,
SQ.FT. 1 P .s L»• r e t. - i `+
INFILTRATION +t P r a. ! / i••,' ! w,' �, l
ROOM VOLUME �� r+ •i� ,i l.j ♦;�, ^ �6� !f r � 1 !� Cai 1 1 , '
C U.FT. 3 t I '
G ROSS
WALL SQ. FT. fEi c,�,
G LASS less lets s j� letss t w less `less I4v,,, /l�es�s f less f� lest. fdl
. lest, �qe Press
SQ. FT. Fil � �^ f Fr / Ir ` "� �rt.' Y• A f
OUTSIDE DOOR les3r wd' le r less,+' les leis r less" less ,-'> lesj lep lei
VENTED FANS
FIREPLACE r
NET WALL �� �t �`���� �� Cf- �J .0. �, t" 15�.'�9
SQ. FT. �� •" rC i f
t
TOTAL r' r �l4d/ r �`� c ",0 *
HEAT LOSS . �" �� " i I 'd •< t�s �. (+ � E
TOTAL WATTAGE +, %t 40
r"r `- f► l( +"f'r +}�' '� L P 1 i *'� 3 " a�' ,`�� {� 'S rs
INSTALLED t� ',�4s,lf 1p�.y �' i ,1 ,> �t,P.� f 1'� � wP4 os
1-4
r .s sP
f � • � _ _• ,�'- . �ft` � ti� zee `�.' �•.ti1 ``�.�3 v
ESTIMATOR . . . . . . . . . . . . . . . . . . . . . . . . . . . COMPANY NAME & ADDRESS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
bUW3
.4o
PLUMBING APPLICATK)N
mXatim No. 6874
on the_.___- — aide of
Lot #11 Country View Dr. Suet
Street Na _._ 105
Owm _T & M Building
plumber Norman Lutzen
Filed in Office of
The Budding
Mar- 1 19—M
No person:hall add to or alder sty
portion of the die system of any 600ldisg
(moept to repair leab) uotg a Pleank is va td
by the Building Impecoor.
Application No. ...... 6.84............... Permit N . .62.22...................
....... ......
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, R-3.... .. 193 Sign here ................. .......... ........ ....................................... ............
Address .... ... ........dY'b.. ............ r............
Location ........... . ......(/(:9 side of ....... ...... ............................................................................ Street
Nature of Building 97
q............................ How many stories .. .........
........................................ ..................................
Owner .......... ...�- 01. 5................ Address ;.01 0..........Aq.;<................ _.<;�.............................
Architect ....... . . ....... . ...... .................... Address X",-V..........................................
Builder .. ........ .. ... .... .... .. ................................. .......... Address . ................ ...... ................ ........ ................................................
Plumber . .....&J'a cm q.rtj.... ...........A 1 .. Address .........-F/... .......2'-- f....ff...
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 .. ...... ..............................................................................................................
SOIL PIPES, Material .. Diameter 24F.1.........//
S ....../. ..................................................
WASTE PIPES, Material ............. .... .... . ...... Diameter ..... .........e�.'l ......................................... ..............
TRAPS,Type proposed to use is ....P...Y_ P g.. . .......... .........................................................................................................................
RAIN WATER LEADERS, where do they run to ...............................................................................................................
REFRIGERATOR WASTES, where do they run to .. . ............................... ............................ ..............................
TANK OVERFLOWS, where do they run to . ... ... ........... ..................................................................................................
FIXTURES
WATER CLOSETS, How many . ... .......... .'r..�.. .............. Where located .... . .............................. .................................................
... .
Distance from trap to vertical soil pipe ...........44=......... Pattern . ............. . . . ...........................................................
WASH TRAYS, How many . . ...... ........../.................... Where located ....................................................................................
SINKS, How many .............. ... ................................/........................... Where located .. . .......................................................................................
BUTLER'S SINKS, How many .......... Where located. . ................................................................................................
REFRIGERATOR SINKS, How many ... Where located .................................................................................................
LAVATORIES, How many ...........*................................................... Where located .....................................................................................................
BATHTUBS, How many.................................... ................................ Where located .....................................................................................................
URINALS, How many ........ .... .... ... ......... Where located ... ... .........................................................................................
Are water closets and urinals to be local vented . . If not,is there a window in outer wall
of room where same are to be located . ..... . .....................................................................................................................................
eA>
Estimated Cost .....................
DEPARTMENT DECISION APPLICATION-FOR HVAC PERMIT PK 39
Application is hereby_ : TOWN of SOUTH WINDSOR
BUILDING DEPARTMENT Bldw4—
it#
APPROVED 1540 SULLIVAN AVENUE
644-2511 earl. 230
� Date Building Inspector
Application must be printed or typed
Location of job
/)S- Coulvm�i v���
N o. Street Lot No.
FEE SCHEDULE Apt. No.
$0 - $1,000 - $12.00
Over $1,000
$12.00 per$1,000 OWNER Xf- t/('0- P U fi-r/^
or any fraction thereof
ADDRESS l CL�'' C D C/,V 1''"/Z- 1l !,f 1 t2 w d
w��-I/1So,jz fr-:J /-i 640- �
OWNERS PHONE# 21 e9 �c
APPLICANT
"to* N S� ADDRESS ; 2 2 S �'
67
ESTIMATED COST $
C = IS THIS A CONTRACT COST?
YES NO
-?
FEE ENCLOSED $ �-
�S TYPE OF JOB:
OR-Co
Original Installation
Alteration/Addition/Repair
Revised 11/95
APPLICATION FOR HVAC PERMIT(Continued from reverse side)
TYPE OF SYSTEM /TYPE OF BUILDING
HEATING L/ RESIDENTIAL f
A/C COMMERCIAL
VENTILATION INDUSTRIAL
HEATING
STEAM LOW PRESSURE LIMIT LBS. HIGH PRESSURE LIMIT LBS.
HYDRONIC WARM AIR UNIT RADIANT HEATER
EXISTING RADIATION ADDITIONAL RADIATION TOTAL RADIATION
DESIGN TEMP. OUTSIDE F INSIDE F DIFFERENCE F
TOTAL HEAT LOSS(BTUH)
(HEAT LOSS SHEET MUST ACCOMPANY APPLICATION)
DESCRIBE ALL HEATING EQUIPMENT I CLUDING MAKE&MODEL NO.)
/A G IV r Tz l Z i ,P
GROSS HEATING CAPACITY (INPUT-BTUH) NET RATING (OUTPUT-BTUH)
TYPE OF FUEL
OIL-GPM GAS-INPUT ELECTRIC-KW
OIL TANK SIZE&LOCATION
INSIDE OUTSIDE if CAPACITY;?7-1 LPG TANK CAPACITY
k 1 ice 5��- __
AIR CONDITIONING
DESIGN TEMP. OUTSIDE F INSIDE F DIFFERENCE F
TOTAL HEAT GAIN(BTUH)
(HEAT GAIN SHEET MUST ACCOMPANY APPLICATION)
DESCRIBE ALL COOLING EQUIPMENT (INCLUDING MAKE&MODEL NO.)
TONNAGE COOLING CAPACITY(BTUH)
VENTILATION
DESCRIBE ALL AIR HANDLING EQUIPMENT(INCLUDING KITCHEN EXHAUST EQUIPMENT)
TOTAL SIZE OF SYSTEM(CFM) FRESH AIR INTAKE(CFM)
(PLANS MUST ACCOMPANY APPLICATION)
Lr
FURTHER DESCRIPTION OF WORK , ti� �t_ J t.f.�i�Z_ I��f
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.
UCH, lo-e YL1- O 13iA/
I ?7 8-G q93 ILI
STATE LICENSE-NO. NAME&TYPE SIGNA E OF PLICANT
PHONE NO. 6 CJ L.j q DATE 2
Y
IHSPEt;rOR DATE g TIME
LOCATION
INSPECTION: CODE: RESULT(D/A) :
=-_ BUILDING: J _ )3/ L)
Y
ELECTRICAL:
y
b
PLUMBING:
HVAC
a 4'J ✓ t
OTHER:
`e
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
TOWN OF SOUTH WINDSOR PERMIT#
Application is hereby: 122
s'3
BUILDING DEPARTMENT
APPROVE 1540 SULLIVAN AVENUE Bldg.Permit#
4(/6 d L 644-2511 ext. 230 J,�6(3
ate Building Inspector
Application must be printed or typed
Location of Job:
FEE SCHEDULE
$0-$1,000=$13.00 Street No. Street Lot No.
Over$1,000=
$13.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT
APPLICANT ADDRESS /�r �c�.Sk h ;;01 Cat
Spy
APPLICANT PHONE r L -
O
W N S OWNER !�
q� OWNER ADDRESS &
si. tI
OWNER PHONE
C ESTIMATED COST$ d
U
IS THIS A CONTRACT COST? 0 Yes B-Nx
{ �! FEE ENCLOSED$
OR.Cps TYPE OF JOB:
dS
ew Installation
0 Alteration/Addition/Repair Revised 8/99
APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side)
TYPE QF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
Z BUILDING PERMIT APPLICATION? ❑ YES ❑NO
I�RESIDENTIAL
❑BUSINESS CURRENT USE AND OCCUPANCY
❑ASSEMBLY
❑MERCANTILE FUTURE USE AND OCCUPANCY
❑EDUCATIONAL
❑INSTITUTIONAL ENGINEER'S NAME PHONE _
❑FACTORY
❑ STORAGE ADDRESS
❑GARAGE
❑MIXED USE CITY STATE ZIP
(Other please specify)
TYPE OF INSTALLATION/WIRING METHOD
SIZE OF SERVICE SIZE OF MAIN CONDUCTORS
NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS
NUMBER OF PANELS REMOTE DISCONNECT REQUIRED? ❑ 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
SEPARATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED.
DESCRIPTION OF WORK
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS TO
COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE
PERFORMANCE OF SUCH WORK.
CONTRACTORS LICENSE NO. / E STATE
///
rev f�.
SIGNATURE OF APPLICANT DATE ��� )
r
j3ectric# APPLICATION FOR BUILDING PERMIT
Plumbing# 105 Country View Drive
Dat :
HVAC # ,rU� t;, 2e o�
Sprinkler# No. 27082
FWAL OV Estimated Cost 2 �• °
Building jZ COMPLETE RED BOXED AREAS Permit Fee
Engineer TYPE OR PRINT ONLY Occupancy Fee $
Affidavit SIGH ON REVERSE SIDE
Appr.for CO. Total Fee $ 3 9
TO BULDNG DEPARTMENT,TOWN OF SOUTH W1 DSOR,CT (Additional Cost) $
The undersigned hereby applies to do work according to the following specifications:
Job Location /o S CoL,V'T `t' V L'Eg' L�k, Lot No. Side of Street Zone
Applicant A l K X Ow c Tel.# 2 2!9 - V 4 V CP
Address C PLV"- 4-A/v9 fe VT41 IV*AO ra 9 Zip Oro OIL/ Lic.# SY r C f?
Owner /CEGC Y f t/TT I-i/ Address la'-' Co 1.VW Y 1/ S AV DA
Architect Address
Sq.Ft.New Area: 1st Fl. 2nd Fl. 3rd Fl. Total New Area
#Rooms #Lavatories #Bathrooms #Garages
Purpose of this permit: 9C. 170,61' Ova& L,srzl r:fJVCr awe Lmig R+e W
ity Water ❑ Well 0 Septic System ❑ Sewer ❑
Ins. H.O. S.P. Cert. Area Basement Garage
Approved by Date 6Wa Use Group Construction Type
R*49d 1197
I hereby agree to conform to all the requirements of the Laws of the State of Connecticut and the Ordinances of the Town of
South Windsor and to notify the Building Inspector of any alteration in the plans or specifications of the Building for which this
permit is asked,and agree that this building is to be located the proper distance from all street lines,side yard lines,and required
distances from all other zones and is loceed in which this building and its use is allowed.
SignedPyby.-AYo��A
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
r
Inspection / Approval Date By Appl
Code Description Due Whom Code Comment
-------------------------------------------------------------------------------
**-27082-B 2,200
B10 FINAL 05/22/01 JFF A
B10 FINAL 05/22/01 JFF A CLOSED OUT.