HomeMy WebLinkAbout150 Abbe Road (6) i
TO THE BUILDING INSPECTOR
of the APPLICATION FOR
TOWN OF SOUTH WINDSOR, CONN. PLAN EXAMINATION ANDBUILDING PERMIT
IMPORTANT - Applicant to complete
all items in sections: 1, It, III, and IV. ZONING
O
I• AT (LOCATION) Akke eel DISTRICT-
LOCATION (NO.) (STREET) {
OF BETWEEN "091J/7s./ AND 042rnC__l4-
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
II. TYPE AND COST OF BUILDING - All applicants complete Parts A - D
�o
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use T
1 ❑ New building Residential Nonresidential
2 ❑ Addition(if residential, enter number 12❑ One family 18 ❑ Amusement, recreational
of new housing units added, if any, 13 Two or more family - Enter 19 Church, other religious
3 Alteration (See 2 above) 20❑ Industrial
in Part D, 13) ❑ number of units - - i ❑ g
®
14 ❑ Transient hotel, motel, 21 ❑ Parking garage
4❑ Repair, replacement or dormitory - Enter number
5❑ Wrecking (if multifamily residential, of units ------- - -i 22 ❑ Service station, repair garage
enter number of units in building in 15 ❑ Garage 23❑ Hospital, institutional
Part D, 13) 16 Carport 24❑ Office, bank, professional
6 ❑ Moving (relocation)
7 ❑ Foundation only p
17 Other - Specify, 25❑ Public utility
26 ❑ School, library, other educational
B. OWNERSHIP 27❑ Stores, mercantile
8 Private (individual, corporation, 28 ❑ Tanks, towers
nonprofit institution, etc.) 29❑ Other - Specify
9 ❑ Public (Federal, State, or
local government)
C.COST (Omit cents) WORK DESCRIPTION:
10. Cost of improvement. . . . . . . . . . . . . . . . $ CCJ �� X a A/
a. Electrical . . . . . . . . . . . . . . . . . . . . . pG- c �(�T 66" f Q li0��
b. Plumbing . . . . . . . . . . . . . . . . . . . . .
c. HVAC . . . . . . . . . . . . . . . . . . . . . . . .
d. Sprinkler . . . . . . . . . . . . . . . . . . . . .
e. Garages. . . . . . . . . . . . . . . . . . . . . .
f. Other
11. TOTAL $ Yoab Fee: ��� CO Fee: Total: yOD�
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. PRINCIPLE TYPE OF CONSTRUCTION G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS
40❑ Public or private company
48. Number of stories...............
30 El Type 1: El El 41 El Private (septic tank, etc.) 49• Total square feet of floor area,
all floors, based on exterior
31 ❑Type 2: ❑A ❑B ❑C dimensions ....................
32 ❑Type 3: ❑A ❑B H. TYPE OF WATER SUPPLY
42 ❑ Public or private company 50. Total land area, sq. ff. ...........
33 ❑Type 4
43❑ Private(well, cistern) K. NUMBER OF OFF-STREET
34 ❑Type 5: El ❑B PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed .......................
35❑ Gas Will there be central air 52. Outdoors........................
36❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37❑ Electricity 44❑ Yes 45❑ No 53. Number of bedrooms..............
38❑ Coal
39❑ Other- Specify Will there be an elevator? 54. Number of Full..........
46❑ Yes 47❑ No bathrooms Partial........
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing addres
s — Number, street, city, and State ZIP code Tel. No
Al,( eG / O Le O 9S/ "t'/7(/
Owner or
Lessee
z. w% -'D r vorno,AbV O 4(v Q9
Contractor
3.
Architect or
Engineer
I
The owner of this building and the undersigned agree to conform to all applicable laws of this jurisdiction.
SignaturZofcant Address Application date
1d �-r cIT�O isa 444
DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans By y
Date Plans B Notes
9 Fee StartedApproved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Dote Dole
Permit or Approval Check Obtained Number By Permit or Approval Check Obtained I4umber 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 number (0 ICJ
Building }� Q
Permit issued y v 19
Building
Permit Fee $
Approved by:
pp
p �5—
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