HomeMy WebLinkAbout100 Arnold Way (12) 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, 11, 111, and IV. O
n / / ZONING
I• AT (LOCATION) L� ` ' r�sL ` DISTRICT
LOCATION IN (STREET)
OF BETWEEN "'�'" �' AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
Vs
11. 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
120 One family 18 E] Amusement, recreational
of new housing units added, if any, 13❑ Two or more family — Enter 19 E] Church, other religious
in Part D, 13) number of units— — — — i
3 ❑ Alteration (See 2 above) 20� Industrial
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) ❑17 Other — Specify 25[] Public utility
7 F-� Foundation only
26J�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 CRIPTION:
10. Cost of improvement. . . . . . . . . . . . . . . . $ 02
a. Electrical . . . . . . . . . . . . . . . . . . . . .
b. Plumbing . . . . . . . . . . . . . . . . . . . . .
c. H VAC . . . . . . . . . . . . . . . . . . . . . . . .
d. Sprinkler . . . . . . . . . . . . . . . . . . . . . /
e. Garages. . . . . . . . . . . . . . . . . . . . . .
f. Other . . . .
11. TOTAL 1 $ o2`/oo O Fee: CO Fee: Total:
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 ❑Type 1: ❑A ❑B 41 ❑ 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
43� Private(well, cistern) 50. Total land area, sq.ft. ...........
33 ❑Type4 K. NUMBER OF OFF-STREET
34 ❑Type 5: ❑A ❑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..............
39❑ 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 address — Number, street, city, and State ZIP code Tel. No.
Owner or O(.UF'°✓ Ci � 314A ✓'.UAJ
Lessee i f/ol�l
2. /9-v
Contractor 0607-f
3.
Architect or
Engineer
The owner of this building and the undersigned agree to conform to all applicable laws of this jurisdiction.
Si a t u ry,of ap icbnt Address Application date
DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans By Date Plans By Notes
Fee Started Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL Is
OTHER Is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date 1 Date
Permit or Approval Check Obtai ed Number By Permit or Approval Check Obttained 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 70 7I Permit number
Building
Permit issued / ZE 19 O
Building p �
Permit Fee $
Approved by:
JCC
6 -. -9
TITLE
TF L.. !fD . eb NN 511* ALI&- 7AW
INSPECTION REPORT
Permit # pj Job ti' 2. 1�'A
1 Footing ID it,IJ 3.rA r i E L
AZOLPAL
2 Foundation *7oA,/A( cc
3 Framing
4 Wiring
5 Plumbing
6 Heating
7 Lathing
8 C.o.