HomeMy WebLinkAbout100 Arnold Way (12)TO THE BUILDING INSPECTOR
of the APPLICATION FOR
TOWN OF SOUTH WINDSOR, CONN. PLAN EXAMINATION ANDBUILDINGPERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, and IV. O
n ZONINGI• 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, recreationalofnewhousingunitsadded, if any,13 Two or more family — Enter 19 E] Church, other religiousinPartD, 13)
number of units— — — — i
3 Alteration (See 2 above)
20 Industrial
14 Transient hotel, motel, 21 Parking garage4 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. HVAC . . . . . . . . . . . . . . . . . . . . . . . .
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 ury,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 NotesFeeStartedApproved
BUILDING
PLUMBING
MECHANICAL
ELECTRICAL Is
OTHER Is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date 1 DatePermitorApprovalCheckObtaiedNumberByPermitorApprovalCheckObttained 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 7IPermitnumber
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 LAZOLPAL
2 Foundation 7oA,/A( cc
3 Framing
4 Wiring
5 Plumbing
6 Heating
7 Lathing
8 C.o.