HomeMy WebLinkAbout127 Rosemary LaneP'v
o
TO THE BUMDING INSPECTOR
of the APPLICATION FOR
PLAN EXAMINATION ANDOFs' H CARM BUILDING PERMIT
IMPORTANT — Applic= complete all item sections: 1, 1, 1 , IV, and IX.O
p ZONIN „•jamI• AT (LOCATION) a D IS T CJ
LOCATION NO.)REET)
OF BETWEEN01"
T
AND
BUILDING CROSS STREET) CROSS STREET)
LOT
SUBDIVISION LOT_/_BLOCK SIZE
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 T
11 [X New building Residential Nonresidential
2 Addition(If residential, enter number 12;Z One family 18 Amusement, recreational
of new housing units added, if any,
in Part D, 13)13 Two or more family — Enter 19 Church, other religious
number of units— — — — -i 20 Industrial3 Alteration (See 2 above)
14 Transient moeTithotel, motel, 21 Parking garage4 Repair, replacement or dormitory — Enter number
5 Wrecking (1/multifamily residential, of units ——————— — — 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
17 Other — SpeciJy 25 Public utility
26 School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
8 R] Private (individual, corporation,28 Tanks, towers
nonpr fit institution,etc.) 29 Other — Specify
9 Public (F dera 1, State, or
local government)
C. COST Omit cents) Nonresidential — Describe in detail proposed use of buildings,e.g.,f ad
processing plant, machine shop, laundry building at hospital,elementary
10. Cost of improvement,,,,,,,,,,,,,,,, S AX apo 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 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 Masonry(wall bearing) 40 r,791 Public or private company
48• Number of stories................
31 W ad frame 41 ri Private (septic tank, etc.)
49• Total square feet of floor area,
all floors, based on exterior
32 Structural steel dimensions ....................
33 Reinf rc d concrete H. TYPE OF WATER SUPPLY
34 Other — Specify 42 Public or private company
50. Total land area, sq.ft. ........... J74
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.......................
96® Oil c nditioning?L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 Yes 45 No 53. Number f bedr ms..............
38 Cal
39 Other— Specify Will there be an el vat r?
54. Number f
Full..........
46 Y s 47 X No bothr ms
Partial........
NOTES and Data — (For deportm nt use)
IV. IDENTIFICATION — To be completed by all applicants
Na a Meiling address — Number, street, city, and State ZIP cod Tel. No.
Owner or
r
Lessee
2.
Contractor
3. 3
Architect orl 04—Ak 21 dpmd;
Engineer 10
T.
Th own r of this building and the undersigned ee to conform to all applicable laws of this jurisdiction.
Signature f ap is nt Address Application date
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans R view R uired Check Plan Review Date Plans By Date Plans By Notes9FeeStartedApproved
BUILDING ow $8= Z
PLUMBING
MECHANICAL
ELECTRICAL
OTHER
V1. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Obta ned Number By Permit or Approval Check ObtDaned
ate 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
U/Permit numb r /
Building
Permit issued 19
Building
Permit Fee $
Approved by:
TITLE
VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
FRONT YAR
I X. SITE OR •T PLAN For Applicant
aaaai..s aa. ..a.. .. ....M.. ................a. • q •••• .• • asses.Savonameaaa r uf i w. +'i.i w u o avUH•uawH a,S:.r ii: i•"ir\•i'i r moo i' 'a.i•3aY r i ?i'L' r.u•
i ' :• : aIF = : i:ili'
s. ::::::Ir' ::it:a' H.M.- niumi ra.• • ern • !a : •" s s:
M wease
R •iw afar Nr moss• awss\• fua HH HHUHwH wf•as a • few••of MOM a
a allWIN
s tarssp a a esNra \afra a. a Newsmeffif.. f.• .u• :.I fu •
s.uu i"
r N
f•:::t i•u : fi •'Iu'"ra•i:w. 1111 ::"Isssq iii:eofNu \ •a iwi wra.w a N as•u \ s rH •r
s:' ;
a Rr:i•1\t • '•i: \\ •a r N•iir•i•isoa •a r f•aaa•w q
ra
Ssst__a++S a ra:MSw': ••i . still : i i4 rAii+ai
sera H r•a..Rf is a.tsNr i fr t .
a •a • tr N•t•i u. r a i i•s •ai••. N.. a i3 . w s :CS' . .a ' r C: .•.Ir'I was
fa _ frIII a
a"af u
Does
a . ar wow • affa
MOO on:me
aa• S• wasjaiar • a• as rf. •. • M wt r w t a •H ! a f sera t"a . r: _L•' .. t::w
Hew:. • ••a i aas s•• aaRgf•wia i ...s .• a R • r i. resg:• i'/w
a VN i sss=ia•"ti 1i'os.il ` . r / •
a rrIi'alit11 i s ws. t• • Ri•Nr iN R: asi li11IMMNUM rf••• ra
see as lstra.aa f••
Massfif.rr fsHHj • as •
ffsi s•fwf !! •
Afir
1:•
f Iiii•
i .r sii a s.N's•."RasR1'1
s= :soon: ai s ii•!
SO
f tf. .s H. . •f NH if .. rR•. q• • tN !i it • s:SS•
Mt : o5•:•Nuns . :s::NS SSS: a err _. i as
i s'r s•L'ia.
a
r""
af=se
a••"
r•a as•a •.: Is
FIs: ,: ta:•Fs. si!;=ss::.=lsF:_sa=s
as*" •
s
i a souse" f•:GffHsu N\ s"asome assesstar . s R • r t
Hilliam • ' so aas s es:se::s ww := iiG sIIs
ii= i ii F
vousposenBan80404aS::. fS .. .:::•f:• e:l0aie .S l.S..:::N:".
f
s:S::o:llown: /brf r t t afM.
Re ssss"FsF•a:/
s'a"•s9' a $I a0 'sass •es s HIissiN •fa.Hea HNIHN•t sR•: rfe• "as a• i weal N• iir tSS .. • sSs:s:Sf. : we
N: N.5
i N ' 11
S
i a • M me*" si ues:a. an A":me;.tSaS Mou 22
s• SS
eS: S: • S•\. •Ne N:!I. 'I.•: H • sf • .f H•sf • H ra of .a He Rf
a s# as i•r ssF.rF•as- s•ssrFsssa•s e. sr s s EH f f• ft t .swat • • i. •• .ate a
U : 88"HUC..:N= is ae: t• i 2.12s "•r :• f 'ia i• 41f
ss__ H • uf S a H 4s• erfsel:wf as :stee: egi f:f• s• w
3 •swasses"is'e a' ii r ':: :_: : =
as::':see•:: :::':Fa =:••"FF"'irissii= • yy L •eF is s':is •'=s =ii:a;'j ii= :: :' s:=s ss::s::::u.. . . s•e s i''Nr: 'f = sE!"s t' .s: iir S: •: a :•e : "non_H:s f: rff e:nouns ass .i
i •aft • tf s f.f•aafaefra.a sou suss\r. r. iF.r. if •r=s . rwa f ra .. •
i ii'= S:ti! =:ii:'H•'::::::::'::::_:::: ::l: :S::''Z:''j::Sr ::'.s''i''jSii' i'= ='f:' 's ' ¢ ' rr' i r•aSaf a: a.fea..sf•t: .et fafa:•••f f••afst HasHwrs::: ffaf fataf•rrs r•.\ ..::a.•:::.A: a f iiri= f.se •.a ri.:f rr *seen:
rw:=/:u==ri•'==':: =::::e_ ::::::::i::'N':i::ii:'::::ss::ssi:'ii:as':::•lull:issfi:nl!in r= i"'ri=' i r 1:1!1:=-i' _'•"
I !`a'is • "':=ii=i== ts.i =ss:e=: . iif r...rr\ff..fe•asesf f•sr•frr.:t.:•ate= Q • rr seen some •e.__=
F: ri S .• i i:!:• •Hpat s• _ a.
i:::es • it:fa.! : She.sl.srs.rrs.sa.f.f....•mousses f.tf.•f. •fst•:eL ri:.•..e=•="se•ts r . Iles•: :
mw*SuW : . ../
eF r.tts i•:e j tr.• fife .f • • ••.•..••••s e.o=fa•afs r woNaa. . •• . sr t .\t no H item H ! . \wf
isji"S== f= i = i ' =_ _=====s ::=:i=ii=s i:'=::si' UM11:irrl•==' :Z'/'i==ttl•=is:i=i:"•"i':ii ZB :."
ss . . . . .. .. .. ....... sf.F.;s=.:"..ast=..s. .Fssassaa .s.ssa.. ..a=
f sf•u=. e::f ff .s.::ae fe:\ .• •f.a•..f rs f• •..• •f•sa .me• •.a•..ats s.f • fr.w .•at •. •\ .•• •••
area= aaa==aFeas awes.aaameaa:aaaeaia:aeaaaasee===e:aa:ea:aeae's's son: a" sFF::s H: : •,p, sss. ::::: :soar fa
sss:=::s::e :ss=ess:=;s:::::s:::::s::::ss::=:::::::::::::s::::::==F::::Fes:=s,•:;: :::::::ss= s:8 House s •':sass:
psi=Fosses_=Fe eia==lea=ssaFs==aes=:e'sas::e i =eems:== iEse HH:eaE=sea= 'sea eea;eai:s ==:•F=e=a^°sa='sssFe' eF ___ " NFs: ='ss' eIsasoZ_Hitfi.Zs a=_sersesss.f s oaf.\:sasaweso eRN:f•a•a e ffaf f•\:•.w tee\rss•essst Bo"ri.Big, i :`i isr:=Y :•t•M:r;N•faw a
FSS '• .:SNS:a:S S% ::::as t,a•::::f Hf..•\f\fff\f Hff•S a..=\aSS .a Ss.f== sS •a• Sp S r
i.- •_ ===
a •.r Net.•
1e . . .f r • SMff::::::::se' . : :: ' ' : ' :: FS* • Ss r: f NN S •:SS \:.::== =sHs :••f:...f.:. i f at••.f ft•i.s=f\•/.f . . •ie aj i ssfi•ess4ss:s••es.
l:s::::::s:•:::::ass:ii::=''ssc:ae6:e::: 6n::::=s:::::m one
s1e': 's F: ' ass• s•a:::s::i : :r:::ORMtsss'F==!:"seas=sii=ffffsi• :i rrse..sfa• asfra•.stf.rf:.s.=.__" _ '_•' I =A h i: art: ___ : =.ri der •f•==•
l::e::sfes•sffa:::s:.::::::::=:s:=::=::.::s:::::::::::::::::::::::::s::::s::::s:e sf::::ff:s::less:a:es:sse ii.f\s:•:::ii:.sssiii::oes:
r w.• • \ •• . seas ff •moss sees ..••• f .Hof••f. • • a•• •..a. •!• •f\• •\• . at •• .a• e••f N.s.,.._.....:....s.....,.---s...._...t.,,.....,..3sal.,__:...............---._:a.:s.!,:ss.s:s..;..asp,...:..,...,---
I
TOWN OF SOUTH WINDSOR
BUILDING PERMIT
Date J111 v 3 1979
Fee Paid $606.00 Est. Value $.101.,000.00
Permit N° 10 916
f
on the side of
Lot #1 Rosemary Lane Street
9 Street No.
Owner U & R Hmi si nZ Corn
i
Applicant U & R HoL s i n Z Carp
CERTIFICATE OF OCCUPANCY ISSUED:
Date
M No. 5478
fQ
Fee Paid $ 3.00
CLASSIFICATION
i Dwelling
s
BUILDING PERWr
N? 10916
OFFICE OF
THE BUILDING INSPECTOR
of the
Town of South Windsor, Conn.
South Windsor, Conn.3 1979
94is is to Crrtifgp That
is hereby granted permission to Dual 14nizlu
at estimated value of $1 1, ,00
on the side of Let #1 Rosemary Loke Street on land
owned by 11 R 9M. sing ce
said w l-k to be as described in Application
No. 11 7 and to conform to specifications and plans filed with said Application, and Building By-
Laws of THE TOWN OF SOUTH WINDSOR.
Issued .R I!, 1 1979
B ing 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."
71V7? 9t,5,-J-1
1
INSPECTION REPORT
Permit #M p Job
1 Footing -
2 Foundation '7-36 _7 l
3 Framing F
4 Wiring
5 Plumbing ?— !f-7
6 Heating
7 Lathing
8C.0.
2-
Permit No. M2/V/17TOWN OF SOUTH WINDSOR
SOUTH WINDSOR, CONN.
Permit M 5478
Certificate of Occupancy
T IS TO C IFY that t
at No in the own of South Windsor, Connecticut, has
been erected and complete in accordance with the uilding Code and Zoning Regulations of
the Town of South Windsor, and is hereby approved for occupancy.
Building Inspector
caner, B lder
Fee Paid Date 19
6850
ti
ELECTRICAL APPLICATION
Application No. 7855
on the side of
Lot #1 Ro s emn ry Lane Street
Street t-;o. l'?
Owner 11 & 'R Hc)iiqi33g Corp_
Electrician El A r t-•r;r
FILED IN OFFICE OF
The Building Inspector
JL1 T 19 19_Z-9
INSPECTION.
1A)"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/kir
APPLICATION FOR PERMIT TO DO ELECTRICAI. WORK.
No. .......7.85.5..................
Permit No. . ...6.8.5.0.. ............ .
TO THE BUILDING INSPECTOR
of the
TOWN OF SOUTH W INDSOR, CONN.
hereby make application tq perform Electr cal Work according to detailed description below. All
provisions of the Rules for Electrical Installation, Section 48, Building By-Laws, shall be complied with
whether specified herein or not.44SouthWindsor, Conn., . ...... . JU1Y .9., 1979 Sign here /.44''Puree ll...P:........ ... .. ...
Address mac es.ter.,.....ct.......O.i.Obit.0.......................
Location Lot 1, R,o s emar Lane..... Side of ...
Nature of Building .Res-idence. .... ...... .. .... How many stories ............2...........................................................................
Newor old Building .........Nevi.. .. ... . ............... . . . . . How many families ...........I................................................................................
Kindof Installation .........Itomex.. ... How many Stores ......................................................................................................
Owner ...............U..& R Housin..Cor. Address P.0.... Box, 248......Manchester_.Ct._......
Architect ........... ... ... . Address . .. . . ......... .......... .................................................
Builder U & R Housing Corp Address P.O. Box 248., Manches ter.=._.Ct. ..........
Electrician DuBaldo Electric Co. ,..Inc. Address 44 Purnell P1 , Manchester, ,Ct._
Size of Main Wires ... ...... 2...AL.........................-
No. of Light Loops .. ..... ....1 No. of Heat Loops .. .., No. of Power Loops .........................
No. of Light Outlets . ....19.. .No. of Heat Outlets . .. No. of Power Outlets ...................................
NoO of Light Circuits ... ...$.. ........ .... No. of Heat Circuits . No. of Power Circuits . ...... ........... ..
No. of Sockets ............... .. ........ .... ... No. of Heat Receptacles No. of Motors .............. ... ........... .............
No. of Panels .................................1.. Size of Heat Circuit No. of Power Receptacles . .............
No. of Switches ......................37.. .. .... Total Wattage Size of Power Circuit .. . ... . .... .. .
Total Horsepower ' .. . ....
No. of Straight Electric Fixtures ..... 20. .. ...... .... . ... No. of Combination Fixtures .... . . . ..
No. of Receptacles ......................... ......... ..........4.7........... .... . No. of Cord Drops .................... ........................................ ...... .......
Remarks: For other kind of Installation ...... ............ ............................ ................. .... ............................................................. .................... ..................
I............................
Estimated Cost ... $.1..,.ZS.O...QQ......... ...
5455
PLUMBING APPUCATION
ApplicafmNo. 6238
on the ......_........._ aide of
La.t.1-1... _.__ S_eect
Street No. ...... 127
Owner ......_G
Plumber (-... l/ag,&=
Filed AL* of
The Building Lrpecaoc
Aug. 14 ig 79
IN
No person shall construct, add to or ahw any
portion of the drainage system of any baMfiog
ezcept to repair lea6) until a Pcomit is graoftd
by the Building lmpecaor.
io Application No............6.2....3.....8................. permit No. .545.5...................
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, Z.V.......... 1Wf... Sign here .......d4n!;...............
Address
StreetLocation ............ . ....................................... ... ................................................. side of ................... 10y..............................
Natureof Building ................. How many stones .........................................................................................
Owner .........2Z. ..<eon......... ddress
Architect ........................................................ Address.....................................................................................................................-
Builder ......................................................................................................................... Address .......................................................................................................................
Plumber ............ Address.......9-YI..........
DRAINAGE
CESSPOOLS, How many ............. Where located ..... . ...... .. ..............................................................................k
Arethey water tight .. .............................................................................. Of what mate mi are they built ........................................................
Size of pipe from house to cesspool .............:/............................ Kind of pipe ... . .....................................................................................
MAINDRAIN IN CELLAR, Materia .....&'......................... Diameter -.5/........................................................................................................
Aboveor below cellar bottom ....................
SOIL PIPES, Material .............................Diameter .....
WASTEPIPES, Material ................ -.0 Diameter .........3...................................................................................................
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 ..............2............................... Where located
Distancefrom trap to vertical sod pipe ......................................... Pattern ...........................................................................................................
WASHTRAYS, How many .............................................................. Where located ............
I.......................................................................................
SINKS, How many ................................../................................................. Where located
BUTLER'S SINKS, How many ....................................................... Where located,.....................................................................................................
REFRIGERATOR SINKS, How many....................................... Where located .....................................................................................................
LAVATORIES,How many..........................j.................................... Where located J.-aa—le....*z...................................................................
BATHTUBS,How many........................................................................ Where located ......2...........................................................................................
URINALS, How many ................................................................................ Where located ....................................................................................................
Are water closets and urinals to be local vented . .. .... ............... .. -..- .. If not,is there a window in outer wall
ofroom where same are to be)ocated .............. I.............................................
Estimated Cost ...c2i-f-"
PERMIT
Application For 6156 5055
DEPARTMENT DECISION Heating Permit
Cd O
3 APPLICATION IS HEREBY:
o
DEPARTMENT OF LICENSES AND INSPECTIONS
tt4 IX APPROVED DISAPPROVED
TOWN OF SOUTH WINDSOR
Cd
0 Cd n
00 DATE
7
F SPECTOR APPLICATIONS MUST BE PRINTED OR TYPED. BEGIN WITH NUMBER ONE BELOW
O W
4j
v 1. LOCATION OF JOB
0 o 12 7 P1 R
Cd 9 NO. STREtT
Cd
O
v s#
CU LOT NO. FLOOR APT. NO.
O
N
2. OWNER p"JE 1C7rlD
I~
0O0 ADDRESS
3
4.PHONE
Cc loobOv*L,illyi
r
rn S. APPLICANTTEIE R I ' I )0 Kt,P
0 StAE&jde. ADDRESSP Ra CsS,
7.PHONE
s. LICENSE NO. 0(2
E w S. EXPIRATION DATE OF LICENSE /40
O
v v'
10. ESTIMATED COST S qq O
C
11. IS THIS A CONTRACT COSTS YES No
Do
7 12. FEE ENCLOSED $ Permit 10916
1a. TYPE OF BUILDING:
r1 CR RESIDENTIAL COMMERCIAL
O
14. TYPE OF JOB: INDUSTRIALcc3
RIGINAL ALTERATION
INSTALLATI N ADDITION
REPAIR
APPLICATION FOR HEATING PERMIT (Continued tr m Reverse side)
11. LOCATION OF JOB k07 4p ) 1305-Chn patQy ,M . 41))w
NO. STREET FLOOR AFT.NO.
12. TYPE OF INSTALLATION: OIL BURNER PkELECTRIC14f" VENTILATION SPRINKLER
GAS BURNER STACK INCINERATOR MISCELLANEOUS
IDENTIFY
SIZE LOCATION SIZE SIZE
13. OF TANK OF TANK OF FILL OF VENT
ta. B.T.U. EQUIP. AT REGISTER NACE MAKE AND N0.C 6V* AT BONNET FIRING RATE
BOILER OR FURNACE MAKE AND NO. B.T.U. OR SQ. FT. NET B.T.U. OR SQ. FT. GROSS FIRING RATE
FLOORS TO BE HEATED --- Fw nR`OLD BUILDING INSULATED - ES R NO
TYPE OF WALL RA INSULATION_s ROOF OR CEILING INSULATION
AVG. SYSTEM WATER TEMP. B.T.U./SQ. FT./HR. EMISSION
INDOOR-OUTDOOR TEMPERATURE DIFFERENCE 70 °FAHRENHEIT
MAKE OF RADIATION: BASEBOARD, COPPER CONVECTORS, OR C.I. RADIATION. OUTPUT PER SECTION OR LINEAL OF RADIATION. SQ.
FT. OR B.T.U. 13 6to d j0.,=.t' 1t L
DESCRIPTION OF WORK
15. TO BE DONE:ea4AM Z&&AW,
U 1 , W4
is. HEAT LOSS SCHEDULE. (TO BE INCLUDED FOR ALL JOBS):
INDOWSROOMSIZEANDDooRS AREA - SQUARE FEET
VOLUME
B.T.U. B.T.U. O o DISTRIBUTION INSTALLED
TOTAL TOTAL N
ROOM NO' GROSS GLASS NET WALL CEILING FLOOR CU. AT 70•F CORRECTED -j LL RAD. REGISTER
L W M AN D E TEMP. TO F f TYPE AND SIZE OR LEADER
SIZE < WALL to INFILT.) DIFF. F O m a SQ• FT. FREE AREA
LIVARA 1
K • OF I
v1 VL_
TTOTALS 00711liltI
A. HEAT LOSS FROM BUILDING 2603 Z B.T.U./HR.
B. DOMESTIC HOT WATER DEMAND 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: e5177XA!5-,o?,:55
NAME ADDRESS
SUBCONTRACT19. THEIR TRADESORS AND L- LCy06
000,
I
ALL WORK COVERED BY THIS APPLICATION HAS BEEN AUTHORIZED Y THE (OWNER) ( NT) OF THIS OPERTY AND WILLI
BE DONE IN STRICT ACCORDANCE WITH THE BUILDING CODE.
APPLICATION TO BE COMPLETELY FILLED IN. 1/C}
DATE SIGNATURE OF APPLICANT
et'a` -,1- 7 IY-5
YORK RESIDENTIAL COOLING AND HEATING LOAD ESTIMATE-ENTIRE HOUSE
Aj• iffo,C/
COOLING HEATINGlREFERENCEAREA
NUMBER sq ft LOAD
SENSIBLE
LOAD
SENSIBLE
FACTOR
HEAT
FACTOR
HEAT
Btuh Btuh
OUTSIDE WALLS A n 7
DOORS (INCLUDE GLASS WITH WINDOWS) B
I 2- J
9
INSIDE WALLS C
1
c - C Oq3 03
CEILING
t
E
l 2 2 2_4 V I LJ V 06ORIt
F
G
FLOORS OR C 0
H
jtiJ
t OUTSIDE AIR J l u t 30 C) to 36106
PEOPLE (5 MINIMUM) K 5 300 1500
C/BLOWER MOTOR HEAT HP OR 2545 OR
KW 3415 J l
APPLIANCES L 1200
WINDOWS TRANSMISSION M p31 113 v '
OVERHANG FT.
O (' V
jSHADING
N
1 - 2_ 3- 4_ NE &NW
n
SINGLE GLASS J E &W N
O
DOUBLE GLASS SE &SW 1 0HEATABSORBING_S 2.G
i`
a
SUB TOTAL
DUCT LOSS:
ATTIC-I " DUCT INSULATION-SUB TOTAL X 1. 15 X 1.25
ATTIC-2" DUCT INSULATION-SUB TOTAL X 1. 10 X 1.20
SLAB FLOOR-INSULATED DUCTS IN ENCLOSED CRAWL SPACE,
UNCONDITIONED BASEMENT OR FURRED SPACES
SUB TOTAL X 1.05 f
X 1. 10
TOTAL SENSIBLE LOAD 17
ALLOWANCE FOR LATENT LOAD—TOTAL SENSIBLE LOAD X 1.30
CORRECT FOR
LOW DAILY TEMPERATURE RANGE—TOTAL LOAD X 1.05
HIGH DAILY TEMPERATURE RANGE--TOTAL LOAD X 0.96
4
1i
J
YORK RESIDENTIAL LOAD FACTORS FOR COOLING AND HEATING
COOLING HEATING
CONSTRUCTION TEMP. DIFFERENCE-Fdb TEMP. DIFFERENCE-Fdb
10 [I 5 20 25 30 35 40 50 60 00 80 90 100 110
A OUTSIDE WALLS - Btuh PER sq ft OF AREA (DO NOT INCLUDE WINDOW AREA)
1 NO INSULATION 4 5 6 8 9 10 10 13 15 18 20 23 25 28
2 1" INSULATION 3 4 5 6 7 8 8 10 12 14 16 18 20 22
3 2" INSULATION 2 3 3 4 5 5 5 7 8 9 10 12 13 14
MORE THAN 2" INSULATION 2 2 2 3 3 3 4 5 6107 8 9 10 11
B DOORS - Btuh PER sq ft OF AREA (DO NOT INCLUDE WINDOW AREA)
1 WOOD OR ALUMINUM 7 9 12 14 17 20 22 1 27 1 32 L371 42 1 47 1 52 1 57
C INSIDE WALLS - Btuh PER 5q ft OF AREA
1 BETWEEN CONDITIONED AND 2 3 4 5 6 7 8 9 10 12 14 15 17 19
UNCONDITIONED SPACE
D CEILING BELOW VENTED ATTIC - Btuh PER sq ft OF AREA
1 NO INSULATION 9 10 11 13 14 24 30 37 43 49 55 61 67
2 2" INSULATION 3 3 3 3 4 4 4 5 6 7 8 9 10 11
3 4" OR MORE INSULATION 2 2 2 2 3 3 3 4 4 6 6 7 8
E CEILING WITH NO ATTIC OR UNVENTED ATTIC - Btuh PER 5q ft OF AREA
1 NO INSULATION 14 16 18 20 22 24 20 25 30 35 40 45 50 55
2 2" INSULATION 7 8 9 10 11 12 8 11 13 L 17 19 21 23
3 4" OR MORE INSULATION 6 6 7 7 8 9 6 8 9 12 14 15 16
F CEILING UNDER UNCONDITIONED ROOM - Btuh PER sq ft OF AREA
1 NO INSULATION 2 2 1 3 1 4 5 1 6 1 9 11 13 15 17 19 21 23
G FLOO (OMIT IF OVER BASEMENT Btuh PER sq ft OF AREA
1 OVER ENCLOSED CRAWL SPACE - - - - - - 9 11 14 18 20 23 26
2 OVER UNCONDITIONED ROOM 2 3 4 5 6 7 9 11 14 6 18 20 23 26
3 OVER VENTED CRAWL SPACE 3 4 5 7 9 11 14 17 20 24 27 31 34 37
H SLAB FLOOR ON GROUND-Btuh PER ft LENGTH OF OUTSIDE WALL
1 NO EDGE INSULATION 32 41 49 57 65 73 81 89
2 1" EDGE INSULATION 27 34 41 48 54 61 68 75
3 2" EDGE INSULATION 22 28 33 39 44 50 55 61
J OUTSIDE AIR-Btuh PER sq ft OF TOTAL FLOOR AREA
1 DUE TO INFILTRATION 1 1 1)1 2 1 2 2 3 6 1 7 1 9 ILI 12 13 14 16
PEOPLE- (USE MINIMUM OF 300 NOT USED IN HEATINGK
FIVE 5( )- Btuh EACH
L APPLIANCES -Btuh TOTAL 1200 NOT USED IN HEATING
M WINDOWS - TRANSMISSION - Btuh PER sq ft OF WINDOW OPENING AREA
1 SINGLE PANE 4 8 12 16 20 24 45 57 68 79 90 102 113 125
2 DOUBLE PANE OR GLASS BLOCK 2 4 7 9 11 13 22 28 33 39 44 50 55 61
N SOLAR WINDOW LOAD -(COOLING ONLY)- Btuh PER sq ft OF AREA
USE ALL WINDOW AREAS)OVERHANG O ft I ft 2 ft a ft 4 ft --
FOR SINGLE GLASS SHADING 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 4
1 NO SHADING DEVICE
2 ROLLER SHADES HALF DRAWN N 20 15 11 20 15 1120 15 11 20 15 11 20 15 11 16
DRAPES OR VENETIAN BLIND NE &NW 50 40 30 50 40 30150 40 30 50 40 30 50 40 30 17
E &W 80 60 45 70 48 38 60 42 33 52 36 28 42 29 23 1 84OUTSIDEVENTILATEDAWNINGS
SE &SW 65 50 35 53 40 32 40 31 24 27 21 17 20 15 1 1 1 7
A) FOR DOUBLE PANE OR STORM S 40 25 20 281 19 14 20115 11120 15 11 20 15 11 16
WINDOWS MULTIPLY FACTORS
BY .90.
B) FOR HEAT ABSORBING DOUBLE
GLASS MULTIPLY FACTORS BY
60.
2
I I
IN 0aiOXEN 'e;ONamesaall
f ''
Owl 0 :'
fib,;,,:,, iif
OEM a:an
Hi:i'' man
nmm=l am all MEN P aa
0 a 131 US0camill ' OM14A qi :: q'iiii : : sons'
1 i. N
8 :.,. :. InSo : ;=N_ : :MON SSON :'III
i',,, I..n 1 m q H C. m:C::llINa. ': C :Noun
fflwn WON . :' o'; N mama.
s a
mans i-
I C 'u C
MEMFRSi i'IC' i
N FlillggommINSi
C M a ME
JEWS Wo imumimmulumunmu;mlOur
i\ .
ma
C. N
M C N dip=i./ mi'i
1:: .. .._.. CD:i"=:: .. .; mama
1
SON
i i:I _ u Iszi=: fflo i ii i'i s: =/i i=:s
IS
I=':=I:i1:i:oil
immilmhosississilown0aIII1191M:%01eone,NMI 0,11 1 ... / ' C::::=::?=a Ni..m'':u:::.man fm1m:
11 No u
q 11l:mama: oilm m;; :I :s somm meONmo ;m;N
noManISIHIM,
so in
Vin I •
ull
N H80 0.
H --N1 w 1115100 Igloos
muma\lmru ill a I N Man
Samoa CwZ=M
5
q e:N a Ci umesari:
Ild •.
q:..Ca..a i sQ iaa=i.:Mamma
us
N
allMIS
FOR
N m q N m ' H _:: ; :'
un=as;;'. M':
n:
am
a. de
R'a ==r S;:;gip;.Q;../'o:o
i .. . . .. .
p u
MMEnema
n
mN •
I
a
C
w.
e e:'• q:
noncoms
i' '
I' a t'I i 'i'a C :..G': oo . . :G".'a'
u : Ci:•a
Gi:::i: ::I
a:::
s ::=:N ii iGiloss a'
u=C :=i'm =ii'=:':::il ii:l=:'• ••
111s; IT = a :S. inn n
aQi:.m ii:: a. IBM
N,;:,i'. .'
N
i.:.'C'i.'C:ia
Ord .
Ki"•
a' .
ai i" •HH•S :s..•:.:i.; . .,
1 : OE a
sumo mo mo mo . . I'
so
N. :':e' ' 'iun 'ata" a'
1'i:mi ai= :11""-' a1a= ' _,R ills a'
iulan aei milsMalle
Nm H mH m H p I' I `! / a I' mop- Haa:'Lo:sCU'211119111119MA31
1•F.'i'aa . •• 1 .
m=sC C!I ! •, I!
amm :
s a.:h::.:..H HmI.
e
D. ..l :::1 A N .P N N'm. fr. ••mmnm :maer'i ain;!:"i 20--mil
C!' - i '=e=ui N'li=mom ;mama mama P
so i . -
angl isice
pp 0a,0191111 man P.
NIX
Gi-
s. :
i\:i`i-i ..i NiG 'C/=m 1' i
pan =3: = 1' 'i'i :i WAN ' 1:11iffirril 1ammo
Il
H ...Einm "Mid _.i 9 _1 .H.H.H i..iir/l .p'
EELS i
fir u i m.; ; .N
0
Mamm a N_u• W 4 a
160ml
New tv!
Is IUU
Man ZM= 11
0ROM on 1.11HN0
w NMI PMall1! M sip IPP
side M I MINa0.5 w!comm
soon a as
mow-rl N
m
Oil::
a: u
C::so"00
a
1Mu MwIlm
A,
1Aw
7021
ELECTRICAL APPLICATION
Application No.R035
on the side of
Rosemary. Lane Street
Street No. 127
Owner Manage Nissanka
Electrician DuBaldo Electric
FILED IN OFFICE OF
The Building Inspector
Dec. 20 19 79
INSPECTION.
car 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.
APPLICATION FOR PERMIT TO DO ELECTRICAI. WORK.
8035No. ........ ...................................
Permit No. . .7 0.2.1.. .............
TO THE BUILDING INSPECTOR
of the
TOWN OF SOUTH WINDSOR, CONN.
We . hereby make application tq perform Electr cal Work according to detailed description below. All
provisions of the Rules for Electrical Installation, Section 48, Building By-Laws, shall be complied with
whether specified herein or not.
South Windsor, Conn., December. 12, 1979. 19 Sign here iu
Address 44 Purnell Place, Manchester, Ct.
Location Lot 1, Rosemary Lane ,, Side of
Natur of Building Res idenCe. How many stories ........... ............... ......................................... .................
New or oId Building ............. ..... . New How many families
Kind of Installation .......... . . Roi[teX ... ...... How many Stores ..................................................................................................
Owner .t....Managg...N, s§snks.. Address Ros.eMAry...Lane..,....S 4..._G•
Architect . ...... .. ... Address ... ................. ......................................................
Builder ........ Address
Electrician DuBa 1 do E 1 ec trsi Co. Address 1..........Manc hes ter,_ C t.Purnell P ,
Size of Main Wires 4/0 AL & 1 AL
No. of Light Loops ......... 1... ....... No. of Heat Loops No. of Power Loops
No. of Light Outlets Existing No. of Heat Outlets . .. No. of Power Outlets ................. .............
NoP of Light Circuits Existing 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 Receptacles ................................... .................................... . No. of Cord Drops ....... ........................................................... .... .... ...
CHANGE SERVICE FROM 200 AMP 1 PHASE TO 300 AMPRemarks: For other kind of Installation ...... ..................... .................... ........................ .................................. ... .. ..... . .. ............ ...............
1 PHASE, W/ 200 AMP EXISTING PANEL AND 1 100 AMP PANEL.
Estimated Cost ......$900.00
ELECTRICAL APPLICATION
Application No.
on the side of
Street
Street No.
Owner
Electrician
FILED IN OFFICE OF
The Building Inspector
19
INSPECTION.
IV No Electrical Work shall be started until a Per-
mit is granted by the Building Inspector.
In New Bulldings 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.
APPLICATION FOR PERMIT TO DO ELECTRICAI. WORM.
No. .. .........................................
Permit No. . . .............. ...............
TO THE BUILDING INSPECTOR
of the
TOWN OF SOUTH WINDSOR, CONN.
V! ..... hereby make application tq perform Electr cal Work according to detailed description below. All
provisions of the Rules for Electrical Installation, Section 48, Building By-Laws, shall be complied with
whether specified herein or not.
South Windsor, Conn., .......Auaus t 1 1980 Sign here
Address
Location12..7.....JZos,errary 1a.ne Side of .... ....
Nature of Building P`es den.. .. ............. How many stories
New or old Building How many families ..............0 .......
Kind of Installation ... . .1 omex . How many Stores ............................ ....................................................................
Owner ........................ .... ........ ............ . ... ......... ................. .... .... .. Address . . .............. ........................................._.................
Architect ........ .......... .... ....... ... .. Address . .. .. ... ... ............. ..................................................
Builder ...................... . Address
Electrician DuBa.ldo.... Co...........IU.Q.. . ... .. Address 44:...Purae.11....YAache .te.r.....CT
Size of Main Wires .. .50 A)
No. of Light Loops .. 1 No. of Heat Loops ......... -- No. of Power Loops --
No. of Light Outlets . .....45... . ....... No. of Heat Outlets .... --No. of Power Outlets ................................
NoP of Light Circuits ..........15.......... .... No. of Heat Circuits .. 2. No. of Power Circuits .. --....... . ....... ......
No. of Sockets .... ...... ......... .. .. No. of Heat Receptacles -- No. of Motors ...................... ..... ................
No. of Panels ...................... .......... .. . . . .. .. Size of Heat Circuit ?'$.0 A. No. of Power Receptacles . . -'.......
No. of Switches .. ................ . Total Wattage .. Size of Power Circuit
Total Horsepower
No. of Straight Electric Fixtures ... . 45.... . No. of Combination Fixtures ....
No. of Receptacles ........ ..0.......... ......... ........ .. .......I.......... . ...... No. of Cord Drops ....... ........ ..................................................... .........
Remarks: For other kind of Installation .. . ............. ............................... ........................ ................................................................................ ..................
Estimated Cost .... .1
TO THE BUHDING INSPECTOR
of the APPLICATION FOR
TO" OF Sj,M WINDSOR,COW PLAN EXAMINATION A N O
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and 1X.
ZONING
O
LOCATION) ` / fQ0 S e,wl and LQ ct.e SRO 'caQ• —DISTRICT—AT
LOCATION NO.) 5 REET)
OF BETWEEN Rose-m at AND
BUILDING V (CROSS STREET CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
H
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 lir
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 religiousinPartD, 13)
number of units— — — — -.*.
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 ——————— — -• 22 Service station, repair garage
enter number of units in building in 15 Garage 23 Hospital, institutional
Part D, 13)
6 Moving (relocation)
16 Carport 24 Office, bank, professional
17 Other — Specify OOW) 25 E] Publicutility
7 Foundation only 26 El School, library, other educational
B. OWNERSHIP 27 Stores, merconfile
8 Rr Private(individual, corporation,
28 Tanks, towers
nonprofit institution, etc.) 29 Other — Specify
9 Public (Federal, State, or
local government)
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•••••••,,••••••• 56t), (I 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......... IiLO
d. Other(elevator, etc.)............
11. TOTAL COST OF IMPROVEMENT s
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 Masonry(wall bearing) 40 Public or private company
48• Number of stories................
31 Wood frame 41 Private (septic tank, etc.) 49• Total square feet of floor area,
all floors, based on exterior
32 Structural steel dimensions ....................
33 Reinforced concrete H. TYPE OF WATER SUPPLY
34 Other — Specify 42 Public or private company Total land area, sq. ft. ...........
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.......................
36 Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 Yes 45 No 53. Number of b dro ms.............
38 C al
39 Other— Specify Will there be an elevator?
54. Number F
Full..........
46 Yes 47 No bothr ma
Partial.......
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, czty, and State ZIP code Tel. No.
9. N/s s r4 N4ti is 9 , KOO JeXACOwneror
Lessee
2.
Contractor 9 7a•3&y.
3.
Architect or
Engineer
The owner of this building and the undersigned agree to conform to all applicable laws of this jurisdiction.
Signature of applicant Address Application date
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Re uired Check Plan Review Date Plans B Date Plans B NotesqFeeStartedyApprovedy
BUILDING
PLUMBING
MECHANICAL
ELECTRICAL
OTHER is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date
Obta ned Number By Permit or Approval Check Date Number ByObtained
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 Z
Building
Permit issued 19
Building
Permit Fee
ApprC),
1
TITL
4f
i
TOWN OF SOUTH WINDSOR
BUILDING PERMIT
Date June 2 7 19 84
Fee Paid $. 2 4 . 0 0 fiat. Value 50 0
3
13918 PPermit1M
f
x
fi
0
on the side of
E
Rosemary Lane Stet
Street No. 127
Owner S. N i s s anka
Applicant S. Niss anka
CERTIFICATE OF OCCUPANCY ISSUED:
Date
No.
Fee Paid $
CLASSIFICATION
Rasemant Play 'rom
BUILDLNG PERMIT
N_`' 13 918
OFFICE OF
THE BUILDING INSPECTOR
of the
Town of South Windsor, Conn.
South Windsor, Conn.June 2 7 19 84
94to is to (f erftfij, That S• Nissanka
is hereby granted permission to
Basement play roan
at estimated value of $ 3,500
on the side of 127 Rosemary Lane Street on land
owned by S« Nissanka
Said Work to be as described in Application
No. 14218 and to conform to specifications and plans filed with said Application, and Building By-
Laws of THE TOWN OF SOUTH WINDSOR.
Issue June 27 19 84
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."
INSPECTION REPORT
Permit # Job
1 Footing
2 Foundation
3 Framing
4 Wiring
5 Plumbing
6 Heating
7 Lathing
8 C.O.
8656
74
ELECTRICAL APPLICATION
Application No. 10071
on the side of
Rosemary Lane Street
Street No. 127
Owner S. Nissanka
Electrician Homeowner
FILED IN OFFICE OF
The Building Inspector
Feb. 25 19 85
INSPECTION.
mNo 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.
Electrical Permit No. .....
Master License No.
TOWN OF SOUTH WINDSOR Building Permit No.
BUILDING DEPARTMENT Date Filed
Date Final Approval ......... ... . ................... ..
APPLICATION FOR ELECTRICAL WORK
Electrical Inspector
JOB LOCATION: 7 eas C 7ki JOB OWNER:
Sideof Between and .................................................................................
Name of Building Owner Address
If work is for Lessee—Give name Address ................ ... ....................... ................. .... .....................
Building now occupied as (unless new) No. of family units now
Building to be occupied as Number of family units to be
Is this work included in a Building Permit? Permit Fee ... .... ...... . . .. .. .... ................................. ............ .... ..............
C9 A If no Building Permit)
aZa(a . ilca 4L'4PermitteeBusinessAddress3S7. .. V ...- Ue'OKWephone 1144.... .
COST OF INSTALLATION: -200 1 6V . ............................. I.. ............... .....................................................
0 7.2-a.39-j...-
TO BE FILLED OUT BY PERMITTEE
TO BE WIRED EXISTING APPLIANCES
Number of light outlets to be installed
Number of convenience outlets to be installed Number of present Appliance Circuits . ... ... ...................... .......
Number of switches to be installed . . . Do these include Range Water Heater Number of appliances to be installed
as listed below) Dryer Air Conditioner F1 Oil Burner E]
TYPE RATING NO.
Dish Washer Gas Burner E]
Range . . . . . . . .
Well Pump Elec. Heaters [j
Range Top . . . . . .
Oven . . . . . . . . REMARKS:
Water Heater
Clothes Washer . . . .
Clothes Dryer . . . . .C,
Dish Washer . . . . . .
Air Conditioning Motor .
Oil Burner Motor . . . .
Gas Burner . . . . . .
Circulator Motor . . . .
Attic or Large Fan . . .
Well Pump . . . . . .
Electric Heat . . . . .
Other . . . . . . . . .
Number of new Lighting Circuits . . . . .. ..... . ..............
Number of new Appliance Circuits . . . .............................
Number of Heating Circuits . . . . . . ............................
Number of Motor Circuits . . . . . . . ...........—...—
Size of present service ............. .
Sizeof service to be . ...... ........ ........ .....................................