HomeMy WebLinkAbout128 Chapel RoadApplication No. 3559 . Permit No. 32-99 ......
TO THE BUILDING INSPECTOR
of the -
TOWN OF SOUTH WINDSOR, CONN.
hereby make application for a permit to (erect N e.a) a building according
to the following detailed statement of the specifications and plans herewith submitted. (Draw a line through
word "erect" or words "make alteration to" as the case may require.)
All provisions of the Buil"g By-Laws (Sections 2 to 32 inclusive) shall be complied with in the execu-
tion of this work whether specified herein or not.
South Windsor, Conn.,/ 1..................... 19..,:;;a
Sign here .... .. ..
Address ./..1. .. .... ... . ... .
Location? 6.........a v.. .............side of?
Nearest cross street? . ri .... i .....................Street No. . .. ....... Lot No. ............................ .
Owner of land i.Z../D..J.rcl.t.. ,,,,+9`+11 t.t '...Address X....2.4F.
Owner of building is? . U c..........Address
00
Architect is? Address
Builderis? .
j.........................................
Address ............................................"-..............................................................
Dimensions of building. FeetFeet front? . Feet rear? 1...... Feet deep?
Extreme height to highest point of roof? ....... . . . No. of stories in height? .. '
Purpose of building i r9.A--,.F ...... of stores? ... ................. .................................................. ................
Howmany families? ... ................................................................................No. of rooms? ... ... ....... ............ ....................................... .. .................
10 f
Distance from street line is? . "V.Q..... ......... ..........from building line is? ........ ...... o........ .................... ...
ADDITIONS AND ALTERATIONS
Give Brief Description)
w
C. .. .. .. r,.s..........t .......... E'-C. .........'............
ra. c ........, c1....9.... ....
Map No. ...... .......
If of steel frame, what is exterior construction? .
What kind of columns used? .......... .. . Size of columns used?
What length of columns used? .. . How protected?
What kind of beams or girders? Size of beams or girders?
Longest span of beams or girders? These rest on?
Roof construction is? ........... ..... ... ...... ..... .............. .. .. Roof covering is?
The floors are of construction and are calculated to carry a safe load of
lbs. per square foot.
See Section 14, Building By-Laws.)
BRICK CONSTRUCTION.
Of what material will walls be constructed?
Compositionof mortar? . .. . .. .
Height and Thickness of Walls
Height Stories Front Walls Side Walls Rear Walls Partition Walls
Basement,
I.. .......... ..... ....................................... .
1st Story
2nd "
3rd "
I..... .......................... ............... . ................ ....................... ............... ......................
4th "
5th 11
6th "
I.............. ........ . ............................ . ................................. .. ........................ ........ ...............................
7th "
I............. ...... .... .. ...................... .. ........ .... . .. . .....
8th "
9th 11
I.
10t.......... .. ..
Material.of Front? If stone, what kind?
Thickness of Ashlar? Thickness of Backing?
Backed up with what? Arches or lintels over openings?
WOOD CONSTRUCTION.
Giv Size, Longest Span and Distance Between Centres, of Joists, Girders and Columns
JOISTS GE&DBBS COLUMNS
Floors Size Longest Span Centres Bridging Size Longest Span Centres Size Length Centres
1st Floor
2nd......`..... .............. Z.......... w ._......................._...... .-................. ..............._ ._.........._ ......-.........
a.....;.....
Size of outside studs?
f ... ...
1.... Distance on centres? Size of sill? ........125.eV.401................
I I M LC *If
Size of rafters?- . ,jV ,57_ Distance on centres?... ... . f o. . ........ Size of plate? .........,.<... ..4.z.............
Size of ledgers or girts? ... .. ... ..... .. . ........ . .........................Size of deck rafters?
Distance on centres? ............ . ........... ....... ....................................Size of studs in bearing partitions? ........ ......................................
MISCELLANEOUS
Style of roof., flat, pitch, Mansard, or hipped? G..... Fireplaces? ..... . ........................ ...............
9d'
Material of roof covering? l .. ..Material of Cornice? ... ............./...'.............a....... .... ...
How is building heated? . .. ............................................. Lining of flues? . .. . . ................ .................. ... .... ... . ............
Thickness of shell of flues? . ... . ..... ........... ........ ....... . .... Any elevators or lifts? ....... ..... .. ...... ............... .. .....................
What kind? How many? .. Any hoistways.
cp
How protected? Total Value of Building d.........
When will work be commenced? .
The applicant warrants that the lot or residential purposes, shown on a plot plan accompanying this appli-
cation, has 20,000 square feet, or more, and at least 100 foot frontage on a Town road shown on a map of
South Windsor showing Town Roads dated December 1949, or on any other roads officially accepted by the
Town of South Windsor since 1949.
Applicant
3299
BUILDING APPLICATION
Application No. ..559
North
on the ... ............ . . ....... side of
Chapel Rd. Street.
Street No, 128
Owner John J.Lawt on,. Jr.
Same
Applicant
CLASSIFICATION
Two car garage and breezeway
321 x2 6 1
Permit issued on above Application.
Date, Aug o 12 r 19 ..60
TOWN OF SOUTH WINDSOR
BUILDING PERMIT
Date us t 1 1g 60
Fee Paid s 4.,00', Est. Value $$ .-s 000'
Permit N? 3299
on the North side of
Chapels. Rdft Street
Street No. 128
Owner John Is, Law ton s,Jr.
Applicant Same
CERTIFICATE OF OCCUPANCY ISSUED:
Date
No.
Fee Paid
CLASSIFICATION
Two car gar-age and breezew•&y
32tx261
BUILDING PERMIT
No 3299
OFFICE OF
THE BUILDING INSPECTOR
of the
Town of South Windsor, Conn.
South Windsor, Conn. August 12- 1960
94ts is to Tcrtifll, That John J. Lawton, Jr.
is hereby granted permission to Two ngr ggr I breeseva r- 32 x261
at estimated value of 1-000
on the North side of Chanel Rd_ Street on land
owned by John J. Lawton. Jr
Said Work to be as described in Application
No. and to conform to specifications and plans filed with said Application, and Building By-
Laws of THE TOWN OF SOUTH WINDSOR.
Issuyd 1960
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."
i
Application No. 543.0 Permit No. 5160...........
TO THE BUILDING INSPECTOR
of the
TOWN OF SOUTH WINDSOR, CONN.
hereby make application for a permit to (erect ( e) a building according
t the pollowing detailed statement of the specifications and plans herewith submitted. (Draw a line through
word "erect" or words "make alteration to" as the case may require.)
All provisions of the Building By-Laws (Sections 2 to 32 inclusive) shall be complied with in the execu-
tion of this work whether specified he or not.
South Windsor, Conn., ....G % .................... ............ 19......
Signlime . '............ .:........................... .»r'' .... .. .........................
Address !.... .. ...../. . .... ../....... .. ..a .c ...........
Location? . ......................................................."side of? ... ...
Nearest cross street? .. ;-)/,,.V........ 5T.....Street No. .................................................... ................................................. .Lot No.
Owner of land is! .Rl. c.vtov...Address .1.2--1........
Ownerof build' is? ...... ".....................................................................Address ... .........`.`...................................................................................................
Architect is? ... ..... .... 5 B.N........ r J!»G. .....-Address 9-..?`.....J .... ......G ".............
Builder is? .. .. z,. .. e ..............»...Address llG'..'
I
Le V r.
Jv
7o ... Feet rear. 11.imensions of building? .. a Z.. Feet front? Q .... Feet dap? ..
Extreme height to highest po' t of roof? ................ ............ .... .... .... . .. No. of stories in height?.....
77.0
Pu se of building is? Ct..+C'll.. d No. of stores
fc1;C!}. Spy PAg` '`'a .
g r ...................
SAHowmanyfamilies? ......................f.??J,. .............._.»...»».»....No of rooms? ....lI ID SYNlT1A Y....................................
T.
MM...............
Distance from street line is? . • ... .....from building
WI'T' T01 IV1! OF
1W. 6
ADDITIONS AND ALTERA
Gve Brief Description)
TARP OFF1
P
Zto...............
A
I....... I...... ....... .. ...........................
f.T'./Af.lfie ........... .........................t...... ..... ........ .. .. ........ ...................
1 V
Map No. .
f
If of steel frame, what is exterior construction?
What kind of columns used? ........................................... ............Size of columns used?
What length of columns used? .......... ................ ... . ....... .......How protected? .. ............ ...... ... .......... . ............ ... .....
What kind of beams or girders? .................. Size of beams or girders? ............. ... ..... ..... ............................ ...
Longest span of beams or girders? ....................... These rest on?
Roof construction is? .....................................................................................Roof covering is. . . . . . ........ ........ ....... . ..............................
The floors are of ............................................ . ........ construction and are calculated to carry a safe load of
lbs. per square foot.
See Section 14, Building By-Laws.)
BRICK CONSTRUCTION.
Of what material will walls be constructed.? . ........ ..... ... . ......... .... ....................... ......................... .....................
Compositionof mortar? . ................................................................................................................................... ................ ............. ... .... ....... ... ... .........
Height and Thickness of Walls
Iffellibl; stories Front Walls Side Walls Rear Walls Partition Walls
Basement,
1st Story
2nd "
3rd "
I....................................................................................... ..................................................................................................................... ............................................................... .....
4th 49
5th 49
6th Of
I...................... .............................................. ......................................................................................................................................................
1..............
V&
10th .................... ................................
Material.of Front? If stone, what kind?
Thickness of Ashlar? Thickness of Backing?
Backed up with what? Arches or lintels over openings?
WOOD CONSTRUCTION.
Give Size, Longest Span and Distance Between Centres, of Joists, Girders and Columns
JOISTS 11 GMDEM OOLUMNS
Floors sie Longest span Centres Zlnx sin Longest span centres she I.enaf6 Centres
1st Floor /...
o ......./0..I....... ../S.P.(».
1
2nd of
E.O dQ» _»..`.........»......
3rd.....0....
4 ........ ............. .....................................................................................
r
Size of outside studs? ...... ..kV............ Distance on centres? ..........1.<o....a................. Size of sill? .........,x...,.....'........
r T
Size of rafters? ......-X...6.............. Distance on centres?................I.............. Size of plate? ................ .'K...V.............
Size of ledgers or girls? ................................................................................Size of deck rafters? ................................................................ ...............
r
Distance on centres? .......................................................................................Size of studs in bearing partitions? ........
MISCELL NEO S
Style of roof, flat,.pitch, Mansard, or hipped? .................o... Fireplaces? .......
Material of roof covering? ....... r F, 1...... ...........Material of Cornice? ...... .. .. ...C2(...........................................
How is building heatedrr7...L..
P..7...`.'......... Lining of flues? .. ..............<::;. lees.
r
Thickness of shell of flues? ..Any elevators or lifts. ......................................................... ......................
What kind? ............ ................................ How many? ............ .. . ........................ Any hoistwaya .....................
Howprotected? ................ .......................................................... ... ....... otal Value of Building ......................... ......o...o.....0..............
Whenwill work be commenced? ............... .. .............................. ... ................................................. 2. -.0 et la............
The applicant warrants that the lot for residential purposes, shown on a plot plan accompanying this
application, conforms to the zoning regulations of the Town of South Windsor.
Applicant
5160
BUILDING APPLICATION
5 .30
ApplicationNo. ............4................................................................
Northonthe ................................................................................ side of
Ch'apel Rd.
Street.
StreetNo, ...............
John J. Lawton, Jr.
Owner ...... ..... ......... ........... .... ...... ........... .. ...........
Applicant .. .......... . Same...... .............
CLASSIFICATION
Dwelling 701x26t
Permit issued on above Application.
3-2-65
Date, 19 ..... ..
TOWN OF SOUTH WINDSOR
BUR DING PERN[rr
March 265
Y .¢
E
Date- 119
84,00 21,00
c tiFeePaid $. . . . . . Eat. Valve $. . . ...
20900RECD. SEPTIC PAYMENT .
Permit 5160
z on the
North
O#frdC
Chapel Rd. save
N
Street No.
Owner John J. Lawton!-' Jr.
AppL' Same r`
cant
CERTIFICATE OF OCCUPANCY ISSUBD: y
Date
N - 3014 A
Fee Paid 3,00
CLASSIFICATION
Dwelling 701X26
BUILDING PERMIT
N? 5160
OFFICE OF
THE BUILDING INSPECTOR
of the
Town of South Windsor, Conn.
South Windsor, Conn. March 2 a 19 65
M#,tIo to to Tierfff1j, That John J. Lawt=# Jr.
is hereby granted permission to
Dwelling To t a26 t
at estimated value of $ 21*000
on the
North side of Chapel R'3ad Street on land
owned by Jon J. Lawtou t Jr.
Said work to be as described in Application
No. 5430 and to conform to specifications and plans filed with said Application, and Building By-
Laws of THE TOWN OF SOUTH WINDSOR.
ivied March 2, 19 65
f,
B,#ilding 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."
Permit No. 6-il,' ) TOWN OF SOUTH WINDSOR
SOUTH WINDSOR, CONN.
Permit N? 3 014
Certific to of Occancy
THIS I O CERT t t e
at No. in the Town f South Windsor, Connecticut, has
been erected d completed in accordance with the Building Code and Zoning Regulations of
the Town of South Windsor, and is hereby approved for occupancy.
N
Gf-e.
ao 7;;13uilding Inspector
Owner, Builder
f
OG
Fee Paid f" Date 19
1897
OIL BURNER
OR
FUEL STORAGE APPLICATION
Application No. 1908 Permit No. 1897
on the;gf side of
7/
0 Street
Street No.
Owner
John J Lawton, Jr
Application
i
1
CLASSIFICATION
American Std. DH5
Permit Issued on Above Application
Date 4-12-65 19
Fee Paid $ Permit #5160
oti
TOWN OF SOUTH WINDSOR
APPLICATION TO INSTALL RANGE AND FUEL OIL BURNERSIr'
EQUIPMENT AND TANKS
PERMIT N . 1897 DATE 4/—
The undersigned hereby applies for a permit for the installation of range and fuel oil burners, equipment and
tanks of the following description:
Address 1st floor 2nd floor 3rd floor
Character of Building: Frame y Brick
Owner of Burner el T C Owner of Building
Lessee or Tenant
RANGE BURNERS
Capacity of Tank at Range in cellar outside—
Name of Range Burner Purchased from
POWER BURNERS
Name of Fuel Oil Burner Model Number
Purchased from d G L
Name of Tank /'s Gauge of Tank -
Where is Tank Located 'Size of Tank S
Size of Motor Size of Wire
Will other heating equipment be installed?5
If so, by whomy
Name of Party Making Installation
Address—
Electrician 1 ` C'C'- !
Address
Signed APPLICANT
All provisions of Ordinances of this Town Regulating Oil Burner quipment and Fuel Storage (Sections 1-23 in-
clusive) and Underwriters' Code applicable to the subject matter of same shall be complied with in execution of this
work whether specified herein, or not.
5 Application for Permit received 4-9-65 andEstimatedCost $
Permit No. 18,97 issued 4-12—6 5
Permit Fee Paid _Permit -#5160 Approved
l
BUILDING INSPECTOR.
I TO THE BUILDING INSPECTOR
of 1116 APPLICATION FOR
PLAN EXAMINATION AND
TOWN 4F SO)TH WINDSOIt, COW
PLAN
PERMIT
z
IMPORTANT — Applicant to complete all i, ms in sections: 1, 11, III, IV, and IX.0
ZONIN
AT (LOCATION) te eezrz DISTRIC
LOCATION NO.) STREET)
OF BETWEEN
G
AND
BUILDING CROSS STREET) CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
II. TYPE AND COST OF BUILDING — A11 applicants complete Parts A — D M
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
1 New building Reside sal Nonresidential
2 Addition(If residential, enter number 12 One family 18 Amusement, recreational
of new housing units added, if any,
Part D, 13)1 Two or more family — Enter 19 Church, other religious
number of units— — — — -i 20 Industrial
3 Alteration (See 2 abov )14 Transient hotel, motel, 21 Parking garage4 Repair, replacement or dormitory — Enter number
5 Wrecking (If multifamily residents of units ——————— — i Service station, repair garage
enter number of units in building 15 Garage 23 Hospital, institutional
Part D, 13) 16 Carport 240 Office, bank, professional
6 Moving (relocation)
17 Other — SpeciJy 25 Public utility
7 Foundation only 26 School, library, other educational
B. OWNERSHIP 270 Stores, mercantile
8 Private (individual, corporation,
28 Tanks, towers
nonprofit institution, etc.) 29 Other — Specify
9 Public (F deral, 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,,,....,•....... $44 school, secondary school, college, parochial school, parking garage for,
department store, rental office building, office building at industrial plant.
To be installed but not included If use of existing building is being changed, enter proposed use.
in the above cost
a. Electrical......................
b. Plumbing ......................
c.Heating, air conditioning.........
d. Other(elevator, etc.)............
11. TOTAL COST OF IMPROVEMENT 1$ vV
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 Reinforc d concrete H. TYPE OF WATER SUPPLY
34 Other — Specify 42 Public or private company
So. Total land area, sq.ft. ...........
43 Private(well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed ......................
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 Gas Will there be central air 52. Outdoors.......................
36 Oil c nditioning? L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 Yes 45 N 53. Number f bedr oms..............
38 C al
39 Other— Specify Will ther be an elevat r?
54. Number of
Full..........
46 0 Yes 47 No bathrooms
Partial.......
NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP cod T I. No.
OOwner or
Lessee
2.
Contractor
3.
Architect or
Engineer
The owner of this building and the undersigned agree to confo to all applicable laws of this jurisdiction.
Signatur of applicant Addres Application dot
4LZ6eJ A14 1
DO NOT WRITE FLOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans R view R quired Check Plan Review Date Plans By Date Plans By NotesFeeStartedApproved
BUILDING
PLUMBING
MECHANICAL
ELECTRICAL
OTHER
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Obtained
Date Number By Permit or Approval Check ob
Date Number Byned
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 9538
Bui lding
Permit issued kept. 28 19 .7_
Bui Iding
Permit Fee $ 12.00
Approved by:
TITLE
VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
IX. SITE OR PLOT PLAN — For Applicant Use
N
TOWN OF SOUTH WINDSOR
BUILDING PERMIT
Date Sept. 28 19 76. I r
i
Fee Paid Est. Value $. .2,.000.0
I
l
i
Permit lq''?9538
i
on the side of
ChaDA1 Road Street
Street No. 198
Owner Tina 7nr-r n
Applicant Conn. Valley Bldrs. Inc.
CERTIFICATE OF OCCUPANCY ISSUED:
Date
i
No.
Fee Paid $
CLASSIFICATION
Al imi- im Si i n
BUILDING PERMIT
Wo 9538
OFFICE OF
THE BUILDING INSPECTOR
of the
Town of South Windsor, Conn.
South Windsor, Conn. 9/28/7 6 19
That Conn. Valley Builders., Inc.
is hereby granted permission to Aluminum S id inz
at estimated value of 00
on the side of 128 Chafe 1 Road Street on land
owned by i;na Z.oceg
Said Work to be as described in Application
No. 9838 and to conform to specifications and plans filed with said Application, and Building By-
Laws of THE TOWN OF SOUTH WINDSOR.
Issu Sept. 28 7 6.
Nildbtj(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 compeller'. to reason therefor."
iNSPEC'T1O REPORT
Permit # gf3--s Job ,:2
1 Footing i
2 Foundation
3 Framing
4 Wiring 4 ~
5 Plumbing
6 Heating
7 Lathing
8 C.O.
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
Application is hereby:TOWN OF SOUTH WINDSOR
PERMIT#
n
BUILDING DEPARTMENT 91t)-(
APPROVED 1540 SULLIVAN AVENUE
Bldg.Permit#
Ut 644-2511 ext. 230
ate Building Inspector
Application must be printed or typed
FEE SCHEDULE Location of Job:
0-$1,000=$13.00 Street No. Street Lot No.
Over$1,000=
13.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT
APPLICANT ADDRESS `72 1 k(
o wr Ej 1c So,l C,T'
APPLICANT PHONE# 2 g a -- I logo
OWN S OWNER 6 O 6 Liq 1.-b'j` 0
q< OWNER ADDRESS
OWNER PHONE a S
C ESTIMATED COST$ 4 7 b 0 C.
1 V
IS THIS A CONTRACT COST? Yes P$ No
FEE ENCLOSED$ /3. 0
TYPE OF JOB:OR•C
P'New Installation
0 Alteration/Addition/Repair Revised 5101
APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
BUILDING PERMIT APPLICATION? YES NO
SIDENTIAL
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
TYPE OF INSTALLATION/WIRING METHOD
SIZE OF SERVICE /G U .4 bq/0 SIZE OF MAIN CONDUCTORS L
NUMBER OF METERS 1 NUMBER OF DISCONNECTS AND RATINGS^
NUMBER OF PANELS 1 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.
00e -z35-78 cT
CONTRACTORS LICENSE
2 .1
TYPE STATE
SIGNATURE OF APPLICANTDATE l"7 0 r