HomeMy WebLinkAbout147 Cambridge Drive (2)TO THE BUILDING INSPECTOR
Of the APPLICATION FOR
OWN OF SOUTH WiNDSOlk CON.
PLAN EXAMINATION AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX.O
AA-3ZONINGI• AT (LOCATION) t3DISTRICT
LOCATION STRE tr
OF BETWEEN AND 1
BUILDING CROSS STREET) OSS STRE T
O
CAMBRIDGE ESTATES LOT
a ' Xl .7a-.yr
SUBDIVISION LOT BLOCK SIZE
Vs
II. TYPE AND COST OF BUILDING — A11 applicants complete Parts A — D o
A. TYPE OF IMPROVEMENT D. PROPOSED 14SE — For"Wracking' most recent use in
fI'X New building Residential Nonresidential
2 Addition(It residential, enter number 12R5,One family 18 Amusement, recreational
o/new housing units added, i/any,
in Part D. 13)13 Two or more family — Enter 190 Church, other religious
number o/units— —— — - 20 Industrial3Alteration (See 2 above)
14 Transient hotel,motel,21 Parking garage4Repair, replacement or dormitory — Enter number
5 Wrecking (i/multi/amity residential, o/ units ——————— —-- 22 Service station, repair gar 9
enter number o/units in building in 15 Garage 23 Hospital, institutional
Part D, 13)
16 Carport 24 Office, bank, professional6 Moving (relocation)
17 Other — Speci/y 25 Public utility7 Foundation only 26 School, library, other educati nal
B. OWNERSHIP 27 Stores, merconfile
6 M Private(individual, corporation, 28 Tanks, towers
nonprofit institution,etc.) 29 Other — SpeciJy
9 Public(Federal, State, or
I cal government)
C. COST Omit cents) Nonresidential — Describe in detail proposed use of buildings,e.g., fo d
7d processing plant, machine shop, laundry building at hospital,elementary
10. Cost of improvement,,,.,,,,,,,,•,,, 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. Oth r(elevator, etc.).............
yJ11. 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
48. Number of stories................30 El Maemy(wall bearing) 40 Public or private company
49. Total square feat of floor area,31`Wo d frame 41 Private (s•pttc tank,etc.) all floors, based on exterior Q s32nStructuralstooldimensions ..................... I
33 Reinforced concrete H. TYPE OF WATER SUPPLY
34 Other — SpeciJy 42 Public or private company
0. Total land area, sq.ft. ........... 1 0 9
43 Privat•(well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed .......................13
F. PRINCIPAL TYPE OF HEATING FUEL 1. TYPE OF MECHANICAL
35 Gas Will there be central air 52. Outdoors........................
Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 Yes 45 N 53. Number f bedrooms..............
38 C of
39 Oth r— SpeciJy Will there b on levator? Full..........
54. Number of
46 Yes 47 No bathrooms
Portlol........
IV. IDENTIFICATION — To b complet d by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
Miller Realty Inc . 658 Ellington Rd . So . Windsor , Ct . 06074 282-0628
Owner or
Lessee
2. Same Same
Contractor
3.
Architect or
Engineer
The owner of this building and the undersigned agree to conform to all applicable laws of this jurisdiction.
Signatur f applicant Address Application date
2!:f= 1
DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Dare Plans
By Date Plans By NotesFeeStartedApproved
BUILDING
PLUMBING
MECHANICAL
ELECTRICAL
OTHER
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Obtained Number By Permit or Approval Check Obttaained 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
Permit number I S K 7U
Bui Iding
P rmit issued rn N ` CR
Building
Permit Fe $ 6,3C7 `0c,
00
r d by:
tA--t
c
TITLE
TOWN OF SOUTH WINDSOR
BUILDING PERMIT
Date May 18
Fee Paid $. .630..00 Eat. Value $10.5%Q00.00
Permit No 15870
on the side of
T.o #1 3 .amhri dgPT)ri ue Tr;*
Street No.
Owner M'11 sir Real ty Tur
Applicant s..zb4YA
CERTIFICATE OF OCCUPANCY ISSUED:
Date May. 18, 11987
No.81 79
Fee Paid $ 3.00
CLASSIFICATION
New hiii 1 di ng
BUILDING PERIVIIT Na' 15 87 p
OFFICE OF
THE BUILDING INSPECTOR
of the
Town of South Windsor, Conn.
South Windsor, Conn. May 19 1ST?
94is to t P1'fi That M4 1 1 er Realt;,x Zuc•
is hereby granted permission to new building
at estimated value of It 05 0 p
on the side of Can =rid.ge_.U-1•i.ue, _Tot 013 Street.on land
owned by Mil]er R=attyinC.
Said =rk to be as described in Application
No. 1.6I61 and to conform to specifications and plans filed with said Application, and Building Br
Laws of THE TOWN OF SOUTH WINDSOR.
Iss 107
uil 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."
9Y'67 J)WE-LL,AIG
C •bc; p.;e d.a+ i3 Permit #Isig70
Electrician
Heating Contr. Qwpq /iv MPK #
Plumbing it 57 w wdsor a 1p(.7351
Oil Burner
Certificate of Occupancy ,, #(`la
Sewer Permit
IASI* r ow r
INSPECTION REPORT
Permit # d Job
y7
1 Footing
kt2Foundation
3 Framing
Wiring C 7 3 LR r
5 Plumbing 7 351 S. k)
036Heating
T
7 Lathing
A
Permit No. TOWN OF SOUTH WINDSOR
SOUTH WINDSOR, CONN.
I
Permit ®8172I
Certificate of Occupancy
THIS IS TO CERTIFY that the 1 ' 1 1'' Yr
at No. J C ;' 'L±Lli in the Town of South Windsor, Connecticut, has
been erected and completed in accordance with the Building Code and Zoning Regulations of
the Town of South Windsor, and is hereby appt ve fo"r occupancy
Ok
Building Inspector
Owner, Milder
Fee Paid Date
CERTIFICATE OF OCCUPANCY CHECK LIST
i
Applicant Certificate of Occupancy
Address '/ Bldq. Permit No. w
Lot No 3 Date Submitted
Project Reviewed By
Date
As required in the Zoning Requlations, no certificate-of-occupancy
shall be issued until grading plans have been complied with and
approved by the Town Engineer. The u=a requirements shall
inlcude-
Approved Denied N/A
1. Approved building permit plan.
2. Finish grading per approved
building permit plan.
3 . Site work; i.e. trees, shrubs, dumps
required parking
4 . utility location
a. sanitary sewer
b. foundation drain
C. electrical a telephone
d. water
e. other
S . Appropriate certification
6 . Bonding
Sewer Permit No .
Pavement Excay . No.
COMMENTS :
BUILDING F9RM1' CHECK LIST
Applicant Building Permit No*
Address Date Submitted 4
Lot No.3 Reviewed by 7>
Proj ect i=o/.&'3 /i - Date
In accordance with the Subdivision Regulations, prior to the building of
any structure on a lot, a Topographic Plot Plan shall be submitted for
approval. The minimum requirements shall include:
Approved Denied N/A S 27
1. Name, address & phone number of owner/
applicant.
2. Name, address & phone number of plan preparer.
3. Zoning information - i.e. - zone, pen s
floodway, etc.
4 . Plot plan at 1" = 40 ' scale.
r/ a. Subdivision reference, abutting
properties , etc.
b. Easements of record.
c. Lot description, bearings , distances,
building lines, area, etc.
d. Contours , existing & proposed, 1 or 2 ft.
interval where appropriate.
e. Building location with dimensions .
Elevations of proposed finish floor,
garage Boor & center line of road at
driveway.
f. Elevations of._gr,_gvity drainage systems, -
foundation drain at
house and the street.
g. T ive utility location gas, electric ,
water etc.
h. Title block with name and address of
preparer, date appropriate certification,
live seal and signature.
S . Sedimentation and erosion control.
6 . Special Planning & Zoning, Inland/Wetlands
considerations . (Plans on file w/Town Clerk)
BUILDING DEPT.
PZC
IWA/CC
wPCA f1 s was- s
OTHERS 1
3/
3GCOMMENTS:
q-73so
ELECTRICAL APPLICATION
Application No. Zy
on side of
Street
Street No.
Owner
Electrician d nn11
FILED IN OFFICE OF
The Building Inspector
19
INSPECTION.
sw 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 Are
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. ........ —..&....70.....
BUILDING DEPARTMENT Date Filed
Date Final Approval .................. .........................
APPLICATION FOR ELECTRICAL WORK
Electrical Inspector
JOB LOCATION. JOB OWNER:"N.....1. s.............(..L.14) ..........1.6.0. ............
kIP4 Side of we en ...%.v\CS... ............................00V...... and .......
Name of Building Owner Address . .. ....11Z
If work is for Lessee—Give name .. .... Address .............................. ............................................................
Building now occupied as (unless new) No. of family units now . .. .....
Building to be occupied as ........... INumberoffamilyunitstobe ....... ... .................
If no Buildin erl I0
Is this work included in a Building Permit? Permit Fee .............. ................
O_g P 4 4-elephone ..0-).—..S)2,--,-3aoPermitteeBusinessAddress
COSTOF INSTALLATION:
W-50. w.4 ............................... . . ...................... .......................................................................................................................
TO BE FILLED OUT BY PERMITTEE
TO BE WIRED EXISTING APPLIANCES
Number of light outlets to be installed . . .. ..D'!.....
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 Oil Burner
TYPE RATING NO.
Dish Washer Gas Burner
Range . . . . . . . .
Well Pump Elec. Heaters
Range Top . . . . . .
Oven . . . . . . . .REMARKS:
Water Heater
r` S
c,,p.
G S 1
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 ................ ... .......-.
4 .... ...........Size of service to be . .............
PLUMBING APPLICATION
ISO
sum
tr+et
owm
Filed in
The
Api 3 i
No person&A mums, add m or slat aW
portion of the &gimp "mm of an! boun
ezoept to repair 66) mma a pha.ic is sawed
bydhe
APPLICATION FOR PLUMBING PERMIT (Continu d from R v rs Sid
TOWN OF SOUTH WI TOR, CONN.
C'm3F, I G R ) Y
11. LOCATION OF JOB710e
NO. STREET FLOOR APT.NO.
GENERAL PLUMBING
12. KIND OF INSTALLATION t a s. /,ec tl 13. SIZE OF MAIN DRAIN e
14. NO. OF TOILETS STYLE ,.T 15. NO. OF URINALS STYLE
16. NO.OF BATHTUBS_17.NO.OF LAVATORIES 18. NO.OF SINKS_ 19. NO. OF WASHTUBS
20. NO.OF CONDUCTORS SIZE 21. NO. OF STACKS OZ SIZE t?
22. AREA OF ROOF 23.NO. OF CATCH BASINS _ 24. NO. OF FLOOR DRAINS
25. NO. OF OTHER FIXTURES KIND y a0 A'e s
26. ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW?27. SIZE OF WINDOW
28. IF NO WINDOW, WHAT KIND OF VENTILATION IS THERE? ZL- 'ae of
29. SIZE OF DUCTS 30. ARE SEWAGE AND WATER FACILITIES AVAILABLE? 2!Lz
t c
SIGNATURE h ADDRESS y ,hz t'
LICENSE NO. e-90j n6B ESTIMATED COST TELEPHONE
OWNER t r ADDRESS G : G `d.
WATER HEATER
31. TYPE 4At 1 / 'G' 32. MANUFACTURER P
TANK SAFETY DEVICES
33. CAPACITY 37. TEMPERATURE RELIEF VALVE E7Zlo 0
34. TEST PRESSURE A t 38. MANUFACTURER
35. WORKING PRESSURE 90/6 f 39. PRESSURE RELIEF VALVE
36. TYPE 17411 A_e 40. MANUFACTURER
ALL WORK COVERED BY THIS APPLICATION HAS BEEN AUTHORIZED BY THE OWNER OF THIS PROPERTY
AND WILL BE DONE IN STRICT ACCORDANCE WITH THE BUILDING CODE.
t2_/lrf_4e 7
C0962 DATE SIG E OF APPLIC
3-30/
PLUMBING APPLICATION
on the ............... A&of
Sam No.
f)--Owner ....lar- I IiUd 9.4
Plumber L L64--CU t- P/Q.
Filed in Ofice of
T6 &A&g
19
No pawn AA commmn, add w or aim my
pomon of the &anw "m of aw bmum
ezmpt to repair 66) until a Pe it is gmmftd
by the Building Inqnctw.
APPLICATION FOR PLUMBING PERMIT (Continued from Reverse Sid )
I4+1
TOWN OF SOUTH WINDSOR, CONN.
11. LOCATION OF JOB Lot #13 Cambridge drive
NO. STREET FLOOR APT.NO.
GENERAL PLUMBING
12. KIND OF INSTALLATION Residential 13. SIZE OF MAIN DRAIN 4
14. NO. OF TOILETS 3 STYLE tank 15. NO. OF URINALS 0 STYLE
16. NO.OF BATHTUBS 1 17.NO.OF LAVATORIES 3 18. NO.OF SINKS 1 19. NO. OF WASHTUBS 0
20. NO.OF CONDUCTORS SIZE 21. NO. OF STACKS 1 SIZE 3
22. AREA OF ROOF 23.NO. OF CATCH BASINS 24. NO. OF FLOOR DRAINS
25. NO. OF OTHER FIXTURES 2 KIND 5-2' whirlpool' and 3811 corner shower stall
26. ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW?Yes- 27. SIZE OF WINDOW
28. IF NO WINDOW,WHAT KIND OF VENTILATION IS THERE? electric vent fan
29. SIZE OF DUCTS 311 30. ARE SEWAGE AND WATER FACILITIES AVAILABLE? yes
SIGNATURE ADDRESS 524 Burnham Street South Windsor
LICENSE NO. 203068 ESTIMATED COST 914"00-9 y TELEPHONE 528-4413
OWNER Miller Realty Inc.ADDRESS 658 Ellington Road
WATER HEATER
31. TYPE g(as fired 32. MANUFACTURER A. O. Smith
TANK SAFETY DEVICES
33. CAPACITY 50 gallons 37. ,TEMPERATURE RELIEF VALVE dl0'
34. TEST PRESSURE—Ty v S 38. MANUFACTURER
35. WORKING PRESSURE 419dA r 39. PRESSURE RELIEF VALVE y
36. TYPE r /,-" 40. MANUFACTURER 1
ALL WORK COVERED BY THIS APPLICATION HAS BEEN AUTHORIZED BY THE OWNER OF THIS PROPERTY
AND WILL BE DONE IN STRICT ACCORDANCE WITH THE BUILDING CODE.
chi
CD962 ATE N R F A (CANT
29 PERMIT #
Application For 3CdIDEPARTMENTDECISIONHeatingPermit0
3 APPLICATION IS HEREBY:
DEPARTMENT OF LICENSES AND INSPECTIONS
1 APPROVED DISAPPROVED
TOWN OF SOUTH WINDSOR
o
0
00 DATE CHIEF INSPECTOR APPLICATIONS MUST BE PRINTED OR TYPED. BEGHI WITH NUMBER NE BEL W
O
j >
b
art
g 'E 1. LOCATION OF JOB
s+ O
NO. BTREET
1 i
LOT NO. tFL0001 AK. N .
19 a. OWNER
ADDRESS01
41
71,
C FHONE 6
e0
r
I. APPLICANT 1=Q/4
0. ADDRESS
q c16.G 6G 7Y 7.PHONE 9
S. LICENSE NO.U Z U
C1.49
9. EXPIRATION DATE OF LICENSE /W p -7
to
10. ESTIMATED COST
11. Is THIS A CONTRACT COS"00 YE.S NO
ts. FEE ENCLOSED s
al 12. UILDING:
y L RESIDENTIAL COMMERCIAL
cc INDUSTRIAL
a)
MAL ALTERATION
ATION ADDITION
REPAIR
I
APPLICATION FOR HEATING PERMIT (Continu d from R v roe Side)
11. LOCATION OF JOB cqin o/' Icj
N STREET FL R AFT.NO.
12. TYPE OF INSTALLATION: OIL BURNER ELECTRIC VENTILATION SPRINKLER
d GAS BURNER STACK INCINERATOR 0 _W CELLANEOUS 2/r
109NTI T
SIZE LOCATION SIZE SIZE
13. OF TANK OF TANK OF FILL OF VENT
1a. B.T.U. EQUIP. AT REGISTER Z-`' FURNACE MAKE AND NO. 'La AT BONNET '7f e4i) FIRING RATE 2 4 J
BOILER OR FURNACE MAKE AND NO. 0" C" B.T.U. OR SQ. FT. NET B.T.U. OR SO. FT. GROSS — FIRING RATE -
FLOORS TO BE HEATED 2 NEW OR OLD BUILDING p INSULATED - YES OR NO yf I
TYPE OF WALL INSULATION 'f- ROOF OR CEILING /?-3:L- INSULATION 7 -PS
AVG. SYSTEM WATER TEMP. B.T.U./SQ. FT./HR. EMISSION
INDOOR-OUTDOOR TEMPERATURE DIFFERENCE -7 T v 0 FAHRENHEIT
MAKE OF RADIATION: BASEBOARD. COPPER CONVECTORS. OR C.I. RADIATION. OUTPUT PER SECTION OR LINEAL OF RADIATION. SO.
FT. OR B.T.U.
DESCRIPTION OF WORK
15. TO BE DONE- 1 d c e ) T27 3 /LO CGe
11 PC PII4r 7
16. HEAT LOSS SCHEDULE. (TO BE INCLUDED FOR ALL JOBS):
woorr SIZE wlNoow• AREA - SQUARE FEET 0.T.U. E.T.U. g o
AND DOORS VOLUME TOTAL TOTAL i~ DISTRIBUTION INSTALLED
R OM NO. S GRDSS GLASS NET ISALL CEILING FLOOR CU.FT. AT A•F CORRECTED J [R[ ISTER
L IS N ANO TEMP. TO f
IL
TYFE AND SIZE RAO. OR LEADER
SIZE MALL Gt INFILT.)
DIFF. F M SO. FT. FREE AREA
mil
u f7
TOTALS
A. HEAT LOSS FROM BUILDING /v r Y 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:
NAME AOORESS
SUBCONTRACTORS AND
18. THEIR TRADES
ALL WORK COVERED BY THIS APPLICATION HAS BEEN AUTHORIZED BY THE (OWNER) OR (AGENT) OF THIS PROPERTY AND WILL
BE DONE IN STRICT ACCORDANCE WITH THE BUILDING CODE.
APPLICATION TO BE COMPLETELY FILLED IN. 2-3 (,?r-7
DATE SIGNATURE Or APPLICANT
r
i
6:
2MJ
3
CALML
SaOUTH WINDSOR CT 06074
E
17
i
R ALCULATIONS ENTERED BY GERRY KURTZMAN AND CONFIRMED BY GERALD KURTZMA
FACTOR USED FOUND I]
AME LENGTH WIDTH HEIGHT EXP. W1
k'ALL 3 17
ip EDROOM 16 12 9 171
12 9i 198
LATH 6 12
OSET 6 12 8 144
Ta-_& HALL-- - - 21 - 8 8 232
OSET 15
DROOM 20 16 8 160
13 12 8 200
I UD ---
gam- -
TH 11 6 8 48
13- - - 15 16 208
VING 25 16 798- -
NI NG 13 16 232
K-;!TCHEN- -20 16 8 160
r'iiI LY 27 16472
r AL
I ,
asel
S
ATED US ING--70 - DEGREE TEKP RI SE --
CALCULATED USING 20 MILE WIND
APPROVED BY(
N - STATE LICENSE # 301283
J MANUEL J***
kLL GLASS CU. FT ----- --BTUDaORS
408 8160
412-00
16 2304 57440
576
0 1152
0 5-76 - - -- -- - - 11-5-2
10 1344 36380
960 1920
16 2560- - --- --- - -- --11-47 0-42- -
32 1248 55360
13 2 0 505521
0 528 1060
32 3120 1091521
185500
60 1664- - - - - -- - - 90280
10 2560 1090042
3456 145120 i
a-----
105564 BTU
Electric# APPLICATION FOR BUILDING PERMIT
Plumbing# 147 CAMBRIDGE DRIVE
HVAC # Date: 41110 91s
Sprinkler# No. 22703
FINAL APPROVALS Estimated Cost $ OCR d
Building 70117AC— COMPLETE RED BOXED AREAS Permit Fee Q —
Engineering TYPE OR PRINT ONLY Occupancy Fee $
Affidavit SIGN ON REVERSE SIDEAppr.for CO. 1[:: Total Fee
TO BUILDING DEPARTMENT, TOWN OF SOUTH WINDSOR,CT Additional Cost) $
Th and rsigned hereby applies to do work according to the following specifications:
Job Location / 6 f Lot No. Side of Street Zone
Applicant0:) — A Tel.# SpZ!W o
Address '7 kc4orlex -cl jgl:-d Zip 0 /C:;/. Lic. #
Own r lOAl (J'Z-fe fT;r i.,i4 Address
Architect Address
Sq. Ft.N w Area: 1st FI. 2nd FI. 3rd Fl. Total New Area
Rooms Lavatories Bathrooms Garages
Purpose of this permit: Re,'os d l/c(' I L-oq y e V—
City Water C Well 0 Septic System 0 Sewer J
Use Group Construction Type Area Basem nt Garage
Approved by Date 0(v E
R.vs.d 6/95
I hereby agree to conform to all the requirements of the Laws of the State of Connecticut and the Ordinances of the Town of
South Windsor and to notify the Building Inspector of any altera' in theessallowed.s of the Building for which this
permit is asked, and agree that this building is to be located proper dlines, side yard lines and required
distances from all other zones and is located in a zone i ch this build
Signed
I hereby apply for a Certificate of Occupancy f r the work described in this application for the permit
Signed
DO NOT WRITE BELOW THIS LINE --
INSPECTION COMMENTS
DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT
TOWN OF SOUTH WIlVDSOR
PERMIT#
Application is hereby:
BUILDING DEPARTMENT
APPR VED 1540 SULLIVAN AVENUE Bldg.Permit#
fL/-7 644-2511 ext. 230 A/A
Date Building Inspector
Application must be printed or typed
FFEESCHEDULELocation of Job:
0-$1,000=$13.00 Street No. Street Lot No.
Over$1,000=
13.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT r1qC T CC N r5
APPLICANT ADDRESS P 3 9, 6-f-
AA)P0LEE OT, ob2.32-
APPLICANT PHONE#
PP
OWN S OWNER 17 z 1 K-1 E U) Z
q OWNER ADDRESS 141 Cdmftiw Ve 1 E
0 OWNER PHONE
C ESTIMATED COST$ 3D0
IS THIS A CONTRACT COST? res O No
f CJ FEE ENCLOSED$ O
TYPE OF JOB:
s R CO New Installation
13 Alteration/Addition/Repair Revised 8/99
APPLICATION FOR HVAC PERMIT (Continued from reverse side
TYPE OF SYSTEM: TYPE OF BUILDING:
0 HEATING RESIDENTIAL
A/C COMMERCIAL
VENTILATION INDUSTRIAL
HEATING
STEAM LOW PRESSURE LIMIT LBS. HIGH PRESSURE LIMIT LBS.
HYDRONIC WARM AIR UNIT RADIANT HEATER
EXISTING RADIATION ADDITIONAL RADIATION TOTAL RADIATION
DESIGN TEMP. OUTSIDE OF INSIDE OF DIFFERENCE OF
TOTAL HEAT LOSS(BTUH) F(HEAT LOSS SHEET MUST ACCOMPANY
APPLICATION)
DESCRIBE ALL HEATING EQUIPMENT(INCLUDING MAKE&MODEL NO.)
kAru2,9ti (5;96 VE_Eti rF,D GoJ.L)_ru BLo0Aj_r e00 L.06
GROSS HEATING CAPACITY(INPUT-BTUH) NET RATING(OUTPUT-BTUH)
TYPE OF FUEL
OIL-GPM OIL TANK LOCATION :INSIDE OUTSIDE CAPACITY
GAS-INPUT LPG TANK CAPACITY ELECTRIC-KW
AIR CONDITIONING
DESIGN TEMP.OUTSIDE OF INSIDE OF DIFFERENCE OF
TOTAL HEAT GAIN(BTUH) HEAT GAIN SHEET MUST ACCOMPANY APPLICATION)
DESCRIBE ALL COOLING EQUIPMENT(INCLUDING MAKE&MODEL NO.)
TONNAGE COOLING CAPACITY(BTUH)
VENTILATION
DESCRIBE ALL AIR HANDLING EQUIPMENT(INCLUDING KITCHEN EXHAUST EQUIPMENT)
TOTAL SIZE OF SYSTEM(CFM) FRESH AIR INTAKE(CFM)
PLANS MUST ACCOMPANY APPLICATION)
FURTHER 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.
30 6,5 5- C'r.
CONTRACfORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT DATE
DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT PERMIT#
TOWN OF SOUTH WINDSORApplicationishereby: D Lg SNryBUILDINGDEPARTMENT
APPROVED 1540 SULLIVAN AVENUE Bldg.Pe -t#
2 fqct 644-2511 ext. 230
Date Building Inspector
Application must be printed or typed
Location of Job:
FEE SCHEDULE
17
0-$1,000=$13.00 Street No. Street Lot No.
Over$1,000=
13.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT Pzprccy SCRYI&C6
APPLICANT ADDRESS l•0. 9p yC 32 9
A fiyoof'l2 6 , DG23z
APPLICANT PHONE# 7 2 -1p Q f9
OWN S F
OWNER n o#14 S 'b 21 K t r Wj C z
OWNER ADDRESS m g p G Lc DR i ya:
S
f
O OWNER PHONE O 4 y — 9 4 86
C ESTIMATED COST$ 3 0 0
o IS THIS A CONTRACT COST? Yes 0 No
FEE ENCLOSED$,
TYPE OF JO
OR CO New Installation
13 Alteration/Addition/Repair Revised 8/99
APPLICATION FOR HVAC PERMIT (Continued from reverse side
TYPE OF SYSTEM: TYPE OF BUILDING:
U HEATING ORESIDENTIAL
A/C COMMERCIAL
VENTILATION INDUSTRIAL
HEATING
STEAM LOW PRESSURE LIMIT LBS. HIGH PRESSURE LIMIT LBS.
HYDRONIC WARM AIR UNIT RADIANT HEATER
EXISTING RADIATION ADDITIONAL RADIATION TOTAL RADIATION
DESIGN TEMP. OUTSIDE OF INSIDE OF DIFFERENCE OF
TOTAL HEAT LOSS(BTUH) F(HEAT LOSS SHEET MUST ACCOMPANY
APPLICATION)
DESCRIBE ALL HEATING EQUIPMENT(INCLUDING MAKE&MODEL NO.)
4;ok o A)e9 0 A)NR r,' G'6 VIF aJ r_eb go ? B r
GROSS HEATING CAPACITY(INPUT-BTUH) NET RATING(OUTPUT BTUH)
TYPE OF FUEL
OIL-GPM OIL TANK LOCATION:INSIDE OUTSIDE CAPACITY
GAS-INPUT LPG TANK CAPACITY ELECTRIC-KW
AIR CONDITIONING
DESIGN TEMP.OUTSIDE OF INSIDE OF DIFFERENCE OF
TOTAL HEAT GAIN(BTUH) HEAT GAIN SHEET MUST ACCOMPANY APPLICATION)
DESCRIBE ALL COOLING EQUIPMENT(INCLUDING MAKE&MODEL NO.)
TONNAGE COOLING CAPACITY(BTUH)
VENTILATION
DESCRIBE ALL AIR HANDLING EQUIPMENT(INCLUDING KITCHEN EXHAUST EQUIPMENT)
TOTAL SIZE OF SYSTEM(CFM) FRESH AIR INTAKE(CFM)
PLANS MUST ACCOMPANY APPLICATION)
FURTHER DESCRIPTION OF WORK
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS TO
COMPLY WITH ALL LOCAL ORDINAL,AND CONNECTICUT BUILDING CODES IN THE
PERFORMANCE OF SUCH WORK. ;;TT L1
S-306570 s
R.375753
CONTRACTORS LICENSE NO.E 0w STATE
SIGNATURE OF APPLICANT DATE •Z "/ /
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PLO`T PLA.VA C AMSRIO&E ES''CATES
PREPA-REfl FOR JVJ GO"STRUC TtOtl CO.
SOUT" '.WIMO%OR, C014N." BY REINO E.
HYVPPQ A$S00NTE1S scAA.E V. 40' LOT 13UhTE2-2-8fo MAP No. -7-9(o-IS
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PREPARED FOR
FvN. Loc,nap An MILLER REALTY
7 `"x" 1f14t.11T`°: '`"-r"i SOUTH W IN DSOR, CONN.Qg`.P Ex.T Tp v W NCa lX f4"TIC+J
1 hereby-declor that this map is substantioNy correct. This mop
nd survey Wert prepared in accordance with the standards of a QE.v. s-2"-8"I A-2 Iroo pClasAte. survey as defined in-the "Recommended Standards for
tU. 3 Zb-e-1 E•Asov oarrRa..Surveys-and U"s in the, State of-Connecticut"' as prepared and
adopted by the Connecticut Association of Land Surveyors, Inc.. REINO E. HYYPPA ASSOCIATESonSeptember13, 1904.
CIVIL ENGINEERS S LAI40 SURVEYORS
f /; GLASTOM'My. CONN.
APPROV D
TOE'JN 0.= FO UTH V`o S :Z31SOR
ET If`d%.ERI:cG DEPARTMENT
DATE: Z—
SIG.: