HomeMy WebLinkAbout155 Gray RoadApplication No.
7137
Permit No. 6837
TO THE BUILDING INSPECTOR
of the
TOWN OF SOUTH WINDSOR, CONN.
hereby make application for a permit to (erect (rn-:.s i6a=o) 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 Building 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., 19. ...
Signhere ......
Address
Location? . ... side of? ............. .. ........................................................................................
tNearestcrossstreet. ... Street No. . .............. ............................. Lot No. ..., l.. .......... .
Owner of land is? . Address
Owner of building is? . Address r. ,......... ..
Architect is? Address A. .....
uilderis? . ... .4t&..V-al.... ..... ... ...... ......................................Address ...................................................................................................................
Dimensions o uilding? Y X... , , Feet front? ...... y ..... . Feet rear? ..... `....... Feet deep? ... . .... ..1
Extreme height to highest point of roof? ............ ... ./.Y.'No. of stories in height?.. . ../.....2
Purpose of building is? 1:04 No. of stores? ..... ...... .....?.......................................................................
1':-/* .....
How many families? ..................................c..... ........................._......No. of rooms? .... ... ....7............................................................. ...............
Distance from street line is? ................ ..... ..Cj..........................from building line is? ....... t ............................................................
ADDITIONS AND ALTERATIONS
Gve Brief Description)
RECD. SEPTIC PAYMENT
INDORSED gY SA MIT RY Qrr,-v
M ACCORDANCE W11 H TOV/ `
SOL"'.. INDSOR....ORDINAR-CE......, a
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? .. ......... .. .... . . .............. ........................ ........... ......... .............. ..
Composition of mortar? ..............................
Height and Thickness of Walls
Height Stories Front Walls Side Walls Rear Walls Partition Walls
Basement,
1st Story
2nd "
3rd "
4th Is
5th 11
I....... ........................................ „.........................._.................................................................... ..................................................
6th "
7th
I....................... .................. ...... ............................................................... ..............................................
8th "
9th is
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 GMDBSS OOLU MNS
FIoors Size Longest Spun Centres Bridging Size Longest Span Centres Size Length Centres
1st Floor
2nd "
41.q .............1..Y.....:......... ....A...'.
3rd
4 ..... ...... .... .........
Size of outside studs? .........2.,.X. ............ Distance on centres? ....................16..r..Size of sill? ,/......... . .............................
Size of rafters? .. Distance on centres? ... .. `...`9 Size of plate? .v1f...Y......................
Size of ledgers or guts? .. ....... ....... ........................................Size of deck rafters? ..... /d
Distance on centres? ............................. , ............................................Size of studs in bearing partitions? ...........Z-A..........................
MISCELLANEOUS
Ze
Style of roof, fiat, pi>tchansard, i Fireplaces? . ........ ............................
Material of roof covering? .. . Material of Cornice? .............. ..
How is building heated? ./..... ... ....... Lining of flues?
Thickness of shell of flues? .. . . .......f......................... ............Any elevators or lifts? ....... ....../yd.......................... .. ......................
What kind? .. ....... How many? . Any hoistways? ...... .... . ........ .............. .
Tots alue of Building P.-O..f,......How protected? . .. .... . .......... ..................................... ............. 8 .. ,,......
When will work be commenced? .. r+4......
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.
Town of South Windsor since 1949.
Applicant
6837
BUILDING APPLICATION
7137
ApplicationNo. ...........................................................................
north
onthe ................................................................................ Side of
Gray Rd.
Street.
Lot
StreetNo,
James MilkieOwner ....... ... .. .... ....... .... ..... . ............ ...............
Applicant . Same
CLASSIFICATION
Dwelling 54'x 33'
Permit issued on above Application.
Date, .9-.12.-69 ...... . 19
TOWN OF SOUTH WINDSOR
BUILDING PERMIT
Date Sept.12, 1969
Fee Paid $. . . . . . Est. Value $. ... 000
RECD, SEPTIC PAYMENT $ 20.00
Permit N 6837
on the north side of
Gray Rd.Street
Street No. Lot #31
Owner James Milkie
Applicant Same
CERTIFICATE OF OCCUPANCY ISSUED:
Date
No. 3 861
Fee Paid $ 3.00
CLASSIFICATION
Dwelling 541x33'
BUILDING PERMIT
N° 6837
OFFICE OF
THE BUILDING INSPECTOR
of the
Town of South Windsor, Conn.
South Windsor, Conn.3ept.12 19 69
94is to to TPrftf1j, That
James Milkie
is hereby granted permission to
Dwilling 54'x33'
at estimated value of $ 23 s 000
on the north side of Gray Ltd' Lot #31 Street on land
owned by Tames Milkis
Said Work to be as described in Application
No. 713 and to conform to specifications and plans filed with said Application, and Building By-
Laws of THE TOWN OF SOUTH WINDSOR.
In4m Sept,1 ,9,.69
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 0iL ZJoe f
Permit #Job
1 Footing
2 Foundation i
3 Framing 9
4 Wiring L)
5 Plumbing A-7-y_6y
6 Heating /-1.2-7 0
7 Lathing I-IJ - 70
8 CIO 3 4 2-70
Permit No. TOWN OF SOUTH WINDSOR
SOUTH WINDSOR, CONN.
Permit N 3861
Certificate of Occupancy
THIS IS TO CERTIFY,,that the
at No. ' in the T can of South Windsor, Conn has
been erected =46mpleted in accordance with the Building Code and Zoning ulatipfis of
the Town of South Windsor, and is hereby approved for occupancy..,
Building Inspector
Owner, Builder
Fee Paid Date 19 _
1
p
y
S
a
0
c°
4-41
o
4
FJ
E' OF ERTY OF UdpOES ONLY
NO. MEADOW LANE SOUTH WINDSOR, CONN.
Being Lot No. 31 on map entitled "Plan of ORCHARD HEIGHTS Avery
Street, South Windsor, Conn. Scale : I " = 40' May 20, 1 ()65
Hayden L. Griswold C . E . Sheet 3 of 3"
SCALE : 1" 40' August 14, IQ69
GR I SWO LD ENGINEERING, INC.
i11"sk",y
G
SU
a
S3
r
4586 1-f
ELECTRICAL APPLICATION
ApplicationNo. .........48-9.7...........................................................
north
onthe ......... .. . . .... ............................... .. ............... side of
G.r.ay. ..Rd....../........................... ... Street
StreetNo. L o t. #3.1.. ......... ... ................ .........
James MilkieOwner
Electrician ...H.Bent l.ey.
FILED IN OFFICE OF
The Building Inspector
12-11-69 19 ..
INSPFkTION.
I......... ................
OrNo 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.
lA/Al
1,4 APPLICATION FOR PERMIT TO DO ELECTRICAI. WORII.
No. 4897 ..... . .
Permit No. 458.6
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. Jf
South Windsor, Conn., ........ 19f77 Sign her
Address. .. — this
Location Side of ..........
Natureof Building How many stories ........................................... ................................ .................
New or old Building . ..... .. .. How many families ................... ........................................ ..................
Kind of Installation How many Stores ........................ ..........................................................................v .... ..
AddressOwner ................. .... .. .......................... ......,./.. dd s ...... ! r.................................
Architect Address .. . .. ........ .............................................................._.............................
Builder Address
n
Electrician i',... .17-'4. Address /1. I.......2 o
Size of Main Wires .. .....................................................
No. of Light Loops .. .. . . No. of Heat Loops . ... No. of Power Loops
No. of Light Outlets . .... No. of Heat Outlets No. of Power Outlets ......... .. . ..
No. of Light Circuits No. of Heat Circuits No. of Power Circuits .
No. of Sockets .... . ... .. No. of Heat Receptacles No. of Motors
No. of Panels ............ ... ......f.. 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 .l. ...........
No. of Receptacles .. ....... ........ ........ . No. of Cord Drops ...... .............
Remarks: For other kind of Installation ... . ............ .. ....................... . .................. .. ........ .. ....... ........ .......... . . ...... ......
I.. .................
Estimated Cost ...G` 4
3916 rt
PLUMBING APPLICATION
AWlicafim N6.
37 o5
on the...._......._..._ of
Gray Rd.
Lot #31
Street No. ......
James Milkie
Owner .......__....
S.Kellis
Plumber
Filed in Office of
The BuiI&og I pectoc
12—2-69 19
II CSOl.
No person shall construct, add to cc alter my
portion of the drainage system of any bwl&g
except to repair leaks) until a Pet is scooted
by the Building Ingxcooc.
f
916v 37 o5 3
ApplicationNo........................................... Permit No. ......................................
TO THE BUILDING INSPECTOR
of the
TOWN OF SOUTH WINDSOR, CONN.
1
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 wi whether
specified herein or not.
ef r
South Windsor, ..../Z.:.......- C................................ 19C: Sign ere k...,, . .
r rAddress .........ram.................. .. ............1j1
Location ......................... r. ...: 1... side of ..............eet
Nature of Building . :. :L .. ..L......................... How many stories '... ..
r 2 r' ZZ T6../ .............Owner Address ....... ........
Architeq. ....................................... ....................... . ............................................. Address... ........................
Builder a. Address .
Plumber .!' . '. .rt. '...'.. ................................... AddressclJ
DRAINAGE 1
CESSPOOLS, How many ' ........ .. Where located ...........
Are they water tight .......• .. :: :... Of what materials are they
Size of pipe from house to cesspool: .. Kind of pipe 3.. .......-..........................................................
MAIN DRAIN IN CELLAR, Material ..L,k...................... Diameter ......`/................................................................
Aboveor below cellar bottom
SOILPIPES, Material . .t.l'u... eter .................................................................................................................
WASTE PIPES, Material Cr...... Diameter `
TRAPS,Type proposed to use is ...........4....... .............. .
RAINWATER LEADERS, where do &y run to 21-1.k: .....Z::................................................................................................................
REFRIGERATORWASTES, where do they run to ........ ... ..........!........................................................................................ ..............................
TANKOVERFLOWS, where do they run to
FIXTURES eq
Where located l llG`WATER CLOSETS How man I....
Distance from trap to vertical soil pipe ......................................... Pattern
WASH TRAYS, How many ....................................................... .. Where located .. ..................
SINKS, How many ...................................................... ................................ Where located ... . ,f ...(........ .....................................................
BUTLER'S SINKS, How many ........................................................ Where located....................................................................................................
REFRIGERATOR SINKS, How many....................................... Where located .......................
LAVATORIES, How many Where located .
BATHTUBS, How many Where located ..... 24. '...................................................................I........................................... .
URINALS, How many ................................................................................ Where located .....................................................................................................
Are water closets and urinals to be local vented 4 .. . If not, is there a window in outer wall
r ,
ofroom where same are to be located ............ ..,f
1 v
Estimated Cos,4/44,. .....L..........
PERMIT #
F Application For 695
a, DEPARTMENT DECISIdIN
w 3$17 Heating Permit
13APPLICATIONISHEREBY: F DEPARTMENT OF LICENSES AND INSPECTIONS
APPROV% DISAPPROVED
TOWN OF SOUTH WINDSOR
0 1-14 74
00 a) DATE CHIEF INSP eT"O APPLICATIONS MUST BE PRINTED OR TYPED. BEGIN WITH NUMBER NE BELOW
o v
cs 1. LOCATION OF JOB
O a)
5 49 Y /ts
q NO. STREET
LOT NO. FLOOR AR. NO.
412 O
V
O
a 2. OWNER 1 A .f 4
J, >~
Id o
11 0 3. ADDRESS
be
4.PHONE
D
t1c r
S. APPLICANT I •1
ce
o 6. ADDRESS 2 11 Nit we/ 't at J"a v4;
a) RA R -r Fe n o 7.PHONE L!ro? /7)
4J . e. LICENSE NO.
o
0 w s. EXPIRATION DATE OF LICENSE
C
10. ESTIMATED COST :eC ad
o
11. IS THIS A CONTRACT COST? ES NO
b0
0 "Cl 12. FEE ENCLOSED S
Permit #6837
ra
v
ai 13. TYPE OF BUILDING:
3 RESIDENTIAL COMMERCIALbjD
o .r.
ce 14. TYPE OF JOB: INDUSTRIAL
r-i
ORIGINAL ALTERATION
INSTALLATION ADDITION
REPAIR
N
1
APPLICATION FOR HEATING PERMIT (Continued from Reverse Side)
n
CI,/ J 11. LOCATION OF JOB 1 IY/- y
f J ( NO. STREET FLOOR APT.NO.
12. TYPE OF INSTALLATION: OIL BURNER ELECTRIC 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 URNACE MAKE AND NO. AT BONNET FIRING RATE
BOILER OR FURNACE MAKE AND N0.Ain S CA B.T.U. OR SQ. FT. NET B.T.U. OR SQ. FT. GROSS FIRING RATE
FLOORS TO BE HEATED Yy NEW OR OLD BUILDING INSULATED - YES OR NO
TYPE OF WALL 2'_"/'It R INSULATION f ROOF OR CEILING INSULATION
AVG. SYSTEM WATER TEMP.T.U./SQ.AFT./HR. EMISSION
INDOOR-OUTDOOR TEMPERATURE DIFFERENCE C ' Q v FAHRENHEIT
MAKE OF RADIATIOIJY,t BASEBOf. EER CONVECTORS. OR C.I. RADIATION. OUTPUT PER SECTION OR LINEAL OF RADIATION. SQ.
FT. OR B.T.Ut' J_J C--P nao B rX d j -n-e-A-J-
DESCRIPTION OF WORK
t5. TO BE DONE: Co I n G'''o Q f r ¢ Q Y
t e. HEAT LOSS SCHEDULE. (TO BE INCLUDED FOR ALL JOBS):
ROOM SIZE WINDOWS AREA - SQUARE FEET B.T.U. B.T.U. 0 DISTRIBUTION INSTALLEDANDDOORSVOLUMETOTALTOTALmLL
ROOM NO'GROSS GLASS NET WALL CEILING FLOOR CU.FT. AT 70•F CORRECTED j LL RAD. REGISTER
L W N AND E TEMP. TO F f: TYPE AND SIZE OR LEADER
SIZE < WALL
F'
to INFILT.) DIFF. F O m u6i SO. FT. FREE AREA
qg
ell
2f
c
7
TOTALS
A. HEAT LOSS FROM BUILDING B.T.U./HR. :) 17 o 4
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 ADDRESS
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. fn
APPLICATION TO BE COMPLETELY FILLED IN.s
DATE IGN TORE OF APPLICANT
5061
ELECTRICAL APPLICATION
Application No. ..............5............3.7.2........................................................
ont6 ........................................................... ..................... side of
Gray.... .Rd.................................................... ... Street
StreetNo. 1>r ... . .................... ......................................
Owner . ..qe.qrgp.
Electrician
FILED IN OFFICE OF
The Building Inspector
8-8-7.2.. ............. ..... ................ .
INSPRCTION.
OrNo 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. WORII.
No. .....53 7.2................
Permit No. .....061
TO THE BUILDING INSPECTOR
of the
C TOWN OF SOUTH WINDSOR, CONN.
L hereby make application to. 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
IV whether specified herein or not.
7
South Windsor, Conn., .............. ........ ..-.....cx ............. 19. ,ZSign here a. ......
Address
i
Location ./. .....5.....................tR.. .. ...................Al................. Side of .............so.-C/...%,...............................................................................
Natureof Building ........................................ ................................................ How many stories ................................................................................ .................
New or old Building ...................4;2/ .................................................... How many families ...................Cr.....C?.....if. _................................................
Kind of Installation .. .. ':...... .....C.111 a..k`7.!........... ...... How many Stores ......................................................................................................
Owner ......t.. .. :..Q. ................... ..R -.' ................, r.................. Address ........... g.^5..............C... .I............. N..:................
Architect .. ................................................... ....... ................ ............. .. .. Address .../....................................................................................._.............................
Builder .......................... . ............................. . ................. ............................. Address
1 Electrician VfA10--R---,49.............., Address ......!. ....CC/.....r.J'....`f" ............I......ZE Y .
U
Size of Main Wires ... ... ..... ..................
No. of Light Loops ........... ..... ... . . ...... No. of Heat Loops ............ ... . No. of Power Loops
No. of Light Outlets .................... ...... .... No. of Heat Outlets ...... No. of Power Outlets .................. ........ .
No. of Light Circuits ................ ............... 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 ...........................................................
Remarks: For other kind of Installation ... . ............................................. ................... ............................................................................................. ................
k7............................. ' a.. .. .... ................... ... ... ..hi.................. ...., ............. ..........................u... .. . .
m' 1?................ l:......?...`v....................../..... ..... 7.`.........r................................ U..--.... ................ . r....r
c....h.....° ..............1 '...y"....` ...... ........ .... ................................................................................. . ........ . ... .. .. ... . ... . .
Estimated Cost'.. .Q...Cl..................................
4
Application For PERMIT3927DEPARTMENTDECISION4149 $eating PermitiCdO
APPLICATION IS HEREBY:
0 0 DEPARTMENT OF LICENSES AND INSPECTIONS
N APPROVED 5APPROVED r
TOWN OF SOUTH WIN DSOR
Cd 8-11-72
00 O DATE
O
CHIEF INSPECTOR APPLICATIONS MUST BE PRINTED OR TYPED. BEGIN WITH NUMBER ONE BELOW
I o a) 1. LOCATION OF JOB
O
c6
O
Cd 9
v NO. STREET
Cd
O
LOT NO. FLOOR APT. NO.O O
2. OWNER -
a~
O
O 8. ADDRESS / S e-o• I.
4J
4.PHONE
Cc
Ale v S _a-taS. APPLICANT- ` !/
v Cd
d. ADDRESS 0 k
o Z a1 4 Y4 Y61 7g 17.PHONE
w
a c g. LICENSE NO. 3 G 635
p w s. EXPIRATION DATE OF LICENSE d ZZ 3
v
4-' pC to. ESTIMATED COST :oZ .2 6 g.
b4 11. IS THIS A CONTRACT COST? ET YES NO
18,00r012. FEE ENCLOSED S
O 13. TYPE OF LDING:
bo RESIDENTIAL COMMERCIALO9
cis 14. TYPE OF OB: INDUSTRIAL
RIGINAL ALTERATIONINSTALLATIONADDITION
REPAIR
tr m Revere SideAPPLICATIONFORHEATINGPERMIfi (Continued
11. LOCATION OF JOB l
NO. STREET FLOOR APT.NO.
12. TYPE OF INSTALLATION: OIL BURNER Cl ELECTRIC VENTILATION SPRINKLER
GAS BURNER STACK INCINERATOR MISCELLANEOUS A Y Cn L'`{t O I..e t U
IDENTIFY
SIZE LOCATION SIZE SIZE
OF VENT13. OF TANK OF TANK 0 FILL
14. B.T.U. EQUIP. AT REGISTER FU'Ri#4EE AND NO1LiTcp'lo 717c AT BONNET
i
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 NEW OR'9L•D•ARl&V"G INSULATED — YES OR-N8
TYPE OF WALL INSULATION P-5 ROOF OR CEILING INSULATION
AVG. SYSTEM WATER TEMP. B.T.U./SQ. FT./HR. EMISSION
INDOOR-OUTDOOR TEMPERATURE DIFFERENCE FAHRENHEIT
MAKE OF RADIATION: BASEBOARD. COPPER CONVECTORS. OR C.I. RADIATION. OUTPUT PER SECTION OR LINEAL OF RADIATION. SO.
FT. OR B.T.U.
v 4 + Cc kr f i 0 K I 'LL4r* i h X L
DESCRIPTION OF WORK __: s z F -
15. TO BE DONE: O b Crfl
RC lia-c`P !tV'LsS e
16. HEAT LOSS SCHEDULE. (TO BE INCLUDED FOR ALL JOBS);
R OM SIZE WINDOWS AREA - SQUARE FEET S•T•U. B•T•U.DISTRIBUTION INSTALLED
AND DOORS VOLUME TOTAL TOTAL a LL
ROOM NO'GROSS GLASS NET WALL CEILING FLOOR CU.FT. AT 70•F CORRECTED j j RAO. REGISTER
L W N AND R INFILT.) TEMP. TO TYPE AND SIZE OR LEADER
SIZE t WALL lk"
o DIFF. F F m N SO. FT. FREE AREA
f
TOTALS
A. HEAT LOSS FROM BUILDING 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; D.'a" A
NAME ADDRESS
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.
DATE SIGNAT OF APPLICANT