HomeMy WebLinkAbout16 Stoughton DriveFINAL SPECTIONS:
Buildin --s ate- APPLICATION FOR BUILDING PERMIT
Plumbin 2 - 06
HV S Date: 3
Sprinkler loe16 STOUGHTON DRIVE
El ctriz-' t Estimated Cost $ 4bi am•60
Zoning Permit Fee$
Affidavit NO. 19042 Occupancy Fee $ 3
Eng. Dept. a z7 9 COMPLETE RED BOXED AREAS.
Fire Dept. TYPE OR PRINT ONLY Total Fee $ 6 3
Health Dept. SIGN ON REVERSE SIDE.
Approved for CO: ' / Additional Cost) $9 Of
TO BUILDING DEPARTMENT, TOWN OF SOUTH WINDSOR, CT
The and rsi ned, hereby applies to do work according to the following specifications:
Job Location v eN e716 `` stlG Lot No. 49 Side of Street -Zone
Applicant £iZT M k-o-oA%JD Tel. #dMa-94 7 6
Address3ia NLTMV& 'PUL %60 4 UPITA-1 &W1ktRK7_ip 040-14- Lic.#
STREET CITY STATE
OwnerVgWk; N OWA.J+"0 SoAyS T-AJC- Address S*ME Ars 44 arc-
Architect Address
Size New Area: Ft. Front Overall Ft. Deep Overall 4(ip" Total Area f 35-D Garages
Lavatories
No. of Families No. of Stories j2 Construction Bathrooms Rooms 1st oZ 2nd-3-3rd
Size of Lot 4400 5 r Dist. from Street Line AY_r
Dist. from Side Street Line dl—
Purpose of this Permit Q6 A3SW SK)CrL f=444 I L W E L.L It*Aj G•-
W IV TH/:;.6
City Water 6_ Well Septic Sewer X
jo!Approved by Date 3 r
BD1A 11/88
I hereby agree to conform to all the requirements of the Laws of th State of Connecticut and th Ordinanc s of the Town of South Windsor
and to notify the Building Inspector of any alteration in the plans or specifications of the Building for which this permit is asked,and agree
that this building is to be located the proper distance from all street lines,side yard lines and requir dis nces from all other zones and is
located in a zone in which this building and its use is allowed.
Signed AJC
1 hereby apply for a Certificate of Occupancy for the work described in this a plicat'o r permit.
Signed 14.
DO NOT WRITE BELOW THIS LINE—
INSPECTION RECORD
Footing Z.S`11 '/J' k q Fram ins `rt
y'd Fireplace/Chimney Insulation r
i t,-, 21.cA I `Q
Plumbing Permit# Q.f Inspection'" --25=t t /
HVAC Permit# Inspections.
Electrical Permit# Inspections ' "Z `I -'C I v c
Sprinkler Permit# Inspections:
L5i w 1 R9"7:$9! d l .'1 t:4d p. 0 'l . . c'r T•'}r l* y' 'Mr)w1 y t}M' t+v
BUILDING INSPECTION DEPARTMENT
SOUTH WINDSOR, CONNECTICUT
FEE PAID: $3.00
CERTIFICATE OF OCCUPANCY
ZONE: DATED 6/2 19 91
This is to certify that 16 Stoughton Drive
Erected under permit No. 19 0 4 z conforms substantially to the requirements of the building ordinances and the
zoning regulations of the Town of South Windsor and is hereby approved for occupancy as indicated below.
Approved for Occupancy— New single family dwelling -- Lot #i:49
USE GROUP° R4 l j
CONSTR. TYPE: 5B
G: Building Official
Notice:If this certificate is lost or destroyed, a duplicate should be obtained immediately from the Building Department.
Any change or extension of the use herein approved requires a new certificate of occupancy.
Location of job AFFIDAVIT Additional Fee . . . . . . . . . . .. . .. . . . . . .
State of Connecticut
ss.
County of Hartford ^
ErT V r a N v 1- t 310 f•vrt bG faof 1 Owner
I .. . . . . .. . . . . . . . . . .. . . .. . . . .. . . . . . . . . . . . . . .. of . . . . . . . . . . . . . . . Agent for building erected under
Contracto
Permit Na .. . .. . .. . . . . . . . . .. . . . .. . . issued by the Dep't of Building of the Zbwn of South Windsor being duly sworn,make oath
1146 Qdc)and say that the actual cost of the completed work authorized under said permit was . . . . .. . .I. . .. .. .. . . . . . . . . . .. . . . . . . . . . . .
c
Signed . . . . . . .. .. .. . . .!r/,.. . . . .. .. .. .. . . . . . . . .
Subscribed and sworn to before me this . .. . . .. .6.... .. . .. .. .day of . . . . . . ...V. . .. . ... . .. . .. . .. .. .. . . A.D.19 . . . . .
Estimate Cost:$
Difference: $ Notary Public.
CERTIFICATE OF OCCUPANCY CHECK LISTZ;Applicant Frank Mannarino & Sons Certificate of Occupancy
Address Bldg. Permit No.
Lot No. 49 , 16 Stoughton Drive Date Submitted 6-24-91 -y?,TI
Project The Neighborhood Reviewed By 96P 17A R
DateK..ado
LTIerr
As required in the Zoning Regulations, no certificate-of-occupancy Z I
issued until grading plans have been complied with and Ishallbegg
approved by the Town Engineer. The minimum requirements shall
inlcude:
Approved Denied N/A
3-/y-911 1. Approved building permit plan.
x 2. Finish grading per approved
building permit plan.
X 3. Site work; i.e. trees, shrubs, dumpsters ,
required parking
4 . Utility location
a. sanitary sewer
x b. foundation drain
c. electrical & telephone
d. water
e. other
5 . Appropriate certification
6. Bonding
y r»s Ts
era•4 DyAiN L+A i Ti o+ L v A.e-.
x F/„p L•/N-/•vA !-o Gi T/a' SJ`/4+L. %3 r/O l /c l Z/5 l i/ TosrJ Nv F/Zsyw
f sDAf&IAll P f/&
v/' yt Jv- j-.. P.ti.%, Sew '' '
Fo N,.je., ,rts S Sewer Permit No.
IOU/ JW Pavement Excay .. No.
row 'Sf8 .fh4II NO/AY P^40 !0 1'
01
aAI -nn="
v
BUILDING PEP11IT CHECK LIST _
Applicant Frank Mannarino & Sons Building Permit No.
Date Submitted (Revihtn
Address Reviewed by
Lot No.
I. DateProject
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
address & phone number of owner/
1. Name,
V/applicant.
2. Name, address & phone number of plan preparer.
3. Zoning information - i.e. zone, open space,
fl oodway, etc. 2v
4 . Plot plan at 1" = 40 ' scale.
abutting
a. Subdivision reference,
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 floor & center line of road at
drive way.
f. Elevations of gravity drainage systems,
sanitary & foundation drain at the
house and the street.
g. Tentative utility location gas, electric,
water, etc.
h. Title block with name and address of
appropriate certification,
preparer, date
live seal and signature.
5 . Sedimentation and erosion control.
6. Special Planning & Zoning, Inland/Wetlands
Clerk)
considerations. (Plans on file w/To
BUILDING DEPT. cr vK4I %;4e—
e- d•.e 1G. off• or cc,-vt kelU- o Q P 7PZCee"'L (2C. I o.tl ii Pot u• f
IWA/CC cb\XWPCA9
OTHERS
5 19
01
1 fv l
11
PERMIT #
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
Application is hereby:
TOWN OF SOUTH WINDSOR
APPROVED DISAPPROVED BUILDING INSPECTION DEPT.
644-2511 Ext . 230
Application must be printed or typed .Date Bui ding Inspector yp
1. LOCATION OF JOB 1p 7
f l Sio c,
FEE SCHEDULE No. Street
0 - $19000 -10. 00 Floor Apt . No.
Over $1 ,000 -10. 00
per $1,000 or 2 . OWNER 1VA1A-,A0e1.Vd )c-,F&VzNC
fraction thereof
3 . A D D R E S S
X c.JiA,)OJ00'L
4 . APPLICANT T`jd,,,a .f I o#•`C e/10
5 . ADDRESS- S770 ZC-jr T-
Se 0,7—/4 We.d b cla,—,
6 . ESTIMATED COST $ .2,70 o
7 . IS THIS A CONTRACT COST _Z
Yes No
8 . FEE ENCLOSED I o
Li9 . TYPE OF BUILDING : 1qd
RESIDENTIAL COMMERCIAL
10 . TYPE OF JOB :
V Original Installation
Alteration/Addition/Repair
BD 3A 11/88
APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side)
Gc,; -7
11 . LOCATION OF JOB 1 r7-0 V r. sAJ
NO . STREET APT. NO
12 . TYPE OF INSTALLATION u
13 . SIZE OF MAIN FEEDER Z
14. NO. OF LIGHT LOOPS 15 . NO. OF HEAT LOOPS
16 . NO. OF POWER LOOPS 17 . NO. OF LIGHT OUTLETS
18 . NO . OF HEAT CIRCUITS 19 . NO. OF POWER OUTLETS
20. NO. OF CONVENIENCE OUTLETS 21. NO. OF HEAT CIRCUITS
22 . NO. OF POWER CIRCUITS 23 . NO. OF LIGHT CIRCUITS
24 . SIZE OF HEAT CIRCUITS 25 . NO. OF MOTORS
26 . NO. OF PANELS /27 . TOTAL WATTAGE
28 . NO. OF POWER FEEDERS 29 . NO. OF SWITCHES_
30. A/C LOAD 31. SIZE OF POWER FEEDERS
32 . NO. OF FIXTURES / 33 . TOTAL HORSEPOWER
34 . NAME OF SUBCONTRACTORS AND THEIR TRADES
35 . REMARKS AND FURTHER DETAILS :
o,Y 7icp 7v 2
LICENSE NO.SIGNATURE OF APPLICANT D TE
PHONE NUMBER: 4 9G1'" 3C74"
Lot No.
Building Permit. Z
Temporary Service
Permanent Service
Pursuant to Permit No.-//'
This Certifies that the Electrical Work for which the above named Permit was granted
has been duly Inspected and Is hereby approved.
Owner-,' Electrician
Street
Jf 199
Building Inspector
PERMIT NO.
z8l 7
DEPARTMENT DECISION APPL ICATION FOR
Application is hereby : PLUMBING PERMIT
TOWM OF SOUTH WINDSOR
ROVED DISAPPROVED BUILDING INSPECTION DEPT.
644-2511 Ext. 230
Date Bui ding Inspector Application must be printed or typed.
1. LOCATION OF JOB:
FEE SCHEDULE 2. OWNER:
y /'
air
0 - $19000 -10. 00 3. ADDRESS: 3146 j u7-mF,-C
Over $19000 - 10.00 nr A c)O&(D71'
per $1 ,000 or r v
fraction thereof
4. APPLICANT:
5. ADDRESS: -30 ( 4,,4 T
6. EST. COST: $ O D
7. IS THIS A CONTRACT COST? 'YES NO
8. FEE ENCLOSED: $ d-C)
r
9. TYPE OF BUILD NG:
RESIDENTIAL COMMERCIAL
10. TYPE OF JOBS
RIGINAL ALTERATION
INSTALLATION ADDITION
REPAIR
BD 2A 11/88
APPLICATION FOR PLUMBING PERMIT (Cont. from Reverse Side)
or
11. LOCATION OF JOB: /o'er 16 `L
GENERAL PLUMBING
12. KIND OF INSTALLATION: 13. SIZE OF MAIN DRAIN
14. NO. OF TOILETS Z STYLE 15. NO. OF URINALS - STYLE
16. NO. OF BATHTUBS 16A. NO. OF SHOWERS 17. NO. OF LAVATORIES Z
18. NO. OF SINKS /19. DISPOSAL 19A. DISWASHER j
20. NO. OF CONDUCTORS SIZE 21. NO. OF STACKS SIZE
22. AREA OF ROOF 23. NO. OF CATCH BASINS 24. NO. OF FLOOR DRAINS
25. NO. OF OTHER FIXTURES KIND
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?
29. SIZE OF DUCTS 30. SEWER OR SEPTIC TANK? SC.c4D
31. SIZE OF WATER MAIN l
e
31A. SIZES OF WATER PIPING & RISERS
32. REMARKS AND FURTHER DETAILS 7419 i 7`!d `I D/2 1 l+
Ftqj*0*7//
It
WATER HEATER
33. TYPE yio°'iL ISS +/f'J.4 34. MANUFACTURER
TANKS SAFETY DEVICES
TEMPERATURE
35. CAPACITY 39. RELIEF VALVE
36. TEST PRESSURE LBS. 40. MANUFACTURER
37. WORKING PRESSURE LBS. 41. PRESSURE RELIEF VALVE
38. TYPE 42. MANUFACTURER
LICENSE NO. DATE SIGNATURE OF P ANT
PHONE NO.
r
FOR OFFICE USE ONLY APPLICATION FOR HVAC PERMIT DATE: Z,2j -&
NO.TOWN OF SOUTH WINDSOR EST.CO T: /I 40
BLDG. PERMIT NO. 1540 SULLIVAN AVENUE FEE G
SOUTH WINDSOR, CT 06074 FEES:P4
644-2511 - Ext. 230 0 - $19000 - $10.00
1000 or fraction
LOCATION OF BUILDING a - 9 thereof - $10.00
OWNER ADDRESS TOWN PHONE NO.
HVAC CONTRACTOR OADDRESS TOWN PHONE NO.
TYPE OF SYSTEM: HEATING V_
0
TYPE OF BUILDING: RESIDENTIAL
A/C COMMERCIAL
VENTILATION BUSINESS
INDUSTRIAL
IF HEATING: STEAM LOW PRESSURE LIMIT LBS. HIGH PRESSURE LIMIT LBS.
HYDRONIC WARM AIR
UNIT RADIANT HEATER (INCLUDING WOOD/COAL BURNING STOVE)
TYPE OF FUEL: OIL-GPM GAS IN-PUT ELECTRIC KW
WOOD COAL
OIL TANK - SIZE & LOCATION: INSIDE OUTSIDE CAPACITY
LPG TANK - CAPACITY
EXISTING RADIATION ADDITIONAL RADIATION TOTAL RADIATION
DESIGN TEMP. OUTSIDE F INSIDE OF DIFFERENCE OF
TOTAL HEAT LOSS (BTUH) HEAT LOSS SHEET MUST ACCOMPANY APPLICATION)
DESCRIBE ALL HEATING EQUIPMENT (INCLUDING MAKE & MODEL NO.) :
GROSS HEAT IN CA ACITY (INPUT-BTUH)/00,o6a NET RATING ( PUT-BTUH)
IF 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)
IF VENTILATION: DESCRIBE ALL AIR-HANDLING EQUIPMENT (INCLUDING KITCHEN EXHAUSE EQUIPMENT) :
TOTAL SIZE OF SYSTEM (CFM) FRESH AIR INTAKE (CFM)
PLAN MUST ACCOMPANY APPLICATION)
The undersigned hereby applies for a permit to perform the following work and is to comply
with all local ordinances and State of Conn. Building Codes in the performance of such work.
FURTHER DESCRIPTION OF WORK:
STATE LICENSE - NAME & TYPE #DATE
C,
APPROVED DATE
r
BD 4A 11/88
B= R CALCULATION SHEET 1503 (Modern Method Copyright 1977 by The Hydronics Institute
OWNER ADDRESS DESIGN TEMPERATURE DIFFERENCE F. DATE
COL.A COL.B COL.C COL.D COL.E COL.F COL.G
1 ROOM Q
O H L W H L W H L W H L W H L W Design Water Temp.
2 ROOM DIMENSIONS, FT.U BTUH per Fo t f
3 LENGTH EXPOSED WALLS,FT. Q Radiation Selected
4 WINDOW AND OUTSIDE DOOR AREA t1
BTUH BTUH BTUH BTUH BTUH
5 WALL CONSTRUCTION ROOM LIN. FT.OF
Table 9, Line 3 x H) TOTALS RADIATION
6 TYPE OF GLASS FROM LINE 12 SELECTED
Bottom of table used for Line 5)
7 CEILING CONSTRUCTION C
Table 9, L x W)
B FLOOR CONSTRUCTIONt O—
Table 9, L x W or Lin Ft) E
9 COLD PARTITION CONSTRUCTION F
Table 9, L x H)
10 c 1 Wall(With Openings)
o -- os H
2 Walls(With Openings) D X
o J 1
3 Walls(With Openings) or Ent Hall F.
11 TOTAL BTUH AT 70F TEMP DIFFERENCE'
12 TOTAL BTUH AT DESIGN TEMP DIFFERENCE K
COL A COL B COL.H COL. I COL J COL. K COL.L TOTAL BTUH TOTAL
OF BUILDING RADIATION1ROOMa: AT SELECTED
O H L W H L W H L W H L W H L W DESIGN TEMP.°
2 ROOM DIMENSIONS. FT
U
DIFFERENCE
3 LENGTH EXPOSED WALLS, FT Q
4 WINDOW AND OUTSIDE DOOR AREA LL
BTUH BTUH BTUH BTUH BTUH
5 WALL CONSTRUCTION INCREASE BATHROOM
Table 9, Line 3 x H)TOTAL 20%
6 TYPE OF GLASS ----
Bottom of table used for Line 5)
7 CEILING CONSTRUCTION tFOR CONCRETE FLOOR ON
GROUND OR FILL AT
Table 9, L x W)GRADE LEVEL,USE LINEAR
B FLOOR CONSTRUCTIONt FEET OF EXPOSED EDGE
Table9, L x W or Lin Ft)
9 COLD PARTITION CONSTRUCTION
Table 9, L x H)
10 c 1 Wall(With Openings) G
0 a3
0 2 Walls(With Openings) z XqJ
3 Walls(With Openings) or Ent Hall F-
11 TOTAL BTUH AT 70F TEMP DIFFERENCE'
12 TOTAL BTUH AT DESIGN TEMP DIFFERENCE
This form is available from The Hydronlcs Institute,35 Russo Place,Berkeley Heights,N J 07922 FORM 1503
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Page 2
DlNING ROOM Prepared by PETER SAVAS
ROOM NUMBER J 1".*.:EILI1W6 HEIGHT TS 8 0 VQL UM 1344. 0» CU IC EET
2 EXPOSED OPENINGS, TOTALItoo / 1`! > 30. 00 SQUARE FEET
EXP 0S D WALL` r'nt i n' | udz''g ope/1 ng` TOTA| TNO >> 6. OUARE E T
ROOIVI, SIZE IS 12. C0 LONG h} 111. 00 W [DE, TOT IV'IW >1 1C8. v3 SQUARF7 FEFT
r-LO[ R TYp17 lS1: r ] am w'or mny Cond/ t p
CET|'INrp rv[`E I9 ndit oned sp ce above
WI'QDOW -11P[ 1,C;. Sj r.gA.e wi|` torm `a i.
WALL CONCT R WCTION IS Fir am :/ ln b k;l ita c/
HFATLT)SS
7-he ) 'L 1.oil BTUH 1or the 'vatside wal } -: are: 436
The TV::Al C!rUH Ior t he [ T'osed Openi ogt are 1 , 7C
Th t l BTUH for t lings
The to l DTUf| +or the' f 1 'nr C
Ths 131011 11.fi lt` t i`/n fo, the wal
Thp D-UH in|^ l V/ stiun fa`' the npeningF5 i s 1 , 41 9
THE ma,,L BTUH FOR THIS ROOM IS 3, 333
The t.otal fcet n ' r.x on rVquzr CHI d for this , CDC)m
EST MAT!ED HEAT LOSS CA|'CULATION FOR RE lDENTIAL BU1LDI:'%I6 /C) 19O6, 1 987 rA
LAVAT[)RY preparrd by PrETER SAV(sS
ROO11 NUMBER 1 CElLING HEIGHT 115 8 . 00 VOLUME IS :1O4 UBlC FEET
Q EXPOSED OPETNINGS, T ALlNG > `-- ,"- `>:`>>>>>>> `!>>>>>>1). 01) SQUARE F11ET
1 EXPOSED WALL3, not zncluding 'ypeni'`gs, TOTN'AM6 O, 00 SOUAF?[ FEET
ROOM SIZF1 IS 6. 00 LON6 by 8. (x' WIT)E I L ING 4 Co. 0n TOM|ARE FEET
rLOO 7.S: F1.our over a: ondit oncd Spac
C[LlN T`.'pE I3: ndi nn a v
WIPiDOW TYnE C: ro'/ ope i.ngu i n \.|.a,
WALL CO T UCT [ON IC e, Jnsul *ten
HEATLQCS
The Total BTUH [or the ou sIde 14a` 17
Fhe Tota 10TU| 1 -10 t1/L. Exposed Opf11 1 H.'
T| tatal DTUH for | he ce` - ir`g 0
7,|a` t^ta UTUH f '/ 17 Ke fl oors
The BTUH anfi1trat on for the wall 0
The BTUH znfi ] tration for the opw'nlngs is 0
THE TOTAL BTUH FOR TulS ROOM IS 317
he tota] fept cf radiot in / uqt'v red fur +Pi s cwm
E TIMAT[ HEAT LOSS CALCULATION FOR RESIDENTIAL BUILDlNG /C) 1q86, 1987 TA
KITC1|EN pr e1 ar ed by PETER S VAS
ROO NUM ER 5 CEILING H[IGHT IS 8. 00 VOLUME IS 1 |2. ) C BIC FEET
7 EXPO3[D O['ENTNG, OTAL lN >>>>>!/ > >>/ `>> '>> 6'. 80 SOUAR[ FEET
2 EXoOSED WALLS, not n' ludzng '/ppnings, TOTALIN6 >>> 27. 20 S )AR1:- FEET
ROOM SIZE IS A2. 0) LUN01 by 12. o0 WID[, TO7 4LI41 144. 00 13QU(sR[ 7EET
FLOOR TWO T3: loor cvo' ar.} ConditioneJ pace
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BUILDING PERPZIT CHECK LIST
t NoBuildingPermi
Applicant Frank Manna, _ & Sons Bu g
Date Submitted (Rev*
Address n Reviewed by
Lot No. L Date sky 4
Project
In accordance with the Subdivision Regulations, prior to the buildi
for
f
any structure on a lot, a Topographic plot Plan shall be submitted
approval. The minimum requirementsishallnclude .
Approved Denied N/A
1. Name, address & phone number of owner/
applicant.
2• Name, address & phone number of plan preparers
3. Zoningonin information - i.e. zone, open space,
floodway, etc 711 Zv
4 . Plot plan at 1" = 40' scale.
Q a. Subdivision reference, abutting
properties, etc.
b. Easements of record.
c. Lot description, bearings, distances ,
building lines, area, etc.
1 or 2 ft.
f - d. Contours, existing &
appropriate.
proposed,
interval where
e. Building location with dimensions.
Elevations of proposed finish floor,
garage floor & center line of road at
driveways
f. Elevations of gravity drainage systems,
sanitary & foundation drain at the
house and the street.
s-Tentative utility location gas, electric,
water, etc.
h. Title block with name and address
fZakearer, date appropriate certi ication,
pr p
live seal and signature.
5 . Sedimentation and erosion control.
6 . Special Planning & Zoning, inland/Wetlands
lk)
considerations. (Plans on file w/Tow
BUILDING DEPT. r f 7 4 0 s'4e-
Qe) off'• O• or Ct,+vt y4 c G uw
PZC ?EA. ?2X-, ek dw r„` \ Ioo.c s Qos-cep• y,
IWA/CC r'
WPCA 9 0OTHERS
9 99\
Cq NT S: R rt„•
Mode
B ildLt9
INSPE N
L
cl J4'APPLICATION FOR BUILDING PERMIT
Plumbi
HVA Date:
Sprinkler 16 STOUGHTON DRIVE c
Electric Estimated Cost
Zoning Permit Fee $
Affidavit NO. 19 S Occupancy Fee $
Eng. Dept. COMPLETE RED BOXED AREAS. d•
Fire Dept. TYPE OR PRINT ONLY Total Fee $ 0
Health Dept. SIGN ON REVERSE SIDE.
Approved for CO:I (Additional Cost) $
TO BUILDING DEPARTMENT, TOWN OF SOUTH WINDSOR, CT
The and rsigned, hereby applies to do work according to the following specifications:
Job Location I& OU r 04 -Lot No. Side of Street Zone 127
Applicant Lu 0 S t 5 e-t yrn c, Tel. # 6 V 4- ua a
Address 1& S O(J h 1U Dry Sav7`h Gv,,va(sc d'-Zip 0607 Lic.#
td=EET CITY STATE
Owner f S f Address ! Si®-i otJ 't>!c urJtx)A'-bcC
Architect Address
Size New Area: Ft. Front Overall Ft. Deep Overall Total Area $`2 -'04 #Garages f
Lavatories
No. of Families No. of Stories _Construction Bathrooms ' Rooms 1st 2nd 3rd
Size of Lot ' tV) lk Q Dist. from Street Line Dist. from Side Street Line
Purpose of this Permit
City Water Well Septic Sewer
Approved by . - Date l° BD1A 11/88
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 alteration in the plans or specifications of the Building for which this permit is asked,and agree
that this building is to be located the proper distance from all street lin s,side yard lines d required distances from all other zon s and is
located in a zone in which this building and its use is allowed.
Sig ned'Z ZC e:"_
I hereby apply for a Certificate of Occupancy for the work described in this application for permit.
Signed
DO NOT WRITE BELOW THIS LINE—
INSPECTION RECORD
Footing Framing
Foundation Fireplace/Chimney Insulation
Plumbing Permit# Inspections:
HVAC Permit# Inspections:
Electrical Permit# Inspections:
Sprinkler Permit# Inspections: