Loading...
HomeMy WebLinkAbout170 Commerce Way8ectric#' 3 APPLICATION FOR BUILDING PERMIT Plumbing# n' 170 WAY Dot June 3, 1999HVAC #O 474 No. 26180Sprinkler# FSK APPROV Estimated Cost $3 952- Building COMPLETE RED BOXED AREAS Permit Fee 2 O Engineering / TYPE OR PRINT ONLY Occupancy Fee A Affidavit SIGN ON Appr.for CO. 00 v V Total Fee a TO BLALDM DEPARTMENT,TOWN OFSOUTH WI CT Additional Cost) $C, S The undersigned hereby applies to do work according to the following specifications: Job Location 170 Commerce Way Lot No. 39&40 Side of Street lef t Zone I Applicant W.I. Mountf ord, Co Tel# 860-291-9448 Addr ss 205 Nutmeg Road, South, South Windsor, CT Zip 06074 Lic.# 00900-574 Own r .Ford Industries, LLC Address 11 White Road, Tolland, CT 06084 Architect Curtis K.S. Burr Address 138 Inverary Drive, Watertown, CT Sq.Ft.N w Area: 1st FL 83,400 2nd FL n/a 3rd FL. n/a Total New Area 89400 Rooms Lavatories Bathrooms Gara s Purpose of this permit: New offices for W.J. Mountf ord, Co.V U City Water 81 Well Septic System 0 Sewer N Ins. H.O. S.P. Cert. Area A Basement Garage Approved by Date t Lhe Group Construction Type 3 Rev6ed 1197 I hereby agree to conform to all the requirements of the Laws of the State of Connecticut and the Ordinances of the Town of South Windsor and to notify the Building Inspector of any alteration in the plans or specifications of the Building for which this permit is asked,and agree that this building is to be located the proper distance from all street lines,side yard lines,and required distances from all other zones and is located in which this building and its use is allowed. Signed'4' 1 1" a -il, "- n J-A,( I I hereby apply for a Certificate of Occupancy for the work described in this application for the permit Signe e C DO NOT WRITE BELOW THISNE INSPECTION COMMENTS I 4 Location of Job:AFFIDAVIT Additional Fee S 72.00 State of Connecticut ss.South Windsor County of Hartford Owner I Scott P. Mountf ord of W. J. Mountf ord Co. Agent for the building erected Contractor under Permit No. 26180 issued by the Building Department of the Tow indsor eing duly sworn,make oath and say that the actual cost of the completed work autho ' under. ai errnit s 4 W,683.00 Sit ned o oun or , President Subscribed and sworn to before me this 7th day of February D.2 00 L' Estimated Cost$ 419,463.00 Difference: $ 5,220.00 No ry Public Leola R. 1,aMothe My commission expires 10-31-00 Inspection / Approval Date By Appl Code Description Due Whom Code Comment 99-26180-B 355,000 B01 FOOTING 06/11/99 DCJ A SOUTH AND EAST SIDES B04 INSULATION 06/24/99 JFF A PERIMETER SLAB INSULATION P02 UNDERGROUND 06/24/99 JFF A WITH CONTRACTOR B03 FRAMING (ROUGH) 08/23/99 DCJ D G.C. NOT ON SITE B09 OTHER 09/08/99 JFF A CEILING SHEETROCKED NO ROUGHS NOTIFIED SHEET ROCKER TO HAVE CONTRACTOR CONTACT US E03 ROUGH 09/16/99 DCJ D EXTERIOR WALLS ONLY, SECURE CABLE AT BOXES E03 ROUGH 09/23/99 JFF A WALLS OFFICE AREA WITH CONTRACTOR P03 ROUGH 09/27/99 DCJ D NO TESTS E01 SERVICE 09/28/99 JDI A RELEASED TO N.U. PO4 GAS TEST 10/07/99 DCJ A LEFT STICKER B03 FRAMING (ROUGH) 11/01/99 DCJ A ABOVE CEILING IN OFFICE AREA, ATTIC ENTIRE BLDG E03 ROUGH 11/01/99 DCJ A ABOVE CEILING B10 FINAL 11/15/99 DCJ A 99-10549-H 29,063 99-10407-P 8,400 99-16397-E 27,000 Total Est Value 419,463 SITE COMPLIANCE CHECKLIST TOWN of SOUTH WINDSOR, CONNECTICUT 170 COMMERCE WAY LOT_#39 Reviewed BY,,-- jF eerin ) MOUNTFORD W J Date Reviewed prov 205 NUTMEG ROAD SOUTH SOR,CT Reviewed By anning) BP_#_26180 Ph_#_(8 0)291-9448 Date Reviewe Denied Date Submitted 11/1 F C OZp As required in the Zoning and/or Subdivison Regulations, no Certificate of Occupancy shall be issued until grading plans have been complied with and approved by the Town Engineer. The minimum requirements shall include: Approved Denied N/A 1. Approved building permit plan 2. Finish grading per approved building permit plan y 3 . Site work; i.e. trees, shrubs, dumpsters, required parking 4. Utility location; a. sanitary sewer/septic system 3 b. foundation drain C. electrical & telephone d. water e. other 5. Sewer connection charge paid UlMc'` 6. Appropriate certification 7. Bonding 8. Planning & Zoning/ J7Inland Wetlands Considerations Sewer Permit No. 7004 Pavement Excavation No. 13 d U COMMENTS: R -PitZia S•Q/.,O P y •• i,i-~-"00 o/pr C'i•. sf =/b NOV f 7 1999 o tea., y''S- .'r.• . a m A r 1q 74 ENG.DEFT. ,10 is 7 S a 06/081'99 TUE 10:59 FAX 860 289 0382 W J MOt1N'TFORD INClz02 CA' Connecticut Engineers in Private Practice JUN 10 1999 Stmictural Fnglncers Coalltlon W, J- M®UNTFQt%L), IN' Statement of peci-al inspections Project: ..,,.. tv c''J ._to I IVI 0 fta C)wrler'a ddre s: _ Architect of Record: Su r r ~I c'r0#AAJ Cr Structural Engineor of Record:aul Ir fP"1 This Statement of Special Inspections is submitted as a candition for permit issuance in accordance with Ilse special inspection requirements of the BOCA National Building Code. It includes a Schedule of Special Inspections applicable to this project as well as the name of the Special Inspector,and the identity of other approved agencies intended to be retained for conducting these inspections. The Special Inspector shall keep records of ail inspections, and shall furnish inspection reports to the code official and to the structural engineer and architect of record. Discovered discrepancies shall be brought to the immediate attention at the contractor for correction. If such discrepancies are not corrected. the discrepancies shall be brought to the attention of the code official and the structural engineer and architect of record.The special inspWion program does not relieve the contractor of his or her responsibilities. interim reports shall be submitted to the code official,owner, structural engineer and arcMdect of record.A schedule of interim reports shall be approved by the Code Official prior to permit issuance. A flnal reponC of inspections documenting completion of aU required special inspections and correction of any discrepancies noted in the inspections shall be submitted prior to the issuance of a certificate of use and occupancy. Interim Report Frequency: or per attached schedule Prepared by Design Professional: jj 1 •- t}'Pe Or print nan1P, t ,•a„GIONF9• iOo0 0 G- 1 G 00 L7 U G'(? 90 NO.13666 ,' 7 c nature Date ENS . SOON At, i r Da.9 0Profe``,`*s soal r s A or' ation- Building Official's Acceptance: aignc pare .. Fl. C3s,te Signature .. DatE? T Fv / rsTi¢ads LLG V,FM ,z CEPP!SEC Form 101 • Staternont of Spacial Inspae ices- i,CCPMLC 1993 tab W'99 TUE 11:00 FAX 860 2.89 6382 _ -- W_ J MOUNTFORD INC 9008 Conne.cUcut Engineers in Private Praclice Suet of 1s icturai rngir1eers coalition Project: Schedule of Special Inspection Services The tollowing sh(sc,-ts comprise the required Schedule Of special inspections for this specific project.T11aconstructiondivisionswflichrequirespecialinspectionsforthisprojectareasfollows: 1"54ils and Foundations Cast-ire-Place Concrete C1 PP ast Concrete sorry StrLe ura Steel 17 wood Special Cases inspection Agents Firm Address 1, Special Inspeoior ifit/1 f-&.(Y. 0, JI dv l G n!P N!3r T Lr Testing Laboratory r 1-STa.Tt (uT n d fk IrT ST 3.Testing aboratcry 4. Other Nate;"'he qualifications of all personnel performing Speciai Inspection activities are subject to the approval of the Buiiding Ofiicsat. CEPPISEC Form im •wernent of Special lnspec'tiom-(ZDCEPP/SEC 1993 96/06,99 TITE 11:00 FAX 860 289 6382 w J MQUNVORD INC 9007 Schedule of SpeCi81 Inspection Services Sheet -_cf_.-- Construction Division —Masoizcy Project: ltel Agent Scope No, nnt-teri{3I t crtillrattorl v- e4rn4;evvj=,,jn-me- TG L L).. Mixing of Mortar and Grcu# l 3. 1(jetallatior)of Masonry 2 4. Reinforcement Installation L r ,n orr-4-,n- "rC> Pla . ocX,.,e_ J-eXcy is 5. 6routing Operations S. Wo-ather Protection 7. Evaivatio n of Masonry Strength 8 Other CEPP155C Form 101 0 Statu'TlOnt Of SPOe;1"1l Inspe rionc,•CICEPP/SEC 1993 06/08/99 TUE 11:00 FAX 860 289 0382 w J HOUNTFORD INC Q 004 schedule of spk,; ia:Imspeotlon Services Sheet of } Constn ction Division- Soils ac)d Foundatiom; project. Item Agent Scope Na. 1. Shailow Founclatioris—1115RU tncL,\S a a-,-0 i C.-S le6f MWY—O\-f 2. Contr'oiled StruCZUra1 Fill G Yl DYl o r m 0< 3. DrMep roundations 1 4. Other CEPPISEC:Form 101.L' atement of Special Inspections•(;tCE:PPISEC 1993 6/08/99 TUE 11.00 FAX 860 289 6382 W ,J HOUNTFORD INC N05 Schedule at Special Irspectlon Services Sheet of Construction Division-Cast-In-Place Concrete Project: Item agent Scope Nv_ 1. Mix Design Matenal Certification 2 0 somasJb 3. Reinforcement Installation 4. Post-'-ensinning Optaralions N } S. Batching Plant II6. Formwork Geometry l h S q:6 j v l S 7. Concrete Placement 8. Evaluation of Concrete ram TSStrength50r S 9. Curing aP4 Protection 10, Other CEPP/SEC i'arm 101 •St.-ternent of Special Inspections• ;,10EPP/SEC 1993 00/08/99 TUE 11:01 FAX 860 289 6382 w J MOUNTFORD INC 9 009 Schedule of SPOClal iizspeclion Service Sheet of Cc,n,truction Division -StruCtL.,rat Steel Protect:_offs. Item Agent Scope No. 1. Fabric;itor CerliticatioN Quality Contw; Proci;citJres 2. Material C,ertiliG,-00n 3 Open Web Steel.foists L C L Gann-ec lbr 5 ., cl, I cam,v u -'f 15 5, welding I q00, 6, Sneer C`,cnnc-ctors NV Y. Structural Details 3. Other 1 CEppfS> Cdorm 101 • ;statement of queri:al Iiispectrons •;aCEPP/SEC 1993 606/08 99 TUE 11:01 FAY_ 860 289 6382 w J HOUNTFORD INC 008 Schedule of Special Inspection Services Sheet_ I of -- 1 7fist ruction, fl{V{" ocIQn—WO Project: _ i IsComm rlfQril Agent Scope No. 7. Fabricator t;ertitiCation I Quaiiiy Control Procedures 2. Mtttpnal Grlding 3. Connectiolls t. Framing and Details CEPRO'EC Farm 101 • Statement of Spacial lr,specticns•r9GEPPPSF--O 1993 50,15, 99 TIT 11:01 FAX 800 289 8382 w J MOMFORD INK lZal; Corivecticul Cnginpers in Private Practice Structural Engineers Coalition Final Report of Special Inspections Project._u,:_ tAou u1-r-v 6z.p .O Fri LE. t cc.:il Urt. 1'7v LoM rl(Z wA•I So Wr vv i?watt — _o6zn vsT6L_.Z't't' W ba-l'C1 20 1 ot,(,,Un CA' uwr INV J2.Art:l tiltc:t q t ktecard: _Gy7S IL-S 'P.Y>R ,._].E ` Tt Strur-lural Eix}eer cat ccord:2_4,, 5 — — To the best Of my intorrnation,knowledge and bel'ef, Gze special inspections required for this project,anditarllii-ed in the Statement of Soecial Inspections subrnitled for permit,have keen perfOrmCU,and alldirccvereddiscrepancieshavepeenreportedandresolvedotherthanthefotlowing_ CcnlmerA.;, attach 8 'iTx I 1"continuaticn sheets it required to corna,ete tho descror'ion of correciions.l lmefim rep4rtS submitted prior to this final report corm a basis for,and are b b6 considered an integral ern of this final repQn. nespectfuliY Submitted, Registration Seal Jpecizl fn p:ctor upuuunn iaMyii&e A 1„ 1 G as pF CO NIVF F-4LA Gam, G 4 Ypa or print narne Date"Q'0'4• t O/V C+G I l T s*:a 0:o: Date 0' No. 13666 O rv gr ature ENS O C°•` NAPO ON AL E'01 RD p 3 1999 W. J. MOUNTFORD, INC. CC-FRSEC Form 1a2 -Find Pwort rat SPGcial In;cw+ctions•r7CLTP/SFC '990,PQV- 1993 BUILDING A ante Of Orlghal Goretructlon Date of Aadltlon WA I. USE GRap cL4s61FIGATION 2. c-a6m 'noN TYP r(4o1.1) MWftm TVO Required. Actual TWO Provided. (exleting) WA new 5. BUILDIN9 HEIx3W(501.0-503A) Allows c Holt (etorveot) 9 Ft Actual Flekfrt (s eet) I STORYr22 ft Stores Above&race) 4. BUILDINS AREA (501.0-SM4) roes BullcIN Arem leach floor) P="t) ExbtIng Conetrvctlon WA Now Comtoxti n 400 s.f, Total Floor 400 61, b) Oro"Buildhg Area. (entire fa III Existing lk ated Comb-uction 61.1 Exist+g Rerwvcted Gp elxvctton f Total existing Ganef wtlom 29 Total HaN Cormtrucklon Total Paclllt9 5. AFC°A TABULATION Open Pertnoter 120 ft. 0_ft. 10 ft. _ 120 ft. N E W 3 Porkroter 560 ft. Open Par)rneter .310 It. As Perrnoter. (opon perlmotor/permator)JA As AS Tobular Area Inareaee . 2 x(GIs Open Perimeter-25%) 114 R; SK of Allow.wblc Tabular Area(Takao 501) 100 SK AS R cke-Llon for Hetght WIA) 0 AS 94 Increase for Open Pertneter(502.2) 1 I RS Increase for FVII F"_` felon(5M.5) +0 AS Total Percentage factor = 14 As Convemlon Factor(Z FactorAoo)4+ 0) A TABULAR AR Au actual floor a eWconverslon Pasta-) e.f. meet be<Tab10 501 C14b) ALLOHABLE SUILDIN9 AREA(per floor)0 Ubuk r area x converolon factor) e.f to JJc) ACTUAL FLOOR AREA(largest floor) 400f. e ss c J b. MIXED USE(313A) X] 5,1 Oise Group)Oise 6r+oup) Actual Area ` Actual Area , <1Allor~+able Area Allowable Area G` 1. OCC.UPANCY LOAD Basement First Second Deslgn Total-Each Floor Total Exit Gcpactty-Each Floor - To al Total for yfor g rotas Exit Go}actty for Bugdhg 9. FIRE RESISTANTco rbr Walls(bad bear xj) tM 2 b) Pre Wa11s 2 We)c) Fro cU Smoke tob I e) Enclsuores of Lxlte W(s)r) OAccess Shorts xit ess corrldore rV eEWO)atlors U trtnterw 13a*,.g W0116Structuralmambo-* a ndo clrolumns O µs) SJ Floor Gonetr Uon Uwludhg Boomal o We)t) ROO?COmbwtlon 9. FIRE PROT6GTION SYSTEMS 0 supprv"ion`xptafn Full Ltmtted Aron b) Notlflcaticm/Alorw* c) Detectbn Yes ,spoke Detection ncOx±out 10. MODIFICATIONS Provide ModMtcatlon Nmiber and Code Sectlon Nmber-be"modifiedcoExletkWAprovedb) Outst0nd>rx3(not yet approved) 11. AC.C.ESSIBL.E BUILDING x C7004wtod mmn-deergna w 12. MINMUM PUPI-VIN&FIXTURE COUNT(P-1202 DESIGN LOAD) N rnberRlgazwqtvhed Nixrixr Provided WC, 0 PER 25) 2. Lave.0 PER 40) 2 D/F(I PER 100) y44-NB=- 13. C.ODE5 TO WfIC 4 THI5 PRO.lECT WAS DCSISfjHD Dated State Bulldhg Gods r Suppler a t(e) State Fire C.Ode State Fieotth C:odeo Supplement(e) 1942 05" Soctlon 504 lqbb Other e r s SED A y DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT Application is hereby:TOWN of SOUTH WINDSOR P A BUILDING DEPARTMENT BIydjPPermit# APPRO 1540 SULLIVAN AVENUE 00 644-2511 ext.230t2 Date Building InspectorF Application must be printed or typed Location ofjob 170 39 * 4-o Street No. Street Lot No. FEE SCHEDULE Floor Apt.No. 0 $1,000 - $12.00 Over $1,000 12.00 per$1,000 OWNER WA ST-9-1 e-,-S JLC,, F-L7 or any fraction thereof ADDRESS 1 l VJ kt IV V) OWNERS PHONE# 960 79- F-sociv E. ff)U-CLQ\)-,rz- APPLICANT OWN S ADDRESS ot ESTIMATED COST$ Doo. tam C ;`: 0 IS THIS A't!ONTRACT COST? NO FEE ENCLOSED $ 3 2 OR C TYPE OF JOB: Original Installation Alteration/Addition/Repair Revised 11/95 APPLICATION FOR ELECTRICAL PERMIT(Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A RESIDENTIAL BUILDING PERMIT APPLICATION YES / NO BUSINESS ASSEMBLY CURRENT USE AND OCCUPANCY MERCANTILE EDUCATIONAL FUTURE USE AND OCCUPANCY INSTITUTIONAL FACTORY STORAGE ENGINEER'S NAME -J& a ,>>;, PHONE 9.b-() GARAGE MIXED USE ADDRESS 1)) J Q-AClaT CITY 91.tiay.,, STATE ZIP 0 01';I- Other please specify) TYPE OF INSTALLATION/WIRING METHOD SIZE OF MAIN FEEDERS AND RATING OF WIRE USED NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS NUMBER OF PANELS 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 SEPERATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED, DESCRIPTION OF WORK 1$K`fl\'4'4 6t O i.-'ice t' THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONN.BUILDING CODES IN THE PERFORMANCE OF SUCH WORK. NAME STATE LICENSE NO. TYPE TIGNATURE OEAPPI ICANT PHONE NO. '%I n &4-6-`7?a,aj DATE rI• INSPECTOR DATE 9 ZS TIME -Am LOCATION INSPECTION: CODE: ESULT(R/A) : 2(1 &0 BUILDING: z ELECTRICAL: ee PLUMBING: HVAC: OTHER: DEPARTMENT DECISION oqAPPLICATIONFORPLUMBINGPERMIT Application is hereby:TOWN of SOUTH WINDSOR BUILDING DEPARTMENT Bldg Permit# 5Zj PROVED 1540 SULLIVAN AVENUE 644-2511 ext. 230 Date Building Inspector Application must be printed or typed Location ofjob 170 COMM69c'k-r, LRW- y 4 o Street No. Street Lot No. FEE SCHEDULE I Floor Apt.No. 0 - $1,000 - $12.00 Over $1,000 12.00 per$1,000 OWNER MT, Foaooranyfractionthereof ADDRESS 11 uo If 1"rt, PRO roLLOA40 Q'T C)60S,4 OWNERS PHONE# gGo 3 APPLICANT t:V/ OW b N ADDRESS c2 ESTMATED,COST$ C) IS THIS A CONTRACT COST? YES NO All, FEE ENCLOSED $AC)197 0 CO TYPE OF JOB: Original Installation Alteration/Addition Repair Revised 10/96 APPLICATION FOR PLUMBING PERMIT(Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A BUILDING PERMIT APPLICATION YES / NO RESIDENTIAL BUSINESS CURRENT USE AND OCCUPANCY ASSEMBLY MERCANTILE FUTURE USE AND OCCUPANCY EDUCATIONAL INSTITUTION FACTORY ENGINEER'S NAME PHONE STORAGE GARAGE ADDRESS MIXED USE CITY STATE ZIP Other please specify) TYPE OF INSTALLATION SIZE OF MAIN DRAIN NO. OF TOILETS STYLE NO. OF URINALS STYLE NO.OF BATHTUBS NO. OF SHOWERS NO.OF LAVATORIES NO. OF CONDUCTORS SIZE NO. OF STACKS SIZE AREA OF ROOF NO. OF CATCH BASINS NO. OF FLOOR DRAINS NO. OF OTHER FIXTURES KIND ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW YES/NO SIZE OF WINDOW IF NONE C.F.M. OF VENTILATOR SIZE OF DUCTS SEWER OR SEPTIC TANK SIZE OF WATER MAIN SIZE OF WATER PIPING&RISER WATER HEATER TYPE MANUFACTURE TANKS SAFETY DEVICES TEMPERATURE CAPACITY RELIEF VALVE TEST PRESSURE WORKING PRESSURE PRESSURE RELIEF VALVE TYPE MANUFACTURER ESCRIPTION OF WORK THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERJCB O DESCRIBED AND IS TO COMP Y WITH ALL LOCAL ORDINANCES AND STATE NG CODES IN THE PERFORMANCE OF SUCH W NAME STATE LICENSE NO. TYPE SI OF APPLICANT PHONE NO. © DATE jo A DONALD R. D COMPANY,INC.TRU05( M EC HAN ICAL CO NTRACTOR S June 16, 1999 Town of South Windsor Building Department Sullivan Ave. South Windsor, CT 06074 Re: W Ford Industries LLC To whom it may concern, I give permission to my employee Richard Poirier to apply for the plumbing permit for the above project. I have made copy of my licenses for your information. Please contact my office should you have any questions. Very yours, Donald R. Tamiso This is to certify that under the prbVfsions of the General StatutesthefollowingpersonorArmislicensedorregistered. DONUAIM.DRTANIISO CONTRACTOR-PI 74 TIMBER TRAIL S WH-gWOR CT 06074 LIC./REG.NO.EFFECTIVE EXPIRES 00'0 3 j 1 1/99, 10/31/99 SIGNED: 205 Nutmeg Road South Unit D • South Windsor,CT 06074 Tel.(860)269-5670 Fax(860)289-5762 C nnwW fCorwacfors License No.'s P-1-203M,S-1-302915. F-1-F11213 DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT PERMIT# vs 9 Application is hereby: TOWN of SOUTH WINDSOR BUILDING DEPARTMENT Bldg e t# APPROVED 1540 SULLIVAN AVENUE f 644-2511 ext.230 Date Building Inspector Application must be printed or typed Location ofjob S No. Street Lot No. FEE SCHEDULE 13 r Floor Apt.No. 0 - $1,000 - ww' Over $1,000 12.00 per$1,000 OWNER i r dU7L j"dl or any fraction thereof ADDRESS 4)A V c, ak 6 OWNERS PHONE# APPLICANT 7qMj,6 T,jet-, W S ADDRESS U O Fq ESTIMATED COST $a. C 3 CVol IS THIS A CONTRACT COST? 6/ I YES NO 1 1 FEE ENCLOSED $ OR-COS TYPE OF JOB: Original Installation Alteration!Addition/Repair 1 Revised 11/95 1iI APPLICATION FOR HVAC PERMIT(Continued from reverse side) TYPE OF SYSTEM YPE OF BUILDING 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 F INSIDE F DIFFERENCE F TOTAL HEAT LOSS(BTUH) HEAT LOSS SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL HEATING EQUIPMENT (INCLUDING MAKE&MODEL NO.) GROSS HEATING CAPACITY (INPUT-BTUH) NET RATING (OUTPUT-BTUH) TYPE OF FUEL OIL-GPM GAS-INPUT ELECTRIC-KW OIL TANK SIZE&LOCATION INSIDE OUTSIDE CAPACITY LPG TANK CAPACITY AIR CONDITIONING DESIGN TEMP. OUTSIDE F INSIDE F DIFFERENCE F 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 I jai Jz,/ THE AD IUNyi HDEBYAPPLIESFOl;f A PERMIT TO PERFORM TH ORK DESC ED AND IS TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONN. ILD IN THE PERFORMANCE OF SUCH WORK. S) ()U 30Z S STATE LICENSE-NO.NAME&TYPE SIGNATUkE WAPPLICANT PHONE NO. 2A9c?—SZ 26 DAT&q Electric# APPLICATIO N FOR BUILDING PERMIT Plumbing# 170 Commerce Way WAC # 26816 Dat Sprinkler# N0• FINAL APPRO A Estimated CostBudding7ACOMPLETEREDBOXEDAREASPermitFee o0EngineeringTYPEORHMTONLYOccupancypantyFee Appr.for CO. 11 SIGN OH REVERSE SDE Total Fee TO BIAU*-, 'DEPARTMENT,TOWN OF SOUTH WNDSOR,CT Additional Cost) $ The undersigned hereby applies to do work according to the following specifications: Job Location zLot No. Side of Street Zone ApplicantAe"dz Tel# Sa S o 7.6 L Address Zip 06 6 7 Y Lit# S•1 3 g S 8 7S' Owner Address Architect Address Sq.Ft.New Area: 1st Fl. 2nd Fl. 3rd Fl. Total New Area Rooms Lavatories Bathrooms Garages Purpose of this permit: a,ub City Water Well Septic System Sewer Ins. H.O._ S.P. Cert. voor_ Area Basement GarageApprovedby-- Dot y`f cYJ Lie Group Construction Type Rev'sed 1197 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 lines,side yard lines,and required distances from all other zones and is located in which thi building and its use is allowed. Signed I hereby apply for a Certificate of Occupancy for the work described in this application for the permit. Signed DO NOT WRITE BELOW THIS LINE INSPECTION COMMENTS