HomeMy WebLinkAbout170 Lisa DriveTO THE BUILDING INSPECTOR
Of the APPLICATION FOR
TOWN OF SOUTH WINDSOR,COWL PLAN EXAMINATION A N D
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, 1V, and IX.O
ZONING .
AT (LOCATION) DISTRICT/
LOCATION N0.1 l TREET)
OF BETWEEN AND
BUILDING CROSS STREET) ICROSS sTREE_T 3c L// `' /Q(1,`
SUBDIVISION OT Y_.3 BLOCK SIZE X
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking"most recent use m
11ETNewbuildingResidetialNonresidential
2 Addition(//residential, enter number 12 LOne family 18 Amusement, recreational
o/new housing units added, iJ any, 13 Two or more family — Enter 19 Church, other eligi weinPartD, 13)
number o/units—— — —— 20 Industrial3Alteration (See 2 above)
14 Transient hotel, motel,21 Parking garage4 Repair, replacement or dormitory — Enter number
5 Wrecking (1/multi/amity residential,o/units ——————— — -- 22 Service station, repair garage
enter number o/units in building in 15 Garage 23 Hospital, institutional
Part D, 13)
16 Carport 24 Office, bank, professional6ElMoving (relocation)p
17 Other — Specify 25 Public utility7 Foundation only 26 School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
8 Private (individual, corporation,28 Tanks, towers
nonprofit institution, etc.) 29 Other — Speci/y
9 Public(Federal, State, or
I cal government)
C. COST Omit cents) Nonresidential — Describe In detail proposed use of buildings,e.g., f d
Q Od 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. Other(elevator, etc.)............
11. TOTAL COST OF IMPROVEMENT ; 0 000
III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Ports 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 p Wo d frame 41 Private (septic tank, etc.) 49• Total square feet of floor area,
all floors, based on exterior c32 Structural steel dimensions ..................... J
33 Reinforced concrete H. TYPE OF WATER SUPPLY
y y34 Other — Speci/y 42 Public or private company
50. Total land area, sq. ft. ...9.....9.
43 Private(well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
51. Enclosed .......................
35 Gas Will there be central air 52. Outdo to........................
36 Oil c nditl ning?
L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 Yes 45 tW N 53. Number f bedr ms..............
38 C al
39 Other— Speci/y Will there be on elevator? Full..........
54. Number f
46 Yes 47 No bathrooms
Partial........
IV. IDENTIFICATION — To be complet d by all applicants
Name Meilinj oddr ss — Number, street, city, and State ZIP cod Tel. No.
Owner or
Dart Fill RealtyInc . 658 Ell 'o
Less** South Windsor.n
2. Same
Contractor
3.
Architect or
Engineer
The owner of this building and the undersigned agree to conform to all applicable laws of this jurisdiction.
Signature of applicant Address Application date
9/a q (o
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans R view Required 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 ApprovalI Check Date Number B Permit or Approval I Check DO1e Number ByppObtainedyppObtained
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
P rmit number
Building
Permit issued eA7 19
Bui Iding
Permit Fe $ tic `
r C .C .
96— f 3` by:
A —R.Qcj
UU7f
A
TOWN OF SOUTH WINDSOR
BUILDING PERIVHT
Date Oct. 8
9 19 86
Fee Paid $.5 4 0 .0 0 Est, Value $. 9 0 ,.0 0 0
Permit No 15472
on the aide of
Lot 083 Lisa Drive Street
Street No.170
Owner Dart Hill Real t-v Tnr__
Applicant Mur i e 1 Jacques
CERTIFICATE OF OCCUPANCY ISSUED:
Date
No. :7766
Fee Paid $ - n n
CLASSIFICATION
Dwelling
BUIIDlNG PERMIT N? 15472
OFFICB OF
THE BUILDING INSPECTOR
of the
Town of South Windsor, Conn.
South Windsor, Conn. Oct. 8 1§6
94is is to (ferfify, That Dart Hill Realty Inc.
is herebyanted ion to Dwellinggrantedpermission
at estimated value of 0 0.0Q O
on the side of Lot #8 3 Lisa Drive Street on land
owned by Dart Hill Realty Inc.
Said Work to be as described in Application
N0.15772 and to conform to specifications and plans filed with said Application, and Building By-
Laws of THE TOWN OF SOUTH WINDSOR.
I ued Oct. 8 1$6
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 coats and damages which it shall sustain, or be compelled to reason therefor."
Dwelling - Lot #83 Mtn.Vw.Est. 3 10/8/86
Dart Hill Realty Inc .
170 Lisa Drive
Permit # 15472
Electrician Richard Barrett # 9455
Heating Contr. Ralph L. Borriellc# 664.9
Plumbing it Scott Antosik 7184
Oil Burner
Certificate of Occupancy 7766
Sewer Permit
Plot plan apprd. per Engr.
C3
a Permit No. TOWN OF SOUTH WINDSOR
SOUTH WINDSOR, CONN.
a
a
M
Permit N O 7766
E
Certificate of OccupancyPYC
THI.S TO CER Y that t4e
M at No. in the Tqo n 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 approv for cupancy.
4440t. Building Inspector
caner, Builder
h c Q'
Fee Paid Date j — 19? 7
CERTIFICATE OF OCCUPANCY CHECK LIST
A licant certificate of Occupancy
5-y t
PP
Address —70 Bldg. Permit No. , X
Lot No. Date Submitted Z- 3/-:06,
Project Reviewed By 1
Date 25
As required in the Zoning 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
inlcude:
Approved Denied N/A
1. Approved building permit plan.
33
2 . Finish grading per approved 1mod45
building permit plan.
3 . Site work; i.e. trees, shrubs, dumpsters ,.
required parking
4 . Utility location
a. sanitary sewer
b. foundation drain
elephone
d. water
e. other
5 . Appropriate certification
6 . Bonding
Sewer Permit No.
Pavement Excay . No.
COMMENTS: 2 I7 /FV, "
j f3 s Z• /-s Slr
7-0
7
9455
ELECTRICAL APPLICATION
Application No. 10966
on the side of
Lot #83 Lisa Drive Street
Street No. 170
Owner Dart Hill Realty
Electrician Richard Barrett
FILED IN OFFICE OF
The Building Inspector
Nov. 10 19 86
INSPECTION.
m 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 fire
stops (if of wood) are installed, without a special
permit from the office of the Building Inspector.
Electrical Permit N o. . ...`.:.
r ......._
Master License No. ..1 .... ..............
TOWN OF SOUTH WINDSOR Building Permit No. . 5.-. - ..................
BUILDING DEPARTMENT
Date Filed .. Y.....................
Date Final Approval ................ ......... ...........
APPLICATION FOR ELECTRICAL WORK
Electrical Inspector
pissJOBLOCATION: JOB OWNER: ti c. r6k......................................................
Side of tit 5.. B twe an ...........
Name of Building Owner ym .5+ r Address
If work is for Lessee—Give name Address ................ ................................ ...................
Building now occupied as (unless new) 1(lp;,Z) No. of family units now .. ......-
Building to be occupied as Number of family units to be ..... ! .. ...............
Is this work included in a Building Permit? Permit Fee .. .... ... ... ...... .. .......... .... .................... .............. .....................
If no Buildi Permit)
Permittee G Business Address V Telephone _. .......
COST OF INSTALLATION: - ................................... .. .......................................... .......................................................................................................
TO BE FILLED OUT BY PERMITTEE
TO BE WIRES G EXISTING APPLIANCES
Number of light outlets to be installed
Number of present Appliance Circuits .Number of convenience outlets to be installed
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
Clothes Washer . . . . W
Clothes Dryer . . . . . 1
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 ............... . .....-.........................
Size of service to be . . ..............................c
7184
PLUMBING APPLICATION
Appl tion Nee 6)R S 4
on the .................. sale of
F
Lot -83 Lisa Drive
Street No. ......170
Owner .Dart Hill Realty
plums ..... Scott Antosil:
Filed in Office of
The Buil&ng Lrpocmr
NOV. 13 19 .
irrsP c,ejox.
No person shall 000struct; add m at alter ay
portion of the drainage system of aay bu7d6g
except to repair leaks) umil a Pkrnia is grasped
by the Building Inspector.
APPLICATION FOR PLUMBING PERMIT (Continued from R v rse Side)
TOWN OF SOUTH WINDSOR, CONN.
Q C_/yl00,- U , s I;,_Je s11. LOCATION OF JOB CJ rev
NO STREE FLOOlr APT.NO.
GENERAL PLUMBING
12. KIND OF INSTALLATION w N.13. SIZE OF MAIN DRAIN
14. NO. OF TOILETS J STYLE 15. NO. OF URINALS STYLE
16. NO.OF BATHTUBS 17.NO.OF LAVATORIES 3 18. NO.OF SINKS 19. NO. OF WASHTUBS
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. ARE SEWAGE AND WATER FACILITIES AVAILABLE? Ylp
SIGNATURE ADDRESS >
LICENSE NO. Z d I y 6 ESTIMATED COST 7 K 00 TELEPHONE 2-V 7"
J a `_rr 11 ..
OWNER 4 t. J c'f o ADDRESS aS r v
WATER HEATER
31. TYPE ma's { '- 32. MANUFACTURER '- r c
TANK SAFETY DEVICES
33. CAPACITY [.° 0 6cJ 37. TEMPERATURE RELIEF VALVE
34. TEST PRESSURE 38. MANUFACTURER_
35. WORKING PRESSURE 39. PRESSURE RELIEF VALVE
36. TYPE 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 CO
44b1-1
CD962 DA E vTURE 6F APPLICANT
PERMIT
Application For 6447 6649DEPARTMENTDECISION
0 Heating Permit
0
31.4
E APPLICATION IS HEREBY:
JPEPARTMENT OF LICENSES AND INSPECTIONSOO
N W
APPROVED DISAPPROVED
TOWN OF SOUTH WINDSOR
c Q 12 -10-86 Thomas P. D' Auria
00 O DATE CHIEF INSPECTOR APPLICATIONS MUST BE PRINTED OR TYPED. BEGIN WITH NUMBER ONE BELOW
O M
O v 1. OF JOB /76 /l ' 1 1r
O
8 Lis
NO. STREET
v
LOT NO. FLOOR APT. NO.
O O6-j N
79
O O
OWNER Mr• Kevin McCannr.
0
Ce O 85 Highland Street
bbo
S. ADDRESS
South Windsor,, C
4.PHONE 6 -ZI 119
c Oil Heat & Engineering Inc.
rn = s. APPLICANT Ralph L. Borriello
s. ADDRESS
1000 New Britain Ave.
Test Hartford, CT 06110 .
PHONE
525-8675
S. LICENSE N0. 300291 S-1
10-87Cw2. EXPIRATION DATE OF LICENSE
v a
a 10. ESTIMATED COST S 10,278'00
C
11. IS THIS A CONTRACT COSTt 19 YES NObo
a Permit #15472
a 12. FEE ENCLOSED s No Fee
1m a. TYPE OF BUILDING:
pp¢
b F RESIDENTIAL COMMERCIALOA
c 3 14. TYPE OF JOB: INDUSTRIAL
IRIGINALNSTALLATION ADDIT ONON
REPAIR
APPLICATION FOR HEATING PERMIT (Continued tr m Reverse Sid )
11. LOCATION OF JOB Lot f 83 Lisa Drive
NO. STREET FLOOR APT.N
12. TYPE OF INSTALLATION: OIL BURNER ELECTRIC VENTILATION SPRINKLER
GAS BURNER STACK INCINERATOR MISCELLANEOUS and air conditioningIDENTIFY
SIZE LOCATION SIZE SIZE
13. OF TANK OF TANK OF FILL OF VENT
14. B.T.U. EQUIP. AT REGISTER FURNACE MAKE AND NO. AT BONNET 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 OLD BUILDING new INSULATED — YES OR NO yes
TYPE OF WALL INSULATION ROOF OR CEILING INSULATION
AVG. SYSTEM WATER TEMP. B.T.U./SQ. FT./HR. EMISSION
INDOOR-OUTDOOR TEMPERATURE DIFFERENCE 0 78 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: Install central warm air heating with air conditioning
Whirlpool Gas furnace Model NUGK100AK 1001000 input & Vhirlpool Condensing 'knit MOdel
16. HEAT LOSS SCHEDULE. (TO BE INCLUDED FOR ALL JOBS): NCABA42
ROOM SIZE WINDOWS AREA — SQUARE FEET B.T.U. O.T.U. I-D
AND DOORS voLUME DISTRIBUTION INSTALLED
TOTAL TOTAL !n LL
ROOM
L W N AND W GROSS GLASS NET WALL CEILING FLOOR CU.FT. AT 70'F CORRECTED t jIL RAID. REGISTER
SIZE WALL •Lt0 INFILT.) TEMP. TO <f;O TYPE AND SIZE OR LEADER
F DIFF. F F m a Q. FT. FREE AREA
TOTALS
A. HEAT LOSS FROM BUILDING 87,,082 BTUH Heating B.T.u./HR.Cooling 30234 BTUH
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: Ginn Electric 17 Monte Vista Ave. Newington
NAME ADDRESS
SUBCONTRACTORS AND
Ia. THEIR TRADES
ALL WORK COVERED BY THIS APPLICATION HAS BEEN AUTHORIZED BY THE (OWNER) OR (ArfENT),OF THIS PROPERT* AND WILL
BE DONE IN STRICT ACCORDANCE WITH THE BUILDING CODE.
APPLICATION TO BE COMPLETELY FILLED IN. Dec. 3, 1986 Ralplie L. Borrie to
DATE SIGNATURE OF APPLICANT
QUOTATION
S 7 8
2 3 4 6
1 ESTIMATE SHEET WARM AIR/AIR CONDITIONING
r"
ssssss ss sswssws ssa ss sss._- -
2 Data=-q*ptawbar 3. 1966
3 Ow+*r l Mr. Ka n iv McCann
4 SMML-u- Wb,`t ----------------
Addr s s s 8S M i l l awd Strut. Mi*say'. CT- i-- is ------iM-----
sssssssssssssssssssss=sass:: r
7 ::s:ssoaaass=s=====s:ssasss:ssssssss:ssssssssssssRssss `
1st F1 RaG2ad Fl Rag Return
Htat Less Neat G&i* sass ssssssssaaass
e Room s sees
c) sassss=ssassas:ss:sasssssssa
6643 1347 187 62 1
10 Laundry Arta 4322 2248- 70- 184- 1
11 Kitchen S63 2468 9 3 1
12 Lavatory 485 78 115 1
13 Din tte 12917 4671 226 216 2
14 Famil -e Room 12433 423® 2N 196 2
is Living Room 1
6425 Sae 10 ZS3 116Foyr68371954111L
17 Dining Room 6755 2936 199 1361
18 LR B d Room 55S9 1808 89 24 i
19 LF Bed Room 1917 642 31 11 1
20 Front Bath 81 38.6 129 1
21 RF B d Room 32" 11 1" 2
22 Masttr Bad Room i Cl ostt 3933
693 . '4.__.8 ' 11
23 Mast r Bath 9
63 364 iO 17
24 Upptr Hall Area
25
26
27
28 7 it
29 y 87882 38234 14111 13" 10
30 TOTALS:---------- T-
sssacsa=asssasssaassess::=====asasssssa=s=xassasa:assess::::::sees
Sectric# L 1 APPLICATION FOR BUILDING PERMIT
Plumbing# 170 L I SA DRIVE
HVAC # Dat : 12 z rc 4
t-b.24868
Sprinkler# _
F! Estimated Cost $
Building t a-9 C OMPLETE RED BOXED AREAS Permit Fee A V-
TYPE OR PRINT ONLY Occupancy Fee $ S
SIGN ON REVERSE SIDE
Appr.for CO.Total Fee
TO BIALDNC'DEPARTMENT,TOWN OF SOUTH WI DSOR,CT Additional Cost) $
The undersigned hereby applies to do work according to the following specifications:
Job Location !?0 L c5,A Dri w Lot No. Side of Street Zone
IV" OV Oki TeL# 6 i6Y-g119Applicant /lam„; r
Address l 7 D L-( S c1 7 r'
e Zip Lic.#
Own r Ke iP-K !/mil 0 005 n/'I Address V 7 C;
Architect Address
Sq. Ft.New Area- . `' s 2nd FL 3rd FL Total New Area
Rooms Lavatories Bathrooms Garages
Purpose of this permit: F 111 i-. h
City Water Well Septic System Sewer
Ins. H.O. S.P. Cert. Area i Basement Garage
Approved by Date IZ zl °) Use Group Construction Type
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 ? -cs`— /yl 1
1 hereby apply for a Certificate of Occupancy for the work described in this application for the permit.
1/1
Signed .r-r 1-
DO NOT WRITE BELOW THIS LINE
INSPECTION COMMENTS
1 s
Inspection / Approval Date By Appl
Code Description Due Whom Code Comment
97-24868-B 2,000
B03 FRAMING (ROUGH) 12/10/98 JFF A WITH OWNER
E03 ROUGH 12/10/98 JFF D NAIL PLATES ADVISED OWNER WILL RECHECK AT B04
E03 ROUGH 12/22/98 JFF A NOTE HOMEOWNER NOT INSULATING WALLS
B10 FINAL 08/19/99 JFF D WITH OWNER
PROGRESS NEED SMOKES
B10 FINAL 11/03/99 JFF D WITH OWNER BEDROOM AN 1ST FLOOR SMOKES
CELLAR HANDRAIL
B10 FINAL 04/11/00 JFF A WITH OWNER
B10 FINAL 04/12/00 JRC A CLOSED OUT.
98-16070-E 900
DEPARTMENT DECISION PE,D-7oAPPLICATIONFORELECTRICALPERMIT
Application is hereby: TOWN of SOUTH WINDSOR
BUILDING DEPARTMENT Bld
1540 SULLIVAN AVENUE ZAPPROVEDMCI
112
644-2511 ext.230
Date ding Inspector
V Application must be printed or typed
Location ofjob
Street No. Street Lot No.
FEE SCHEDULE
Floor Apt.No.
0 - $1,000 - $12.00
Over $1,000
12.00 per$1,000 OWNER klev;,n
or any fraction thereof
ADDRESS 90 V C--
OWNERS PHONE#
APPLICANT A/#//?L/;//C-
OWN S ADDRESS g /3&6!2 4L A 6121099'
EST MATED COST$
IS THIS A CONTRACT COST?
YES NO
1w ,
FEE ENCLOSED $
TYPE OF JOB:sOR Original Installation
Alteration/Addition Repair
Revised 11/95
APPLICATION FOR ELECTRICAL PERMIT(Continued from reverse side)
TYPE OF BUILDING
IS THIS APPLICATION ASSOCIATED A
RESIDENTIAL BUILDING PERMIT APPLICATION YES / NO
BUSINESS
ASSEMBLY CURRENT USE AND OCCUPANCY L
MERCANTILE
EDUCATIONAL FUTURE USE AND OCCUPANCY
INSTITUTIONAL
FACTORY
STORAGE ENGINEER'S NAME PHONE
GARAGE
MIXED USE ADDRESS
CITY STATE ZIP
Other please specify)
TYPE OF INSTALLATION/WIRING METHOD 1,l4
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
moo, cd
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS
TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONN. BUILDI G CODES IN THE
PERFORMANCE OF SUCH WORK.
NAME STATE LICENSE NO. TYPE GNAT OF APPLICANT
PHONE NO. 6 `7 0 Y DATE /