HomeMy WebLinkAbout191 McGrath Roads
65 ... .Application No. 4905 .. Permit No.
TO THE BUILDING INSPECTOR
of the
TOWN OF SOUTH WINDSOR, CONN.
C! hereby make application for a permit to (erect 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.,«; . r ... ,, ........ 19...40
Ia2Signhere .......
Address ...... ... .... .... .Q.... t.....
Location? . side of?
Nearestcross street? .../ Street No. ..... ......... ............................ Lot No. ..... ,......I......... .
1d.MW..9fJOwneroflandis. 1VU)", Address ....P0.Al't.....:1...,5....
Owner of building is? . ..'....r...G......................................Address ... ......_ ..............................
Architect is? 5 d............ ......................Address ......................................................................... ........... ....... ..........
00
Builderis. . ..... ........................... a Address ............ .............. ........................................................................ ...........
g?42 t ,X. s ' 64F iXeet deep? ....ions of buildin eet front. . . .. .Z Feet rear. ..
v v 11Cheight?.h !Extreme height to highest point of roof? .No. of stories in height.... .
Purpose of building is? /' .1!. 11..'4j.40...a.....................No. of stores? ..... ........... ..... .......................................................................
How many families? ... G?./?.. ........................................r......._........No. of rooms? .... ..
000
Distance from street line is? . .s.. .. ......... ....... .........from building line is?
ADDITIONS AND ALTERATIONS
Give Brief Description)
OECD. S`WV,'e . 4`
i ..
w......... ... . R,..,....v-...
ENDORSED BY SANITARY OFFICER
IN ACCORDANCE WITH TOWN OF
Map No. UTH WI RDINAN E NO. 6
t r 7
SA ITARY OFFICER,
i
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? .. .... . . .... . .. . ...............
Compositionof mortar? . ........................................................ ..... .. ......... ....................................... .. ........ . .....
Height and Thickness of Walls
Height Stories Front Walla Side Walls Rear Walls Partition Walls
Basement,
1st Story
2nd "
3rd "
r.............................................. ........................................... -.................... . .. ... ....... ........ ..... ... ..
4th Is
5th 11
6th
7th ds
r................ . . ....... .............................. ....... . ......... ....................................
8th
9th id
10th
Material.of Front? If stone, what kind?
Thickness of Ashlar?Thickness of Backing?
Backed up with what? Arches or lintels over openings?
WOOD CONSTRUCTION.
Giv Size, Longest Span and Distance Between Centres, of Joists, Girders and Columns
d01828 GMDAM COLUMM
Floors Size Longest Span Centres mint Size eat Span Centres 81se I.ensllt Centres
1st Floor Zo ......,r...,t................. ..l(e...... ../K-2... , Z __..._$..........._. .._........... grid
4 .... .... ............. .............. .................. ...................
Distance on centres? Size of sill? ......r.Size of outside studs. ... .. .............
Size of rafters. Distance on centres........... .......Size of plate?
Size of lodgers or girls? .. ....... .. ....Size of deck rafters?......... ........................
Distance on centres? ............... ............... .. ..... .........................................Size of studs in bearing partitions? ..................................................
MISCELLANEOUS
t
Style of roof, flat, pitch, Mansard, or hipped? .. I. tG ......................... Fireplaces? .............. ...................................
Material of roof covering? ... ,t .A,.............. ..........Material of Cornice? . ...... .. I...A!!'.........
How is building heated? . ,,ro?5...17A ........ 1.Y...............Lining of flues? .le................... .................. ......... . ..............
Thickness of shell,of flues? ......../....:- Any elevators or lifts? . .......................
What ,kind% .. ....:... . ...... How many? . Any hoist ? .. .......... .. ........... . ............
How protected? . ... . .. ...... ............................ .. ... ............Total Value of Building . . .1,f...10.G`jaig....................
I r t I
When will work be commenced? . ,• f? ,.G,. ... ..CP.........
00/
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
4645
BUILDING APPLICATION
Application No. . ..90.r..................................................
on the ..South. . .... aide of
McGrath Rd. Street.
Street No,Lot #21
Owner Nutmeg .HOme s Inc-
Same
Applicant
CLASSIFICATION
Dwelling 261x5821
Permit issued on above Application.
Date, 11-29-63 19
TOWN OF SOUTH WINDSOR
BUILDING PERMIT
Date MOv. 29 s P
Fee Paid $. .60.•.40 Est. Value $. 15i 000
IZECD, SEPTIC PAMENT Z9.p.00
Permit N° 4 6 4 5'
on the South side of
McGrath Rd. Save
Street No. Lot #21
f
Owner Nutmeg $Ome H Iuc.
Applicant same
CERTIFICATE OF OCCUPANCY ISSUED:
Date
No 2730
Fee Paid $ 3.00
CLASSIFICATION
Dwelling 26 tx58V
i
i
t
r
BUILDING PERMIT
N? 4645
OFFICE OF
THE BUILDING INSPECTOR
of the
Town of South Windsor, Conn.
South Windsor, Conn. - "''•'• 19`
Tots to to Terfif1j.9 That
is hereby granted permission to
at estimated value of $ '
on the side of C Street on land
owned by C
Said to be as described in Application
No. and to conform to specifications and plans filed with said Application, and Building By-
Laws of THE TOWN OF SOUTH WINDSOR.
Issugl ''' '` 19
r wilding Inspertok,
s
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."
t1100,
I Permit No. , TOWN OF SOUTH WINDSOR
I SOUTH WINDSOR, CONN
I
Fernd t N° 2730I
I
Corti 'cote 0 cupancy
i THIS IS TO C the
at No. G in the Toldof South Windsor, Connecticut, has
I been erected and completed in accordance with the Building Code and Zoning Regulations ofI
th Town of South Windsor, and is hereby approved for occupancy.111
r`j
I ding Inspector
I
Builder
I Fee Paid . Date
I
I
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PURPOSES ONLY01
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PROPERTY OF
536
1
GrAtb R"d South Windsor, Q`onsn.Y
kM
fi 7C4,f••.
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1` #
p •L goo 21 ox vaap entitled "SgbAivixiou Map Property of KcGrath
Wtv South Vixdsor* Coon. *ot. 22f 1960 Scale 401 Morton S.Fine
E .. An9" OL Most, 2 of 2
xv
Hayden €..Grievold CA.
f'-r t A n ,. ..d' , F. . V y
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12_,Ri _iiL9_'T-'a'X L.Y,t" n tL "i=.j... +ti • l .JS4_S=A' n lu.T "'S'.L k.
2929
VVVVY°4'oy;
PLUMBING APPLICATION
2718sAppficatiomNa.
South aide of
Street Na Lot #21
Nutmeg Home a Ina.owner . _..
s" Phnam _ nee D'Agat Rockville Sheet Metal Inc.
in Mice of
T6 BUi1diq9t
11-1-5-6pi ig j
no ,
h` ff
No peon shall oonwoct; add w or abw ate
portion of the die system of ow bwlW6g
esapt torepair leab) uoa a Pkrmits grasped
by the Building
71 2718 2929ApplicationNo. .... .... ......................... Permit No. . ...................... .........
TO THE BUILDING INSPECTOR
of the
TOWN OF SOUTH WINDSOR, CONN.
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 with whether
specified herein or not.
South Windsor, 19 Sign here ... .. . . ......... .. ........
Address
Location side of ... . . .......... ...... ...... . . ...... ....... ...... . .. ..... Street
Nature of Building ... DU01.11ft................................. How many stories At
Owner ....... - W. .. . ................................... Address .. .......... . . ............ ................ . .................................
Architect . ........... . ............... ... ..... . ........ ................... .................... Address .. ........ . ......... ... ....... .......... .....
Purahm Rd*
Builder W004911 f*0*4.... . ................................ .... .... Address P CAM.,......................................
Plumber t1PrA0VV1U#. 101*tal.....Ila**........ Address .. .......JIB....V#-10"
DRAINAGE
CESSPOOLS, How many a Where located .... .......... .................. ............. ............... ...................
Are they water tight i..... Of what materials are they built ............. . ......
Size of pipe from house to cesspookh!................. .. ... Kind of pipe .......C1 IbLtft...SO&Vy. ...............................
MAIN DRAIN IN CELLAR, Maerial COPPOW... Diameter 3*.....tw-P& L........................................ ... .....
0" 44Aboveorbelowcellarbottom
SOIL PIPES, Material . 9.4.....b.#OVY... ..... Diameter I..................................
WASTE PIPES, Material 9072*1V... ............ ..... .. .. . Diameter upt....L....It..... ...2.............. . . ............
TRAPS, Type proposed to use is .?* W10. -CO....... ......................................................................... ...................... .............
RAIN WATER LEADERS, where do they run t
REFRIGERATOR WASTES, where do they run
TANK OVERFLOWS, where do they run to
I#TURES
WATER CLOSETS, How many . Ao...... ..... .. Where located ft.ft...........
Distance from trap to vertical soil pipe .. .... .. ... Pattern
WASH TRAYS, How many . ................ .......... .......41 Where located
2
SINKS, How many Where located K111MM. ............. ... .......... ........
BUTLER'S SINKS, How many ....................................... ... Where located. . . . ......................................... ................ ...........
REFRIGERATOR SINKS, How many . .... ................ ..... Where located . ... . . .................. ... .. .. .............. ...............
LAVATORIES, How many Where located . . . DO.*............
BOOBATHTUBS, How many Where located ...... ................................ .... ... ........... . .......
URINALS, How many . .... . . ... ............. ...... .... . ... Where located . .. .............................. .. .................. ... . ....
Are water closets and urinals to be local vented no If not, is there a window in outer wall
of room where same are to be located
Estimated Cost4O*O .... .. .............
PERMIT #
Application For
d DEPARTMENT DECISION 2984 Heating Permit 2762
Cl W
O O
3 APPLICATION IS HEREBY: DEPARTMENT OF LICENSES AND INSPECTIONS
N fl APPROVED DISAPPROVED
TOWN OF SOUTH WINDSOR
c 4-15-64
04 O DATE CHIE TOR/ APPLICATIONS MUST BE PRINTED OR TYPED. BEGIN WITH NUMBER HE BELOW
O
I-
1. LOCATION OF JOB
O av
o
to
cdd 9 NO. STREET
o
cd O
O LOT h0. FLOOR APT. N0.
O+ 0,
N
O O
2. OWNER 2,0
cd Nu me g o m no
0
o 8. ADDRESS
3
O 4.PHONE
m
rn APPLICANT
O w 6. ADDRESS
ai 7.PHONE
S. LICENSE NO. f
O 4oa
9. EXPIRATION DATE OF LICENSE
W 10. ESTIMATED COST S y
0
4JI o
IS THIS A CONTRACT COST? LJ YES NO
12. FEE ENCLOSED S.Permit #4645
o t9. TYPE OF,BUILDING:
w RESIDENTIAL COMMERCIAL
O .
ce 14. TYPE OF JOB: INDUSTRIAL
ORIGINAL ALTERATION
i LI INSTALLATION ADDITION
REPAIR
0 f--
APPLICATION FOR HEATING PERMIT (Continued from Rev rse Side)
t
11. LOCATION OF`JOB
N0.
T....._w.__,._..._..__.__.__._,..r_......,
FLOOR APT.NO.
J
12. TYPE OF INSTALLATION: OIL BURNER HEATING SYSTEM VENTILATION SPRINKLER
I GAS BURNER STACK INCINERATOR MISCELLANEOUS
IDENTIFY
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 N 1001)T.U. OR SQ. FT. NETB.T.U. OR SQ. FT. GROS RING IM
FLOORS TO BE HEATED NEW OR OLD BUILDING INSULATED — YES upNow1419TYPEOFWALLINSULATIONROOFORCEILING2wINSULATION
AVG. SYSTEM WATER TEMP. B.T.U. Q. FT./HR. EMISSION
INDOOR-OUTDOOR TEMPERATURE DIFFERENCE opt A FAHRENHEIT
MAKE OF RADIATION: BASEBOARD, COPPER CONVECT RS. OXIV61IRYDIAT9W. OUTPUT PER SECTION OR LINEAL OF RADIATION. SQ.
FT. OR B.T.U.
DESCRIPTION OF WORK
I.S. TO BE DONE:
1 s. HEAT LOSS SCHEDULE. (TO BE INCLUDED FOR ALL JOBS):
ROOM SIZE WINDOWS AREA - SQUARE FEET B.T.U. B.T.U. o<F DISTRIBUTION INSTALLEDANDDOORSVOLUMETOTALTOTALa
ROOM NO.GROSS GLASS NET WALL CEILING FLOOR CU.FT. AT 70•F CORRECTED J D LL
LL
REGISTER
L W N AND K TEMP. TO F f TYPE AND SIZE RAO. OR LEADER
SIZE < WALL SO INFILT.)
DIFF. F O N SQ. FT. FREE AREA
COOL -to
Bed "a" 1' 9 cool
75<
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:
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 SIGNATURE OF APPLICAN
4,4
4,
N
G,I` t ear
mi Rf
AAwlication No.". . .. .......PT.-I...
77
TO "A"HE :BUIL, DING INS ' OR
of dke
TOWN OF SOUTH WINDS(K CONNS
1Z.:l0-0hereby make application for a permit make alteration to) a buildmg acewding
to the following detailed statement of the spocifications and plans herewith submitted. (Draw a line duvqgh
word "erect" or words "make alteration W' as the cue may require.)
All i i of the Building By-Laws (Sections 2 to 32 inclusive) shall be ompfied with in the execu-prov1sWW
tion of this work whether specified herein or not.
South Windsor, Coon., .....
Sign .. .. ..........
Addreu ..... .. ........... . .......... ..,........... .. .. ......... ...........
Location? ........v...... ..C CtAA....... ....................side of? ........................................................................................................................
Nearest cross street?Cn y ?arom..4AA.C.#.Street No. .................................................... Lot 0. .................................
e.. ... .
Owner of land is?lika........5a:..ls ll......................-Address ............ ... . . . ............ ............t...........
4....4 91.............Owner of building is?14-6)..... Address
lot
Architectis? ......................... ..............................................................................Address ...................................................................................................................
Builderis? .. ........................................................................... 7--******-,**--
Dimensions of building? ..J"7#_S7.07...Feet front? ...Feet rear? ...wp2l...... Feet deep? ........... ........
Extreme height to highest point of roof? .................1.3...... ... .... .... ... ..... No. of stories in height?.............../
Purposeof building is? ..................................................................................No. of stores? ....................................................................................................
Howmany families? ...................................................._-_-.-No. of rooms? .... .................................................................................................
Distance from street line is? ... ............ .............................................from building line is? .................................................................................
ADDITIONS AND ALTERATIONS
Give Brief Description)
000fl1h
to.............. Q..e.r.........................
III?NE000................................. I.........................................................................................................................................................
I...................I..................................................................................
MapNo. .................
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
N. 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
Rekht Stories Front Walla Side Was Rear Walls Partition Walls
Basement,
1st Story
2nd "
3rd "
I......................... ........................................... ......................................... '..................... .. ........ ......... .. ....... . ......... .. . .... . ...
4th
5th of
6th "
I.............
7th "
8th of
9th "
10th "
Material.of Front? If stone, what kind?
Thickness of Ashlar? Thickness of Backing?
Backed up with what? Arches or lintels over openings?
WOOD CONSTRUCTION.
Giv Size, Longest Span and Distance Between Centres, of Joists, Girders and Columns
J0I87S 11 OMDMS OOLUMM
Floors Bite Longest Bpw CentM Brldging Bice Longest 8psn Centns SIM Length Centres
1stFloor...... .............. ....
I.............................
4 .... .... ..................11
Size of outside studs? Distance on centres? Size of sill?.............. ......... ......
Size of rafters? ................... ............... .. Distance on centres?................................................. Size of plate? .....................................................
Size of ledgers or girts? .................... ...... . ............................................Size of deck rafters? .................................................................... ...............
Distance on centres? ............. .........................................................................Size of studs in bearing partitions? ..................................................
MISCELLANEOUS
Style of roof, flat,.pitch, Mansard, or hipped? ....Fireplaces? ........................................................
Materialof roof covering. ........................................................ ...........Material of Cornice? .....................................................................................
How is building heated?Lining ofRues? . ...... .. ...................................... ... .......... . .............
Thickness of shell of flues? .Any elevators or lifts. ................. ... .............................. ......................
What kind? ... ...... ........... How many? .... .. Any hoistwa 7 ....... ......
Howprotected? ..... .... .. .................................................... . ...............Total Value of Building ........ ........<. m a . ............................
When will work be commenced? . . .
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.
l
Applicant
V
5507
BUILDING APPLICATION
5777
ApplicationNo. ... ......................................................................
onthe ..................................... ........................................ side of
McGrath Road............. ....... ... Stmet.
191
StreetNo, ... ..... .....
John SamsellOwner .... . .. .. .... .... .... ............ .......... . ............
Applicant . ..J.o.seph.
CLASSIFICATION
Apply aluminum siding to existing
house.&....... ......... . . ......
Permit issued on above Application.
Date,1-2-1-15
TOWN OF SOUTH WINDSOR
BUILDING PERMIT
Date DOC• 6, 19 65
8.00 1,600FeePaid $lue $. . . . ..
i
OPermitN. 5507
on the side of
McGrath Rd., Street
1StreetNo. 1,9
Owneri
Applicant Joseph J. Ko zma
CERTIFICATE OF OCCUPANCY ISSUED:
Date
j No.
i
r Fee Paid $
CLASSIFICATION
j AppV aluminum siding to existing
I house
I
BUILDING PERMIT
N° 550'7
OFFICE OF
THE BUILDING INSPECTOR
of the
Town of South Windsor, Conn.
South Windsor, Conn.
Doc*6#
19 65
94is is to Terttfij, That Joseph J. KOS=
is hereby granted permission to
Apply aluminum aiding to ex i s a i ag house
at estimated value of 1 i 600
on the side of McGrath Road #191 Street on land
owned by i ohn Sam,Ve11
Said Work to be as described in Application
No. 5777 and to conform to specifications and plans filed with said Application, and Building By-
Laws of THE TOWN OF SOUTH WINDSOR.
I DOC. 6,, 19 65
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."
DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT o31 b k
Application is hereby:TOWN of SOUTH WINDSOR
BUILDING DEPARTMENT Bid Permit#
APPRO 1540 SULLIVAN AVENUE
10 Q 644-2511 ext.230
Date Building Inspector
Application must be printed or typed
Location ofjob
OIA
Street No. Street Lot No.
FEE SCHEDULE
Floor Apt.No.
0 - $19000 - $12.00 i
Over $1,0o0
12.00 per$1,000 OWNER
or any fraction thereof
ADDRESS q I2u '
OWNERS PHONE#
APPLICANT
N $ ADDRESS 7 P
s' ESTIMATED COST
f IS THIS A CONTRACT COST?
YES NO
l G FEE ENCLOSED $_ Z
01t.co TYPE OF JOB:
Original Installation
Alteration/Addition/Repair P PGt Revised 11/95
APPLICATION FOR HVAC PERMIT (Continued from reverse side)
TYPE OF SYSTEM TYPE 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 ATIN EQUIPMENT NCLUDING MAKE&MODEL NO.)
GROSS HEATING CAPACITY (INPUT-BTUH) NET RATING (OUTPUT-BTUH)
TYPE OF FUEL
OIL-GPM GAS-INP 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.)
j rz xe?00
TONNAGE __-3 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
1
e
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 TH
PERFORMANCE OF SUCH WORK.
STATE LICENSE-NO. NAME&TYPE fGlqXffW OF AP LICANT
PHONE NO. ,117`"(9' DATE fQ 45
I-NSPEr-TOR DATE /U 1 TIME
LOCATION
INSPECTION: CODE: RESULT(D/A) :
BUILDING:
ELECTRICAL:
PLUMBING:
J
HVAC:
J
OTHER: