HomeMy WebLinkAbout193 Tumble Brook DriveTO THE BUILDING INSPECTOR
Of the APPLICATION FOR
PLAN EXAMINATION ANDT' of H W SO,BUILDING PERMIT
z
IMPORTANT — Applicant to complete all item in sections: 1, If, III, IV, and IX.O
ZONIN
I• AT (LOCATION) DIST -''
LOCATION NO.) STREET)
OF BETWEEN AND
BUILDING CROSS STREET) CROSS STREET)
LOTzzrSUBDIVISILOT4a—BLOCK SIZE
N
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D v
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use
1 New building Residential Nonresidential
2 Addition(It residential, enter number 12 X One family 18 Amusement, recreational
of new housing units added, if any,
in Past D, 13)13 Two or more family — Enter 19 Church, other religi us
number of units— — — — -Jo- 20 Industrial
3 Alteration (See 2 above)14 Transient hotel, motel, 21 Parking garage4 Repair, replacement or dormitory — Enter number
5 Wrecking (1/multifamily residential, o/units ——————— — i Service station, repair garage
enter number of units in building in 15 Garage 23 Hospital, institutional
Part D, 13)
16 Carport 24 Office, bank, professional
6 Moving (relocation)
17 Other — Specify 25 Public utility
7 Foundation only 26 School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
8 FO Private (individual, corporation,
28 Tanks, towers
nonpr fit institution, etc.) 29 Other — Specify
9 Public (Federal, State, or
local government)
C. COST Omit cents) Nonresidential — Describe in detail proposed use of buildings,e.g.,food
processing plant, machine shop, laundry building at hospital,elementary
10. Cost of improvement,,,,,,,,,,,,,,,, S 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 ng buildi is eing changed, enter proposed use.
in the above cost
a. Electrical...................... r 4SAC
b. Plumbing ....................... ry
c.Heating, air conditioning.........
r
d. Other(elevator, etc.)............
11. TOTAL COST OF IMPROVEMENT S
III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts 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
48• Number of stories................
30 Masonry(wall bearing) 40 Public or private company
31 Wood frame 41 Private(septic tank, etc.)
Total square feet floor area,
all floors, based on exterior
32 Structural steel dimensions ....................
33 Reinforced concrete H. TYPE OF WATER SUPPLY
34 Other — Specify 42 Public or private company
50• Total land area, sq.ft. ...........
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. Outdoors.......................
3604011 conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 Yes 45[N No 53. Numb r f b dr ms..............
38 C al
39 Other— Specify Will there be an levat r?
54. Number f
Full..........
46 Y s 47 N bathr ms
Partial........
NOTES and Data — (For deportment use)
IV. IDENTIFICATION — To b c mpl t d by all applicants
Nam Mailing address — Number, street, city, and State ZIP cod Tel. N
Owner or
Lessee
2.
Contractor
3.
Architect or
Engineer
Th own r of this building and the undersign d agree to conform to all applicable laws of this jurisdiction.
Signatur of gp&lica t COD Address Application date
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans R vi w R uired Check Plan Review Date Plans By Date Plans By NotesqFeeStartedApproved
BUILDING
PLUMBING
MECHANICAL
ELECTRICAL
OTHER
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approva I Check Obtateainedned Number By Permit or Approval Check Obt
Date
a ned Number By
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 numb r
Building
P rmit issu d 19
Building
Permit Fe $
Approved by:
I
TITLE
ZONING
DISTRICT
FRONT YAR
SIDE - .SIDE YARD
REAR YARD
NOTES
IX.- SITE OR • Applicant
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l-
TOWN OF SOUTH WINDSOR
BUILDING PERMIT
Date May 30 19 79
Fee Paid $. .433 -00 Eat. Value $. .7 3 9 000.00
Permit N9 10837
on the side of
Lot #12 Tubblebrook Dr. Street
Street No. 193
Owner U & R Housing Corn
Applicant U & R Horn i g i n g Carprp _
CERTIFICATE OF OCCUPANCY ISSUED:
Date
No. 5394
Fee Paid $ 3.00
CLASSIFICATION
Dwelling
BUILDING PBRIVIIT
NY 10837
OFFICE OF
THE BUILDING INSPECTOR
of the
Town of South Windsor, Conn.
South Windsor, Conn. 20 19 79
i 'i t, tiZ *rt , That• T ,
4
CrisherebygrantedpermissiontoD°'&-- r'
at estimated value of $ 00
on the side of t Rj- 012 '',•*•,a ,— • Drive Street on land
owned by
Said Wax`" to be as described in Application
No. 1 113 r" and to conform to specifications and plans filed with said Application, and Building By-
Laws of THE TOWN OF SOUTH WINDSOR.
Issuc 1979
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 peesm 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"
i
I
i
I
1
TIP1'7y rNe'SP:EC' T/ION REPORT
Permit # Job
1 Footing _ /S-7
2 Foundation _ 1-.7
3 Framing
4 Wiring `
5 Plumbing 9-- 7— 7
6 Heating
7 Lathing
s C.O. 3 9y o2 790
Penn -:tea. .A37 TOWN OF SOUTH WINDSOR
SOUTH WINDSOR, CONN.
Permit Nd 5394
Certificate of Occupancy
THI S TO CERTIFY v e 1
at N in the To f South Windsor, Connecticut, has
been erected and completed in accordance with the Bui ing Code and Zonin Regulations of
the Town of South Windsor, and is hereby appro)ied for occup
r
Building Inspector
Owner, Builder
Fee Paid Date 19
GARDNER Et PETERSON ASSOCIATES 576 OLD POST ROAD TOLLAND, CONNECTICUT 06084
k so.00
Q 0
Q 0
13 6 0 1 0 12
0
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S•V 3Sl'q 351•o
AD Z
s
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M A
f AR•FIFt T.W
o
3> N
Z.q 4311 >
Sd • 2 5• 5.1 b
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3 i D
35.•S
5••B ISS 41
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TUME3LEE3RooY,, fl R1VE
14.1-?-OF CO y
MORTGAGE SURVEY Pf'
C
LOT # T2 TIMBER RIDGE SECTION III No. 4395
TOWN OF SOUTH WINDSOR, CONNECTICUT ISTEREO,r',
SCALE: 1 " = 40' 9UREyVE*N
I hereby certify to Hartford Home Savings & Loan Association
that the location of the building as shown is substantially
correct and that there are no zoning violations of the same.
L. S. # 4395
September 14, 1979
N A EERS LAND SURVEYORS
v s li°rlvrrL T
BEING LOT # 10 ON A MAP UNTITLED : W001D PONDS SECTION II
SOUTH WINDSORgCT.
PROPERTY MAPPED FOR
LOCAVA CONSTRUCTION COMPANY
1
OPEN SPACE
N,77°48'/2a2r--+
10
m
O
t FOUNDATION SHOWN l0`0
AS LOCATED 12--22-82 tij pL,
Z80.0.1
SI.04' 0 W9M0
t N FOUNDATION N o
SG B.L.
N
d a 25,
L.s 86.Qd.53.Q0'R 47$'00,
4;"#-C.PER AS•V1LT PLAN
TAN.SEWER
M.H. WOAD POND ROAD
LUCHS A BECKERMAN
CIVIL ENGINEERS - PLANNERS - NAND SURVEYORS
GLASTONBURY,CONN.
M
CtR'ti d"IAPMALLY CORRECT. SCALE- 1 tts40 9 DATE- 12-2 8-82
ACCURACY CLAW A-2 E-80-68-10
c
51G..
pow N sf''<
7-awn- O-Ps1cwt.. -
v 1540 SULLIVAN AVENUE • SOUTH WINDSOR, CONN. 06074
f
osOR-co' AREA CODE 203/644-2511
May 6, 1983
Received from La Cava Construction Company, a certified check in the
amount of $1,000 as surety for grading Lot #10 - Wood Ponds Subdivision.
Peter R. DeMallie
Director of Planning.
PRD/ds
C BS 0) 5E
1
6834
ELECTRICAL APPLICATION
Application No.7939
on the side of
T_nt #1 2 Tumbl Pbrnnk Dri yp Street
Street No. 19 3
Owner _ n R 14Ousi na Cor-
Electrician DiiLRalfia FI gn trir
FILED IN OFFICE OF
The Building Inspector
Kx July 16 19_79
INSPECTION.
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.
APPLICATION FOR PERMIT TO DO ELECTRICAI. WORK.
No. ....7.8 39........................
Permit No. . .6.8.3.4.... ....... ......
TO THE BUILDING INSPECTOR
of the
TOWN OF SOUTH WINDSOR, CONN.
We......... 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
whether specified herein or not.
South Windsor, Conn., ........JU1Y.. 197 Sign here 4t '...................
Address 44 F'urnej.j I'1. .......I Gkt Ct.R
Lot #12 Tumble ... . Dr.Location ... ................... .a.....'....... ........ .....Side of ... ..... . .... ..............................................................................................
Nature of Building R...... .....s id Ape ....How many stories 2
New or old Building ...New...... How many families ...............1...........................................................................
Kind of Installation ......Romex.... . . .. .... ........ How many Stores ......................................................................................................
Owner U...6...R...I;Que.ir. ....GArp.... Address ..Q......BRA...240..*.... 1a_
Architect .............. .............Address
BuilderU...t..R....HouB in&....Corp.• ... ... . ...... . .. .... Address
Electrician Du.,.B.4l.d9....Z149.tr.1C...CO.....a...Inc..... ....... .. Address 4.4. Pnrne11....2.1&..a....YAUC JaP.81P.X. JL,....
Size of Main Wires .. 2.... ........................
No. of Light Loops No. of Heat Loops ....., No. of Power Loops ........................._._...._....
No. of Light Outlets .............18 No. of Heat Outlets ...... No. of Power Outlets ...................................
Nob of Light Circuits ... .... ..... ... .... .... No. of Heat Circuits No. of Power Circuits .. ... . . ...... ...
No. of Sockets ..... .... .......... ...$.. ... ....... No. of Heat Receptacles No. of Motors ............... ..... ........ .............
No. of Panels ...............................1..... .. Size of Heat Circuit No. of Power Receptacles .. .. ........ ...
No. of Switches ........... .............36 Total Wattage Size of Power Circuit .. .. ..... . ... ..
Total Horsepower
No. of Straight Electric Fixtures ...... 22. .. .. ........... No. of Combination Fixtures ... . . .. ..... ............. ... .. ........
No. of Receptacles ......................... ........ ...........4$.................. . . . ........ No. of Cord Drops .... .. ........................................................ ....... ... ...
Remarks: For other kind of Installation .. .. .......... ................................. ........................ ................................... ......................................................................
Estimated Cost .......$.j.,.Z50..00
5450
PLUMBING APPLICATION
Application No. 6233
on the ................... i&of
Lot
S_
Street Igo. ...193...—
Owner .....
Plumber
Filed in fo0
The Building Inspector
Aug, 13
No person AA cmstrw:t, add w at alder my
portion of the drainage system of my bwl&og
except to repair leaks) until a Pranit is gutted
by the Building Inspector.
545ApplicationNo......6233..................................... Permit N . ......................0...............
TO THE BUILDING INSPECTOR
of the
TOWN OF SOUTH WINDSORe 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.
FSouthWindsor, A ...... ....................... ..197 ..... hereSipS1
d
0Locatiotc
r_.
2................................... .................................................................... side o ............./Street
Nature of B Ildin How many stones .............................................................................U g
Owner .........Address..........]:.. .....
Architect ............... ................................................................................................. Address .....................................................................................................................-
Budder .............. .. ...Address .......................................................................................................................
Plumber ......... Address
DRAINAGE
001ro X-f.lip....4'aCESSPOOLS, How many .....J(....I?........... ................... Where located ......X...........................................................................
Are they water tight ...... .... ........X................................................. Of what mate* are they built ........................................................
Size of pipe from house to ces ool ..........<............................... Kind of pipe .........-.4.. .....................................................................................
MAIN DRAIN IN CELLAR, Materio _,C........ ............. Diameter .-,K.......................................................................................................I.
1( 'Ile --tAboveorbelowcellarbottom ... .......1, /'1.671-o.--.......................... ......................................................................................................................................
SOILPIPES, Material ...................0,2:........................................... Diameter 3.04......................................................................................................
WASTEPIPES, Material .........11 Diameter ..... .......................................................................................................
TRAPS,Type proposed to use is
RAINWATER LEADERS, where do they run to .... ................................................................................................................................................
REFRIGERATORWASTES, where do they run to ..................................................................................................................................................
TANKOVERFLOWS, where do they run to . . .. ... ..........................................................................................................................................
FIXTURES
WATERCLOSETS, How many .................................................... Where located ...................................................................................................
Distancefrom trap to vertical sod pipe ......................................... Pattern I..................................I...............................................................
WASHTRAYS, How many .............................................................. Where located .....................................................................................................
SINKS, How many .........................../........................................................ Where located ...e....................................................................................
BUTLER'S SINKS, How many ........................................................ Where located.....................................................................................................
REFRIGERATORSINKS, How many....................................... Where located .....................................................................................................
LAVATORIES,How many...............5............................................. Where located Z k..................................................................
BATHTUBS,How many......./.......................................................... Where located ....'...............................................................................................
URINALS, How many ................................................................................. Where located .....................................................................................................
Are water closets and urinals to be local vented . . .. . .......... .. . .. If not,is there a window in uter wall
ofroom where same are to be located .............. ... .. .. ...... .. ...............................................................................................................................................
Estimated Cost
60
TO THE BUELDING INSPECTOR
of the APPLICATION FOR
PLAN EXAMINATION ANDTOWNOFSOITtHWINDSOR,CONN. BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX.O
I•
INGW` A/AT (LOCATION) N. C DISTR CT
LOCATION NO.) STREET)
OF BETWEEN AND
BUILDING CROSS STREET) CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
11. TYPE AND COST OF BUILDING — All applicants complete Parts A — D v
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use M
1
1 New building Residential Nonresidential
2 Addition(!/residential, enter number 12 One family 18 Amusement, recreational
o/new housing units added, if any,130 Two or more family — Enter 19 Church, other religiousinPartD, 13)
number of units— — — — -- 20 Industrial3 Alteration (See 2 above)14 Transient hotel, motel, 21 E] Parking garage4 Repair, replacement or dormitory — Enter number
5 Wrecking (1/multifamily residential, of units ——————— —i E] Service :lotion, repair garage
enter number of units in building in 15 Garage 23 Hospital, institutional
Part D, 13) 16 Carport 24 Office, bank, professional
6 Moving (relocation)
17 Other — Specify 1A10Q h 25 Public utility
7 Foundation only 26 E] School, library, other educational
B. OWNERSHIP S' • 3 Jlt` 27 Stores, mercantile
8 Private (individual, corporation,
28 Tanks, towers
nonprofit institution, etc.) D E 290 Other — Specify
9 Public(Federal, State, or
local government)
C. COST Omit cents) Nonresidential — Describe in detail proposed use of buildings, .g.,food
QQ 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 .......................-
7c.Heating, air conditioning.........
d. Other(elevator, etc.)............
Q
11. TOTAL COST OF IMPROVEMENT $
III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts 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 Wood frame 410 Private (septic tank, etc.)
49• Total square feet of floor area,
all floors, based on exterior
32 Structural steel dimensions ....................
33 Reinforced concrete H. TYPE OF WATER SUPPLY
34 Oth r — Specify 42 Public or private company 50. Total land area, sq. ft. ...........
43 Private(well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
51. Enclosed .......................
35 Got Will there be central air 52. Outdoors........................
96 Oil c nditi ping?L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 Yes 45 No 53. Number f b dro ms..............
38 Cal
39 Oth r— Specify Will th re b an elevat r?
54. Number f
Full..........
46 Yes 47 No bothr ms Partial........
NOTES and Data — (For department use)
IV. IDENTIFICATION — To b compl t d by all applicants
Nam Meiling address — Number, street, city, and State ZIP code Tel. No.
Owner or C.>rl l L-c96 0
Lessee Ce N/V
2.
Contractor
3.
Architect or
Engineer
Th own r of this building and the undersigned agree to conform to all applicable laws of this jurisdiction.
Signature of applicant Address Application da e
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans R vi w Required Check Plan Review Date Plans B Date Plans B NotesqFeeStartedyApprovedy
BUILDING
PLUMBING
MECHANICAL
ELECTRICAL
OTHER
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or A rova I Check Date Number B Permit or Approval 1 Check Date t4umber 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
Permit numb r 11186
Bui lding
P rmit issu d Oct. 15 19 19
Bui Iding
Permit Fee $ 4.00
Appro ed by:
TITLE
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TOWN OF SOUTH WINDSOR
BUILDING PER Err
f
Date Oct. 15 ig 79
4,00 500,00FeePaid $. Eat. Value $
Permit N° 1118 6
on the side of
Tumblebrook Drive Street
Street No. 193
Owner Ung Lim Le e
9
C Applicant I_ng Lim LtaP
f
I CERTIFICATE OF OCCUPANCY ISSUED:
Date
f
No.
Fee Paid $
CLASSIFICATION
Wood Stove/fireplace
e
BUILDING PERMIT
N9 11186
OFFICE OF
THE BUILDING INSPECTOR
of the
Town of South Windsor, Conn.
South Windsor, Conn. geti. t A 19 i tj
94!9 to That uni'- ---Ira Tom
is hereby granted permission to Wood stove in fireplace
at estimated value of $
on the side of 193 M iziahlahroolc Drive Street on land
owned by Ung Ljm Trap
Said Wark 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.
Issued r 19 79.
IA ilding 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 costa and damages which it shall sustain, or be compelled to reason therefor"
El ctric# APPLICATION FOR BUILDING PERMIT
Plumbing# 193 TUMBLEBROOK DRIVE
HVAC #23282
Sprinkler#
Date:
No.
FINAL PRO Estimated Cost $ 0 G;o d
Building'i `j COMPLETE RED BOXED AREAS Permit Fee 3Q
Engineer' g TYPE OR PRINT ONLY Occupancy Fee $
Affidavit SIGN ON REVERSE SIDE
Appr.for CO. FTotal Fee 3d
TO BUILDING DEPARTMENT, TOWN OF SOUTH WINDSOR,CT Additional Cost) $
Th and rsigned hereby applies to do wor according to the following specifications:
106 Location/ Lot No. Side of Street Zone
Applicant- 4 Tel. # e C,2Z Z
Address 4 Zip O CO 4 tLic.
Owner Addresses P ra o o
Architect Address
Sq. Ft. New Area: 1st FI. 2nd FI. 3rd Fl. Total New Area
Rooms Lavatories Bathrooms Garages
Purpose of thisP Permit: f .Z
City Water Well Septic System Sewer
Use Group /N 14 Construction Type N A a Basement Garage
Approved by Date (;//3N -
655 1 Revsed 6/95
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 Bu' n which this
permit is asked, and agree that this building is to be located the proper dis ce fr a s et li s,s' ines and required
distances from all other zones and is located in a zone in is bui g a u s a
Signed
I hereby apply for a Certificate of Occupancy for the work described in this plication for the permit
Signed
DO NOT WRITE BELOW THIS LINE --
INSPECTION COMMENTS
Inspection / Approval Date By Appl
Code Description Due Whom Code Comment
96-23282-B 2,700
B01 FOOTING 06/17/96 JFH A
B10 FINAL 07/17/97 JFF A 26" ABOVE GRADE/APPROVED FOR CLOSEOUT
DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT
PERMIT#
Application i reby:TOWN OF SOUTH WINDSOR
9BUILDINGDEPARTMENT
APPROVED 1540 SULLIVAN AVENUE Bldg.Permit#
644-2511 ext. 230
Date Buil ing Inspector
Application must be printed or typed
Location of Job:
FEE SCHEDULE
93
0-$1,000=$13.00 Street No. Street Lot No.
Over$1,000=
13.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT 0 s eQ./ rc) .
APPLICANT ADDRESS
APPLICANT PHONE# .tea g o 6
1
O W N S F,q
OWNER eol-l"PI r cG
OWNER ADDRESS 61C.AronGe ,0 2
OWNER PHONE
C ESTIMATED COST$ 3, 90 0 d v
IS THIS A CONTRACT COST? J'Yes 13 No
CJ FEE ENCLOSED$ O I
TYPE OF JOB:
SOR-C O
13 New Installation
13 Alteration/Addition/Repair Revised 8/99
3
i
E
APPLICATION FOR HVAC PERMIT (Continued from reverse side
TYPE OF SYSTEM: TYPE OF BUILDING:
HEATING 0 RESIDENTIAL
A/C COMMERCIAL
VENTILATION INDUSTRIAL
HEATING
STEAM LOW PRESSURE LIMIT LBS. HIGH PRESSURE LIMIT LBS.
93 HYDRONIC WARM AIR UNIT RADIANT HEATER
EXISTING RADIATION ADDITIONAL RADIATION TOTAL RADIATION
DESIGN TEMP. OUTSIDE OF INSIDE OF DIFFERENCE OF
TOTAL HEAT LOSS(BTUH) F(HEAT LOSS SHEET MUST ACCOMPANY
APPLICATION)
DESCRIBE ALL HEATING EQUIPMENT(INCLUDING MAKE&MODEL NO.)
t.[J. / c o, /Jdi c GUc tcl`i Qfcr o c/ Gd'c /;s y
GROSS HEATING CAPACITY(INPUT—BTUH)Z_tf NET RATING(OUTPUT BTUH)
TYPE OF FUEL
OIL—GPM/• /O OIL TANK LOCATION:INSIDE OUTSIDE CAPACITY
GAS—INPUT LPG TANK CAPACITY ELECTRIC—KW
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)
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 /Pe PX/s fi i,ram le-
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS TO
COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE
PERFORMANCE OF SUCH WORK.
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT DATE /3' a
rl
eectrit# APPLICATION FOR BUILDING PERMIT
Plumbing# 193 Tumble Brook Dr i v
HVAC # 28001 Dat . Cy /
Sprinkler# No.
FKU APPR VALS Estimated Cost $
Budding apd.°t COMPLETE RED BOXED AREAS Permit Fee v e
Engineering TYPE OR PRINT ONLY Occupancy Fee $
Affidavit SIGN ON REVERSE SIDE ZAir.for CO.Total Fee
TO BUILDNC'WARTM13q,TOWN OF SOUTH WIDSM CT Additional Cost)
The undersigned hereby applies to do work according to the following specifications:
Jo6 Location/3 Lot No. Side of Street Zone
Applicant j Tel# oZ V.2,F6
Addr ss zipl Lic# 7
Owner Addressit,Aola
Architect Address
Sq.Ft.N w Area: lst FI. 2nd Fl. 3rd Fl Total New Area
Rooms Lavatories Bathrooms Garage
Purpose f this rmit: * F
to
City Water Well Septic System 0 Sewer
Ins. H.O. S.P. Cert. Area Basement Garage
Approved by Date 6 Use Group Construction Type
R•vs.d 1197
I hereby agree to conform to all the requirements of the Laws of the State of Connecticut and th 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 eet lines,side yard lines,and required
distances from all other zones and is located in which this b ' ing and its is a
Signe
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
Inspection / Approval Date By Appl
i Code Description Due Whom Code Comment
28001-B 6,300
B10 FINAL 10/29/01 GRM A
B10 FINAL 10/29/01 GRM A CLOSED OUT.