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HomeMy WebLinkAbout2 Jeffrey Drive (3)THE BUILDING INSPECTOR of the APPLICATION FOR PLAN EXAMINATION ANDOFS'OU'1'H W COS BUILDING PERMIT IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O 2 Jeffrey Drive ZONING AT (LOCATION) DISTRICT LOCATION NO.) STREET) OF BETWEEN Pleasant Valley Rd. AND Nutmeg Rd BUILDING CROSS STREET) CROSS STREET) SUBDIVISION 1170R001 LOT 1 LOT BLOCK SIZE 24!94o sfU f t 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 M 1 C,New building Residential Nonresidential I 2 Addition(1f residential, enter number 12 One family 18 Amusement, recreational of new housing units added, if any, in Past D, 13) 13 E:] Two or more family — Enter 19 Church, other religi us number of units— — — — — 20 Industrial3 Alteration (See 2 above) 14 Transient hotel, motel,21 Parking garage4 Repair, replacement or dormitory — Enter number 5 Wrecking (if multifamily residential, of units ——————— — -i 22 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 M ving (r location) 17 Other — Specify 25 Public utility 7 Foundation only 26 School, library, other educati Dal B. OWNERSHIP 27 Stores, mercantile 8'0 Private(individual, corporation, 28 Tanks, towers n nprofit institution, etc.) 29 Other — Specify 9 Public (F deral, 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,,,,,,,,,,,,,,,, 1 000 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...................... Industrial & Office-- Light Ind. b. Plumbing ...................... c. Heating, air conditioning......... d. Other( levator, etc.)............ 11. TOTAL COST OF IMPROVEMENT III. SELECTED CHARACTERISTICS OF BUI ING — 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 Mas my(wall bearing) 40© Public or private company 48• Number of stories................ A, 31 Wo d framZ 41 Private (septic tank, etc.) 49• Total square feet of floor area, all floors, based on exterior 32 Structural steel dimensions ..................... `© 0 Q 33 R inf rced concrete H. TYPE OF WATER SUPPLY 34 Other - Specify 42® Public or private company 50• Total land area, sq. ft. ........... Z ' l(O 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....................... 36 F1 Oil c nditioning?L. RESIDENTIAL BUILDINGS ONLY 37 El ctricity Yes 45 No 53. Number of bedr me.............. 38 C al 39 Oth — Specify Will there b an levator? 54. Number f Full.......... 46 Yes 47® No bothr me Partial....... IV. IDENTIFICATION — To b compl t d by all applicants Name Mailing address — Number, street, city, and State ZIP code Tel. No. I H. 13 . elasco 40 Eli7,abeth Lane- Tolland , CT. 06084 875-5651Owneror Lessee 2. Contrac+or 3. John -Eberle 8' MP ple St. ':"I in(9sor, CT 688-0913 Architect or Engineer The owner of this building and the undersigned agree to conform to all applicable laws of this jurisdiction. Si ure p lica A44r e/ss Application date J e5&in S-Z a I 0,/z -2z zV 00 NOT WRITE BELOW THIS LINE V. PLAN REVIEW RECORD — For office use Plans Revi w Required Check Plan Review Date Plans By Date Plans By NotesqFeeStartedApproved BUILDING PLUMBING MECHANICAL ELECTRICAL OTHER VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Date Date P rmit or Approva I Check Obtained Number By Permit or Approval Check Obtained 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 r VII. VALIDATION Building Permit number J"':) Building i Permit issued 19 Building Permit Fe A rove V- a,- TITL 1 TOWN OF SOUTH WINDSOR BUILDING PER ffr Date may 19 8 6 Fee Paid $.1.,.2 6 0 Eat. Value $. Z1 Q,0 0 0 Permit N° 15085 on the side of Jeffrey Drive Sava Street No. 2 Owner H. R. De l a se o Applicant H. R. De la sc o CERTIFICATE OF OCCUPANCY ISSUED: Date No. 7 614 Fee Paid $ 1 _Q n CLASSIFICATION Industrial Building BUILDING PERMIT M 15085 OFFICE OF THE BUILDING INSPECTOR of the Town of South Windsor, Conn. South Windsor, Conn. May 36 4 1986 t t That H_ R_ARCO is hereby granted permission to T 8 at estimated value of on the side of 2 je ff rey ar s ye Street on land owned by u..;.. Dei$sc^ Said Work to be as described in Application No.and to conform to specifications and plans filed with said Application, and Building By- Laws of THE TOWN OF SOUTH WINDSOR. Issued May 14 1986 Building Inspector. Streets and sidewalks, obstructed by excavations or building materials, must be guarded by barriers during the day and by both barriers and colored lights by night. SECTION 1343, GENERAL STATUTES OF CONNECTICUT: "When any persm shall place or keep building materials, or any obstacle in any highway (or any sidewalk) either with or without a license therefor from the city or borough in which such highway may be situated, he shall pay said city, t wn or borough all costs and damages which it shall sustain, or be compelled to reason therefor." Industrial Building 5/14/86 H. R.- Delasco 2 Jeffrey Drive permit # 15085 Electrician Dennis Shea 9363x- Heating Contr. M. R. Delasco 6573 Plumbing it Freedom Mech. 7 0 3 6 1414 Oil Burner Certificate of Occupancy 7614 Sewer Permit INSPECTION LPORT Permit # /j Job 1 Footing 2 Foundation 3 Framing 4 Wiring 5 Plumbing 6 Heating 7 Lathing 8 C.O. Permit No. y.,` ` TOWN OF SOUTH WINDSOR SOUTH WINDSOR, CONN. I Permit NU 7 614 Certificate of Occupancy, THIS IS TO CERTIFY tt}at at No. in the Town of South Wf dsor, Connecticut, has been erected 4 ;%cor Oleted in accordance with,the Building Code and Zoning Regulations of the Town of South Windsor, and is hereby appredo yr occupancy. BuildIng Inspector OOwner, Builder Fee Paid .i Date 19 I 9363 ELECTRICAL APPLICATION Application No. 10875 on the side of T _f f rev Tyr i ve Street Street No. 2 Owner 14 R_ -ne 1 a cr-n Electrician Den is Shea FILED IN OFFICE OF The Building Inspector Aug_ 25 19$fl- 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 No. .`5/. Master License No. ...... n. '. ............... TOWN OF SOUTH WINDSOR Building Permit No. ./-. BUILDING DEPARTMENT Date Filed .....iV If,.1... .................................... Date Final Approval ................. .......................... APPLICATION FOR ELECTRICAL WORK Electrical Inspector JOB LOCATION.JOB OWNER: . Sideof Between ... ....and ................................................................................. Name of Building Owner 1 1-=! .... `-!° .a.................. Address y O ..-1.Z..-T+l.....I llE... ...'Tb AN...... If work is for Lessee--Give name Address ............................................................. .... ..................... Building now occupied as (unless new) 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 Building Permit) r '/ Q Permittee C1-61 SV\Efk Business Address $GrLk\1\4 2 l0UaND z`Zc)Telephone . ............ COSTOF INSTALLATION: I 1j q00 . ................................ ... .............................................. ......................................................................................................... TO BE FILLED OUT BY PERMITTEE TO BE WIRED EXISTING APPLIANCES Number of light outlets to be installed Number of convenience outlets t,o be installed Number of present Appliance Circuits ...... ..... 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 p 5 - A IQ Clothes Washer . . . . Clothes Dryer . . . . . 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 .... ................ ......................................_..___ ----- 7036 PLUMBING APPLICATON A-* • No. 6807 on the side of Jeffrey Drive Street Street No. - I Owner .- H. R. Delasco Piun&r Freedom MECHANICAL Fled in Office of The Building 6/20/ 19 86 IN 4 1 11 C TWN. No person shall rr; add wor moor my portion of the drainage Wstm of my bw'l&g ezccpt to repair 66) una a Plesmit in Scomod by the Budding Inspector. t APPLICATION FOR PLUMBING PERMIT (Continued from Rev rse Sid ) TOWN OF SOUTH WINDSOR, CONN. 11. LOCATION OF JOB 2 Jeffery Drive NO. STREET FLOOR APT.NO. F GENERAL PLUMBINGl 12. KIND OF INSTALLATION Office Building Plumbing 13. SIZE OF MAIN DRAIN 419 14. NO. OF TOILETS 5 STYLE Tank - Floor 15. NO.OF URINALS STYLE 16. NO.OF BATHTUBS 17.NO.OF LAVATORIES 5 18. NO.OF SINKS 1 19. NO. OF WASHTUBS 1 20. NO.OF CONDUCTORS 1 SIZE 4 21. NO. OF STACKS 1 SIZE 411 22. AREA OF ROOF 6000 sq. Ft. 23.NO. OF CATCH BASINS 24. NO. OF FLOOR DRAINS 25. NO. OF OTHER FIXTURES KIND 26. ARE TOILET COMPARTMENT VENTILATED TO OUTER AIR BY A WINDOW? 27. SIZE OF WINDOW 28. IF NO WINDOW,WHAT KIND F VENTILATION IS THERE? Exhaust Fan 29. ZE OF DUCTS 41 30. ARE SEWAGE AND WATER FACILITIES AVAILABLE?Yes c/o Free m 1Aech' tricaltrical, Inc. SIGNATURE DRESS 245 Weston Street, P.O. Box 2109 rdUl C. Gray Hartford, Ct. 06144-2109 LICENSE NO. 2U3519 ESTIMATED COST 10,000 TELEPHONE 522-3920 OWNERH•R. Delasco(- ADDRESS 5 Elizabeth Lane, 'Tolland, Ct. WATER HEATER 31. TYPE Electric 32. MANUFACTURER Bradford White TANK SAFETY DEVICES 33. CAPACITY 37. TEMPERATURE RELIEF VALVE 34. TEST PRESSURE_ 38. MANUFACTURER_ 35. WORKING PRESSURE 39. PRESSURE RELIEF VALVE 36. TYPE 40. MANUFACTURER S, ALL WORK COVERED BY THIS APPLICATION HAS BEEN A HORIZED BY THE WNER OF THIS PROPERTY r• AND WILL BE DONE IN STRICT ACCORDANCE WITH THE B DING CODE. 5/29/86 Paul C. Gray, Pr CD962 DATE SIGNATURE OF APPLICANT PERMIT # Application For DEPARTMENT DECISION Heating Permit O 3 APPLICATION IS HEREBY:DEPARTMENT OF LICENSES AND INSPECTIONS d 15t APPROVED DISAPPROVED TOWN OF SOUTH WINDSOR 0 l (1 /ti T8-Thnmac I ER NE BELOWCNEFINSFCTO9APPLICATIONSMUSTBEPRINTEDORTYPED. BEGIN WITH NUMB O W 1. LOCATION OF JOB J2,14T Y vd—vl voy 4 a~ O NO. STREET c v LOT NO. FLOOR APT. NO. O LV 2. OWNER Cd O O s. ADDRESS 40 00 3 4.PHONE v Cc j S. APPLICANT A o gos. ADDRESS ZZ- Y PHONE--,' L` s. LICENSE NO. d 4; EXPIRATION DATE OF LICENSE 10. ESTIMATED COST S Cq t 1. IS THIS A CONTRACT COSTY Cd\YEs NO b0 tz. FEE ENCLOSED s PermitPermi-t 15085 a c d 13. TYPE OF BUILDING: rA RESIDENTIAL COMMERCIAL b0 O • 14. TYPE OF JOB: INDUSTRIAL T, 3 RIGIMAL ALTERATION ADDITIONNSTALLATIM REPAIR • APPLIEATIO FO #= ATE G PERMIT (Continued tr m Rev me Sid r 60 11. LOCATION OF JOB NO. STREET FLO R AFT.N . 12. TYPE OF INSTALLATION; OIL BURNER ELECTRIC VENTILATION SPRINKLER BURNER STACK INCINERATOR MISCELLANEOUS IDENTIFY SIZE LOCATION SIZE SIZE13. 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 INSULATED — YES OR NO TYPE OF WALL INSULATION ROOF OR CEILING INSULATION AVG. SYSTEM WATER TEMP. B.T.U./SQ. FT./HR. EMISSION INDOOR-OUTDOOR TEMPERATURE DIFFERENCE FAHRENHEIT MAKE OF RADIATION: BASEBOARD, COPPER CONVECTORS. OR C.I. RADIATION. OUTPUT PER SECTION OR LINEAL OF RADIATION. SQ. FT. O R B.T.U. DESCRIPTION OF WORK Z Top UNITS 4) Go 6 - I) 0015. TO BE DONE; 16. HEAT LOSS SCHEDULE. (TO BE INCLUDED FOR ALL JOBS): R OM SIZE WINDOWS AREA - SQUARE FEET B.T.U. B.T.U. F DANDDOORSvoLUME DISTRIBUTION INSTALLED TOTAL TOTAL H ROOM NO, GROSS GLASS NET WALL CEILING FLOOR CU.FT. AT 70•F CORRECTED -J j LL REGISTERLWNANDQWALLSOINFILT.) TEMP. TO F F TYPE AND SIZE RAD. OR LEADER SIZE <F'c DIFF. F O O a SQ. FT. FREE AREA ty le p (,\y 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; 3 t.— T;k 0 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 WILLBEDONEINSTRICTACCORDANCEWITHTHEBUILDINGCODE. APPLICATION TO BE COMPLETELY FILLED IN.17—t(or-yo DATE SIGNATURE OF 0111LICANT HOT I W 111FIF I A 114F.I.? I I.L!j 1 1 :41 f:? AM 1 1 Mi (if? r 117D I L it I T W 310 1.. ....D 1.:IF D B 'I P-1 P 1-017-'11.. Fw 131 1 10 N S Q M I J(IN is,F A;.1,1., 7',*-:-.(:-) p P.641i 1 n 4 F",9 P :3 1 JI . W 9 A.M. 70.66 4.55 Ff.EAR 1. 1111.1 13 EK Fy AA T :1 (J- v'i..171 75 4 90 S P-4 7 Sli 1`1 1; 1- y: P.11. W;.4 A. .8:1 73.0 5 61 is JIT to F A. 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Ill W 1; FIF fit IL I I M-i F;:(I(JI'l l-I,H Fm k Ps ii , to E FR i kwv= mia,(w 1 1 wamus rot I v I n() II-'I 'L V F A 1`-1 '-; I -:i*1 :1 1 1 `pit 1. 1.i-1(..i F.,f- I I I 1:_1 RAZE OF CONNEMCUT OF PMMECnON ow wr smm"dr*Awn*ypwomM ihr y W PAUL,C.Aw 34 PW gem 1 rift 0/0 r AIR-CONDITIONING LOAD CALCULATION FORM (C ntinued) Sensible Latent 6. VENTILATION OR INFILTRATION (Tables 7 and 8; use the larger quantity only) Dry-Bulb Cubic Feet Temperature Per Minute Difference 6 0 P P. X ? . . X 1.08 Specific Cubic Feet Humidity Per Minute Difference X . . . . . . . . X 0.67 7. DUCT HEAT GAIN— Factor for thickness of a duct insulation from Fig. 1) x Heat Gain from Fig. 1) x Duct length (ft)—100 r u ,;,' f 8. TOTAL SENSIBLE AND LATENT LOADS Z . . . . . 9. TOTAL COOLING LOAD 3 A/ / 73 B. HEATING LOAD 1. DESIGN CONDITIONS Dry-Bulb Temp, F Specific Humidity, Gr/lb Outside (Table 1) Inside S. . Difference ITEMS HEATING LOAD (Btuh) 2. TRANSMISSION GAIN (Table 4) Dry-Bulb Temperature Sq Ft Factor Diff rence Windows 7r. X oS . X 57.(7 Walls70. X Z. X QgO X X . . . . . . . . _ X . . . . . . . . X . . . . . . . . _ X . . . . . . . . X . . . . . . . . _ Floor X 4a. . . X . . . . . . . . Other X . . . . . . . . X . . . . . . . . — X . . . . . . . . X . . . . . . . . _ 3. VENTILATION OR INFILTRATION (Tables 7 and 8; use the larger quantity only) Dry-Bulb Cubic Feet Temperature Per Minute Difference O Sensible Load e! X . . .757 X 1.08 gl Specific Cubic Feet Humidity Per Minute Difference Humidification . . . . . . . . X . . . . . . . . X 0.67 Load 4. DUCT HEAT LOSS Heat loss (from Fig. 1.) x Factor for thickness of duct insula- tion—From Fig. 1.) x uct Length (ft)—100. . . . . . . . . . 5. TOTAL HEATING LOAD 2 7 pip RIF*, R o e ca i AIR-CONDITIONING LOAD CALCULATION FORM FOR COMMERCIAL APPLICATIONS Customer: Name Date I gAddress Contractor: Name o I-1 r K.C__ By Address__ A. COOLING LOAD 1. DESIGN CONDITIONS Dry-Bul Temp, F Wet-Bulb Temp, F Specific Humidity, Gr/lb Outside (Table 1) Inside 3 q,. Difference i ITEMS COOLING LOAD, Btuh Sensible Latent 2. SENSIBLE HEAT GAIN THRU GLASS Table 3) S Ft Fa or w X . . . . . . . . Total Sensible Heat Gain thru Glass g.4 i. . 3. TRANSMISSION GAIN Table 4) Dry-Bulb Temperature Sq Ft Fac or Difference 18G oWindows /.2 . X . . .: .X . . . . .5. . _ Walls S'? X <31 . X . . .?$. . X . . . . . . . . X . . . . . . . . _ X . . . . . . . . X X . . . . . . . . X Partitions . . . . S . X 3 Z.. . X . . . /. . • . = l/.?.7. . . . . Roof . . . . . . . . X . . . . . . . . X . . . . . . . . _ Ceiling . . . . . . . . X . . . . . . . . X . . . . . . . . _ Floor . . . . . . . . X . . . . . . . . X . . . . . . . . _ Total Transmission Gain 4. INTERNAL HEAT GAINS, PEOPLE & LIGHTS Table 5) Sensible Latent Number Fact r Factor People . . . . . . X Peo le . . . X . p Watts Lights . X 3.4 Lights . . . . . . . . X 4.25 Total Heat Gain of People & Lights 5. INTERNAL HEAT GAINS, OTHER Motors . . . . . . . . HP X 3393 Appliances (Use values given in Table 6) . . . . . . . _ Total of Other Internal Heat Gains For use with fluorescent lamps with ballast within conditioned space. Over) ARI Form 220 ALC-1 011 DEPARTMENT DECISION ID-T# APPLICATION FOR HVAC PERMIT Application is hereby:TOWN of SOUTH WINDSOR BUILDING DEPARTMENT BldyPermit# APPROVED1540 SULLIVAN AVENUE A J142—644-2511 ext.230 Date Building Inspector Application must be printed or typed Location ofjob IDYI Y Street No. Street Lot No. FEE SCHEDULE Lzwer Le- s w Floor Apt.No. 0 - $1,000 - $12.00 Over $1,000 12.00 per$1,000 OWNER- JAS +1 or any fraction thereof ADDRESS CT OWNERS PHONE# ?79-5Zo,5-1 APPLICANT 1>mc(no XIS 113 C, OWN SF,q ADDRESS H T"E- -M l th LT 06 0 74- fij ESTIMATED COST $ .91d0 O IS THIS A CONTRACT COST? q)4 YES NO FEE ENCLOSED $ OR CO TYPE OF JOB: Original installation Addition Repair Revised 11/95 APPLICATION FOR HVAC PERMIT(Continued from reverse side) TYPE OF SYSTEM TYPE OF BUILDING HEATING RESIDENTIAL A/C COMMERCIAL Li VENTILATION INDUSTRIAL HEATING STEAM LOW PRESSURE LIMIT LBS.HIGH PRESSURE LIMIT LBS. HYDRONIC WARM AIR_L,— 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 ACCOMP APPLICATION) DESCRIBE ALL HEATING EQUIPMENT (INCLUDING MAKE&MODEL NO.) GROSS HEATING CAPACITY (INPUT-BTUH) NET RATING (OUTPUT-BTUH) TYPE OF FUEL OIL-GPM GAS-INPUT7S40 ELECTRIC-KW OIL TANK SIZE&LOCATION INSIDE OUTSIDE CAPACITY LPG TANK CAPACITY AIR CONDITIONING ISDESIGNTEMP. OUTSIDEF INSIDE F DIFFERENCEZ F TOTAL HEAT GAIN(BTUH) 51 Z 3 HEAT GAIN SHEET MUST ACCOMPANY PLCATION) DESCRIBE ALL COOLINP EQUIP E!g (IIJCLUDING MAKE&M O.) 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 "1;4 THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONN. UILDING CODES IN THE PERFORMANCE OF SUCH WORK. A a STATE LICENSE-NO. NAME&TYPE IGNATUMK09F APPLICANT PHONE NO. DATE 4)741 ?7 qx 9xq xb N o X A t ' N Boom