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Home My WebLink About21 Rockwell Courtui d`,9 SPECTIO APPLICATION FOR BUILDING PERMIT Plumbin HVAC— 21 ROCKWELL COURT Date: Sprinkl SElectric7 ""'- Estimated Cost $ Zoning Permit Fee $ Affidavit NO.20560 Occupancy Fee $ Eng. Dept. Fire Dept. COMPLETE RED BOXED AREAS. Total Fee $ . Health Dept. TYPE OR PRINT ONLY Approved for CO:w SIGN ON REVERSE SIDE. Additional Cost) $ TO BUILDING DEPARTMENT, TOWN OF SOUTH WINDSOR, CT The undersigned, hereby applies to do work according to the following specifications: Job Location t No. Side of Street Zone Applicant Tel. y `" gD3 Address Zip V Lic.# !F200 ST E CITY STATE Owner 5 Address he9ZArchitect Address Q — Size New Area: Ft. Front Overall Ft. Deep Overall Total Area Garages a Lavatories 3SizeofLotDist. from Street Line_Bat ooms _Rooms 1st w 2nd 3rd Purpose of this Permit g City Water 01 Well 0 Septic 0 Sewer7 Use Group Construction Type Approved by V157 Date BD1A 1 des I hereby agree to contorm to all th requirements of the Laws of the State of Conn cticut and the Ordinanc s 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 a zone in which this building and its use is allowed. Signed ti 1 hereby apply for a Certificate of Occupancy for the work described in this application for permit. Signed DO NOT WRITE BELOW THIS LINE— INSPECTION RECORD Footing Framing Foundation Fireplace/Chimney Insulation y Plumbing Permit# ` Inspections: HVAC Permit#y C Inspections: Electrical Permit# r— Inspections: Sprinkler Permit# Inspections: Location of job AFFIDAVIT Additional Fee . . . ..707. . ... . . State of Connecticut ss. County of Hartford f7 l orvs . . . . ... . . . of 0r . . . . . 7 for building erected under Permit No. 20560.. . . issued by the Dept of Building of the 7bwn of South Windsor being duly sworn,make oath and say that the actual cost of the completed work authorized under said permit not exceed the submitted estimated cost 73, 500. 00. Signed . l q Subscribed and sworn to before me this . . . . / day of U A.D.19 !... Estimate Cost:S 7 3 , 5 0 0. 0 0 0Difference: S Notary Public. Inspection / Approval Date By Appl Code Description Due Whom Code Comment 93-20560-B 65,000 BO1 FOOTING 05/05/93 JFH A B02 FOUNDATION 05/10/93 JFH D NEEDS MOORE TAR E01 SERVICE 05/19/93 DDS A B03 FRAMING (ROUGH) 06/08/93 JFH A E03 ROUGH 06/08/93 JFH A P03 ROUGH 06/08/93 JFH A P02 UNDERGROUND 06/08/93 JFH A H03 ROUGH 06/08/93 JFH A B04 INSULATION O6/10/93 JFH A B10 FINAL 07/12/93 JFH A 93-12597-E 2,500 93-9242-P 3,000 93-8676-H 3,000 Total Est Value 73,500 Dwelling 1,398 51,977.64 Basement 977 9,721. 15 Garage 264 3,102.00 Smoke Det 3 225.00 BOCA Value 73.479. 14 Difference 20.86) a_ CERTIFICATE OF OCCUPANCY CHECK LIST Appll cantclark Realty, Inc Certificate of Occupancy Address Bldg. Permit No. 20560 _ Lot No.Date Reviewed Project Reviewed By Date submitted proved/ S As required in the Zoning n n 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: Anpro ed De- N/A 1 . Approved building permit plan. 2 . Finish crading per zperoved bu i king pe-gini t plan.- 3 . Site i .e . trees, sh-u Ds , dumcsters, required par- ng, 4 . lit i l i tv location ca.,i tary sewer b. f ounda ticn drain C . ejectr, cal & telephone C . water e . c-her a rr• 5 . Sewer connec-t-ion Charce paid. r0 rlae CertfC " On6 . ii 7 . Fonding 8 . Planning & Zoning Sewer Permit No. Pavement Excavation No. COMMENTS: BUILDING PERMIT CHECK LIST Applicantealty, Building Permit; No. ' d• Address aine T T Date Submitted 4/3 0/9 3 m. ) Lot No. 4?1 Rar•kwpl 1 r;t , Reviewed by49 Project gedfield SubdivisionDate JI l In accordance with the Subdivision Regulations, prior to the building of any structure on a lot, a Topographic Plot Plan shall be submitted for approval. The minimum requirements shall include : Approved Denied N/A 1. Name, address & phone number of owner/ applicant. UAA _ 2. Name, address & phone number of plan preparer. 3. Zoning information - i.e. zone, open space, floodway, etc. ZO i 4 . Plot plan at 1" = 46-' scale. a. Subdivision reference, abutting properties, etc. b. Easements of r ec-ord. c. Lot description, bearings, distances, building lines, area, etc. d. Contours, existing & proposed, 1 or 2 ft. interval where appropriate. e. Building location with dimensions. Elevations of proposed finish floor, garage floor & center line of road at driveway.S&z c4w.7 0"211t *Zz For, F-F. f. Elevations nage systems, sanitary & oundation drai at the house and the eut. .AR Lo"L g. Tentative utility location gas, electric, water, etc. h. Title block with name and address of preparer, date appropriate certification, live seal and signature. 5 . Sedimentation and erosion control. 6. Special Planning & Zoning, Inland/Wetlands considerations. (Plans on file w/Town Clerk) BUILDING DEPT. ZZ - C-i'ev, PZC IWA/CC WPCA OTHERS EN T S: 2 S n T yvc PIxT rZA= 1ceMW 7b ae ZVI^4& eK-%'C- ?b C. e F 0 , PERMIT DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT 5 4 Application is hereby: TOWN OF SOUTH WINDSOR BUILDING INSPECTION DEPT. APPROVED ISAPPROV 1540 SULLIVAN AVENUE 644-2511 Ext. 230 Date Building Inspector Application must be printed or typed 1. LOCATION OF JOB FEE SCHEDULE No . Street 0 - $19000 - 10.00 Floor Apt . No. Over $1,000 - 10.00 2 . OWNER per $1 ,000 or LT fraction thereof p z 3. ADDRESS 1a59CT-I 4. APPLICANT p p S. ADDRESS PD. C E r A-)C)&),0 Cen bCp C-0 6. ESTIMATED COST $ 7 . IS THIS A CONTRACT COST Yes No 8. FEE ENCLOSED $ 3D, aj 9. TYP OF BUILDI G : RESIDENTIAL COMMERCIAL 10. TYPE OF JOB: i/ Original Installation Alteration/Addition/Repair BD 3A 11/88 APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side) 11. LOCATION OF JOB kp-L qa bctw ELL-. NO. STREET APT. NO , 12 . TYPE OF INSTALLATION QS,j,'I CL",` 13 . SIZE OF MAIN FEEDER j 14. NO. OF LIGHT LOOPS 15 . NO. OF HEAT LOOPS_ 16. NO. OF POWER LOOPS 17 . NO . OF LIGHT OUTLETS 18 . NO. OF HEAT CIRCUITS 19. NO. OF POWER OUTLETS_ 20. NO. OF CONVENIENCE OUTLETS 21. NO. OF HEAT CIRCUITS 1 22. NO. OF POWER CIRCUITS 23. NO. OF LIGHT CIRCUITS 24. SIZE OF HEAT CIRCUITS_I)! l 25 . NO. OF MOTORS 26 . NO. OF PANELS- 27 . TOTAL WATTAGE 1r0 28 . NO. OF POWER FEEDERS_ 29. NO. OF SWITCHES_ 30. A/C LOAD 31. SIZE OF POWER FEEDERS a C 32. NO. OF FIXTURES_ 33. TOTAL HORSEPOWER 34 . NAME OF SUBCONTRACTORS AND THEIR TRADES 35 . REMARKS AND FURTHER DETAILS : LICENSE NO. SIGNATUR F APPLICANT DATE PHONE NUMBER: (?;2' Lot No. Building Permit 9tic Temporary Service Permanent Service Pursuant to Permit No. This Certifies that the Electrical Work for which the above named Permit was granted has been duly inspected and is hereby approved. r Owner Electrician n Street Building Inspector PERMIT N0. DEPARTMENT DECISION A P P L I CAT I O N FOR Application is hereby: PLUMBING PERMIT TOWM OF SOUTH WIIvTDSOR APPROVED DISAPPROVED BUILDING INSPECTION DEPT. 644-2511 Ext. 230 ate Building -Inspector Application must be printed or typed. 1. LOCATION OF JOB: 4y FEE SCHEDULE 2. OWNER: 0 - $19000 -10.00 3. ADDRESS: Over $1 ,000 - 10.00 1T DGa741 per $1 ,0 0 0 or 4. APPLICANT:fraction thereof 5. ADDRESS: 2 GL GZ i Dl o 7Z 6. EST. COST: 7. IS THIS A CONTRACT COST?YES NO 8. FEE ENCLOSED: $ all OD 9. TYPE OF BUILDING: RESIDENTIAL COMMERCIAL 10. TYPE OF\JOB: ORIGINAL ALTERATION INSTALLATION ADDITION REPAID. BD 2A 11/88 APPLICATION FOR PLUMBING PERMIT (Cont. from Reverse Side) 11. LOCATION OF JOB: GENERAL PLUMBING 12. KIND OF INSTALLATION: 9'ta) 13. SIZE OF MAIN DRAIN 14. NO. OF TOILETS STYLE 15. NO. OF URINALS STYLE 16. NO. OF BATHTUBS 16A. NO. OF SHOWERS 17. NO. OF LAVATORIES 18. NO. OF SINKS 19. DISPOSAL 19A. DISWASHER 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 3 SEWER OR SEPTIC TANK? 31. SIZE OF WATER MAIN SIZES OF WATER PIPING & RISERS 32. REMARKS AND FURTHER DETAILS 2z. WATER HEATER 33. TYPE 6Z,4,J /V ' ( Q !e6o,I 34. MANUFACTURER TANKS SAFETY DEVICES TE11PERATURE 35. CAPACITY 39. RELIEF VALVE 36. TEST PRESSURE LBS. 40. MANUFACTURER 37. WORKING PRESSURE /Jr s LBS. 41. PRESSURE RELIEF VALVE A 38. TYPE 42. MANUFACTURER LICENSE NO. DATE SIGNATUR OF AP ICANT PHONE NO. FOR OFFICE USE ONLY APPLICATION FOR HVAC PERMIT DATE: G• NO. 7 ,- ) TOWN OF SOUTH WINDSOR EST.COST: BLDG. PERMIT NO. "t) 1540 SULLIVAN AVENUE FEE SOUTH WINDSOR, CT 06074 FEES: 644-2511 - Ext. 230 0 - $12000 - $10.00 1000 or fraction LOCATION OF BUILDING Q YoZ °/ LUj thereof - $10.00 OWNER ADDRESS TOWN PHONE NO. HVAC CONTRACTO ADDRE S TOWN PHONE NO. TYPE OF SYSTEM: HEATING TYPE OF BUILDING: RESIDENTIAL `O A/C COMMERCIAL VENTILATION BUSINESS INDUSTRIAL IF HEATING: STEAM LOW PRESSURE LIMIT LBS. HIGH PRESSURE LIMIT LBS. HYDRONIC WARM AIR UNIT RADIANT HEATER (INCLUDING WOOD/COAL BURNING STOVE) TYPE OF FUEL: OIL-GPM GAS IN-PUT/ , l/ ELECTRIC KW WOOD COAL OIL TANK - SIZE & LOCATION: INSIDE OUTSIDE CAPACITY LPG TANK - CAPACITY EXISTING RADIATION ADDITIONAL RADIATION TOTAL RADIATION DESIGN TEMP. OUTSIDE OF INSIDE OF DIFFERENCE OF TOTAL HEAT LOSS (BTUH) HEAT LOSS SHEET MUST ACCOMP4NY APPLICATION) DESCRIBE ALL HEATING EQUIPMENT (INCLUDING MAKE & MODEL NO.): ow-, aA el4d,-IMAZel GROSS HEATING CAPACITY (INPUT-BTUH) NET RATING (OUTPUT-BTUH)dcV,DD IF AIR CONDITIONING: DESIGN TEMP. OUTSIDE OF INSIDE OF DIFFERENCE F TOTAL HEAT GAIN (BTUH) HEAT GAIN SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL COOLING EQUIPMENT (INCLUDING MAKE & MODEL NO.): TONNAGE COOLING CAPACITY (BTUH) IF VENTILATION: DESCRIBE ALL AIR-HANDLING EQUIPMENT (INCLUDING KITCHEN EXHAUSE EQUIPMENT): TOTAL SIZE OF SYSTEM (CFM) FRESH AIR INTAKE (CFM) PLAN MUST ACCOMPANY APPLICATION) The undersigned hereby applies for a permit to perform the following work and is to comply with all local ordinances and State of Conn. Building Codes in the performance of such work. FURTHER DESCRIPTION OF WORK: Z4, -(--f STATE LICENSE - NAME & TYP It DATE ISICCNATURE PLICANT MI_ It <<-r APPROVED AT BD 4A 11/88 I as B ss R CALCULATION SHEET 1503 (Modern Method) Copyright 1977 by The Hydronics Institute OWNER ADDRESS DESIGN TEMPERATURE DIFFERENCE F. DATE COL.A COL.S COL.C COL.D COL.E COL.F COL.G 1 ROOM Q O H L W H L W H L W H L W H L W Design Water Temp. 2 ROOM DIMENSIONS, FT.U BTUH Per F of of 3 LENGTH EXPOSED WALLS, FT. Radiation Selected 4 WINDOW AND OUTSIDE DOOR AREA LL BTUH STUN STUN BTUH STUN 5 WALL CONSTRUCTION ROOM LIN.FT.OF Table 9,Line 3 x H) TOTALS RADIATION 6 TYPE OF GLASS FROM LINE 12 SELECTED Sott m f table used f r Line 5) 7 CEILING CONSTRUCTION C Table 9, L x W) g FLOOR CONSTRUCTIONt O Table 9, L x W or Lin Ft) E 9 COLD PARTITION CONSTRUCTION F Table 9, L x H)G 10 C 1 Wall(With Openings) 0 H 2 Wells(With Openings) D J 3 Wells(With Openings) or Ent.Hall 1 J 11 TOTAL BTUH AT 70F TEMP DIFFERENCE' 12 TOTAL BTUH AT DESIGN TEMP. DIFFERENCE K COL.A _ __-- —_ COL.B COL.H COL.1 COL_) COL.K COL.L TOTAL BTUH TOTAL OF BUILDING RADIATIONiROOMATSELECTED O H L W H I L W H L W H I L I W H L W DESIGN TEMP.* 2 ROOM DIMENSIONS. FT DIFFERENCE U 3 LENGTH EXPOSED WALLS, FT Q 4 WINDOW AND OUTSIDE DOOR AREA LL STUN STUN BTUH BTUH BTUH 5 WALL CONSTRUCTION INCREASE BATHROOM Table 9,Llns 3 x H) TOTAL 20% 6 TYPE OF GLASS Gott m of table used for Line 5) IFOR CONCRETE FLOOR ON7CEILINGCONSTRUCTIONGROUNDORFILLATTable9, L x W)GRADE LEVEL,USE LINEAR B FLOOR CONSTRUCTIONt FEET OF EXPOSED EDGE Table 9,L x W or Lin Ft.) 9 COLD PARTITION CONSTRUCTION Table 9,L x H) 10 1 Wall(With Openings) O 2 Walls(With Openings) D X 3 Wells(With Openings)or Ent Hall 11 TOTAL BTUH AT 70F TEMP DIFFERENCE' 12 TOTAL BTUH AT DESIGN TEMP DIFFERENCE This form is available from The Berkeley FORM 1503HdronicsInstitute,36 Russ Place,v y Heights,N J 07922 F W WEBB COMPONY 1BR J IL IB 1\4 t i -ItI--' jui'. t_ucHFicji,j :Souft-i tv I-IA w L:.LA LA r_JJNT,4411,_ ftj,d L.L E i P1:4 E D by :F PINJU JULA kElelfl"Kc) bli"IING Hm i -`A _L =14 ct 4 'D t L I v f ri 6 R il 13. 0I/j 6 X i A 3 ;1 3 LOV 4. Vj Q1 a x 3 x tj c 79. f4l W 4 K I I*CHEi\j J. 01-1 A 1 J,x I IJ j FiDkM 6. 00 6X 13A 17 n,j_v,,_,. 'S- L 0 T 7. 'itv] 1X 4 X 'JI IlA fil. 414 7 k S-1 E_k EIATH 6. w Y-1 6 x I Ox b l b Z:j ILII. hi b R m IV). 4 b. ,6 ri. 1. QI V-1 ax t+ o. 3 7603. 6 1 10 BI-IJ COLCULOFfONS HAVE BEEN fiNCREA',oED 214IN TO i-40-OW FOit Hic__t4f U,f DIPIENS10NAL DATA SU. FT SU. f-T SU. F-f SCSI. FT CU. FT 6U. k-T WALL GLASS EXP CEIL X P F I-R VOLUPli=I-I V. f)I-REI-4 144 46 0 0 1162 144 2s 1415 19 0 0 1—:1286 3 34 141 00 J i+ l 66 Z._j 2:1 16 24 0 ad Vj 7 9 164 12 121 ILt 1-7 1 li:.,I I a 24 14 IS 0 1 14 4 143 T sOIAL-b 1349 7 0 v 6 1 Ic3i 13 Yt J A F I.033 5 1)A TA M. 4 WALL L 0'C3'S 6 L A5 CE I L I N(73 FLOOR b f u I I IJ 8. IJ0 2 13 4. 0 Q1 Q1 V-1 J. Q10 14 I'J J.2 3 1410 12, 3. 0. 0111 4oe, 4 116112. V-10 4'1-j:J. 00 o 0 0 C-16,/Y. wo 5 151i2. 00 10 912. lit 0 IY 0 1 Y 141 1 1. lej la G 33.3. !-IF.3 1 0 1c)a. w0 46. 0124 1 il-i4. IJ 0 CA. 00 10%:',0. 40 o. 1110 too_. 44,41 V.1 4V_1 %J 1u L 4L,0. 00 52 7. 6O b.6. vib 0. o1z, b. 69 1474. 37 9 114S. 00 t 46. 10 931. 70 0. I!_O 1-.1,). 66 fib 1 L/i 1 176. Q-10 1 QlL)L'. kIili 1 101. 10 ki. kiwi 144 J . 44 4&..t k1. 154 TOTALS y 5 1 00 10363. 1 W 4 7%-5-6. 56 1'965, C)3 376 61 THL= NVERAGE BTU PER SCE!. FT. OF LIVINC3 AREA IS 31. 66 1 Hf_ HVLRAl3E:= B-1 U PIER CU. FT. OF L1 V ING Akc.A 1S 25. 96 F Ht: FCJR i U:.:')'CI) IN CALCULA T ION B-f U\F T F ACTOk 4# WHL-L 6 LA S` CE I L I N(.3 F LCJ0h' I NF I LT. OU T},u i TEftli= L. k1 0 0. 1121 0. 6 55 k1. 1 1 kI. k19 ILA. 1 6 600 70 3. 00 W. 10 I1I. 6b W. 11 k1. V y 0. L I 600 71[1 4. 00 k1. I(A 0. 65 CA. 11 0. 09 0. 12 6ktO 70 5. kilo 0. 10 0. 65 0. 11 0. 09 0. 16 coo 116 6. k1k, 0. 1 k1 0. 65 0. 11 0. 09 lip. 16 600 70 1. 00 0. 10 0. 65 0. 11 0. 09 0. 1 L: 600 7L1 6. 00 0. 1 kl k). 65 ki. 11 0. V19 W. 1 L_ 60CA 70 S. OV-1 0. 1 k1 k1. 65 kl. 11 0. lil9 0. 1 al., 600 70 10. 012, k1. 10 0. 65 0. 11 0. Q19 0. lb 6 k10 70 1 0 0. 1 b 6 Ql0 7 k1 FINAL INSPEC 10 Building APPLICATION FOR BUILDING PERMIT Plumbin HVAC Date: Sprinkler 21 ROCKWELL COURT Electric Estimated Cost $ ro W Zoning Permit Fee$ 'ro 216 2 2AffidavitNO.Occupancy Fee $ Eng. Dept.COMPLETE RED BOXED AREAS.Fire Dept.TYPE OR PRINT ONLY Total Fees l0 Health Dept. SIGN ON REVERSE SIDE.Approved for CO: Additional Cost) $ TO BUILDING DEPARTMENT, TOWN OF SOUTH WINDSOR, CT The undersigned, hereby applies to do work according to the following specifications: Job Location DO&M% WJ#40YAA Lot No. Side of Street cZlone6'Applicant A'A Tel. # 6(1 -7 3-7 Address 20) yfi'T Sr. yV"4V$*A 47 Zip 404461Y" Lic.# STREET CITY STATE Owner +w ,'C' Address Va^04 ' Architect Address Size New Area: Ft. Front Overall Ft. Deep Overall Total Area Garages Size of Lot Dist. from Street Line Lavatories_. Bathrooms Rooms 1 st 2nd 3rd Purpose of this Permit 4=nA2 'l'.L ',= ? epIg' ,' Ir ' W G C 'Po City Water 19 Well 0 Septic 0 Sewer Use Grou Construction Type <"J' Approved by Date 7 1T / BD1A 11/88 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 th Building Inspector of any alteration in the plans or specifications of the Building for which this p rmit 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 a zone in which this building and its use is allowed. Sign I hereby apply for a Certificate of Occupancy for the work described in this ap I ation for p mit. Signed- DO Nor WRITE BELOW THIS LINE— INSPECTION RECORD Footing Framing Foundation Fireplace/Chimney Insulation Plumbing Permit# Inspections: HVAC Permit# Inspections: Electrical Permit# Inspections: Sprinkler Permit# Inspections: Inspection / Approval Date By Appl Code Description Due Whom Code Comment 94-21622-B 1'000 B10 FINAL 11/03/94 JFH A 4'HIGH Total Est Value 1 '000 c i l s 1540 SULLIVAN AVENUE SOUTH WINDSOR, CONN. 06074 AREA CODE 203/644-2511 Octo er 28, 1994 Certified Mail Z 262 395 707 John Grady 21 Rockwell Court South Windsor, Ct. 06074 RE: Building Permit #21622 Dear Mr. Grady: It has been 3 months since our office issued a stop work order for your retaining wall. A permit was issued on July 15, 1994 at that time we explained to you what you would need to do to remedy the problems with the wall . We have not heard from you since. A Caveat will be placed in the land records five days after you receive this letter stating that an unsafe condition exists on your property. If the repairs have been done and we are shown proof of the repairs this will not be necessary. At this time I urge you to contact the Building Department at your earliest convenience. We are in the office Monday thru Friday 7 :30 to 9:00 am. and 12:30 to 2:00 PM. Very truly yours, ohn F. Hogan Building Official 644-2511 ext. 232 enclosures UNITED STATES POSTAL SERVICE Official Business PENALTY FOR PRIVATE USE TO AVOID PAYMENT U,S MAIL OF POSTAGE,$300 Print your name, address and ZIP Code here South Windsor Town Hall Mr. John Hogan 1540 Sullivan Avenue South Windsor, CT 06074 ram. SENDER: ti0 Complete items 1 and/or 2 for additional services.I also wish to receive the Complete items 3,and 4a&b. following services (for an extra vi • Print your name and address on the reverse of this form so that we can fee): d return this card to you. Attach this form to the front of the madplece,or on the back if space 1. Addressee's Address does not permit. t • Write"Return Receipt Requested"on the mailpiece below the article number. Q.2. Restricted DeliveryTheReturnReceiptwillshowtowhomthearticlewasdeliveredandthedate V c delivered. Consult postmaster for fee. o 3. Article Addressed to: 4a. Article Number Mr. John Grady Z 262 395 707 16. a 21 Rockwell COUr Service TypeE 0 SO. Windsor, CT egistered El insured a rtified COD W E press Mail Return Receipt for .5 cc Merchandise 0 74,,., to of Delivery a o 5. Si at ( d ee) 9 Addressee's Address (Only if requested and fee is paid) t 6. Si ture (Ag nt) F' L 3 yPS rm 3811, December 1991 *U.S.GPO:1993-352-714 DOMESTIC RETURN RECEIPT