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HomeMy WebLinkAbout24 Fitch Meadow LaneElectric# 2 4 FITCH MEADOWLLCATION FOR BUILDING PERMITPlumbing# HVAC # wFOUND4 ';QW ONLY Date. l 0 9 6 Sprinkler# HNAL APPROV Is Building a /' A f Estimated Cost 3 coo, COMPLETE RED BOXED AREAS Permit Fee 30,Engineering l Affidavit TYPE OR PRINT ONLY Occupancy Fee $ Appr.for CO. SIGN ON REVERSE SIDE Total Fee 30, -' TO BUILDING DEPARTMENT, TOWN OF SOUTH WINDSOR,CT Additional Cost) $ Th undersigned hereby applies to do work according to the following specifications: Job Location '2 4-M e_A v w L s,,P z Lot No. 4- Side of Street Zone Applicant e,-e' Dc v.to P s ;7M A a s e R AD ?. Tel. # G 4A 4— Z /s Address J 5,4.E ri,g Piz ,,i t S. LJiN=x o 2. ZjpQ 6 07¢ Lic. # Owner --5 a m-e— Address Architect Address Sq. Ft.New Area: 1st FI. 2nd Fl. 3rd Ff Total New Area Rooms Lavatories Bathrooms Garages Purpose of this permit: Fa 011 j-v T t 0 0 O,01 S/A o 2.o 4m/e. C Ca City Water Well Septic System Se Use Group Construction Type 9JIft Area Basem t Approved by fi Date Revisal 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 Building for which this permit is asked, and agree that this building is to be located the proper distance from all street Imes,side yard lines and required distances from all other zones and is located in a zone in which this building and its use is lowed. Signed 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 Electric# y?APPLICATION FOR BUILDING PERMIT Plumbing# Q 1 24 F I TCH MET.DOW LANE pate:HVAC # 4?-Gi No 23944 Sprinkler# FINAL APPR V lS Estimated Cost $ Building COMPLETE RED BOXED AREAS Permit Fee Engineering Z? TYPE OR PRINT ONLY Occupancy Fee $ Affidavit SIGN ON REVERSE SIDE Appr.for Co. S Total Fee 4 TO BUILDING DEPARTMENT, TOWN OF SOUTH WINDSOR,CT Additional Cost) $ i6im Th undersigned hereby applies to do work according to the following specifications: ob Location ' -1 fG r-A o w L-r> e, Lot No. Side of Street Zone Applicant +C I P s M A 2 s R+ j s s Tel. # i! -+4.,c Address -rY S N 4AA 7D n N- s, c-31 a s Zip o 6 o-7+ Lic. # Owner S A"-c_. Address Arekiteet y -D Is12J 3sAddress ) c, 6 r=C-'j *- r+•a*,M n..c sf'E - Sq. Ft.New Area: 1st Fl. -7.3 a 2nd Fl. -7ag. 3rd FI. Total New Area 1 Rooms Lavatories I'-'Bathrooms Garages I G A 1p e t- Purpose of this permit: Iei1l e- 4 rY r,"o, e 2 ca I Pt.a.e S s - ' t' r -1 3 K J/ifk-City Water Well Septic System Se Use Group Construction Type 1513Area /if Basem nt Approved by Date Rwvs.d 61 5 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 a zone in which this building and its use is allowed i Signed 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 Location of Job: AFFIDAVIT Additional Fee'S 3 0 0 . 0 0 State of Connecticut ss.South Windsor County of Hartford l Owner I / A 'A a S w of MA 2 s - I:ote,%PP;WAgent for the building erected Contractor under Permit No. 23944 issued by the Building Department of the Town of South Windsor being ly sworn,make oath and say that the actual cost of the completed work authorized under said permit did notCDteedthemostcurrentacceptedBOCAvalueofS70, 3 5 6 . 00 . Signe0 Subcribed and sworn to before me this jV<-sx day of A.D. 19,,,_ Z saedCostS 4r, F700 . 00 nce S 24 , 656 . 00 Qtary bl' Inspection / Approval Date By Appl Code Description Due Whom Code Comment 96-23944-B 35,000 P02 UNDERGROUND 02/27/97 JFH D NOT READY P02 UNDERGROUND 02/28/97 JRC A P03 ROUGH 03/31/97 JFH A E03 ROUGH 04/02/97 JFF A PO4 GAS TEST 08/22/97 JFH A B10 FINAL 05/18/98 DCJ A APPROVED FOR CO & CLOSEOUT 97-9901-P 3,000 97-9712-H 3,000 97-14296-E 1,700 Fob) Total Est Value 42,700 Dwelling 1,436 58,761.12 Basement 0 0.00 Garage 240 2,976.00 Smoke Det 7 525.00 BOCA Value 70,356.20' Difference a 4.rr. t 14 s 1*40 SITE COMPLIANCE CHECKLIST TOWN of SOUTH WINDSOR, CONNECTICUT a Z7 81 24 FITCH MEADOW LANE LOT_# 4 Reviewed By d4l Engineeri C & C DEVELOPERS/MARSH ENT Date Reviewed Approved enie 55 SANDRA DRIVE,SOUTH WINDSOR,CT Reviewed By 1 ing) BP_# 23944_ Ph_##_(860)644-2815 Date Review d'Z pro /Denied Date Submitted 00/0 00 R C le 41-2-7-9g As required in the Zoning and/or Subdivison 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: Approve Denied N/A 1. Approved building permit plan 2. Finish grading per approved building permit plan 3. Site work; i.e. trees, shrubs, dumpsters, required parking 4. Utility location; a. sanitary sewer/septic system b. foundation drain c. electrical & telephone d. water e. other V 5. Sewer connection charge paid 6. Appropriate certification 7. Bonding 8. Planning & Zoning/ Inland Wetlands Considerations Sewer Permit No. Y4W 7 Z Pavement Excavation No. COMMENTS: 4&;;d rC N u rJ r ISCANr4EDI SITE COMPLIANCE CHECKLIST TOWN of SOUTH WINDSOR, CONNECTICUT 24 FITCH MEADOW LANE LOT_## 4 Reviewed By _ Engineering) C & C DEVELOPERS/MARSH ENT Date Reviewed o ,s— rove enied 55 SANDRA DRIVE,SOUTH WINDSOR,CT Reviewed By Planning) BP_##_23732_ Ph_##_(860)644-2815 Date Reviewe a 7 9(, Approved/Denied Date Submitted 10/10/96 FOR BUIIL15ING PERMIT ***** rzjaN p>,q to All Y In accordance with the Zoning and/or 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 2. Name, address & phone number of plan preparer 3 . Zoning Information - i.e. zone, open space, floodway, etc. 4. Plot Plan at 1" = 40' scale a. Subdivision reference, abutting properties, etc b. Easements of record Af C. Lot description, bearings, building lines, distances, 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 & centerline of road at driveway f. Elevations of gravity drainage systems, sanitary foundation drain at the house and the street g. Tentative utility location (gas, water, electric, septic system, etc.) h. Title block with name and address of preparer, date, appropriate certification, live seal and live signature consistent with the Board of Registration requirements. (P.E. & L.S.) 5. Sedimentation and erosion control 6. Special Planning & Zoning, Inland/Wetlands considerations (Plans on file w/Town Clerk) COMMENTS: N N DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT PERMIT Application is hereby: TOWN of SOUTH WINDSOR BUILDING DEPARTMENT Bldg,P 40#APPROVED 1540 SULLIVAN AVENUE In 644-2511 ext. 230 LU zDatwildingInspector Application must be printed or typed z Location ofjob Street No. Street Lot No. FEE SCHEDULE 0 - $1,000 - $12.00 Floor Apt. No. Over $1,000 12.00 per$1,000 OWNER or any fraction thereof ADDRESS OHO 7 OWNERS PHONE APPLICANL1 iYJI G. '0A.9 OWN 8,0 ADDRESS 17 e- C-20 ESTIMATED COST$ 1 2 IS THIS A CONTRACT COST? YES NO FEE ENCLOSED $4 OR-Co TYPE OF JOB: Original Installation Alteration/Addition Repair Revised 11/95 APPLICATION FOR ELECTRICAL PERMIT(Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATE H 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) mmmma TYPE OF INSTALLATION/WIRING METHOD 1\ SIZE OF MAIN FEEDERS AND RATING OF WIRE USED /Q 0 iq NUMBER OF METERS r NUMBER OF DISCONNECTS AND RATINGS NUMBER OF PANELS l REMOTE DISCONNECT REQUIRED?YES/NO NUMBER OF LIGHT CIRCUITS 9' NUMBER OF POWER CIRCUITS NUMBER OF SWITCHES ICv NUMBER OF OUTLETS cP NUMBER OF LIGHT FIXTURES IY NUMBER OF HEAT CIRCUITS NUMBER OF A/C CIRCUITS SEPERATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED. DESCRIPTION OF WORK 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 THE PERFORMANCE OF SUCH WODV NAME STATE LICENSE NO. TYPE SIGNATURE OF APPLICANT PHONE NO. DATE T----_- s mat *-s+_- INSPECTOR DATE TIME LOCATION 6T INSPECTION: CODE: RESULT(D/A) : BUILDING: ELECTRICAL: PLUMBING: HVAC: r t OTHER: k- sca- DEPARTMENT DECISION PVNRMT# APPLICATION FOR PLUMBING PERMIT 4!101 Application is hereby: TOWN of SOUTH WINDSOR UJBUILDINGDEPARTMENTBidF # AP PRO 1540 SULLIVAN AVENUE z 644-2511 ext. 23)0 ul7z Date Building Inspector Application must be printed or typed 0 Location ofjob Street No. Street Lot No. FEE SCHEDULE Floor Apt. No. 0 - $1,000 - $12.00 Over $1,000 12.00 per$1,000 Of OWNER ''-.v or any fraction thereof ADDRESS t J/ - OWNERS PHONE# APPLICANT 1-lve:: OWN ADDRESS 00XAA4 ESTIMATED COST$ IS THIS A CONTRACT COST? VIA YES NO wool CI FEE ENCLOSED $ OR-CO E OF JOB:Voriganal Installation Alteration/Addition Repair Revised 10/96 APPLICATION FOR PLUMBING PERMIT(Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A BUILDING PERMIT APPLICATION YES / NO RESIDENTIAL BUSINESS CURRENT USE AND OCCUPANCYASSEMBLY MERCANTILE FUTURE USE AND OCCUPANCYEDUCATIONAL INSTITUTION FACTORY ENGINEER'S NAME PHONE STORAGE GARAGE ADDRESS MIXED USE CITY STATE ZIP Other please specify) TYPE OF INSTALLATION A/e7vv SIZE OF MAIN DRAIN NO. OF TOILETS STYLE OF URINALS --_ STYLE NO. OF BATHTUBS_ NO. OF SHOWERS NO. OF LAVATORIES NO. OF CONDUCTORS' SIZE NO.OF STACKS SIZE `? AREA OF ROOF --' NO. OF CATCH BASINS NO.OF FLOOR DRAINS NO. OF OTHER FIXTURES KIND ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW YES/NO SIZE OF WINDOW IF NONE C.F.M. OF VENTILATOR SIZE OF DUCTS SEWER OR SEPTIC TANK SIZE OF WATER MAIN SIZE OF WATER PIPING&RISER WATER HEATER TYPE MANUFACTURE TANKS SAFETY DEVICES TEMPERATURE CAPACITY RELIEF VALVE O TEST PRESSUR>;,ORKING PRESS PRESSURE RELIEF VALVE 2 TYPE MANUFACTURER DESCRIPTION OF WORK 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 CODE PERFORMANCE OF SUCH WORK.. NAME STAIALICENSE O E SIGNMURE OF AP ICANT PHONE NO. DATE --` DEPARTMENT DECISION PERNUzAPPLICATIONFORHVACPERMIT Application is hereby: TOWN of SOUTH WINDSOR BUILDING DEPARTMENT BldIld AFPR0 1540 SULLIVAN AVENUE 644-2511 ext. 230 Date Building Inspector Application must be printed or typed Location ofjob 41p/ Street No. Street Lot No. FEE SCHEDULE Floor Apt.No. 0 - $1,000 - $12.00 Over $1,000 12.00 per$1,000 OWNER or any fraction thereof 4ADDRESSSAW-4 aW OWNERS PHONE# APPLICANT 111,11,11111 1 st ADDRESS 01 OC ESTIMATED COST $ IS THIS A CONTRACT COST? S NO FEE ENCLOSED k6 FOR-CO KTYPE OF JOB: Original Installation Alteration/Addition Repair Revised 11/95 APPLICATION FOR HVAC PERMIT(Continued from reverse side) TYPE OF SYSTEM YPE 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) DESCRIBE ALL HEATING EQUIPMENT (INCLUDING MAKE&MODEL NO. 4 S a o 59,4 9 GROSS HEATING CAPACITY INP-BTUH)NE'Olr//RIWNG (OUTPUT-BTUH) TYPE OF FUEL OIL-GPM GA -INPUT OGV ELECTRIC-KW OIL NK 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.) 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 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 TIRE PERFORMANCE OF SUCH WORK. TATE LICENSE-NO. NAME&TYPE 1916&A E OF APPLICANT PHONE NO. - f DATE o l CD ARGO CALCULATION SHEET W R C tJ P_ ice` A C9 L DATEOWNERADDRESS DEALER— J KIND OF BUILDING CHIMNEY SIZE CONSTRUCTION. WALL. WINDOWS ROOF OR CEILING RASEMENT HEIGHT ABOVE GRADE BELOW GRADE DESIGN WATER TEMPERATURE DESIGN TEMP. DOFF COL.1 2 3 4 S d 7 + $ 9 10 it 12 13 14 tS 16 17 is vvINsows AREA-50. FT. rvluwt NASINCAMOSROOMSIZEitoow A«o a0ows tltt NOTiI Cu.rT-TOTAL* cowwce•ce wAiEt LENGTH ROOM Nur![w GROSi GLASS NET WALL GLIL-1NG IQ TrM*. o Q 11"r AA Q-511-1 uLWHo. AnEA WALL OMB- tt S LcMfSGUZSaleiJ7I ` ramp DOFF. IT. 0in 1 kG00- o2 Q 0 3 s . 6' POO co ix, 3 C r v o oCO e y 71 ILO 7 16 L1300 tooQ '3 fiu 20c oc 900 o37&749 te c 9,6 Cl s 6 't, I F I i'a 13 Cho AZ 31 2 lam, oa o o Dap d ar U/ Z22 179. 3 NOTW-- Pan CO.0 CTK BOOR OM 400- 00 FILL AT RAaK LKVKM.rx LINKAO W99T OI LXPOSCD Kama,TOTALS OWOOALLOVNCMFL0010USKSOVARMV=ff a ARIA. Sectric# -/&404 24 FI'PCH MEP,D APPLICATION FOR BUILDING PERMIT Plumbing# 1,6430V LANE WAC # 26363 Date: Sprinkler# NO• I ima sf Builcli COMPLETE RED BOXED AREAS Permit Fee i TYPE OR PRINT ONLY Occupancy Fee S Affidavit SIGN ON REVERSE SIDEAppr.for CO. 3 Total Fee TO BULDM WARTMIM,TOWN OF SOUTH WNDSOR,CT Additional Cost) $ The undersigned hereby applies to do work according to the following specifications: Job Location Lot No. Side of Street Zone Applicant Tel# 14/1 V2- Address Y09 .CAtj 9,fMV-Ab 690 9S7 Zip Lic.# s5W0.2, OwnerIiy2lk1A22&a9QJ Address y Architect Address Sq.Ft.New Area: 1st FI. 2nd FI. 3rd Fl. Total New Area Rooms Lavatories Bathrooms Garages Purpos of this permit: &PPS LLSt I&gd M2?1gp &P 0. City Water Septic System Sew Ins. H.O. A . Cert. Area BasementkoApprovedbyDate `7 Z7 9 Use Group 4 7 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 ilding nd its u s allow . Signed I hereby apply for a Certificate of Occu r th work d i application for the permit. Signed DO NOT WRITE BELOW IS LINE INSPECTION COMMENTS Inspection / Approval Date By Appl Code Description Due Whom Code Comment 99-26363-B 2,000 B03 FRAMING (ROUGH)07/30/99 RAN A E03 ROUGH 07/30/99 RAN A P03 ROUGH 07/30/99 RAN A B10 FINAL 03/08/00 JFF A WITH OWNER B10 FINAL 03/08/00 JRC A CLOSED OUT 99-16404-E 400 99-10430-P 6,400 Total Est Value 8,800 i M DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT PERK UT# Application is hereby: TOWN of SOUTH WINDSOR BUILDING DEPARTMENT BldFrmit# J APPROVED 1540 SULLIVAN AVENUE 644-2511 ext. 230 Date lding Inspector Application must be printed or typed Q Location ofjob d Iri 7 e6Z.w" w Street No. Street Lot No. FEE SCHEDULE Floor Apt. No. 0 - $1,000 - $12.00 Over $1,000 12.00 per$1,000 C or any fraction thereof OWNER c ADDRESS J A,0 OWNERS PHONE# G J APPLICANT 1,218 nJ OVI N S f ADDRESS ej 4ge,. Op CIO)ESTIMATED COST$ C - IS THIS A CONTRACT COST? YES NO wC FEE ENCLOSED $ e>4 TYPE OF JOB:SO R.C Original Installation Alteration/Addition/Repair Revised 10/96 r APPLICATION FOR PLUMBING PERMIT(Continued from reverse side) TYPE BUILDING IS THIS APPLICATION ASSOCIATED WITH A BUILDING PERMIT APPLICATION YES / NO RESIDENTIAL BUSINESS CURRENT USE AND OCCUPANCYASSEMBLY MERCANTILE FUTURE USE AND OCCUPANCYEDUCATIONAL INSTITUTION FACTORY ENGINEER'S NAME PHONE STORAGE GARAGE ADDRESS MIXED USE CITY STATE ZIP Other please specify) TYPE OF INSTALLATION I ,rit SIZE OF MAIN DRAIN NO. OF TOILETS STYLE NO. OF URINALS STYLE NO. OF BATHTUBS V _NO. OF SHOWERS^ NO. OF LAVATORIES NO. OF CONDUCTORS SIZE NO. OF STACKS SIZE AREA OF ROOF NO. OF CATCH BASINS NO. OF FLOOR DRAINS NO. OF OTHER FIXTURES KIND ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW YES/NO SIZE OF WINDOW IF NONE C.F.M. OF VENTILATOR SIZE OF DUCTS SEWER OR SEPTIC TANK SIZE OF WATER MAIN SIZE OF WATER PIPING&RISER WATER HEATER TYPE GW MANUFACTURE Sm TANKS SAFETY DEVICES TEMPERATURE o CAPACITY RELIEF VALVE TEST PRESSURF/O"' WORKING PRESSURE <F0 PRESSURE RELIEF VALVE TYPE MANUFACTURER l 44T DESCRIPTION OF WORK 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 THE PERFORMANCE OF SUCH WORK c?voy-220 zg/(7 NAME STATE LICENSE NO. TYPE SIGNATURE OF 40FLICANT PHONE NO.G 25— DATE o' p DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT P Application is hereby: TOWN of SOUTH WINDSOR BUILDING DEPARTMENT Bl Permit# APPROVED 1540 SULLIVAN AVENUE 76 //////644-2511 ext.230 q9 dP Date iding Inspector Application must be printed or typed Location ofjob C/Fi Street No. Street Lot No. FEE SCHEDULE r-- Floor Apt.No. 0 - $1,000 - $12.00 f Over $1,000 12.00 per$1,000 or any fraction thereof ADDRESS 7`r el lnfAt-mow L T Zl-(/.,t©saw 6,40 7 OWNERS PHONE# pld 33 APPLICANT D A 0* ADDRESS w 46 q4( S oAwo 7 G •: ::::: ESTIMATED COST$ DD 400 C IS THIS A CONTRACT COST? YES NO f*41V F C! FEE ENCLOSED $ Z = 0 TYPE OF JOB: Z OR C Original Installation Alteration/Addition/Repair Revised 11/95 Q APPLICATION FOR ELECTRICAL PERMIT(Continued from reverse side) TYPE OF BUILDING p IS THIS APPLICATION ASSOCIATE= NO A RESIDENTIAL BUILDING PERMIT APPLICATION BUSINESS ASSEMBLY CURRENT USE AND OCCUPANCY MERCANTILE EDUCATIONAL FUTURE USE AND OCCUPANCY INSTITUTIONAL FACTORY STORAGE ENGINEER'S NAME PHONE GARAGE MIXED USE ADDRESS CITY STATE ZIP r` Other please specify) TYPE OF INSTALLATION/WIRING METHOD 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 Z-- NUMBER OF SWITCHES 2 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 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 PERFORMANCE OF SUCH WORK.5EI-4- 1r3 NAME STATE LICENSE NO. TYPE GNATURE OF APPLICANT PHONE NO.— DATE 7?