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Home My WebLink About2589 Ellington RoadApplication No. 4071 Permit No. 433.1 TO THE BUILDING INSPECTOR of the TOWN OF SOUTH WINDSOR, CONN. hereby make application for a permit to (erect (make alteration to) 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., 6. .. .................................. Sign here ................. .......4a."....... o. ......_.... Address Rt........... .I..l..... . .. f. ... .. fi.. Location? . .-FAST..................................................._............................side of? 5..4io.#-,..............JYA............................................. Nearest cross street? q..Street No. Lot No. ......z-'................ . Owner of land is?, aS7......I c;...f .^ 5...:.+i...m.-Address .--?W. ..................z Owner of building is? . l.1.. t ........(...!....................{.....................................I..t.. ...........Address ... ......................... Architect is? ... ..r.,l,.5.........r-Address .. e. . ................ ........ Builder is. . ..S7..... .i..1. -*Yi. .......................Address f;r 7' .......... ... Dimensions of building?3 c.... ..Fat front? ....L/.- L... .... Feet rear? .3.q.- ...... Feet deep? Extreme height to highest point of roof? ............off.)............. ... ...No. of stories in Purposeof building ta.1.2 ............................No. of stores. .............................................................. . ....... Howmany families? ............'t- ...'............._....................................No. of rooms? .... .................................................................................... Distance from street line is? .. .... ..... .......................................from building line is? ........ .................................................................... ADDITIONS AND ALTERATIONS Give Brief Description) d ENDO D SANIT RY OFFI ER IN ACCORDA N WITH TOWN OF Nlap,No.UTH W S R RDINAPJCE NO. 6 SA TARY OFFICER 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 Heitht Stories Front Walla Side Walls Rear Walls Partition Walla Basement, 1st Story 2nd " 3rd " 4th If 5th " I.............................. ............ .......................................... ................................................ 6th " 7th " I. ....... .............. ........................... 8th is 9th " 10th....... .... ... .. ............ .. I................. 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 JOISTS GMWE88 COLUMNS Floors Size Longest Span Centres Erldgft Size est Span Centres Size Lengtlt Centses 2nd a.....;..... .............. .................................. .................. ..................... _....._.. _..............._......_ 4 .... ..... ............. Distance on centres. r Size of outside studs? ....x.. Size of sill? Size of rafters? .-2.x.. ............. ... Distance on centres?.............1.Size of plate? G of 9 Size of ledgers or girts? ..°t' ..F. Size of deck rafters? .................................................................... ............... Distance on centres? ............. .......................... .........................................Size of studs in bearing partitions? .................................................. MISCELLANEOUS Style of roof, flat, pitch, Mansard, or hipped? . . J ` . ... . . ..................... .. FirPP !. ...... . Fireplaces? ......... Material of roof covering? Material of Cornice? ............ ....................P. . .......................... How is building heated? j``10 7' t,c,4 '?'.cry...........................Lining of flues. .. ..................`.:.....'........... ............ .............. Thickness of shell of flues? ..Any elevators or lifts?.................................................................. What kind? .................. .. ... ........... How many? ..... Any hoislrys? .................. How protected? Total Value of Building 0. ... .......................................... When will work be commenced. j 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 4071 BUILDING APPLICATION Application No. ... ...413.1................................................. East onthe .................................. . .... . .......... side of Ellincton Rd.Street. Street No, L-.).t 11'4`2 Yost Builders Inc.Owner Applicant Same.... .. .... CLASSIFICATION Dwellin- 24, '1416 Permit issued on above Application. 8-7-62 Date, 19 ..... TOWN OF SOUTH WINDSOR BUILDING PERMIT Date Aug•71,19 62 Fee Paid $7 2-.0 0 Est. Value 18,000 Permit 1r d 4071 on the East side of Ellington Rd. Street Lot #2 0;?S8?Street No. Owner Yost Builders Inc. Applicant Same i CERTIFICATE OF OCCUPANCY ISSUED: Date No.2439 Fee Paid 3.00 CLASSIFICATION Dwelling 24+x3419" BUILDING PERMIT N° 40'71 OFFICE OF THE BUILDING INSPECTOR of the Town of South Windsor, Conn. South Windsor, Conn. Aug*7. 19 62 T4io to to Terttf1j, That Yost Constr.Co. is hereby granted permission to Dwelling 24.1 x 3 4 16" at estimated value of la,000 on the Ea st side of Ell inFt on Rd. Lot #2 Street on land owned by Yost Builders Inc, Said Work to be as described in Application No. 4331 and to conform to specifications and plans filed with said Application, and Building By- Laws of THE TOWN OF SOUTH WINDSOR. Issued Aug.?' 1962 St.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." d 7PermitNo. TOWN OF SOUTH WINDSOR SOUTH WINDSOR, CONN. Permit NQ 2439 Certificate of Occupancy THIS IS TQPCERTIFY tbotethe _ at No.0 in the To of South Windsor, Connecticut, has been erected a completed in accordance with the Building Code and Zoning Regulations of the Town of South Windsor, and is hereby approved for occupancy. Building Inspector Owner, Builder Fee Paid Date 19 10 OPb NOTE: Leaching Field 8 0 1100 gal, septic tank 5 h 3 leaching trenches 3 ft. wide. Total pare area 500 sq. f t. Pere rate: 1" in 5. 3 min. 30 r nl et Zs is N V) r -JG ---I Q o it Z I b` if_ r ryl 4_3 1 II Rockvi/fie ELL //V &TON ROAD PLAN OF INDIVIDUAL DISPOSAL SYSTEM LOT #2 LAND OF YOST BUILDERS INC. SOUTH WINDSOR CONNECTICUT Scale 1" = 80i Certified substantially correct C44R- P.B. 1117 August 7, 1962 Rockville, Conn. FEE TO THE BUILDING DEPARTMENT Application No. TOWN OF SOUTH WINDSOR Date I hereby apply for permit to build a sewage disposal system for a Residence ,, boarding house, hotel , etc.) Owned by Vo0 i` !,,. :7' of And located at Lo? To be built by o S c s i of 27l 1 k7 y-, in accordance with detailed information stated below. Signed Applican GENERAL INFORMATION 1 . Estimated population of premises (present)future) 2. Description of premises (including number of bedrooms) 41- 3.,4r R ao No. Fixtures Above basement): Water Closets 2-Urinals Lavatories- Bathtubs Showers Kitchen Sinks r Laundry Tubs Garbage Grinder List basement fixtures "it 3. Water Supply a e-4-h 1% r— . Kind of Well Public, well , spring,, cistern) Location of well and underground water piping Method of obtaining or storing supply Pumps , tank, etc.) 4. Character of soil at proposed location of leaching system, including depths of various strata r sand, loam, clay, hardpan, rock, etc. --Use test pits.) 5. Elevation of highest ground water with reference to both present & future grade) s Description of proposed system (Furnish drawings of same , with plot plan showing system including location, size , grade and material of house sewer and locations of ground or surface water drains , wells and bodies of surface water.) Septic Tank Dimensions Capacity below flow line /J Inlet and outlet arrangements g'e - ( { Facilities for cleaning Distance from dwellings on same T property oZ y on adjoining property Automatic Dosing Apparatus , if any (describe) Soil Absorption System If cesspools , No. diameter ,3 ft.; depth below inlet 2--ft. If tile field or leaching trenches , total length is 1'K ft. Width of trenches -3 ft. , depth of broken stone or screened gravel 7- ft. Stone or gravel will be covered by Ste/ 1 Distance between tar paper, sali hay) trenches ft. Distance from water supply on same property on adjoining property Secondary Treatment, if other than soil absorption. Describe in detail and locate on map System was designed by Above information furnished by No discharge of sewage or sewage effluent into a watercourse should be permitted without approval of the State Department of Health and State Water Commission. 1575 OIL BURNER OR FUEL STORAGE APPLICATION Application No. 1586 Permit No. i575 on the d-s.7- side of A — Street Street No. L ot #2 Owner Application CLASSIFICATION American Std. PH5 Permit Issued on Above Application . Date Sept.12, 19 62 Fee Paid $ Permit ;4071 1 TOWN OF SOUTH WINDSOR APPLICATION TO INSTALL RANGE AND FUEL OIL BURNERS EQUIPMENT AND TANKS PERMIT N 1575 DATE v The undersigned hereby applies for a permit for the installation of range and fuel oil burners, equipment and tanks of the following description: Address Jea.,e 450'44Z 1st floor 2nd floor _ 3rd floor XCharacterofBuilding: Frame Brick Owner of Burner Yost ' 7 5 —Owner of Building b ` sr' Lessee or Tenant RANGE BURNERS Capacity of Tank at Range in cellar outside_ Name of Range Burner — Purchased from POWER BURNERS Name of Fuel Oil Burner_!o r/ Model Number Purchased from / d Name of Tank a S s L / Gauge of Tank !- Where is Tank Located --' r/"• Size of Tank Size of Motor a ` Size of Wire / Z Will other heating equipment be installed? If so, by whom Cc oe )30,z le Name of Party Making Installation A d c O_11 Address— Electrician L" 10, Address— loo`>— Signed APPLICANT All provisions of Ordinances of this Town Regulating Oil Burner Equipment and Fuel Storage (Sections 1-23 in- clusive) and Underwriters' Code applicable to the subject matter of same shall be complied with in execution of this work whether specified herein, or not. 9-12-62 Estimated Cost $ Application for Permit received and Permit No. 1575 issued 9—12—6 2 Permit ,`4071 A d `alter F.Mar!.:ett,Jr. Permit Fee Paid Approved BUILDING INSPECTOR 5655 5385 Application No. Permit No. TO THE BUILDING INSPECTOR of the TOWN OF SOUTH WINDSOR, CONN. b,-, . . hereby make application for a permit to (erect vte) a building according t 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, Connv,2f ...... //.......................... 196ts. Sign here AddressZ.///`/*""?00 Location? .... ,, /..7... ..e...................................................................side of? ...................................................................................................................... n) Nearest cross street? Street No. ........ .... ....... /.., Lot No. V Owner of land is?ve. . .... eel".e...............Address j..'.,Gl/.. ,1'... erof building is? ..r.C.. ...........................................Address ... ................................................................................................................ 3 ' Architect is? ................................................................................ ......................Address ................................................................................................................... Builder is f 66so ,. 1?Addrmv/.Ytif...,,,,t-........`..,1.!.....YVIZ156er........ ........... Dimensions of building? 4.2..5....Feet front? ... .. .. ......... Feet rear? ...R'l-........... Feet dap? .QZi..... .. .. Extreme height to highest point of roof? ....J.., .........(p...... ... .... .. No. of stories in height?......../... Purpose of building is?,;2".. .14,`ie..........No. of stores? .......................... ......................................................................... Howmany families? .........................................._..._...........of rooms? .... ................................................................................................ Distance from street line is? ...' ...f1...................................from building line is? .............. c....../.............................................. ADDITIONS AND ALTERATIONS Give Brief Description) 7 ` J /0.......e:::! -.Z........V;9`. 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 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 Walls Side Walls Rear Walls Partition Walls Basement, 1st Story 2nd is 3rd so r.............................................................................................. .................................................... ...................... ..... ...... ....... 4th 19 5th it 6th if I............................................ ............................................................................................................................ 7t.h is I.................................................................................................. .....I............................................ 8th Is 9th 11 I.............................. 10th.................................... ...................... ... ................ ................ ............. ....... .......... I ...... . .............I.............................. ........................ I Material.of Front? If stone, what kind? Thickness of Ashlar? Thickness of Backing? Backed up with what? I Arches or lintels over openings? WOOD CONSTRUCTION. Give Size, Longest Span and Distance Between Centres, of Joist:, Girders and Columns J01578 QIIiDEBB 00LUMM Floors She UnMt 8"n Gank" RrW*ft N" Lowe" 8"n Centres ffift xM4* Centres tat Moor 4 .....;;...... ....................................................... th JOr 41e Size of outside studs? '2*.-Y.................... Distance on centm? ....14............................... Size of sill? .2X.6....................... V ............r Size of rafters? Distance on centres?........111 e...' f............................ 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? ....... Material of roof covering? MaterialMaterial of Cornice? ....................................................................................... How is building heated? .....Lining of flues? ... ........................................................................... .............. Thickness of shell of flues? ......................................................................Any elevators or lifts? ............. 110.. ............................. ...................... Whatkind? .................................................. How many? ...... ... ..... . ............................... Any ho!71says. ....................ev........................ How protected.? . .... .. ................. ................................... .................Total Value of Building .... Whenwill work be commenced? 0 .0......................................................................................................................... ................. 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. Applicant 5385 BUILDING APPLICATION Application No. .................5....6..5.......5 onthe ................................................................................. Side of Ellington Rd* Street. Street No, . .... .2589. . .......... .... ...................... William RyderOwner ................ .... ... .... ... ....................... .............. Applicant ......... . Same........ ....... CLASSIFICATION Two car garage 221x261 Permit issued on above Application. Date, ..87 1676.5 ......... a M TOWN OF SOUTH WINDSOR BUILDING PERMIT Date Aug. 16,19 65 Fee Paid $. _8.00 Est. Value $. .1520.00 Permit N°` 5385 on the side of Ellington Rd. Street Street No. 2589 Owner William Ryder Applicant Same CERTIFICATE OF OCCUPANCY ISSUED: Date o No. 316 Fee Paid 3 00 CLASSIFICATION Two car garage 221x261 BUILDING PERMIT No 5385 OFFICE OF THE BUILDING INSPECTOR of the Town of South Windsor, Conn. South Windsor, Conn. Aug,. 16 0,19 65 alas to to Ter#tf1j, That William Ryder is hereby granted permission to Two car garage 22tx261 at estimated value of $ 1 20 s00 on the side of 2589 Ellington Rd.Street on land owned by William Ryder Said Fork to be as described in Application No. 5655 and to conform to specifications and plans filed with said Application, and Building By- Laws of THE TOWN OF SOUTH WINDSOR. Issued AU9.61.6 0 19 65 i Buif ing 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." Pe*mit No. -5 3 TOWN OF SOUTH WINDSOR SOUTH WINDSOR, CONN. Permit NQ 3164 Certificate of Occupancy THIS IS TO CERTIFY that the moo" at No. L`. i;the Town of South Windsor, Connecticut, has been erected and comp d in accordance with the Building Code and Zoning Regulations of the Town of South Windsor, and is hereby ap roved for occupancy. C7-7T,Q 1 B in or Owner, Builder 00 Fee Paid Date 19 FINAL o Z_Buildingg APPLICATION FOR BUILDING PERMIT Plumbing HVAC Date: Sprinkler 2589 ELLINGTON ROAD El ctric Estimated Cost $ Zoning 19 2 3 2 Permit Fee$ -mod Affidavit NO.Occupancy Fee $ Eng. Dept. COMPLETE RED BOXED AREAS. t Fire Dept. TYPE OR PRINT ONLY Total Fee $ 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 Lot No. Side of Street Zone Applicant dQm . Tel. # y '" JIF Address Zip Lic.# STREET CITY STATE Owner Address 55a,M 3z Architect Address Size New Area: Ft. Front Overall Ft. Deep Overall Total Area Garages Lavatories No. of Families No. of Stories Construction Bathrooms Rooms 1st 2nd 3rd Size of Lot Dist. from Street Line Dist. from Side Street Line Purpose of this Permit A`k U "1 Aj A S DCA1 6- City Water Well Septic Sewer O Approved by Date ''`'` BD1A 11/88 I hereby agree to conform to all the requirements,of the Laws of thl. 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 th proper distanc from all street lin s,side yard[in s and required distances from all other zones and is located in a zone in which this building and its use is allowed. Signed I hereby apply for a Certificate of Occupancy for the work described in this application for pe Signed DO NOT WRITE BELOW THIS LINE— INSPECTION RECORD Footing Framing Foundation Fireplace/Chimney Insulation Plumbing Permit# Inspections: HVAC Permit# Inspections: Electrical Permit# Inspections: Sprinkler Permit# Inspections: Electric# 7 3 C)a APPLICATION FOR BUILDING PERMIT Plumbiiig# 2589 Ellington road HVAC #Hate: 01 Sprinkler# No. 27890 FINAL P O Estimated Cost BuildingZ o/ COMPLETE RED BOXED AREAS Permit Fee 3 9,C3b g7 TYPE OR PRINT ONLY Occupancy Fee $ S: go Affidavit SIGN ON REVERSE SIDEAppr.for CO.Total Fee Y d a c- TO BIALDIISK'DEPARTMENT,TOWN OFSOUTH WNDSOR,CT Additional Cost) $ The undersigned hereby applies to do work according to the following specificatilow Job Location a K l l 'n Lot No. Side of Street Zone Applicant 1=rr e s`t" 1' c.a S LYI TeL# ?S Q--6' Y-J 7 71 Addr ss 6L F.1 Z°' Zip06e F'V lic.# Ctvvn r 'c'a Address 07 Architect 1' Address '' It fol / ' 7 Sq.Ft.New Area: 1st FI. all O 2nd FI. 3rd FL Total New Area ZI 0 Rooms I ?o mV%, #Lavatories — Bathrooms Garages — Purpose of this permit: j c, \0 V r d 1 ct'X &4 T t w 1 1 . City Water Well Septic System Sewer Ins. H.O. S.P. Cert. Area Basement Garage Approved by We - -dV Use Group Construction Type Revsed 1197 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 wh' h this building and its us is allowed Signed I hereby apply for a Certificate of OCCUDancy for the woeklcribed in this application for the permit Signed DO NOT WRITE BELO IS LINE INSPECTION COMMENTS t Inspection / Approval Date By Appl Code Description Due Whom Code Comment 27890-B 3,000 B01 FOOTING 05/30/01 JFF A WITH OWNER B01 FOOTING 06/05/01 CJD A W/JACK E03 ROUGH 07/09/01 CJD A B10 FINAL 07/26/01 JFF A WITH OWNER NOTE DECK LEES THAN 30IN ABOVE GRA GRADE RAILS NOT REQUIRED B10 FINAL 07/26/01 JFF A CLOSED OUT. 17302-E 500 r bl NOTE: Le Ching Fieldy`p 1100 gal, septic tank y y 3 leaching trenches 3 f t. wide. Total perc area 500 sq. tt. Para rate: V in 5 3 min. 1; 0 of All AL at K i Y T`Y4r i^',•_ i- yam- .. `..- .,. . w II RocA-vi/k EL L /N G-T01V ROAD PLAN OF INDIVIDUAL DISPOSAL SYSTEM LOT #2 LAND OF YOST BUILDERS INC. SOUTH WINDSOR CONNECTICUT Scale 1" = 80= Certified substantially correct. P E. 1117 August 7, 1962 Rockville, Conn 0 TC' ^'? ".qt l •'',S[, C''-'1. 1^' ', " STIR N rl 3 c.nr t.rs t,lrn .r,J ap<-c f c..1:.„,•r W re ,;rcp,)scd build,ng or :Ieerrtlnnc. to t ther %+-t;. ,rr,u,l.W fit'- st,tcd Ir1 .il rdicition ,", 1 Irh p!..,, ,nd I „;r to umiply :riih Ali zonir, nd -.,t, I_rv,c and su.,h .)rd rs as str,ill _ I,.3 by tlrc 011ilUlfig to.t=nrt+r„of during p,,uderrc this jop tl n and final Issuance of a buudrn, m_rrnit. rrt;ned t/\ h;. pian is aporovrd subject t the ndttron tha; c, h rs a,d o,,Cviances rogulatrng bur ding shall b• n•,II•_d wrth Conditionally Approved These filed with Building Inspector Cler Date No 7 t? d Proposed building(s), usc(s) a:,dlor structurc;- as sho in on this plan appea,r(s) to be onicrmance With current Su,tin 1,lind gulations. Vari races and special exceptio nay a -y. to Zoning Enforcement Officer f i DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT PERMIT# Application' •eby:TOWN OF SOUTH WINDSOR 3 GoBUILDINGDEPARTMENT APPROVED 1540 SULLIVAN AVENUE Bldg.Permit#644-2511 ext. 230 g Date B ldi g Inspector Application must be printed or typed EE SCHEDULE Location of Job: ck &Wm'A%V- 0-$1,000=$13.00 Street No. Street Lot No. Over$1,000= 13.00 per$1,000oranyfractionthereof F Tenant Designation Apt.No. APPLICANT APPLICANT ADDRESS APPLICANT PHONE# W N S OWNER t_ll OWNER ADDRESS v;i o C t vti s a r, c _(U 7 OWNER PHONE ESTIMATED COST$ (X 0 IS THIS A CONTRACT COST? Yes XNo FEE ENCLOSED$1,3. 0-6 TYPE OF JOB: New Installation Alteration/Addition/Repair Revised 5101 APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A BUILDING PERMIT APPLICATION? Xr ES NO RESIDENTIAL BUSINESS CURRENT USE AND OCCUPANCY ASSEMBLY MERCANTILE FUTURE USE AND OCCUPANCY EDUCATIONAL INSTITUTIONAL ENGINEER'S NAME PHONE FACTORY STORAGE ADDRESS GARAGE MIXED USE CITY STATE ZIP TYPE OF INSTALLATION/WIRING METHOD O SIZE OF SERVICE SIZE OF MAIN CONDUCTORS NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS NUMBER OF PANELS REMOTE DISCONNECT REQUIRED? YES NO NUMBER OF LIGHT CIRCUITS NUMBER OF POWER CIRCUITS NUMBER OF SWITCHES (9, NUMBER OF OUTLETS NUMBER OF LIGHT FIXTURES NUMBER OF HEAT CIRCUITS NUMBER OF A/C CIRCUITS SEPARATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED. DESCRIPTION OF WORK O LC 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. l 6-eouj A 'etc CONTRACTORS LICENSE NO. E STATE SIGNATURE OF APPLICANT DATE Cj