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HomeMy WebLinkAbout26 Mountain View RoadJ Application No. .... 32...... . ........ Permit No. r TO THE BUILDING INSPECT R of the TOWN OF SOUTH WINDSOR, CONN. hereby make application for a permit to (erect (make alteration to) a uile ing according to the following detailed statement of the specifications and plans herewith submitted. (D w 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.,1962 . Sign h Address r j , 4....Street side of? Location? e- Nearest cross street?t.......... ... No. . .. ............................. Lot No. .......................... . Owner of land is? . . - .........4.........Address `-............ r.. ..... 1....:.. s ....... .,. .'......... ey Owner of building is? . Architectis? ........... ................................................ .......................Address Builderis? Address r Dimensions of building? . .Feet front? ......... Feet rear? .... Feei deep? .. Extreme height to highest point of roof? ...... ... . ............... No. of stories in heig t? . Purposeof building is? ... .......................................... .........................No. of stores? .... ................. ................................... ............................... Howmany families? . . ................................................................................No. of rooms? .... . ........ . ........... ........................................... ............... Distance from street line is? . from building line is? . ADDITIONS AND ALTERATIONS Give Brief Description) f/ • ..............1 j,.. -_: .. .... !E........... i'l'. 4-4'=r.` •. S 1.......................... f../........... ....... 4 •• .... ,.- L....^:r :(.1...:..lr .:L..... .F........1.:....Z... .,(,r :G...[...........1.. ...`....................... uS:` .r L- !....:%.... .......... L ...........yr...• ... l jc/Z ........ .. Map No. L........ 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 " 3rd " 4th " 5th " I................ I............................................. .................... ..... ............. ........ . .... ..................... 6 h " 7 h `{ 8th " 9th " 10th.....;;. Material.of Front? If stone, what kind? Thickness of Ashlar?Thickness of Backing? Backed up with what? Arches or lintels over openings? WOOD CONSTRUCTION. Size, Longest SPm and istame Between Centres, of.fob Girders am d ins a JOTBn t#IRD iS C10 Ste bmwe" S"n Gmt m arm9ft N"e" Span Cent M 81ae I.e ttm Centres a" oor u.... .............. .................................. VaY.... N.....I................... ... ............. 4.........N..». ...........» .............................. .. ....»..........» ......................... Size Distance on centres?of outside studs? .................,,.................... Size of sill? ............................................. Size of rafters? ........ ........................ . Distance on cehtres?.............................................. Size of plate? .................................................... Size of ledgers or girts? .............................. ..............................................Size of deck rafters? ............................................. ............... ............... Distance on centres? .................................... ....... ...........»...........................Size of studs in bearing partitions MISCELLANEOUS Style of rood flat itch Mansard or hipped? .. .... ... tY pitch, pp Fireplaces. ..................................................... Material of roo 'covering? ....... ...................... ... ...........................Material of Cornice? ...................... How is building heated? ... ... . Lining of flues? .. ... ..... Thickness of shell of flues? ......... ............................................ ......Any elevators or lifts? ..................... .... ................ .. ..................... What kind? . . ... . . ...... How many? ..... . Any hoistways? . .... ... How protected. ..... ... . ..... ....... .................... ................. . ....... ......Total Value of Building }....... ... ....... ..................................... When will work be commenced? The applicant warrants that the lot for residential purposes, shown on a plot plan accompanying this appli- cation, has 20,000 square feet, or more, and at least 100 foot frontage on a Town road shown on a map of South Windsor showing Town Roads dated December 1949, or on any other roads officially accepted by the Town of South Windsor since 1949. pplicant 3372 BUILDING APPLICATION Application No. . ... on the . side of Mountain View Drig reet. Street No,2-6 Owner Warren Westbrook Applicant Kitchen Center, Inc.. .. CLASSIFICATION Renovate kitchen. Permit issued on above Application. Date, Nov..10, 19 60 MIN,IMM QT TIW Date vo Fee aid . . . . . . Bot. ti ' ox44 Permit437 on the pe MAtain V14DU .VI& i r+.r .wrrrn+.iw.r,; SL'.p" ,S'r•--, ,,`' =c;,F,'1,?n+' F a, ...€<"_.'=i*•', _ ,:iry:'9`3 c "--'-j-'-aim'' V„ rI C Street No 26 r Owner i 54 3® Y/ 5.: 3H9: hrL1GK"'.rFi•'&';`#o-:it iE"w!'' Applicant 3 z.• ,$..._ -,,x3•,•s= r 4'.`_t-+r`,`'LH.,:lr; t;,,g•:;,sy ep.r.., yx r CERTIFICATE OF OCCUPANCY Date n Fee Paid F f'., _ _ _ i r r195 T?8 ...'Av,?r:„r<r=_5p_'3~• F 4 ;,; a ^° BUILDING PERMIT N° 33'72 OFFICE OF THE BUILDING INSPECTOR of the Town of South Windsor, Conn. South Windsor, Conn. Nov-, 10M 1960 t t' tLY rft That _itci en GPne_rT_I ne: is hereby granted permission to !te nov u t e ki t c h en at estimated value,of 0 on the side of ivi o urn` g i n i nw ..r,, y e Street on land owned by liarrnm v.e stbrook Said vv ork 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 j,Qv 10, 19(,0 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." 1674 OIL BURNER OR FUEL STORAGE APPLICATION Application No. 1685 Permit No. 1674 on the side of Mountain View Rd. Street Street No. C4 Owner G.Edgar We stbrook Application George Mellen CLASSIFICATION Carlin 150 Permit Issued on Above Application Date 6-24-63 19 Fee Paid $ 2.00 TOWN OF SOUTH WINDSOR APPLICATION TO INSTALL RANGE AND FUEL OIL BURNERS EQUIPMENT AND TANKS PERMIT N . 1674 DATE The undersigned hereby applies for a permit for the installation of range and fuel oil burners, equipment and tanks of the following description: Address N1 00-1 "f4a`+-•., G 1st floor 2nd floor 3rd floor Character of Building: Frame Brick Owner of Burner r,Ew e S'4 0 Owner of Building S a 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 Model Number /6_0 — = Purchased from 1\1 t \ VC 0d 2c,J Name of Tank ti Gauge of Tank Where is Tank Located Size of Tank _4 d d Size of Motors /'r • Size of Wire c' Will other heating equipment be installed? If so, by whom Name of Party Making Installation Address Electrician %h Address S o J "\ w ` S a Signed APPLICANT All provisions of Ordinances of this Town Regulating Oil Burner Equi t and Fuel Storage (Sections 1-23 in- clusive) and Underwriters' Code applicable to the subject matter of same sha be complied with in execution of thiss work whether specified herein, or not. a o6-24-63 Estimated Cost $ 175 Application for Permit received and 16746-24-63PermitNo.issued Permit Fee Paid Appr6fed BUILDING INSPECTOR TOT BUELDING INSPECTOR of dw APPLICATION FOR TOWN OF SOUM WUMSM COMA. PLAN EXAMINATION ARD B ILOING PERMIT z IMPORTANT — Applicant to complete all items in sections: 1, 11, III, IV, and IX.O ZONING AT (LOCATION) DISTRICT LOCATION NO.) STREET) OF BETWEEN AND BUILDING CROSS STREET) CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE N II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D 70 A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use A 1 New building Res'dential Nonresidential 2 Addition(If residential, enter number 12 One family 18 Amusemen recreational of new housing units added, i/ any,13 Two or more family — Enter 19 Church, of er religiousinPartD, 13) number of units— — — — -20 Industrial3 Alteration (See 2 above) 14 Transient hotel, mote ,T i h ll 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, histitutional Part D, 13) 16 Carport 24 Office, bank, professional 6 Moving (relocation) 7 Foundation only 171K Other — SpeciJy 25 Public utility J / \ 26 School, library, other educational B. OWNERSHIP J 27 Stores, mercantile 8 Private (individual, corporation, 28 Tanks, towers nonprofit institution, etc.)V Y 29 Other — Specify 9 Public (Federal, State, or local government) C. COST Omit cents) Nonresidential — Describe in detail proposed use of bu Idings, e.g., food processing plant, machine shop, laundry building at hospi al, elementary 10. Cost of improvement,,,,,,,,,,,,,,,, c " school, secondary school, college, parochial school, parking garage for, department store, rental office building, office building all 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 ...................... c. Heating, air conditioning......... d. Other(elevator, etc.)............ 11. TOTAL COST OF IMPROVEMENT $ III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts — 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 41 Private (septic tank, etc.) 49• Total square feet of floor area, all floors, based on exterior 32 Structurel steel dimensions ..................... 33 Reinf reed concrete H. TYPE OF WATER SUPPLY 34 Oth r — Specify 42 Public or private company Total land area, sq.ft. ... ....... 43 Private(well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES 51. Enclosed ....................... F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 35 Gas Will there be central air 52. Outdoors........................ 36 Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY 37 Electricity 44 Yes 45 No 53. Number of b drooms.............. 38 Coal 39 Oth r— Specify Will there be an levator? 54. Number f Full.......... 46 Yes 47 No bothr ms Partial........ NOTES and Data — (For department use) IV. IDENTIFICATION — To b complet 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 owner of this building and the undersigned agree to conform to all applicable laws of this jurisdiction. Signature of applicant Address Application dot 00 NOT WRITE BELOW THIS LINE V. PLAN REVIEW RECORD — For office use Plans R vi w Required Check Plan Review Date Plans By Date Plans By NotesFeeStartedApproved BUILDING PLUMBING MECHANICAL ELECTRICAL OTHER VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Permit or Approval Check O Date bta ned Number By Permit or Approva I Check tDained 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 10044Prmitnumbr Bui Iding P rmit issued Nov. 4 1q 77 Building Permit Fee $3.00 Approved by: 1 ITLE Vi}E, r,_+-''_ J- w- r,{*-+' Fi'_ y+°eT. I.-*_-;» t.• axp,»;'....._ I4-ro. t..-• F- T."-.. 1 a.,,. ya ry., I,..-• y«, Z jg- N_, zq:_ s+ j. fy",' d.,..,,.-.---,--.- 4, M~-'.`# aa,..•. a,..--,,-. I- A(,- N- A» 4kf t.;,. s ra. p. 7 r±- j K. A-."- G- x d a••<,. 4+- aE o-+•` f-',-. gy-. p1s"<- a. P_. '. Lr_ d, A. N., ia}+, Ya t;}.¢. p,.«.".-.° F. 1,« a., q aqes. 1ts4% f.'# f•., a m 9v:- R,-- v- EXAMINERS XAMINERSr-.--..- a ki'+-ace{.> 3. T-.- a_+ pft, y_. kf.•i„ w>- 4.,>.- qNy r-_ a K tkfpa4,•. M,,.,.. s- d. e'„ qn+, i,, xetr,.a1-.vd» a---.,. w,¢¢- s, m 4t.`.• NOTES DISTRICT USE FRONT YAR SIDE (ARD o 5'-,+{` f k'. r,. t, PzCcy m--}! e6a«,•. s. r4.>-,„-& y dcy-{` nsq. p. bf-. p}. tM.!. pl..° v A---- tri i f saax,.r.._ rt+. p'; 3- iE-., a,..- s am,. 1 i}.. p_^ eq. 6ii._,- o+- a,. s y. aa-.•,-.« i." y';., j{-i9P.,,p«-'„ a_ i,. yb--^-, s- ia,+-,s+;' tl„ RRn 34,iy_~--- harh,,,; yt- b d? t. ed._„_-.,- f.-- t' qws3sFfiett- r. a. V' fr, t-,., adti_•- a'` x rrP- 9a3-, x. q+ i: x+' t, axt?? t. i.• a•.{• a. s a., s-, a' p^.,-+.' q+, aa x'»_# a. t. i,- y, 9--„ r 3. z., yeF>. ti,,. dj..-.+.- p` m+aQws-,aT,_ t• 3.' xai. rP^»..}:§-..; f.,, am, h.. l; n dqf&- r¢ p g{ ts$ F. b= wy".'-- A' fa 1rt,. 4. V-', o.° r<., e a` av.;.. q.Lm fi,-", k5-_,.. r qz,+, r.., o.., s t.,, I,-{ b.„< nF.-,_ ar« i sa_, rY-_ sa f' ro 1,,}-+^ tsa_{,.-- g So s g dxg. c5qq$.' x_ g,._ f. mosa.` ro- ro5^. 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L fR'_~...{r,}.-{ s.. l a F- t A; rp a} d;,. i a s.:". ro-- ry_ r.•- yl-..r ri-+ Y. t(} 4.. ex. 4.---..+ abiie4+_.t+.^ Y e.._-.,- b-, m a.'-{ f,+ i,«bl y'?+ c'"-.""' i-, E^.,.-, 1bratv, i$- f,•}° k- g4i.-yzbira-+ i yq?t$ j d{l.. r r. 0, M,,- sw- i` aa.^ dt•j-, j•.,-,- a• x' p-,;. d-•. 5, a... y s,,,§ i,} 11t..,-.-,-- N"- v•,.,, a#. b,#}-, r,a4L$.• b. i yo-aa v t--, 4.}_ Pq tat'`-a,-• o<. i.<, w}< t.' 4.{,,•-.,-. w..,. aroP'' q{ a' tey." y,.-..,.--. eg.'? 4eF"t} aa. s x, 6.'. 9'- y, y$« b4;,4¢ Y< kv fµb s., ai${,13x Y,ri ta9 y abs_. jiy Ay° p§ i$ e}$ 4` A,-? a.-";..- 0_' p#,. dss_ 0#aE.,r g.°. o. J,,-«.., W, rt_,.-+- d. p{ 3,.++ T-,. E: gis-•-.._'_ b,,,, i_+ d..+{ ibE,.-_.}._-• x-+- w a=,. ase1ar{br.,..,$ da..., x' g-$. a-- tEs af-g, t k x%., 4. 4:.. 4..<.-..., 9p..c a r} a, j 3-, Sre¢ y rF- L. g,, da.„ f- re.' n r- 1t,-`,. i1§, b'.,, x' ri y+_:brr. x°-. w. r,. p•-,,` s-'},, a. f a- rr}' a+. f<, r,.._&,..{". t^ 4--, p-3%,.- a.%+ a}- e v.._. iib", r>-., a- a w, t_- e,_". a.+ t: ia.r, r;. er}{+$, rr. da- F-}..--},, s,. t„%: a- ya 5mo}. H ke,_ tt r,_ x< ai. teaw-`# t,1. q- t,- c_-- m8- 4 ta E_„ 4«-} a,-_ a,. a.; r?,tm.--.. t,--, i„. a e. L#_ a•.•#}, sd-, p. itE4..- E}} t--: rE`•-',.- a., ax.,} s t._ra, f} 44. i•-a a..-`-* z n--. yb, x; g. t14ay4 fe- b-- e-" j b @k3 cu$$. yd q.,•` gr---L,, 4i r. m-+# 4 s{ qiy'ar-ya` 4,.-„.+.,=> 4,,... a ia{g. i-,.._ q^ i, E. a„. Eb,- 5.--,.-'-- i, a- sfft,-; i qi y1,-.' m o,_-.'? q, b. e,' tr, s•'. r, Y-_,- b. y,- rr„,-; r+#+, aab¢+ tt. r} da.tj#.-.4yi,•-.,-.,.k S- a_ a.' a,Qt' ir= r. a_."' L-, a--. A- Pµ•.¢ta0. 3a K t 1 6_gytt*y Cr e t.• r,${- e» p' s., q-,rt1.'-Ea~..., r$ p. E• R- r'._• s yy#--. w•#- s,.-- mo-.-®_ t+ f,'•..-. etY. a o ar tr}_. rv» y„ 4 f4 ye,;g46 2 . 4 1 t d 471r 4 p 4 yk.Fy a te 4iit U,Hi: it t 4 t v J- }1. i{ t dIt s4 W4 t Q 4 y§. k ay Fw 3j TOWN OF SOUTH WINDSOR BUILDING PERMIT j Nov. Date 4 ig77 j Fee Paid $. .3..00 Est. Value . .ZOO.00 Permit N® 10044 on the We of Mountain View Roar] Street Street No. 2 6 Pamela BPaiidnzOwner Applicant Pamela Beaudry CERTIFICATE OF OCCUPANCY ISSUED: Date No. Fee Paid $ i CLASSIFICATION Wood burningng stove t BUILDING PERMIT N° 10044 OFFICE OF THE BUILDING INSPECTOR of the Town of South Windsor, Conn. Nov. 4 77, South Windsor, Conn. 19 name:!a Beau iry M#jS jS to (gP i That Oc- , That stove is hereby granted permission to J•00) a lima v of $ l Mount3 Wew Rota" on the side of Street on land Pamela Bea nv owned by Work Said to be as described in Application 10344 No. and to conform to specifications and plans filed with said Application, and Building By- Laws of THE TOWN OF SOUTH WINDSOR. Nov. 4 77 11-102 1 B Udi 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 perm 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." FINAL INSPECTIONS: Building V APPLICATION FOR BUILD NG PERMITI— !' Plumbing HVAC Date: Sprinkler 2 MOUNTAIN VIEW DRIV El ctric Estimated Cost $1i Q,0 0, 00 Zoning Permit Fee$A 6 c U o Affidavit NO. 1 R R S R Occupancy Fee $ Eng. Dept. COMPLETE RED BOXED AREAS.Fire Dept. TYPE OR PRINT ONLY Total Fee $ D a0 H alth Dept. SIGN ON REVERSE SIDE.Approved for CO: Additional Cost) $ TO BUILDING DEPARTMENT, TOWN OF SOUTH WINDSOR, CT The undersigned, hereby applies tq do work according to the following specifications: Job Location L ot No. Side of Street Zone Applicant- j a -14 640 Tel. # 6, V4, 94-6 V Address -3 2TY St., )44wt,esZ a E Zip 0(P 0 YD Lic. 67 416 7 3 7 STREET Cn a CITYA STATE I{ Owner l X/i 74 S,oG1 Architect Address Size New Area: Ft. Front Overall Ft. Deep Overall Total Area Garages Lavatories No. of Families No. of Stories Construction Bathrooms Rooms 1 t 2nd 3rd Size of Lot Dist. from Street Lin Dist. from Side Street Line Purpose of this Permit 0 0 5 0 0 a 10 a City Water Well Septic Sewer Approved by Date "`^1U BWA 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 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 distanc s from all other zon s 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 permit. 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: DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT PERNIIT# q) qY Application is hereby: TOWN of SOUTH WINDSOR ON[DE NT DECISION BUILDING DEPARTMENT Bldg Permit# P' Application s hereby: APPROVED 1540 SULLIVAN AVENUE 644-2511 ext. 230 Date V J ding Inspector Application must be printed or typed Location ofjob Street No. Street Lot No. FEE SCHEDULE Floor Apt. No. 0 - $111000 - $12.00 Over $1,000 iwAi12.00 per$1,000 OWNER C so any ftction thereofor ADDRESS 0 6 )-7!2 OWNERS PHONE# APPLICANT S, F,,5,, r- L-(::2- ADDRESS Lill R'd io 3 rL- V0 6 K)42 r4 ESTIMATED COST$ IS THIS A CONTRACT COST? NOANN FEE ENCLOSED $ Zr OR-Cov- ME OF JOB: Original on Alteration/Addition Repair Revised 11/95 APPLICATION FOR ELECTRICAL PERMIT(Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A RESIDENTIAL BUILDING PERMIT APPLICATION YES / NO BUSINESS ASSEMBLY CURRENT USE AND OCCUPANCY I'Z65 MERCANTILE EDUCATIONAL FUTURE USE AND OCCUPANCY INSTITUTIONAL FACTORY STORAGE ENGINEER'S NAME PHONE. GARAGE MIXED USE ADDRESS CITY STATE ZIP 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 A"h--P NUMBER OF PANELS f REMOTE DISCONNECT REQUIRED YE /NO NUMBER OF LIGHT CIRCUITS NUMBER OF POWER CIRCUITS NUMBER OF SWITCHES 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 C6,12-0/C"Z F='12,6;-n 4 i 0,4 t!1,2 Z T_ Pe-e ef ! d i0A D is/z/Q12A T '7 S'612, LJ I v 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. NAME STATE LICENSE NO. TYPE SIGNATURE OF APPLIC PHONE NO. g~F b U DATE S 'J INSPECTOR 1- DA7 LOCATION p s INSPECTION: CODE: RESULT(D/A) : 3 BUILDING: 1' 1 ELECTRICAL: PLUMBING: iVAC: OTHER: