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HomeMy WebLinkAbout100 EVERGREEN WAY SPACE 101 B APPLICATION FOR ELECTRICAL PERMIT DEPARTMENT DECISION TOWN OF SOUTH WINDSOR PERMIT# Application is hereby: BUILDING DEPARTMENT 1,a3 App O ,� 1540 SULLIVAN AVENUE Bldg.Permit# LT,,1 > 644-2511 ext. 230 !ate d S7o2 Dat Building Inspector Application must be printed or typed FEE SCHEDULE Location of Job: $0-$1,000=$15.00 �9a zA Over$1,000= Street No. Street Lot No. $15.00 per$1,000 4(0 yn 11�0 or any fraction thereof Tenant Designation Apt.No. APPLICANT APPLICANT ADDRESS > r7 ,//i���( �c, rr P APPLICANT'S PHONE# y/ 3 f:(y C12 G OWNER z., , -,/ �,/o,1.5 �(OW,N S fq< OWNER ADDRESS t1{ r OWNER PHONE ESTIMATED COST$ V y O c)O —r— ,� lr" IS THIS A CONTRACT COST? Yes No FEE ENCLOSED$ 3(Ls �fOR Y 0 TYPE OF JOB: OX-iv SOR•CO A New Installation Alteration l Addition epair , 77 Revised 03/05/10 36 APPLICATION FOR ELECTRICAL PERMIT(Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A BUILDING PERMIT APPLICATION?/q YES ❑ NO ❑ RESIDENTIAL CURRENT USE AND OCCUPANCY ., Sid r ❑ BUSINESS ❑ ASSEMBLY FUTURE USE AND OCCUPANCY ✓n ❑ EDUCATIONAL ❑ INSTITUTIONAL ENGINEER'S NAME PHONE ❑ FACTORY (3 STORAGE ADDRESS ❑ GARAGE ❑ MIXED USE CITY STATE ZIP (Other please specify) TYPE OF INSTALLATION/WIRING METHOD SIZE OF SERVICE goc,7A, SIZE OF MAIN CONDUCTORS NUMBERS OF METERS NUMBERS OF DISCONNECTS AND RATINGS NUMBERS OF PANELS NUMBERS OF DISCONNECTS REQUIRED? ❑ YES ❑ NO NUMBERS OF LIGHT CIRCUITS -,i:C NUMBER OF POWER CIRCUITS NUMBER OF SWITCHES�_ 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 p/ �5�© /-) ,,tl l.,S�. l/ �m ia✓ Frofny3 Ct/f J-11,- C /< �/ 7f' S THE UNDERSIGNED NEARBY 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 PERFOR- MANCE OF SUCH WORK vI ,�y 3 ; �,/ c� v CONTRACTORS LICENSE NO. TYPE STATE p SIGNATURE OF APPLICANT r�1 cl� DATE o DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT TOWN OF SOUTH WINDSOR PERMIT# Application is hereby: BUILDING DEPARTMENT APPRO 1540 SULLIVAN AVENUE Permit 644-2511 ext. 230 (tea 7 Date Building Inspect �k Application must be printed or typed FEE SCHEDULE Location of Job: $0-$1,000=$15.00 Street No. Street Lot No. Over$1,000= $15.00 per$1,000 �y11 U(,� or any fraction thereof Tenant Designation Apt.No. APPLICANT Alf 1`10/,'-e. 04 1* f►i H If APPLICANT ADDRESS S/a rk s C,/ C, 6�S APPLICANT PHONE# 7 L k 3 H Y o W N St. OWNER `o O r f Ae 614,y 41 q� OWNER ADDRESS' 2d sU 74a4,5 Alpee i7Ti/5��' b OWNER PHONE C ESTIMATED COST$ �� 2 S�V. Cl G �•� IS THIS A CONTRACT COST? Yes _No FEE ENCLOSED$ TYPE OF JOB: 2� SCR CO New Installattiiotn Alteration/Addition/Repair (�O(�T7 Revised 4/01//2002 APPLICATION FOR PLUMBING PERMIT (continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A ❑RESIDENTIAL BUILDING PERMIT APPLICATION? Ja YES ElNO ❑ BUSINESS I CURRENT USE AND OCCUPANCY l:CG t&u ❑ASSEMBLY A MERCANTILE FUTURE USE AND OCCUPANCY ❑ EDUCATIONAL O INSTITUTIONAL ❑FACTORY ENGINEER'S NAME PHONE 0 STORAGE ❑GARAGE ADDRESS ❑MIXED USE CITY STATE ZIP (Other please specify) TYPE OF INSTALLATION_,' Jv�T SIZE OF MAIN DRAIN NO.OF TOILETS STYLE NO.URINALS --- STYLE �— NO.OF BATHTUBS NO.OF SHOWERS ' NO.OF LAVATORIES NO.OF CONDUCTORS — SIZE NO.OF STACKS�_ SIZE '3� AREA OF ROOF NO.OF CATCH BASINS NO.OF FLOOR DRAINS NO.OF OTHER FIXTURES 2 KIND a/f, C d o /rr y,,C/ kf If ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW ❑YES 19 NO SIZE OF WINDOW IF NONE C.F.M.OF VENTILATOR SIZE OF DUCTS SEWER OR SEPTIC TANK I r �' SIZE OF WATER MAIN 2 SIZE OF WATER PIPING&RISER I WATER HEATER: TYPE 6'� '�( MANUFACTURER �. O. S_Gt, , J( J DESCRIPTION OFF � WORK [ t0 / Co7//IM5 0"60 4 ✓. 4#/W V y rd THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRII;ED AND IS TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE PERFORMANCE OF SUCH WORK. r CONTRACTORS LICENSE NO. ITYPE STATE SIGNATURE OF APPLICANT DATE DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT PERMIT# Application is hereby: TOWN OF SOUTH WINDSOR / G S BUILDING DEPARTMENT �2 APPR vE 1540 SULLIVAN AVENUE 644-2511 ext. 230 Bldg. Permit# ir).,3.,� 1 Date Building Inspector Application must be printed or typed FEE SCHEDULE � Location of Job: F ��,�G�/I "A., ��� /q.) $0-$1,000=$15.00 Street Lot No. Over$1,000$15.00 per$1,000 or any fraction thereof gnation Apt.No. APPLICANT -5�GO �, ').} ir,�4 C APPLICANT ADDRESS Sn APPLICANT PHONE# O 66 7- 7 OWN St OWNER �� V /YG ZAZ&U OWNER ADDRESS ,orz �,lor�.s��r�Q.s�s ►/� Ob OWNER PHONE C ] ESTIMATED COST$ +r IS THIS A CONTRACT COST? _XYes _No FEE ENCLOSED$ Zssi 00 1� TYPE OF JOB: SO C�� New Installation Alteration/Addition/Repair /X Revised 4/01//2002 APPLICATION FOR HVAC PERMIT (Continued from reverse side) TYPE OF SYSTEM: TYPE OF BUILDING: ■HEATING ❑RESIDENTIAL 8 A/C ■COMMERCIAL O VENTILATION 0 INDUSTRIAL HEATING ❑STEAM LOW PRESSURE LIMIT LBS. HIGH PRESSURE LIMIT LBS. ❑HYDRONIC ❑WARM AIR 0 UNIT RADIANT HEATER EXISTING RADIATION ADDITIONAL RADIATION TOTAL RADIATION DESIGN TEMP. OUTSIDE OF INSIDE OF DIFFERENCE °F TOTAL HEAT LOSS(BTUH) OF(HEAT LOSS SHEET MUST ACCOMPANY APPLICATION) DESCRIBEALL HEATING EQUIPMENT(INCLUDING MAKE&MODEL NO.) GROSS HEATING CAPACITY(INPUT-BTUH)�� NET RATING(OUTPUT-BTUH) 8Z TYPE OF FUEL ❑OIL--GPM OIL TANK LOCATION :❑INSIDEO OUTSIDE CAPACITY ®GAS—INPUT LPG TANK CAPACITY ELECTRIC—KW AIR CONDITIONING DESIGN TEMP.OUTSIDE OF INSIDE OF DIFFERENCE OF TOTAL HEAT GAIN(BTUH) (HEAT GAIN SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL.0�09LING EQUIPMENT(INCLUDING MAKE&MODEL NO.) TONNAGE _ COOLING CAPACITY(BT6H)� 000 VENTILATION DESCRIBE ALL AIR HANDLING EQUIPMENT(INCLUDING KITCHEN EXHAUST EQUIPMENT) TOTAL SIZE OF SYSTEM(CFM) FRESH AIR INTAKE(CFM) (PLANS MUST ACCOMPANY APPLICATION) ��JS "")151_/1.� 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 CONNECTICUT BUILDING CODES IN THE PERFORMANCE OF SUCH WORK. CONTRACTORS LICENSE NO. TYPE STATE SIGNATURE OF APPLICANT DATE DEPARTMENT DECISION APPLICATION FOR SPRINKLER PERMIT PERMIT# Application is_h,rely., TOWN OF SOUTH WINDSOR I�0 o 0y6- BUILDING DEPARTMENT APPROVED 1540 SULLIVAN AVENUE 644-2511 ext. 230 Bldg.Permit# ,t�0005?2 Date H ding Inspector Application must be printed or typed FEE SCHEDULE Location of Job: RV t r g.c-ee d i 3� W� $0-$1,000=$15.00 Street No. V Street Lot No. Over$1,000= $15.00 per$1,000 yow,\\N�e4 o or any fraction thereof Tenant Designation Apt.No. APPLICANT If'\u� -��e row APPLICANT ADDRESS �• D 0 2 3 S� APPLICANT PHONE# T(O O — (0 ZI—KX Z O N SFq OWNER OWNER ADDRESS a INA OWNER PHONE C ESTIMATED COST$ 0 0.O 0 �.� IS THIS A CONTRACT COST? Yes _No �`1*0 FEE ENCLOSED$ ��.5 40 0 1��5 co TYPE OF JOB: -1 v UR _New Installation AZAlteration/Addition/Repair C (o Revised 4/01//2002 APPLICATION FOR SPRINKLER PERMIT (Continued from reverse side) TYPE OF BUILDING TYPE OF CONSTRUCTION USE GROUP NO.OF STORIES ❑ RESIDENTIAL ❑BUSINESS IS THIS APPLICATION ASSOCIATED WITH A U/SSEMBLY BUILDING PERMIT APPLICATION? ❑YES ❑NO Lif MERCANTILE ❑EDUCATIONAL CURRENT USE AND OCCUPANCY ❑INSTITUTIONAL ❑FACTORY FUTURE USE AND OCCUPANCY ❑ STORAGE ❑GARAGE ENGINEER'S NAME PHONE ❑MIXED USE (Other please specify) ADDRESS CITY STATE ZIP KIND OF INSTALLATION SIZE OF MAIN DRAIN FIXS WATER PRESSURE AT STREET(PSI) ARE SPRINKLER HEADS ALTERED? 31ES ❑NO IF YES,CHECK ALL THAT APPLY: ❑ADDED ❑DELETED WALTERED IF MORE THAN 3 HEADS ARE ADDED HYDRAULIC CALCULATIONS ARE PROVIDED BY(CHECK ONE) ❑PROFESSIONAL ENGINEER ❑INSURANCE COMPANY WATER FLOW WATER PRESSURE AT SPRINKLER HEADS(PSI) ARE PUMPS REQUIRED? ❑YES ❑NO IF YES,CHECK ALL THAT APPLY: ❑FIRE ❑BOOSTER ❑OTHER ARE STANDPIPES PROVIDED? ❑YES ❑NO IS A SPRINKLER SYSTEM PROVIDED? ❑YES ❑NO SPRINKLER SYSTEM MAIN WATER SUPPLY RATING GPM TOTAL DYNAMIC HEAD(TDH)OF FIRE PUMP PSI I q DESCRIPTION OF WORK Rt,\,gc,,- 1 oCcr-ho n 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. ''ll C T CONTRACTORS LICENSE NO. TYPE STATE SIGNATURE OF APPLICANT DATE ! z