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Home My WebLink About115 EVERGREEN WAY DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT Applica ' t y: TOWN OF SOUTH WINDSOR PERMIT# BUILDING DEPARTMENT 191 1 PRO 1540 SULLIVAN AVENUE Bldg.Permit# T n ^^ 644-2511 ext. 230 Date Bu' p for Application must be printed or typed FEE SCHEDULE Location of Job: $0-$1,000=$15.00 Street No. OStreet Lot No. Over$1,000= $15.00 per$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANT "��([' S �' Jtt r ` - SaC APPLICANT ADDRESS `e,d , (l�OY, ��m.`V�X Q3,( m c5o- APPLICANT PHONE# �{ I.� ()� — �O�L�� F-ja x r- 0 W N S f,q OWNER C �C.S�a01�-e/�r� 4f1�G bJC OWNER ADDRESS (,t/FYI � r n u, �Il1 �y OWNER PHONE CO ESTIMATED COST$ of l (S1SD b x IS THIS A CONTRACT COST? Yes _No lL o '"'' ' �C1 FEE ENCLOSED$ 3 (S, 6 r��s - O�� TYPE OF JOB: O R•C ✓ New Installation Alteration/Addition/Repair Revised 4/01/2002 APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A El RESIDENTIAL BUILDING PERMIT APPLICATION? 4-YES ❑NO ❑BUSINESS CURRENT USE AND OCCUPANCY l yi ASSEMBLY MERCANTILE FUTURE USE AND OCCUPANCY C . ❑EDUCATIONAL IL` ❑INSTITUTIONAL ❑FACTORY ENGINEER'S NAME PHONE I 0_S SaS ❑ STORAGE P d e,�x✓n``ti` ❑GARAGE ADDRESS ❑MIXED USE "' CITY Q_��,�.� STATE TZIP � O (Other please specify) TYPE OF INSTALLATION/WIRING METHOD��QL C1 17m 4e W 1 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 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. DESCREMON OF WORK Cow j 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. c-t" CONTRACTORS LICENSE NO. TYPE STATE SIGNATURE OF APPLICANT DATE v DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT P RMIT# Application is her TOWN OF SOUTH WINDSOR / BUILDING DEPARTMENT '1 5 O�PRV D� 1540 SULLIVAN AVENUE Bldg.Permit# �G 1 644-2511 ext. 230 Date Building Inspector 1 1 l Application must be printed or typed FEE SCHEDULE Location of Job: CVO rte, waV $0-$1,000=$15.00 Street No. V Streett7 Lot No. Over$1,000= $15.00 per$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANT SO Mac., k C,_h,c_ APPLICANT ADDRESS PO 130X G 3 S/ New 13n��;r . Cr 06050 APPLICANT PHONE# r1(�0) ;2.2 9 - p gOo 001, OW N S�'4 OWNER ��- S+Do�+tr u�+d �idn�S�ti �nC OWNER ADDRESS OWNER PHONE C ESTIMATED COST$ x * IS THIS A CONTRACT COST? Yes _No lG �G FEE ENCLOSED$ L/0-O lU O�� TYPE OF JOB: 1 OR C New Installation _Alteration/Addition/Repair Revised4/01//2002 , APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A ❑RESIDENTIAL BUILDING PERMIT APPpLICATION? ❑ YES ❑ NO ❑BUSINESS CURRENT USE AND OCCUPANCY IR a+u i ❑ASSEMBLY ❑MERCANTILE El EDUCATIONAL FUTURE USE AND OCCUPANCY R2+&: ❑INSTITUTIONAL ❑FACTORY ENGINEER'S NAME PHONE OSTORAGE ❑GARAGE ADDRESS 0 MIXED USE (Other please CITY STATE ZIP TYPE OF INSTALLATION/WHMG METHOD SIZE OF SERVICE SIZE OF MAIN CONDUCTORS NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS NUMBER OF PANELS REMOTE DISCONNECT REQUIRED? EI YES ❑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 SEPARATE BEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED. ) DESCRIPTION OF WORK ) / IA;A;S I N . et S S ELM ytQ/ idal► GOCC S, loco.( COdCS, ll 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 APPLIC �Q.G DATE / ��LL �4A k S APPLICATION FOR BUILDING PERMIT Elecuyc # 17)Z.1 Plumbing# I I Le S-7 115 Evergreen Way Date: (0 - HVAC # i Z Z y Sprinkler# 1379 ,139V 30962 FINAL APPROVALS — — -- - Estimated Cost $ 176620 Building COMPLETE RED BOXED AREAS Permit Fee $ v Engineering Occupancy Fee $ / O Affidavit TYPE OR PRINT ONLY Eng. Insp. Fee $ Appr. for CO. SIGN ON REVERSE SIDE Total Fee $ (S TO THE BUILDING DEPARTMENT,TOWN OF SOUTH WINDSOR, CT (Additional Cost) $ The undersigned hereby applies to do work according to the following: Applicant far+ 1 u � + Location of Work'(titQ%(4Z ew Wt( A_ Lot No. Applicant's Address H 9 5-c- lylo in 0 L� LU rl P Ste. A r Tel.# Town � Zip t(o Lic.# Owne Architect knn- i�/� Owner's Addres 1alY►1 Architect's Address 21'15 - M 5_s-1 Zip , W N Zip SS 1110 Sq. Ft. New Area: Ist FI.)AlO 2nd FI. 3rd FI. Total New Area Purpose of this permit qeLACw,�(,kiN-Y)of cotu 1,60cc ce.C.t- _sInt"Os co & ee i W(o(0- Lkres4,o er + ��►KS City Watero Wello Septic System❑ Sewero Ins: HO SP Cert. 1z Area Basement Garage Approved by Date Use Group Construction Type Revised 6102 I hereby agree to conform to all the requirements of the Laws of the State of Connecticut and the Ordinances of the Tam 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 this building��- Ilowed Signed hereby apply for a Certificate 4zupancy for the work descnb this application for the permit. Signe '��: NOT WRITE BELOW THIS LINE INSPECTION COMMENTS Inspection / Approval Date By Appl Code Description Due Whom Code Comment -� ------------------------------------------------------------------------------- **-30962-B 176,000 E03 ROUGH 09/20/04 CJD A B03 FRAMING (ROUGH) 09/20/04 CJD A P03 ROUGH 10/08/04 PJP A B09 OTHER 10/18/04 PJP D SEAL PENETRATIONSOELEC RM,NO DIFFUSERS,LOWER REAR EXIT SIGN,SPRINKLER ABOVE FR DISPLAY B09 OTHER 10/20/04 CJD A CORRECTIONS MADE P03 ROUGH 10/22/04 PJP A PRESSURE TEST B10 FINAL 11/08/04 PJP A CORRECTIONS MADE, CO PENDING BUILDING CO B10 FINAL 10/26/04 PJP D P02 UNDERGROUND 09/08/04 PJP A B10 FINAL 11/08/04 PJP A B10 FINAL 01/07/05 PJP A CLOSEOUT **-11687-P 8,500 **-1379-S 10,000 **-19108-E 7,850 **-1386-S 7,000 **-19121-E 21,000 **-19158-E 1,380 DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT TOWN OF SOUTH WINDSOR PERMIT# Appli is ere —CL* 1 BUILDING DEPARTMENT 0 1 APPROVE 1540 SULLIVAN AVENUE y 2 4 644-2511 ext. 230 Bldg. Permit# Date Buff ding Inspector Application must be printed or typed FEE SCHEDULE F Location of Job: e �,r C-mac/ tyA 4 $0-$1,000=$15.00 Street Lot No, Over$1,000= $15.00 per$1,000 or any fraction thereof gnation Apt.No APPLICANT (fAC-S7 ,` /II��Gv/ S�� it CrT,f APPLICANT ADDRESS I jPc.� l zj"iO, C —,-- — T e-,7 APPLICANT PHONE# �'6�� 7> c/ —3 V 3 J O W N SF Fq OWNER OWNER ADDRESS e OWNER PHONE C = ESTIMATED COST$ ow� M 6. IS THIS A CONTRACT COST? Yes _No FEE ENCLOSED$ 3 7 S, W �S 0�� TYPE OF JOB: o R C New Installation Alteration/Addition/Repair Revise14/01/ 001 APPLICATION FOR HVAC PERMIT (Continued from reverse side) TYPE OF YSTEM: TYPE OF BUILDING: HEATING El RESIDENTIAL A/C y COMMERCIAL gftNTILATION /j INDUSTRIAL HEATING 0 STEAM LOW PRE5SURE LIMIT LBS. HIGH PRESSURE LIMIT LBS. ❑HYDRONIC / ARM AIR ❑UNIT RADIANT HEATER EXISTING RADIATION/ ADDITIONAL RADIATION TOTAL RADIATION DESIGN TEMP. OUTSIDE OF INSIDE OF DIFFERENCE OF TOTAL HEAT LOSS(BTUH) °F(HEAT LOSS SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL HEATING EQUIPMENT(INCLUDING MAKE&MODEL NO.) GROSS HEATING CAPACITY(INPUT BTUH) NET RATING(OUTPUT—BTUH) TYPE OF FUEL ❑OIL—GPM OIL TANK LOCATION:❑INSIDE❑OUTSIDE CAPACITY �OAS—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 COOLING EQUIPMENT(INCLUDING MAKE&MODEL NO.) S 6-& /U,, / TONNAGE COOLING CAPACITY(BTUH) VENTILATION DESCRIBE ALL AIR HANDLING EQUIPMENT(INCLUDING KITCHEN EXHAUST EQUIPMENT) '-'s se �t ,c`/4/7 TOTAL SIZE OF SYSTEM(CFM) FRESH AIR INTAKE(CFM) (PLANS MUST ACCOMPANY APPLICATION) FURTHER DESCRIPTION OF WORK _ aA 4 4c C?w c5' /��T G1t, 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. 9/ 3J?///y Ji Gi CONTRACTORS LICENSE NO. e/ TYPE p STATE SIGNATURE OF APPLICANT �(q,�i� -l�pr< DATE / �D DEPARTMENT DECISION APPLICATION FOR SPRINKLER PERMIT TOWN OF SOUTH WINDSOR PERMIT# Application is her BUILDING DEPARTMENT R 1540 SULLIVAN AVENUE Bldg.Permit# 0 i 2 7 2 644-2511 ext. 230 r Date uilding Inspec Application must be printed or typed FEE SCHEDULE Location of Job: F $0-$1,000=$15.00 Street Lot No. Over$1,000= $15.00 per$1,000 or any fraction thereof gnation Apt.No. APPLICANT 6CE&-f }3Al/C4 APPLICANT ADDRESS APPLICANT PHONE# 044 N SC.4 OWNER C./�.0',r-ro A149C 6A ieS OWNER ADDRESS CO) * OWNER PHONE C ESTIMATED COST$ ?, p ��G"ICJ IS THIS A CONTRACT C T? "Yes _No 1k;G FEE ENCLOSED$ /SU. TYPE OF JOB:,. SOL.R•C�� -New Installation Alteration/Addition/Repair 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 ❑ASSEMBLY BUILDING PERMIT APPLICATION? ❑ YES ❑ NO MERCANTILE ❑EDUCATIONAL CURRENT USE AND OCCUPANCY ❑INSTITUTIONAL ❑FACTORY FUTURE USE AND OCCUPANCY ❑ STORAGE UGARAGE❑MIXED USE ENGINEER'S NAME C f f'1I�,gT/ �/ /yIo o� PHONE ADDRESS �� ItC0G UA�� 'f"yrxS (Other please specify) CITY 7 n 1W6 -// /1,5; STATE /l ZIP S-sI/.3 KIND OF INSTALLATION SIZE OF MAIN DRAIN A/ WATER PRESSURE AT STREET(PSI) ARE SPRINKLER HEADS ALTERED? ❑YES /VNO IF YES,CHECK ALL THAT APPLY: RED 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 O BOOSTER O OTHER ARE STANDPIPES PROVIDED? O YES ❑NO IS A SPRINKLER SYSTEM PROVIDED? ❑ YES ❑NO SPRINKLER SYSTEM MAIN WATER SUPPLY RATING GPM TOTAL DYNAMIC HEAD(TDH)OF FIRE PUMP PSI 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 PLUMBING PERMIT PERMIT# TOWN OF SOUTH WINDSOR 11 (0 Apph ere BUILDING DEPARTMENT PPRO A 1540 SULLIVAN AVENUE Bldg.Permit# L 644-2511 ext. 230 Date Building lnspec Application must be printed or typed FEE SCHEDULE ILocation of Job: E 6y(--A6rxC-ed iA k4 $0-$1,000=$15.00 Street Lot No. Over$1,000= $15.00 per$1,000 or any fraction thereof gnation Apt.No. APPLICANT Ckc-57- /11G�i�nl� cam( SEX- ✓i CCU -- APPLICANT ADDRESS I aF4/ XkCel) <JT Gr r� c 06 /3c,/ APPLICANT PHONE# �0 �if� 7� 3 a 3 OWN s F,q OWNER C-&-1<S7U aA0;5;0 S -- OWNER ADDRESS OWNER PHONE C ESTIMATED COST$ IS THIS A CONTRACT COST? _Yes _No G FEE ENCLOSED$ l,3 S. TYPE OF JOB: R New Installation _Alteration/Addition/Repair Revised 4/01//2002 APPLICATION FOR PLUMBING PERMIT (Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIA D WITH A ❑RESIDENTIAL BUILDING PERMIT APPLICATION.XYES ❑NO / ❑BUSINESS CURRENT USE AND OCCUPANCY �� ❑ASSEMBLY MERCANTILE❑ DUCATIONAL FUTURE USE AND OCCUPANCY — r- ❑INSTITUTIONAL ❑FACTORY ENGINEER'S NAME 6,,A WS /rI /rJyo c.E PHONE �65/) 63Y'96o�O ❑ STORAGE❑GARAGE ADDRESS 7o y nosC D, * emu/6t S ❑MIXED USE CITY �ySF Y/ /�C STATE /1/a n/ ZIP (Other please specify) TYPE OF INSTALLATION / SIZE OF MAIN DRAIN y �/ NO.OF TOILETS�_STYLE ,!Ze-,!�"z NO.URINALS STYLE NO.OF BATHTUBS NO.OF SHOWERS NO.OF LAVATORIES /C NO.OF CONDUCTORS SIZE NO.OF STACKS SIZE AREA OF ROOF NO.OF CATCH BASINS r, � I NO.OF FLOOR DRAINS NO.OF OTHER FIXTURES KIND ARE TOILET COMPARTMENTS VENTILATED TO OUTE11� BY A WINDOW WoY S ❑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 MANUFACTURER DESCRIPTION OF WORK ot COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE PERFORMANCE OF SUCH WORK. Ti --� 03s-&/ R--, (' T CONTRACTORS LICENSE NO. E STATE SIGNATURE OF APPLICANT DATE .._ DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT TOWN OF SOUTH WINDSOR PERMIT# Applicat' BUILDING DEPARTMENT 9 1 S APPROVE 1540 SULLIVAN AVENUE Bldg.Permit# 0 644-2511 ext. 230 -� c Date o uilding Inspec Application must be printed or typed FEE SCHEDULE Location of Job: G�.Q�s+anise $0-$1,000=$15.00 Street No. Street Lot No. Over$1,000= $15.00 per$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANT APPLICANT ADDRESS LIA-111 n �a�� G f 06Z/ APPLICANT PHONE# O W N St OWNER < OWNER ADDRESS OWNER PHONE C C = ESTIMATED COST$ & x IS THIS A CONTRACT COST? _Yes _No " �C./ FEE ENCLOSED$ rs O�� TYPE OF JOB: R C New Installation Alteration/Addition/Repair Revised 4/01//2002 APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A ❑RESIDENTIAL BUILDING PERMIT APPLICATION? ❑ YES ❑NO ❑BUSINESS CURRENT USE AND OCCUPANCY ❑ASSEMBLY ❑MERCANTILE❑EDUCATIONAL FUTURE USE AND OCCUPANCY O INSTITUTIONAL O FACTORY ENGINEER'S NAME PHONE ❑ STORAGE ❑GARAGE ADDRESS ❑MIXED USE (Other please specify) CITY STATE ZIP TYPE OF INSTALLATION/WHUNG METHOD 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 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 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. lv5 2?,o CONTRACTORS LICENSE NO. TYPE STATE SIGNATURE OF APPLICANTA DATE ADTSecuntyServices,Inc tqc 0 10 Research Parkway Wallingford.CT 06492 , Fire & Security Tele:203 74 14000 Fax:203 294 1514 CTState Lic.# 105789 ADT Date: �' 7 I, Peter Eglinton give permission to to obtain a low voltage electrical permit for e �i�►�I� on behalf of ADT Security Services, 10 Research Parkway,Wallingford CT 06492. w Sign Lic.Type 1=5 Lic# 105780 Job Cost Permit Cost i DEPARTMENT DECISION APPLICATION FOR SPRINKLER PERMIT A is a y: TOWN OF SOUTH WINDSOR PERMIT 5# BUILDING DEPARTMENT APPRO 1540 SULLIVAN AVENUE Bldg.Permit# 644-2511 ext. 230 �� a Date Application must be printed or typed FEE SCHEDULE Location of Job: $0-$1,000=$15.00 If Street Lot No. Over per$1,=$15.00 per$1,000or any fraction thereof Apt.No. APPLICANT 6e&I' �/Fi4y, APPLICANT ADDRESS ��ell Xe-OeJ— r FW7,ee,2" , of /3 APPLICANT PHONE# b0 y y 3 OWN S Fq OWNER OWNER ADDRESS CIO) . e , OWNER PHONE Q .. [� /l C ;D ESTIMATED COST$ 4�T/ law IS THIS A CONTRACT CST? V/ Yes _No FEE ENCLOSED$ �� 5 TYPE OF JOB: /New Installation Alteration/Addition/Repair Revised 4/01//2002 APPLICATION FOR SPRINKLER PERMIT (continued from reverse side) TYPE OF BUILDING TYPE OF CONSTRUCTION USE GROUP NO.OF STORIES ❑RESIDENTIAL O BUSINESS IS THIS APPLICATION ASSOCIATTDWrM A O ASSEMBLY BUILDING PERMIT APPLICATION? ❑NO L1 MERCANTILE � O EDUCATIONAL CURRENT USE AND OCCUPANCY O INSTITUTIONAL ❑FACTORY FUTURE USE AND OCCUPANCY ❑ STORAGE ❑GARAGE ENGINEER'S NAME g I GAWrb fr,01410�1 PHONE (/b 6?1 O MIXED USE (Other please specify) ADDRESS CITY C64/—,-en STATE ZIP /e1o3y KIND OF INSTALLATION SIZE OF MAIN DRAIN 4141 WATER PRESSURE AT STREET(PSI) ARE SPRINKLER HEADS ALTERS ? ❑YES ANO IF YES,CHECK ALL THAT APPL ADDED O DELETED ❑ALTERED IF MORE THAN 3 HEADS ARE DE V RAULIC CALCULATIONS ARE PROVIDED BY(CHECK ONE) � OOFESSIONAL ENGINEER ❑INSURANCE COMPANY WATER FLOW WATER PRESSURE AT SPRINKLER HEADS(PSI) ARE PUMPS REQUIRED? ❑YES ❑NO IF YES,CHECK ALL THAT APPLY: ❑FIRE O BOOSTER ❑OTHER ARE STANDPIPES PROVIDED? ❑YES ❑NO IS A SPRINKLER SYSTEM PROVIDED? YES El NO SPRINKLER SYSTEM MAIN WATER SUPPLY RATING S S— GPM / \ TOTAL DYNAMIC HEAD(TDH)OF FIRE PUMP PSI DESCRIPTION OF WORK THE UNDERSIGNED HE APPLIE F R 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. E STATE SIGNATURE OF APPLICANT DATE /D BUILDING INSPECTION DEPARTMENT TOWN of S UTgNIINDS�O ECTICUT C E R T S 14C U A N C Y 1 ZONE: w�,��y A § y�C l ' �� anuary 7 2005 This is to certif tkq; pY�,, a it No. 30962 confor s sub Esau' 11 t uire jit's.t,.f the Connecticut Basic Building s $ e orn o South Windsor a d� e �� pro r Sica ed below Approved for Oc u04 f_NANTI R PHE iC •#K U 5 Use Group: Constr. Type: .Y �� „ ' .z W "A g Official 1> Notice If this cer is df3- a y d;'� duplicate should be obtained im�n � �B& be rdi g Department Any change or extension of se' herein approved requires a new certificate of occupancy.