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HomeMy WebLinkAbout1425 MAIN ST DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT Application is hereby: TOWN OF SOUTH WINDSOR PERM # BUILDING DEPARTMENT APPROVED 1540 SULLIVAN AVENUE 644-2511 ext. 230 Bldg. Permit# i ,tom ------ Date Building Inspector 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$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANT .-,/ , -f , R D APPLICANT ADDRESS n( 7 &A) c� I-r.p r C-- I-'e,y r1 APPLICANT PHONE# c' 7 2 2 - G G O W N S f,q OWNER OWNER ADDRESS r. .4* , OWNER PHONE ,���,,, ��G r C ;D ESTIMATED COST$ y_5• n o xIS THIS A CONTRACT COST? CL Yes _No !� �C► FEE ENCLOSED$ 7.5, O o f��s - O�� TYPE OF JOB: �R•C _New Installation Alteration/Addition/Repair r 8' Revised 4/01//2002 APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A BUILDING PERMIT APPLICATION? ❑ YES ❑NO ❑RESIDENTIAL ❑BUSINESS CURRENT USE AND OCCUPANCY ❑ASSEMBLY ❑MERCANTILE FUTURE USE AND OCCUPANCY ❑EDUCATIONAL ❑INSTITUTIONAL ❑FACTORY ENGINEER'S NAME PHONE ❑STORAGE ❑GARAGE ADDRESS ❑MIXED USE CITY STATE ZIP (Other please specify) TYPE OF INSTALLATION/WHUNG METHOD SIZE OF SERVICE 2 b © SIZE OF MAIN CONDUCTORS 74, NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS J a U O 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 \ �Co r .S Af T Q A A t \ 0 h 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. /0 3 S >v E"z O,o�-24 CONTRACTORS LICENSE NO. TYPE STATE SIGNATURE OF APPLICANT DATE ttJJ '♦ '• �/ •�. � � •' �r yr t!r •� ,�,:'rlA� t �'t � '. •♦. t r�}. # t' Olt +�. + '7• -mil �. .e TF{� � jw � � � •�'♦ 1� YT; A _ Fi s F � ♦•1 � nQ (76bl,48.3 � .-' r��jrf�jcf� •r t•r�( P., r".._ .�. �I ],�ri `-4• ••.n,4:!'• " f•(.�. .,ii�rr. - F 1t ; •;, `jam `' '.I; i F�.�,'f♦ ( -l4 •+'�3�.�r'�e�- L¢- t '. r j,.�},, � '�1�� �,i t.41. k �P. � r� f,}�•1,`�f��;'' S4-ll•L"+� �..f ;�� ~ ' _ `_ SN r: �.- r �rl' F'.•T%'�.`Tr'. y,i, ff�� �j 1 �•- - y t `I' � `r' y��i•� l a .. 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TOWN Of $QtlTH WINOSOQ This r1:111-•d th I this phn and Specifications are true c_�tr�s of the prcpoced bullding or aiteratlorts to hS era ct Id at 7 Va •ch n••ndrm•nts stated in application and wi h zgrvo to comply with all zoning. lS LLL��Saa I,rros and such orders as shall be D 'd tic r;g Opartm t Burin OCT 2 2008 S pendency " hi +Ppl; ion d final t anCe of a bulldlnm South Windsor BUILDING DEPARTMENT Is approve )act o e eonditton that o:d -rid caruinanc re„ul in building shalt bm —th. Cc -- .,,rally Approved These flied W"m I 1 •'omd Inspector Cw� • _ — »v_ Gib� ' PERMITS/INSP PAYMENT RECPT# 20312294 TOWN OF SOUTH WINDSOR 1540 SULLIVAN AVENUE SOUTH WINDSOR CT 06074 DATE: 11/17/08 TIME: 10 21 CLERK: dayshelll DEPT: CUSTOMER# 0 PARCEL: CHG: BLDPRM BUILDING PERMIT 75 00 AMOUNT PAID: 75 00 PAID BY: J.J. ROSA PAYMENT METH: CHECK 14315 REFERENCE: A1425 MAIN S AMT TENDERED: 75 00 AMT APPLIED: 75 00 CHANGE: 00 DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT PERMIT# Application is hereby: - TOWN OF SOUTH WINDSOR BUILDING DEPARTMENT APPR VE 1540 SULLIVAN AVENUE Bldg.Permit# 644-2511 ext. 230 nrl ID��- i Date Building Inspector Application must be printed or typed FEE SCHEDULE Location of Job: F:Ten:ant _ 09-Z1 S� $0-$1,000=$15.00 Street Lot No. Over$1,000= $15.00 per$1,000 r " or any fraction thereof gnation Apt.No. APPLICANT o •v► s T *c t= h -Lv c . ;E FARTIgIHN? APPLICANT ADDRESS _ 1 00 (,J e:s T 11:Nn�-0.., C+ APPLICANT PHONE# S o t+s o g o o O W N SF,q OWNER f 6 - r.► s S c�1 w o b OWNER ADDRESS (9 1/ CIO) ,. OWNER PHONE C ESTIMATED COST$ .� IS THIS A CONTRACT COST? X Yes _No FEE ENCLOSED$ U f�OS,O CO TYPE OF JOB: iA S`-4(k� k R _New Installation Alteration/Addition/Repair l Revised 4/01/2002 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 OCCUPANCY ❑ASSEMBLY ❑MERCANTILE❑ EDUCATIONAL FUTURE USE AND OCCUPANCY ❑INSTITUTIONAL ❑ FACTORY ENGINEER'S NAME PHONE ❑ STORAGE ❑ GARAGE ADDRESS ❑MIXED USE CITY STATE ZIP (Other please specify) TYPE OF INSTALLATION SIZE OF MAIN DRAIN NO.OF TOILETS 2- STYLE NO.URINALS STYLE NO.OF BATHTUBS Z NO.OF SHOWERS I NO.OF LAVATORIES NO.OF CONDUCTORS SIZE NO.OF STACKS 1 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 Pto Az Ns MANUFACTURER DESCRIPTION OF WORK sr411zr..� oC Q1 v.r. 1D..,e► \ o� ��c�.�� •,.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. Pt Z7& A-a2— f l CONTRACTORS LICENSE NO. TYPE STATE SIGNATURE OF APPLICANT DATE I L - Z DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT TOWN OF SOUTH WINDSOR PERMIT# Application is hereby: BUILDING DEPARTMENT APPRO "-Inspect6r 1540 SULLIVAN AVENUE 1-6 ;V 644-2511 ext. 230 C)CABldg. IQ't# Date B Application must be printed or typed FEE SCHEDULE Location of Job: FTenant $0-$1,000=$15.00 Street Lot No. Over$1,000= $15.00 per$1,000 or any fraction thereof gnation Apt.No. APPLICANT �:vll 11'4L APPLICANT ADDRESS 1 0 o W<%T Z-.-a o C-� aLO'Z'q APPLICANT PHONE# % V o .a.�a %Z i v OWN S F,Q OWNER `T� o en-A t s c, w L -- OWNER ADDRESS 1 Lk2 5-- T. .0 OWNER PHONE C ESTIMATED COST$ ~ 1 U S-�o • .0 o x <� IS THIS A CONTRACT COST? X Yes —No o �G FEE ENCLOSED$ �5 TYPE OF JOB: rJ OS�R C O� New Installation - Alteration/Addition/Repair Revised 4/01//2002 .v APPLICATION FOR HVAC PERMIT (Continued from reverse side) TYPE OF SYSTEM: TYPE OF BUILDING: HEATING RESIDENTIAL 2f A/C (❑COMMERCIAL ❑VENTILATION ❑INDUSTRIAL HEATING ❑STEAM LOW PRESSURE LMT LBS. HIGH PRESSURE LIMIT LBS. ❑HYDRONIC WARM 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 NOS.!) 1'K11 14-oP�« fi 9e`T 4.1.+ !y4,«oCA AvG tt l.owfliTa�,v,ti� GROSS HEATING CAPACITY(INPUT—BTUH) I Soi,oa a NET RATING(OUTPUT—BTUH) 3'8 a TYPE OF FUEL 0 OIL—GPM OIL TANK LOCATION:❑INSIDE❑OUTSIDE CAPACITY tR GAS—INPUT ls-,� .. LPG TANK CAPACITY ELECTRIC—KW AIR CONDITIONING 470 DESIGN TEMP.OUTSIDE 4*0 OF INSIDE -16 OF DIFFERENCE 15' OF TOTAL HEAT GAIN(BTUH) (HEAT GAIN SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL COOLING EQUIPMENT(INCLUDING MAKE&MODEL NO.) TONNAGE 3 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 CONNECTICUT BUILDING CODES IN THE PERFORMANCE OF SUCH WORK. / 3 SS (. ,V , 14 CONTRACTORS LICENSE NO. TYPE STATE SIGNATURE OF APPLICANT DATE SovJH ui�...o1o/L RIGHT-J SHORT FORM �3L, Entire House r>3z 3 Homestead Fuel Inc C/32- atia Job: 11-14-2008 100 West Road,Elington,CT 06029 Phone:870-8700 Fax:870.7731 Email:jeRg@horriesteadhiel.com Web:www.homesteaoftiel.com Project • • For: Jacques Const./Schowb Res. Old Main St,South Windsor, CT 06074 Phone: 305-1861 Design Information Htg Clg Infiltration Outside db('F) 4 88 Method Simplified Inside db(°F) 70 75 Construction quality Average Design TD(°F) 66 13 Fireplaces 0 Daily range - M Inside humidity(%) - 50 Moisture difference(gr/lb) - 22 HEATING EQUIPMENT COOLING EQUIPMENT Make Make Trade Trade Efficiency 80.0 AFUE Efficiency 0.0 EER Heating input 0 Btuh Sensible cooling 0 Btuh Heating output 0 Btuh Latent cooling 0 Btuh Heating temperature rise 0 `F Total cooling 0 Btuh Actual heating fan 1400 cfm Actual cooling fan 1400 cfm Heating air flow factor 0.013 cfm/Btuh Cooling air flow factor 0.029 cfm/Btuh Space thermostat Load sensible heat ratio 95 % ROOM NAME Area Htg load Clg load Htg AVF Clg AVF (ft2) (Btuh) (Btuh) (Cfm) (cfm) ADDITION 0 0 0 0 0 Family Room 360 24215 12887 311 377 Entry 264 9528 2172 122 64 2nd Floor 0 0 0 0 0 Bath 1 108 1986 262 25 8 Walk-In Closet 96 1146 299 15 9 Master-Bath 168 4728 2286 61 67 Master-Bedroom 308 8055 4613 103 135 Laundry 80 1114 727 14 21 Old 1st Fir 0 0 0 0 0 Kitchen 180 2714 147 35 4 Dining Room 143 4035 1659 52 49 Living Room 264 8782 3148 113 92 Foyer 28 2301 413 30 12 Bathroom 20 907 553 12 16 Back Entry 150 10387 2809 133 82 Sunroom 220 16563 8418 212 246 BOIdrNalk values have been manually overrkkftn Printout certified by ACCA to meet all requirements of Manual J 7th Ed. wrightsoft Right-Suite Residential"'5.0.28 RSR27407 2008-Nov-2013:57:17 14CCK C:Vocuments and SethngsUeRlMy D=xnents\Wrightsoft HVACUacques-Sdwjob.rsr Page 1 Old 2nd Flr 0 0 0 0 0 Up-Bath 45 978 665 13 19 Bedroom 1 144 3023 1749 39 51 Bedroom II 204 4058 2633 52 77 Bedroom III 216 3495 1717 45 50 Closet 35 1147 700 15 20 Entire House d 3033 109162 47857 1400 1400 Ventilation air 0 0 Equip.@ 0.93 RSM 44507 Latent cooling 2744 TOTALS 3033 109162 47251 1400 1400 BoUttalie values have been manually overrddden Printout certified by ACCA to meet all requirements of Manual J 7th Ed. ti W rIg ht50ft Right-Suite Residential"'5.0.28 RSR27407 2008-Nov-2013:57:17 /CCX Moaanerds and SettingsUelMAy DoaanerdslWrigtdsoft WACUacques-Schwob.rsr Page 2 a m DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT � PERMIT# $ TOWN OF SOUTH WIMSOR Applieae Y BUILDING DEPARTMENT 1540 SULLIVAN AVENUE Bid&Pit# 644-2511 ext.230 Date OW105 Inwouwr 8 Application must be printed or typpedd RESCHEDULE Location of Job: ES'v!mNo. ..M&\r� SJSO-S 1,000=S 15.00 Street Lot No. over s l.000- S15.00 par$1,000 o[auy fraction thereof adon Apt.No. APPLICANT APPLICANT ADDRESS Ann MAKWAn Tpa: F1�M�IPTON,CT 06247 APPLICANT PHONE# 9595 ,SOW N aF4 OWNER 'VN-\o OWNER ADDRESS i`,�A Apr C�T O 1?O`� QOWNERPHONE �n0 —a `0 %-Ot9 1 C ESTIMATED COST$ 3 a as.�J IS THIS A CONTRACT COST? Yes No �` PEE ENCLOSED S u�i fir�SOR co TYPE OF JOB: Now Installation —Alteration/Addition/Repair A Pwv6W"11/2002 r .�I Mar 03 09 10;51a Jacques Construction 8604322510 p.6 (((111 11 i P, ..r ,z APPLICATION FOR PLUMBING PERAHT (Continued fromreveme side) TYPE OF BM DING IS THIS APPLICATION ASSOCIATED WITH A RESIDENTIAL BUILDING PERMIT APPLICATION? ClYES 0 NO 0 BUSINESS CURRENT USE AND OCCUPANCY 0 ASSEMBLY 0 MERCANTILE FUTURE USE AND OCCUPANCY 0 EDUCATIONAL 0 INSTITUITONAL 0 FACTORY ENGINEER'S NAME PHONE O STORAGE 0 GARAGE ADDRESS S r v 0NM(ID USE CITY - L✓t pi do✓ STATE ZIP (Other Please specify) TYPE OF INSTALLATION LP 6 rtS Tin I\ 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 AREA OF ROOF NO.OF CATCH BASINS NO.OF FLOOR DRAINS NO.OF OTHER FIXTURES KLPID ARE TOILET COMPARTMENTS VENTILATED TO.OUTER AIR BY A WINDOW D 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 MANUFACTURER DESCRIPTION OF WORK :rr<S tc�J — 1 DDD 6 r4 L t�If COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE PERFORMANCE OF SUCH WORK. C CONTRACTORS LICENSE NO. TYPE STATE SIGNATURE OF APPLICANT DATE 0 PAYMENT ON METHOD OF PAYMENT SALES/SERVICE ORDER 112 8 4 �merK�s. ❑wW ACCOUNT ❑ CREDIT MEMO ICE ❑NEW INSTALLATION DATE CUSTOMER REQUESTED a�,e�w� EMIT T UFSTED: ❑EXISTING INSTALLATION CALLED / / SERVICE DATE C}REMIT TO tY ❑ CASH SALE ❑ FINAL ❑ CHECK# ❑ CASH SALE WTURN❑ SERVICE ❑ CASH BOX 371473 ❑ CHARGE SALE ❑ INVOICE ❑ OTHER INSTALL ❑ INSTALL ❑ MOVE ❑ RANGE ❑ DRYER PITTSBURGH,PA ]MOVE ❑ CONNECT ❑ WATER HEATER 152 7473 ]DISCONNECT 1 LOSS REASON CODE ❑ DISCONNECT ❑ SPACE HEATER AMERIGAS ]REMOVE J ❑ REMOVE ❑ FURNACE 400 HARMRDTPKE ]OTHER ❑ HER 800-229-9595 a � e.H.A`MPTON CT 06247 r ! W� ACCOUNT INVOICE NUMBER NUMBER C 6112 8 4 I DATE MO`' sf' CUSTOMER / �♦ NAME C AND ADDRESS p 6 ;ERVICE PERFORMED: DATE 40169610 HOURS HOME PHONE WORK PHONE P.O. NUMBER NUMBER NUMBER � VQ COMMENTS: (�s• I E�& ' l . 1' T. CIRCLE ONE a �' TANK LOCATION CODE G F I E TANK TANK GRID H D SIZE PERCENT NUMBER A C s DLS(;HJF 1 ION. ►�n� /03--n i4 if 2GALLONS OF BULK PROPANE SOLD WITH INITIAL SET UP. r. GALLONS IN DRIVER- TANK WHEN SET. COLLECT C.O.D.$ s ` 1 Residential Customers:All fees, rates and charges are due within ten (10) ) after the date of this invoice at the office designated by The Company. .. iraquent accounts will be assessed a LATE PAYMENT CHARGE. 5ommercial Customers:Charges shown are due in full by the"15th of the DLPO following the date of this Invoice.Delinquent accounts will be assessed PAYMENT CHARGE. R ACKNOWLEDGES THAT A S CUSTOMER �,, HAS BEEN PERFORMED. ❑YES ❑NO REWIRE A COPY? [:]YES ❑NO?,%"!, IMPORTANT TERMS AND CONDITIONS ARE USTED ON THE REVERSE SIDE OF THIS DOCUMENT DATE SERVICE DATE' 14PPROVAL DATE PERSON'S SIGNATURE ) SA(REV 6M7) T. .rIAA'F� 1=11 F\ RESIDENTIAL INSTALLATION SET-UP FORM wz s WON ow: 4 i PROPOSAL? Y N TANK SWAP NEW INSTALL I"APPUANCE 1 MAN JOS 1 MAN XW OP TANK(S): locoAAL U.O ESTIMATED XW TIME: AM Of CONCERN! CAU MOM SLOP! STAIRS SEPTIC PENCE PETS fN0 TO m RUN LSNp7i/: am. La COPPER PLASTIDYLACKIRON TWW PIPE I I WOOD ORICK OONORETE AUAINNMI VINYL TlAmwmlouc : rvm �eCu�erern �:MIDIOATE%V"M TA N 4%AM TO SE IWTALLW A W OWQLO ED sY TW lrOf.AL MIN MUC/ION,NICLUM TO EACH KWJWUNOINQ PROPERTY LNIE. NOTE OMWErM M SUIM SYSTEMS.WALtBi MU=,AWM STC. 714 lKNC � you grls SQU6 --------------- �J t FRONT OF SE �w• . • �w� •n.w www !. • ! •�• ��s •w n��. �! vn•1• IA CA_!"A�.�O/./ f 7w ti Ameri Gas DISTRICT PROPOSAL America's Propane Company Hampton,CT Contact Person: John Jacques Phone: 860-305-1861 Date: 02/12/09 Email:jacquesconstruction@coz.net To: 1425 Main St. Job Address: Same South Windsor, CT 06074 /) 911(c� % ^cam John, I am pleased to offer the following proposal for your propane needs. Per our conversation, AmeriGas will provide the following: • One 1000 - Gallon UG tank package: Package consists of the following; tank, 2 anode bags, 1st & 2nd stage regulators, misc. parts/fittings, metallic indicator tape, up to 25 feet UG piping & installation. Cost $3,225.00 + tax • Propane: Vt fill price of$1.749 per gallon as of 02/12/09. Price is subject to market conditions. • Uses: Heat, Hot water, fireplace Excavation for tank & line and all interior gas piping to be done by others. Customer to be billed for permits and propane. This proposal is valid for 30 days from above date. Thank you for the opportunity to quote on your propane needs. SUBMIT'IBD BY CUSTOMER James L.Tavino Account Manager (860)-833-8132 A 1V/l2lJLUUtf 11L:!!I :LiJ rA t'AALT01•V� a.1a►ua�a••a.•. . ..�,.. .. AC0* 29 008 AM Msk 3eitvites Central. Inc. 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IdLow etlrrAttttletaltlottnftlAu tRnRerleeeureAnmtnttaAalllY lTr ASAT1[NA tt'DM rIR MIl�,in AC.iMI!OR RSrt6lRtYt7t rlVrlt Electric # APPLICATION FOR BUILDING PERMIT Plumbing# BCt;,,-AR 1425 Main street Date: HVAC # gcc��3 Sprinkler# 8 0 0 6 9 2 Doo FINAL AP ROVALS --E, - - -_ - -- - -- - —� Estimated Cost $ f� - --- - - - -- Permit Fee $ Building d COMPLETE RED BOXED AREAS Engineering TYPE OR PRINT ONLY Occupancy Fee $ ft7 Affidavit Eng. Insp. Fee $ Appr. for CO. SIGN ON REVERSE SIDE Total F $ I S11 TO THE BUI DING DEPARTMENT,TOWN OF SOUTH WINDSOR, CT (Additional Cost) $ The undersigned hereby applies to do work according to the following: Applicant 1SIV Location of Work J11A w1 S Lot No. Applicant's Address Tel.# Town Zip 9' _Lic.# Owner ®kii Architect db� ta,+ Owner's Address Architect's Address Zip Zip Sq. Ft. New Area: 1st Fl. 6 19� FI., 77Tiro 3rd FI., Total New Area Purpose of this permit City Water Well❑ Septic System❑ Sewer of Ins: HO SP Cert. a Basement Garage Approved b Date IN Use Groin -�Construction Type 7 /' 77 Revised 8l02 /v g b 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 this building and its use is allowed. 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