HomeMy WebLinkAbout206 LAUREL ST Electric#�v o� APPLICATION FOR BUILDING PERMIT
Plumbing# Po (_f
HVAC206 Laurel Street
# 13
Sprinkler# 2
FINAL R - _32"S 4 -— ---- = -- ---- Estimated Cost $�
Buildingll COMPLETE RED BOXED AREAS ; Permit Fee $
Engineer' TYPE OR PRINT ONLY Occupancy Fee $
Affidavit Eng. Insp. Fee $
Appr. for CO.t n
► SIGN ON REVERSE SIDE
Total Fee $
TO THE BU LDI G DEPARTMENT,TOWN OF SOUTH WINDSOR, CT (Additional Cost) $
The undersigned hereby applies to do work according to the following:
Applicant y Location of Work j. Qr, hken-L Sf.��7�- Lot No.
Applicant's Address Tel.# K& �yy- 3a99
Town - r Zip 130>1q Lic.#
Owner Snug Architect Q K__
Owner's Addresses Architect's Address JC ou--
Zip —
Zip--Sq. Ft. New Area: 1 st FI. 1JQTr 2nd FI. 3rd FI. Total New Area z�IO.k�_
Purpose of this ermit
Q,.- La
City Water[ Weil( , Septic System❑ Sewer
Ins: HO 'Jasp, Cert. Area Basem t Garage
Approved y Date 1 3 v Use Group l Construction Type
Revised 6/02
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 thi building and its is al wed.
Signed _
I hereby apply for a Certificate of Occu ncy or the work de r ed i this a plication for the permit.
Signed
DON T WRITE BELOW THIS LINE
INSPECTION COMMENTS
Inspection / Approval Date By Appl
Code Description Due Whom Code Comment
-------------------------------------------------------------------------------
**-32254-B 5,000
BO1 FOOTING 11/22/05 JFF A 3 8IN SONO LEFT APPROVAL NOTICE
B03 FRAMING (ROUGH) 12/12/05 JFF A FLOOR OR DECK ONLY LEFT APPROVAL SLIP
B04 INSULATION 12/12/05 JFF A FLOOR OR DECK ONLY LEFT APPROVAL SLIP
E03 ROUGH 03/09/06 JFF A WITH OWNER
B04 INSULATION 03/14/06 JFF A WITH OWNER R38 CEILING R15 WALLS
B03 FRAMING (ROUGH) 10/27/06 JFF A WITH OWNER BATH AND BEDRM
E03 ROUGH 10/27/06 JFF A WITH OWNER BATH AND BEDRM
P03 ROUGH 10/27/06 JFF A WITH OWNER BATH AND BEDRM
B10 FINAL 04/17/07 JFF D WITH OWNER BEDRM COMPLETED BATH FINISH FLOOR
AND GFI TO FINISH AND CALL
B10 FINAL 11/02/07 JFF A WITH OWNER OK FOR COFO
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South Windsor
South V./inds@PILDING DEPARTMENT ,UN 0 2W)
1UILDING DEPARTMENT
ro THE wILDItu DEPT. TOWN OF SOUTH WINDSOr South Windsor
This certified that this ,Ian and specifications are tru. BUILDING DEPARTMENT
copied of the proposed pwidins or alterations to hr
etoctod at
1201. L Sir.
together with amendments stated In application
l lied with plan and 1 agree to comply with all zon..
Ruilding and state laws and such orders as shall
issued by the Building Department during pendt—
.If this application and final issuance of a build.,
pernllt.
,C 1`0 THE BJILDING DEP(, TCW,v (",h- SfIrTH WNiO5fl11
Signed
This plan is ap oved subject to the condition in rhis certified that this plan end specilieations ere;rue
orders and o inancea regulating building shall al copies of the proposed building of aftets orm op be
complictl with. erected at
Conditionally Approved These tiled with
S Street
"gether with amendments stated in application and
Building Inspector CIerY riled with plan and I agree to comply with all zoning,
Building and state laws and such orders as shall be
yy 1 issued by the Building Department during pondency
Data 11L (J` of this application and final issuance of a buildinri
permit.
Signed
CERTWICATION OF ZONING COMPLIANCE This plan Is approved subject to the condition that
orders and ordinances regulating building shall be
. roposed buildings), uses) and)or structure cor,.plied with.s Conditionall
y Approved These filed with
shown on this plan appear(s) to be i.r
,iformance with current South Wind;
Bi dl g Inspector
gulations. Variances and special exception,-- q CIerY
jay apply. •" 4—(�Q�- •,� ����
;ate "? v
l� '
g of rcement Officer
x 1 -2
�`�r�'�2d bui.�di(; r ' +a 1,�•�rri-LrtitvC;E
r�ec shotivn on this Plan
uses) and/or structure(s)
l8' onf hovin e with Plan apPear(s) to be in
-cgulations. Variances current South Wi.nd,or
w UU may apply. and special exceptions
Date
. 7jrig Enforcer,;ent Officer
7 ' , .• ti I,Fr
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BLOZIE Uerclo•Jer lflL;,IA:-- t::CK Sc:lc :4{{ el- 'tls .�t:� A�:2•i1
1t3, 1. :7:: K:s l:1Cj1 L. GrAlswolc:
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L. Gri c .old
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QFI�I)j
South Windsor
BUILDING DEPARTNIENT
To Tt' 1Cl,i Dot T. TO" of sC.LrM Vw.INOSOO
C"In and `te.ftlnnsor*
bvi:zling or a;,erationg to bs
Stre.
JS %h,,Ii 0
S"anCe Of a buiWini
to t.-I ,,
Cjr.j,ri.,n taf
rag- 'I-ig L:ul,ding shall be
These filed with
Clerk
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oil to bo
Of
1Cmitations. al.d
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BLO ME Derclo.,er I-P,L Scale
L. 'GrIswo 1 C. 0.E,
�Cale V, eqt."ale
L. " 1av-old
joxAt4D
70-00
li%Opiar-y OF
Lot &D eiftitled IPI-jap of
'
522X.ET ;XUTH Property of XELIA L.
BLOZIE Derclo-Jer 6m10 equalo X' A'.,,ri 1
lat 1^16o- Hayden L. Gxrlstiroll'.'
Scale ,V -- "alo
H":-aem L. Gri sum id G.L.
NOV t 7 2000
South Windsor
13UILDING DEPARTMENT
c,
Ow Al
t11d1'�h(JJ�/VV/ w3�adsul aufFr+r._:
11411M Polls —041 panoaddy RNruo+Iq
M 1194s aulplln4 sa3—ip— t,—
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qua uo13eo1ldd• ut paleis 431A J041v11.
a,sli$
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,lit aiv cwaleayy{aaK Owe w"d S144 iw4i P-Woaaa sl,e,
10SGNVR HIPOS 10 NMI '1d30 W0]1fJ MU 01
s,.1-^;fn oa th e p:2n anp--::r(s) to be in
n ^di'il c:� rent SJ i-h W7;d
IC11 C
ui:Aions. Variances and sp�cial exceptions
ap,o;�.
ate (�I7 Oc)
Zoning Enforcement Officer
0
14 Af
ry
let
OF •
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mw
cc-;,
NG
Lc an en.titioled 'I.iap of
4VZR:: STPZET i3L-UTH Prcnerty o.. AIMIA L.
BLO ME Derclo-jer 6 cal e,--,uals XI A-.,ril
OW
V$
L. Grfav*old C.L.
CERTIFIC,q TION
Proposed OF ZONING COMP � . U z JWA
as shown buildings) use LIANCE
on this (s) and/or structure(s�
conformance Plan appear South Windsor
regulations. with cures (s) to be in BUILDING DEPARTMENT
1/ariances an nt South Windsr_;
may apply. d special Date exceptions
r;
Zo i
orc nt Officer
TO THE BUILDING DEPT. TOWN OF SOUTH 04DSo►
This certified that this plan and specific'.tl.-os•rn•ink
copies of the proposed building or alterotloos to be
erected at Z04 /`fz.,/e � _ str—t
together with amendments stated in apMi, tip n
filed with plan and 1 agree to comply with t• •ing.
Building and state laws and such orders .t 1• tie
issued by the Building Department durtng ii—iorrncy
of this application and final issuance of a undntg
permit.
Signed
This plan m proved subject to the condition that
orders and r-rdinances regulating building shall be
eurnphed with.
Conditionally Approved T4ese filed with
uildiag 1ASPOONG1grR
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44
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ry
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LIAM,izL 6' 6GU,� H ia.24M CC
z L o444 N- o U3 or ='I) eillt ', ` ed 'PI-jap of ',WC)GDJjA..*,D
;
IT.'; Pmperty of AM-MIA
STPZE" .)60 ) -
BLO ZI F, Derclo,)er 6 cal,,, e- al X A-.,ril
jc6o Hayden L. Cx1riswoIC1. Ca.-co'O
L. GrIawold C.L.
IQ THE BUILDING DEPT. TOWN OF SOUTH WINDSOF
JUN 1 & 1996
;his certified that this plan and specifications are true
c..pies of the proposed building or alterations to be
1 South Windsor reeted at
BUILDING DEPARTMENT '�20� — Street
SU,1 lAlln Or v. tber with amendments stated in application anC
y� �f d with plan and 1 agree to comply with all zoning.
BUILDI DEPA MENT Ming a"d state laws and such orders as shall be
• d by the Building Department during pendency
I:is rppl'Ca tIon and final issuance of building
Omit.
CER14FICATIM OF ZONING COMPLIANCE "`ned A-
plan is app vetl su ct to the condition that
.'roposed building(s), use(s) and/or structure(s) Und nanees reaulating building shall be
nth.
s shown on this plan appear(s) to be in ,attion4lip Approved The" tNw wkb
.informance with current South Windsor
.gulations. Variances and special exceptions WOO Ong Insp for Cler«
iay apply. Data
Ate j n
ng Eno ement Officer
F—
v �
i \
00
1'iV• �:1LL '1/ v1-�+.-/�.+ Jar y'�:1 ,�....•�lJ�'1:� dL1i:.•
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STREET S50 vh .i+i.'1✓/.11ii'�� NUl'1.�• �i'ti�f.`1�4 yY tl_� l�i'1�.111 L�
LLOME Derclo,_.,er WIL"!A:,t ril
Dit lCbr- Hayden L. Grlswoli. �.�.
ha-pier: L. Lltr1 o k-o:3 L.
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ST''.Er ;iC'L"'ii "'"''' IN Pmpert;� of d2•I=A G.
A
BLOB£ Dere3.o•;ei• W1L:,L : Scale :�" a c:�1s150 :ril
I.t3 l.;;:.. � ��r:ic;l %I. �r..s.co...... ,.�. ..��••f�,� — � -�
tvV �Jy�•v.I1
S
,. ��t�It
t0 The NG giYT. TGNM OF SOUTH N'/NVW,,
:his certried t" this pan and syecificatlons ar
co,ies of the Proposed bulidtng or
erected at a vu.
8iter8tlV ns to'
M
to t/r`V
Str-
with amendment
tiled with s stated in application ,
Plan and 1 agree to Sof ed and state law COnlWY with all O �{ ( ( C /y1
s and Inn;r.. 1 `A l', 1l
�saacd by the such orders as shalt y —�
this epphcatonitand analDell i s- during pendrr� l
Permit. final Issuance of
Siff d
",
This n is y
plan is proved subject to the
orders and ordinances condition
regutatin Ma;
ctmplied with. R bu Udin6 shall be
Condrttonally Approved /)
These filed with
euildind Inspector
Clark
Oats
CERTIFICATION OF ZONING COMPLIANCE
Proposed buildincl(s), ,►�o�S� _ ,.� structure s
SS Shown on ( )
conforms,-)Ce wi,�t u:an'app�`; - ) to be in
curr,,rt W�ulz a� -Y.s. Var-onces and
may Sp";'- oX:= .Pc1on3
Oete C!
ni omm.
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
TOWN OF SOUTH WINDSOR PERMIT#
Application is hereby: �/
BUILDING DEPARTMENT , _
314APPROVE 1540 SULLIVAN AVENUE Bldg.Permit#
0f, '� 644-2511 ext. 230
aWil mg Inspector
Application must be printed or typed
FEE SCHEDULE -1- Location of Job:
$0-$1,000=$15.00 Street No �Q t�r eL �S I re� Street Lot No.
Over$1,000=
$15.00 per$1,000
or any fraction thereof Tenant Designation Apt. No.
APPLICANT
APPLICANT ADDRESS
APPLICANT PHONE# &.0 - 99 CiA\ `11(o-0283
�0 N g�q OWNER SAmr,
< OWNER ADDRESS Sgrv�pJ
• �, OWNER PHONE SLzk,
O ESTIMATED COST$ a U
•� IS THIS A CONTRACT COST? _Yes _No
!i 04G FEE ENCLOSED$�
l�4N ON� 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 ASSOCIATE,_D,/WITH A
BUILDING PERMIT APPLICATION? L7 YES 0 NO
RESIDENTIAL
U BUSINESS I CURRENT USE AND OCCUPANCY
O ASSEMBLY
0 MERCANTILE O EDUCATIONAL FUTURE USE AND OCCUPANCY
❑INSTITUTIONAL
O FACTORY ENGINEER'S NAME PHONE
OSTORAGE
❑GARAGE ADDRESS
❑MIXED USE
(Other please specify) CITY STATE ZIP
TYPE OF INSTALLATION/WIRING METHOD
SIZE OF SERVICE 1 M A , X'A" SIZE OF MAIN CONDUCTORS /
NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS T—'g q�ar
NUMBER OF PANELS REMOTE DISCONNECT REQUIRED? ❑YES Uf4O
NUMBER OF LIGHT CIRCUITS�_NUMBER OF POWER CIRCUITS
NUMBER OF SWITCHES I NUMBER OF OUTLETS r
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 1
t-1�'Jec� i41�1� Tt e AroC)jM I1 fl-L) ,r 1 yi 1" mc) �^ c�
C, .�I s !J M� he t`e vvtt�v� Ian 1�er M� t,oltp c `T� nu���►'�S•
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
PERFO CE OF SUCH WORK.
ONTRACTORS LIC SE NO. E STATE
i
SIGNATURE OF APPLICANT DATE /
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
TOWN OF SOUTH WINDSOR PERMIT#
Application is hereby: Q
BUILDING DEPARTMENT
APPROVED 1540 SULLIVAN AVENUE
Bldg.Permit#
±Dat
644-2511 ext. 230 i ding Inspector
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$1,000or any fraction thereof gnation Apt.No.
APPLICANT 1,I)C, 4)g- J
APPLICANT ADDRESS ,Z(�(„
APPLICANT PHONE# j?(DO . (.,LA I - ,-q4
.OW N St OWNER SlO-U
OWNER ADDRESS
U) OWNER PHONE q�K�
C = ESTIMATED COST$
IS THIS A CONTRACT COST? Yes ✓ No
FEE ENCLOSED$
SOR CO TYPE OF JOB:
New Installation
y1 Alteration/Addition/Repair
APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
BUILDING PERMIT APPLICATION?'❑YES 0 NO
❑RESIDENTIAL
❑BUSINESS CURRENT USE AND OCCUPANCY
❑ASSEMBLY
❑MERCANTILE FUTURE USE AND OCCUPANCY
❑EDUCATIONAL
❑INSTITUTIONAL
❑FACTORY ENGINEER'S NAME PHONE
0 STORAGE
U GARAGE ADDRESS
O MIXED USE
CITY STATE ZIP
(Other please specify)
TYPE OF INSTALLATION/WIRING 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.
` DESCrRIPTION OF WORK
o
-SaA -tyb Jo A GFc t
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.
r
CONTRACTORS LICENSE NO. :TYPE STATE
DATE SIGNATURE OF APPLICANT /d (/
f 10 Heete.r '
32 HeAte r C
e
1
� x
� Y
'Los s ►
10 6/15e,�Donr�` �rvn�n�
� c �eC�'ItA � �►tvJ C�rt.���' �'a�Wvr1
' � IJC�rUUM
S
e
e.�rnoK1 Pl�mbinc� ► SPA
I SMwe.�
U Van i
c
y"
1
TO THE Bury 4C ;,ZpT. TCt'N OF WUTPI WIN:S()
This Certified that this plan and spocificstinns are true
Copies of the proposed building or terations to bR
erected at
Street
together with amendments e;.ted in replication and
filed with plan and I agn•e to con•ply with all zoning,
Building and state Iiws 'I•d h orders as shall be
issuf d .Y the Building Oeparb7 nt during pendency
of this appl;cation and final issuance
of a ullding
Permit. / 2
Signed
This plan Is a pr ved subject to the condition that
orders and crdlnances regulating bj{iding shall be
co rrpt i' with.
Con t itpproved These file) with
d
uilding spe
Clat7t
patel0
nv.
DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT
TOWN OF SOUTH WINDSOR PERMIT#
Application is hereby: �,
BUILDING DEPARTMENT --.�6 6 —
APPROVE 1540 SULLIVAN AVENUE Bldg.Permit#
a0�
4 644-2511 ext. 230
c
ate ilding Inspector
Application must be printed or typed
FEE SCHEDULE Location of Job:
F-Fenant
$0-$1,000=$15.00 Street Lot No.
Over$1,000=
$15.00 per$1,000
or any fraction thereof gnation Apt.No.
APPLICANT 1A J
APPLICANT ADDRESSC�
APPLICANT PHONE# kl O ("ALA- 3.S q 9
W N St OWNER 4�vtt
OWNER ADDRESS 5grt e,
(01) p, F. OWNER PHONE
O
C = ESTIMATED COST$
IS THIS A CONTRACT COST? _Yes ✓No
!� -o '�CJ FEE ENCLOSED$
!�Y �✓ TYPE OF JOB:
LSD R C O� _New Installation
_�,/Alteration/Addition/Repair
Revised 4/01//2002
APPLICATION FOR HVAC PERMIT (Continued from reverse side)
TYPE OF SYSTEM: TYPE OF BUILDING:
❑HEATING ❑RESIDENTIAL
❑A/C ❑COMMERCIAL
❑VENTILATION ❑INDUSTRIAL
HEATING
❑ STEAM LOW PRESSURE LIMIT 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) OF(HEAT LOSS SHEET MUST ACCOMPANY
APPLICATION)
DESCRH3E ALL HEATING EQUIPMENT(INCLUDING MAKE&MODEL NO.)
GROSS HEATING CAPACITY(INPUT-BTUH) NET RATING(OUTPUT-B'i'TqE[)
TYPE OF FUEL
❑OIL-GPM OIL TANK LOCATION :❑ INSIDE❑ OUTSIDE CAPACITY
❑GAS-INPUT LPG TANK CAPACITY ELECTRIC-KW
AHZ 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.)
TONNAGE 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 r
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. E STATE
SIGNATURE OF APPLICANT r DATE /G D
DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT
Application is hereby: TOWN OF SOUTH WINDSOR PERMIT#0 c_
BUILDING DEPARTMENT
APPROVED 1540 SULLIVAN AVENUE Bldg.Permit#
vb6 oG 644-2511 ext. 230
Dat wilding Inspector
Application must be printed or typed
FEE SCHEDULE Location of Job:
�� L1�1('tl..� �•�eil
$0-$1,000=$15.00 Street No. Street Lot No.
Over$1,000=
$15.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT (d)Ci
APPLICANT ADDRESS a20[ ",jrrj_ S+
APPLICANT PHONE# -S Cl q
Ow N St-4 OWNER
OWNER ADDRESS ��
&07 + , OWNER PHONE
0
C ESTIMATED COST$
x IS THIS A CONTRACT COST? Yes _No
�1G o FEE ENCLOSED$ D ��
S TYPE OF JOB:
�R C New Installation
Alteration/Addition/Repair
Revised 4/01H2002
1 i
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 FUTURE USE AND OCCUPANCY
❑EDUCATIONAL
❑ INSTITUTIONAL
❑FACTORY ENGINEER'S NAME PHONE
❑ STORAGE
❑GARAGE ADDRESS
❑MIXED USE
CITY STATE ZIP
(Other please specify)
TYPE OF 4STALLATION 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 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 MANUFACTURER
DESCRIPTION OF WORK
Alto COPI L6 "1>:ro, :yr/ 4 f� T(�. Iower yA^4 4
TM UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM WORK DESCRIBED AND is T
COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE
PERFORMANCE OF SUCH WORK.
CONTRACTORS LICENSE NO. STATE
SIGNATURE OF APPLICANT ho 2,eTwE DATE G G