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Home My WebLink About21 HOLLIS RD Electric # APPLICATION FOR BUILDING PERMIT Plumbing# 21 Hollis Road Date: HVAC # Sprinkler# 32656 - - - - Estimated Cost $ 3.0 FINAL APPROVALS Building `�'��'0 COMPLETE RED BOXED AREAS Permit Fee $ Engineering TYPE OR PRINT ONLY Occupancy Fee $ Affidavit Eng. Insp. Fee $ Appr. for CO. W SIGN ON REVERSE SIDE Total Fee $ �—�—�` TO THE BUILDING DEPARTMENT,TOWN OF SOUTH WINDSOR, CT (Additional Cost) $ �9 The undersigned hereby applies to do work according to the following: Applicant u#;l /`1. t140N Location of Work 21 �o10.�J /2a/. Lot No. Applicant's Address 2 I oLLJ J Rg(_ Tel.# L0 (114 -YYY/ Town .Sevd Vitiyiom _ Zip OW 7`f Lic.# Owner s"r✓ _Architect Owner's Address Architect's Address _ Zip Zip Sq. Ft. New Area: 1 st FI. 2nd FI. 3rd FI. Total New Area Purpose of this permit /Ly +�"c City Water❑ Well❑ Septic System❑ Sewer❑ Ins: H SP Cert. Area Basement Garage Approved Date ' t Use Grou Construction Type Revised W02 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 r specifications of the Building for which this permit is asked,and agree that this building is to be located th roper distan rom all street lines,side yard lines,and required distances from all other zones and is located in which t s u i allowed. Signed I hereby apply for a Certificate of Occupancy for the rk described in this application for the permit. Signed — DO NOT WRITE BELOW THIS LINE INSPECTION COMMENTS BU1LU1NU VI KMIT-,7 � STATE OF CONNEC77CUT WORKERS'COMPENSATION COMMISSION Building Permit Affidavit for Property Owners or Sole Proprietors A (Conn.Gen.Stat. §31-286b) Property located at tti J �i h' In the town of c�d y h W/PV JJ 4 Name of building permit applicant: L1 h t/L WN LJ oN Please check one: 1._I am the owner of the above property. 2._I am the sole proprietor of a business. 2A.Name of business 2B.Federal Employer Identification Number(FEIN) .................................................................................................................... Pursuant to §31-286b,"a property owner or sole proprietor[who]intends to act as a general contractor or principal employer"may provide either a certificate of workers'compensation insurance or a"swom notarized affidavit... stating that he will require proof of workers' compensation insurance for all those employed on the job site in accordance with this chapter." Please check one: 1. I do not intend to act as a general contractor or principal employer. [Sign an st p here] Signs of applicant 2._I intend to act as a general contractor or principal employer.Applicant must either provide a certificate of workers'compensation insurance or sign the affidavit below. .................................................................................................................... Affidavit I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers'Compensation Act(Chapter 568). I understand that pursuant to§31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. Signature of applicant Subscribed and sworn to before me this day of ,200 . (Notary Public/Commissioner of the Superior Court) APPLICATION FOR HVAC PERMIT DEPARTMENT DECISION TOWN OF SOUTH WINDSOR PERMIT# Application is hereby: BUILDING DEPARTMENT 0 0137 APP VE 1540 SULLIVAN AVENUE Bldg. Permit# 644-2511 ext. 230 Date Building Inspect Application must be printed or typed FEE SCHEDULE Location of Job: $041,000=$15.00 :2— � \\k S Czd Over$1,000= Street No. Street Lot No. $15.00 per$1,000 or any fraction thereof Tenant Designation Apt. No. � APPLICANT Q r, C o APPLICANT ADDRESS APPLICANT'S PHONE# 2 q I o s, .s OWNER SOW N St < OWNER ADDRESS 21rn,�s+ OWNER PHONE <� y ESTIMATED COST$ I - Q 1\4 6 0 C � IS THIS A CONTRACT COST? "''es No FEE ENCLOSED$ p TYPE OF JOB: NCO L�O SOR.CQ New Installation ✓Alteration/Addition/Repair a-o�goo�z Revised 03/05/10 APPLICATION FOR HVAC PERMIT(Continued from reverse side) TYPE Oy 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 E STING RADIATION ADDITIONAL RADIATION TOTAL RADIATION DESIGN TEMP.OUTSIDE °F INSIDE °F DIFFERENCE °F TOTAL HEAT LOSS(BTUH) °F(HEAT LOSS SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL HEATING EQUIPMENT(INCLUDING MAKE&MODEL NO.) W e.L crn �-1 cam.cv VW) CS U- 3 GROSS HEATING CAPACITY(INPUT BTUH) �J O NET RATING(OUTPUT BTUH) \ O U TYPE OF FUEL U OIL-GPM OIL TANK LOCATION: ❑ INSIDE ❑ OUTSIDE CAPACITY �j GAS-INPUT LPG TANK CAPACITY ELECTRIC-KW AIR CONDITIONING DESIGN TEMP: OUTSIDE °F INSIDE °F DIFFERENCE °F 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 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-�- CONTRACTORS LICENSE NO. TYPE STATE SIGNATURE OF APPLICANT X"p DATES/ VS APPLICATION FOR,ELECTRICAL PERMIT DEPARTMENT DECISION TOWN OF SOUTH WINDSOR PERIVHT# Application is hereby: BUILDING DEPARTMENT h y�� APPI�OV� _ 1540 SULLIVAN AVENUE +. 644-2511 ext. 230 B1dg:.Pcimit# Date Building Inspector Application must be printed or typed FEE SCHEDULE / ' / Location of Job: $0-$11000=$15.00 �- I �10/I S 2) Over$1,000= Street No. Street Lot No. $15.00 per$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANT a�C,7 �- APPLICANT ADDRESS U v�.qh c e 7 r I t ,L APPLICANT'S PHONE OWNER S,. / S Li c✓ cc.oy �W N S F44 OWNER ADDRESS r C OWNER PHONE e � ESTIMATED-COST$ O 1--'• c":' V IS THIS A CONTRACT COST? vYes No FEE ENCLOSED$ 2j a G c- a TYPE OF JOB: K dSOR•COS New Installation Alteration/Addition/Repair O(YS0077/ Revised 03/05/10 APPLICATION FOR ELECTRICAL PERMIT(Continued from reverse side) TYPE OF BlJH,DLliG IS THIS APPLICATION ASSOCIATED WITH A BUILDING PERMIT APPLICATION? ❑ YES a ❑ RESIDENTIAL CURRENT USE AND OCCUPANCY ❑ BUSINESS Cl ASSEMBLY FUTURE USE AND OCCUPANCY ❑ EDUCATIONAL O INSTITUTIONAL ENGINEER'S NAME PHONE ❑ FACTORY ❑ STORAGE ADDRESS ❑ GARAGE ❑ MIXED USE CITY STATE ZIP (other please specify) TYPE OF INSTALLATION/WIRING METHOD, S�`� G�t�•�ras �d�,¢, Tu SIZE OF SERVICE OG SIZE OF MA IN CONDUCTORS .: NUMBERS OF METERS NUMBERS OF DISCONNECTS AND RATINGS NUMBERS OF PANELS / NUMBERS OF DISCONNECTS REQUIRED? ❑ YES ❑ NO WIMBERS OF LIGHT CIRCUITS NUMBER OF POWER CIRCUITS .-NUMBER OFSWIIx�= NUMBER OF OUTIJ S NUMBER OF LIGHTFD[TURES NUMBER OF-BEAT CIRCUITS NUMBER`OF A/C CIRCUITS SEPARATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBNIITTED. DESCRIPTION OF WORK o's ro u h 'f �fi�7er oh C rS THE UNDERSIGNED HEARBY 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 e7 S CONTRACTORS LICENSE NO. TYPE STATE SIGNATURE OF APPLICANT DATE C / l 9��5 1500137 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER HVAC PERMIT DATE: 04/10/2015 G1S ID:44400021 FEE: 60.00 MUNIS APPLICATION# 201500302 BUILDING DESCRIPTION: APPLICANT LOCATION NAME: IMPERIAL PLUMBING CO.,INC. ADDRESS: 21 HOLLIS ROAD ADDRESS: 648 SULLIVAN AVENUE OWNER: NELSON SHERWIN M&JANE E P.O.BOX 875 21 HOLLIS ROAD SOUTH WINDSOR,CT 06074 SOUTH WINDSOR,CT 06074 DESCRIPTION OF WORK: BOILER REPLACEMENT. SPECIAL CONDITIONS: ALL WORK TO BE DONE IN ACCORDANCE WITII THE APPLICATION AND PLANS APPROVED BY THE BUILDING DEPARTMENT. CONSTRUCTION TYPE: OCCUPANCY GROUP: BUILDING OFFICIAL 4/10/2015 3:52 PM THE FEE ABOVE INCLUDES A$0.26 PER THOUSAND CT STATE EDUCATION SURCHARGE 1500177 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER ELECTRICAL PERMIT DATE: 06/23/2015 GIS ID:44400021 FEE: 30.00 MUNIS APPLICATION# 201500771 BUILDING DESCRIPTION: APPLICANT LOCATION NAME: AMATO ELECTRIC LLC. ADDRESS: 21 HOLLIS ROAD ADDRESS: 41 UNION PLACE OWNER: NELSON SHERWIN M&JANE E MANCHESTER,CT 06040 21 HOLLIS ROAD SOUTH WINDSOR,CT 06074 DESCRIPTION OF WORK: CHANGE OLD ELECTRICAL SERVICE TO NEW. UPDATE GROUND AND WATER BONDING. SPECIAL CONDITIONS: ALL WORK TO BE DONE IN ACCORDANCE WITH THE APPLICATION AND PLANS APPROVED BY THE BUILDING DEPARTMENT. CONSTRUCTION TYPE: OCCUPANCY GROUP: BUILDING OFFICIAL 6/23/2015 3:32 PM THE FEE ABOVE INCLUDES A$0.26 PER THOUSAND CT STATE EDUCATION SURCHARGE