HomeMy WebLinkAbout225 EVERGREEN WAY DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
PERMIT#
Applicatio TOWN OF SOUTH WINDSOR / Z Z
BUILDING DEPARTMENT
OVE 1540 SULLIVAN AVENUE Bldg.Permit#
pul— 644-2511 ext. 230
Date � Building Inspect '--� j o 6-3
Application must be printed or typed
FEESCHEDULE FTefiant
CA� ocationofJob:$0-$1,000=$15.00 et Lot No.
Over$1,000= 11
lj� �$15.00 per$1,000 �i✓hi�E �duSC C�(for any fraction thereofgnation Apt.No.
APPLICANT X,A 11d000
APPLICANT ADDRESS & .0 Sr
ZY6ellAP 4 Gr 00'976
APPLICANT PHONE#_ 203' 632)'aS�
0* N 3 F,q OWNER fr-2( L-/-c -
OWNER ADDRESS qos ,_'
L n 1 -
��c�
O
OWNER PHONE 612- 'ZOZ�'--�3'
C ESTIMATED COST$ ow, G°
•� left IS THIS A CONTRACT COST? Yes _No
FEE ENCLOSED$ ?0. O
SO 0 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
BUILDING PERMIT APPLICATION? ❑ YES ❑NO
❑RESIDENTIAL /f /
O BUSINESS CURRENT USE AND OCCUPANCY
❑ASSEMBLY
L3 MERCANTILE❑ EDUCATIONAL FUTURE USE AND OCCUPANCY
O INSTITUTIONAL
❑FACTORY ENGINEER'S NAME ,D,A• Z-.&-V/ K- A710- PHONE 330 666-67,
❑ STORAGE I ��J L
❑GARAGE ADDRESS 6-0/ e/AQ,2 Y ('i0�f IN►�
O MIXED USE `
CITY �f;lec/ I� STATE ('1//D ZIP ely33.3
(Other please specify)
TYPE OF INSTALLATION/WIRING METHOD SIC
SIZE OF SERVICE /00 MP Z77f�`f 0 PSIZE OF MAIN CONDUCTORS_ 2
NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS 4LI�O td/i+�
NUMBER OF PANELS ` REMOTE DISCONNECT REQUIRED? O YES ❑NO
NUMBER OF LIGHT CIRCUITS /2 NUMBER OF POWER CIRCUITS
NUMBER OF SWITCHES 6 NUMBER OF OUTLETS �s
NUMBER OF LIGHT FIXTURES 0NUMBER OF HEAT CIRCUITS
NUMBER OF A/C CIRCUITS /
SEPARATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED.
DESCRIPTIOON OF WORK
v �
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.
cl-aI669 �l c-r
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT DATE D
DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT
PERMIT#
Application is-hereby: TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
PROVED 1540 SULLIVAN AVENUE
DCT 2 644-2511 ext. 230 Bldg.Permit#
3
Date Building Inspecto
Application must be printed or typed
FEE SCHEDULE F
Location of Job:
4VM6RA" WAY
$0-$1,000=$15.00 treet Lot No.
Over$1,000=
$15.00 per$1,000 fo✓Sti Bl09c4< fr' ��or any fraction thereof gnation Apt.No.
APPLICANT /-I H.S W#A
APPLICANT ADDRESS /,3.3 1 Y S/l�� 426)Vh
G,�sT �d�ier� c-r-
APPLICANT PHONE# V o
O W N S f q OWNER W/-h Tl; /5 44e4" M!m1 r
OWNER ADDRESS
d , F, OWNER PHONE
C ESTIMATED COST$
b
IS THIS A CONTRACT COST? v Yes _No
c ("J �i✓ FEE ENCLOSED$ 70, v u
TYPE OF JOB:
SOR.Co v New Installation
_Alteration/Addition/Repair
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? XYES O NO
❑BUSINESS CURRENT USE AND OCCUPANCY
O ASSEMBLY
MERCANTILE EDUCATIONAL FUTURE USE AND OCCUPANCY
❑INSTITUTIONAL
O FACTORY ENGINEER'S NAME PHONE
❑ STORAGE
❑GARAGE ADDRESS
❑MIXED USE
(Other please specify) CITY STATE ZIP
TYPE OF INSTALLATION ,r—ln4 SIZE OF MAIN DRAIN It
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 O YES O 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
/NiTfwL F/��L /�/Q•T�-1J u/y � �� /�-%i�79'e!'f�� �l��hl!/�l
THE UNDERSIGNED HER BY APPLIES FOR A PERMIT TO PERFORM P FHEWORKDESCRI EDANDIrrU-
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 c-
Applica ' e BUILDING DEPARTMENT
APPRO 1540 SULLIVAN AVENUE Bldg.Permit#
7 `� 9 644-2511 ext. 230
Date T Building Inspecto
Application must be printed or typed r/
Location of Job:
FEE SCHEDULE /
7115
$0-$1,000=$15.00 Street No. Street Lot
Over$1,000= 1 ,
$15.00 per$1,000 "�� FL�10 ( B IC ✓�Q� �
or any fraction thereof Tenant Designation Apt.No.
APPLICANT �9/�l/G �,7--
APPLICANT ADDRESS
APPLICANT PHONE# Al��—�Z=, :i;�L iz
Ow N SF OWNER
q� OWNER ADDRESS
OWNER PHONE
C ESTIMATED COST$ xaok . OG
IS THIS A CONTRACT OST? _ es _No
FEE ENCLOSED$
TYPE
s .< 0 PE OF JOB:
OR'C �ZwInstallation
Alteration/Addition/Repair
Revised 4/01//2002
�1 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 _�f/
❑ASSEMBLY --�
)AWRCANTILE❑EDUCATIONAL FUTURE USE AND OCCUPANCY od _47-
❑INSTITUTIONAL
❑FACTORY ENGINEER'S NAME PHONE
0 STORAGE
❑GARAGE ADDRESS
O MIXED USE
CITY STATE ZIP L
(Other please specify)
v
TYPE OF INSTALLATION — IZE OF MAIN DRAIN
NO.OF TOILETS _STYLE NO.URINALS ----'STYLE
If
NO.OF BATHTUBS NO.OF SHOWERS NO.OF LAVATORIES
NO.OF CONDUCTORS SIZE NO.OF STACKS SIZE
AREA OF ROOF NO.OF CATCH BASINS 0.OF FLOOR DRAINS .3
NO.OF OTHER FIXTURES KIND
ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW JXYES ❑NO
y
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
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORMI HE WORK DESCRIBED AND ISTO
COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE
PERFORMANCE OF SUCH WORK.
��-
tOXTRACTORS LICENSE NO. Y E STATE
SIGNATURE OF APPLICANT DATE Z�
,Ah, CREST MECHANICAL SERVICES, INC.
-1841 Broad Street
P.O.Box 340683 TEL(860)724-3431 .�
Hartford,CT 0613"683 FAX(860)251-7132
Date: �� y
Attn: Building Official
Re: Application for Steer lambing Permit
Gentlemen:
In accordance with Public Act 91-95: This letter authorizes the below named agent to
sign the above referenced permit application.
1) Project Name: 'OtW �fOl��� ,�L��/G
2) Location:
3) Starting Date: 'ZZ 00
-��
4) Licensed Contractor's Name: 7-
5) Licensed Contractor's Trade License No.
6) Name of Agent:
7) License numbers of all contractors involved in the work in applicable:
Sincerely,
Signature of Company Official if applicable:
Signature of Licensed Con ctor required by Public Act 91-95
15�
Connecticut License Numbers 391112,203561,F10140
www.crestmechanical.com
DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT
PERMIT#
Application' TOWN OF SOUTH WINDSOR CA
00 BUILDING DEPARTMENT 3 C 10
—
�`� 1540 SULLIVAN AVENUE Bldg.Permit#
Y 644-2511 ext. 230 �j 3
Date Building I or
Application must be printed or typed
FEE SCHEDULE Location of Job:
F
er cc1,14 )AItelu,
$0-$1,000=$15.00 Street Lot No.
Over$1,000= ] 1
$15.00 per$1,000 or any fraction thereof gnation Apt.No.
APPLICANT
APPLICANT ADDRESS _ ,', NCO .S, �c 3o)q
OVri,u kcuvt C f C6',V20
APPLICANT PHONE#'� —Qc)--4, Q 70 - `i 3 y 77
O W INS F,q OWNER 1 _ cce Ru,f r 1,
OWNER ADDRESS a'�o ,,_, ,. L"Ca-LtA 't
r 176 7 U
OWNER PHONE
C ;D ESTIMATED COST$
— 3
x IS THIS A CONTRACT COST? Z Yes _No
All
FEE ENCLOSED$ x�S
1+ �•i�� TYPE OF JOB:
dS�R•C�� _4-4ew Installation
_Alteration/Addition/Repair
Revised 4/0 t//2002
APPLICATION FOR HVAC PERMIT (Continued from reverse side)
TYPE OF�YSTEM: TYPE OF BUILDING:
EATING ❑RESIDENTIAL
aC PfOMMERCIAL
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)
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
U-CiAS-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.)
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.
3� d-1yoc) S — C 7—
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT - DATE >U A-G
��
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
PERMIT#
Application' re1Zy: TOWN OF SOUTH WINDSOR 9
BUILDING DEPARTMENT
PROVE 1540 SULLIVAN AVENUE Bldg.Permit#
644-2511 ext. 230 '2 t
Date BuiKing Ins ctor 1
Application must be printed or typed
FEE SCHEDULE Z.Z Location of Job:
c c-. �C- s ,'� a2s
$0-$1,000=$15.00 Street No. Stree Lot No.
Over$1,000=
$15.00 per$1,000
orany fraction thereof Tenant Designation Apt.No.
APPLICANT S e ll a C,
APPLICANT ADDRESS eO Qcx-
APPLICANT PHONE# NCO 2a q—0e00
0 W N St OWNER NoyLy Zgjac k h-lo✓l�a}"
OWNER ADDRESS
OWNER PHONE
C = ESTIMATED COST$
IS THIS A CONTRACT COST? _ZYes _No
FEE ENCLOSED$
TYPE OF JOB: 1
SOR C� X New Installation
Alteration/Addition/Repair
Revised 4/01//2002
APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side)
TYPE OF BUILDING IS TINS APPLICATION ASSOCIATED WITH A
❑ RESIDENTIAL
BUILDING PERMIT APPLICATION? ElYES ❑NO
ff '
❑BUSINESS CURRENT USE AND OCCUPANCY RG16 , I
❑ASSEMBLY
0 MERCANTILE
UC ONAL FUTURE USE AND OCCUPANCY ne,�4 i
❑INSTITUTIONAL
❑FACTORY ENGINEER'S NAME PHONE
❑ STORAGE
❑ GARAGE ADDRESS
❑MIXED USE
(Other please specify) CITY STATE ZIP
TYPE OF INSTALLATION/WIRING METHOD )C,/,e,, w MMp
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
- v
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.
lo31 C � r ) CT"
CONTRACTORS LICENSE NO. TYPE ST TE
SIGNATURE OF APPL S2ac, DATE
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
Applicati y: TOWN OF SOUTH WINDSOR PERMIT#
BUILDING DEPARTMENT 9;L s-Q
PRO 1540 SULLIVAN AVENUE Bldg.Permit#
.t 644-2511 ext. 230 73( 0o3
Bu
Application must be printed or typed
FEE SCHEDULE Location of Job:
$0-$1,000=$15.00 Street No. Street Lot No.
Over$1,000= 4'\/ Cam„e e-,,..,e Q^
$15.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
H;3 APPLICANTe 0R 0 7—
APPLICANT ADDRESS I6 C,o a
APPLICANT PHONE# �C> s - 3 3 O
0 W N S F,q OWNER w
< OWNER ADDRESS
a
b. ,r OWNER PHONE
C ESTIMATED COST$ 7
� IS THIS A CONTRACT COST? ' Yes _No
FEE ENCLOSED$ jd.
f��SO- 0���� TYPE OF J()B:
R C New Installation
Alteration/Addition/Repair
Revised 4/01//2002
r
APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side)
\1
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
❑RESIDENTIAL BUILDING PERMIT APPLICATION? ElYES ❑kO
U6USINESS CURRENT USE AND OCCUPANCY
❑ASSEMBLY
❑MERCANTILE El EDUCATIONAL FUTURE USE AND OCCUPANCY
0 INSTITUTIONAL
❑FACTORY ENGINEER'S NAME PHONE
0 STORAGE
❑ GARAGE ADDRESS
❑MIXED USE
(Other please specify) CITY STATE ZIP
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.
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.
L S `T'
CONTRACTORS LICENSE NO. TYP STATE
SIGNATURE OF APPLICANT DATE
ADTSecuritySefwcea Inc.
tgco 10 Research Parkway
Wafhngford.CT 06492
Fire &
Security Tele:203 7414000 r
Fax:203 294 1514
CTState Lic.# 105789
aor
Date: 9-/ct-O
I, Peter Eglinton give permission to to obtain
a low voltage electrical permit for 4A(4r"E /f pl/1F k1,1 ' W/o- ,
on behalf of ADT Security Services, 10 Research Parkway,Wallingford CT 06492.
i
Sign
Lic.Type L=5 Lic# 105780
Job Cost
Permit Cost
SEP-ZZ-Z004(WED) 08 ; 31 D. k Eevy Assoc, (F,AO M 666 8334 P, OO AE
& A S S O C I A T E S
FACSIMILE
DATE:
THWE: �
TO: �DV�e`Vl CX S���T►�_l �I
ATTENTION: --
G
FAX NUMBER: �3(r —
FROM:
REGARDING: Y\ e- I
NUMBER OF PAGES_ Z INCLUDING THIS COVER SHEET
CC:
IF YOU DO NOT RECEIVE ALL OF THE PAGES,PLEASE CALL: (330) 666-6767
TRANSMITTED ❑
MEMO❑
3501 EMBASSY PARKWAY • SUITE 201 • AKRON,OHTO 443334064
(330)666-6767 • FAX(330)666-8334
SEP-ZZ-Z009(WED) 08 ; 31 D. levy Assoc, (FA0M 666 8339 P. 00AH
A. S =U C T A T L .S
do
Town of South Windsor September 21, 2004
1540 Sullivan Ave.
South Wmdsor,.CT 06074
Attn: Chris Dugan
Re: White House I Black Market
Evergreen Walk
151 Buckland Rd., Bldg 200 i
South Windsor; CT 06074
Dear Mr. Dugan,
We approve the change the General Contractor would like to make regarding the concrete footer.
A monolithic pour of the footer is acceptable, ,
Should you have any questions or,coneems.please do not hesitate to contact me. '
Sinccre'ly,
Katie Horvath ,
Project Manager
It (: H I T N' C."I' U It E
:i.501 KM13ASSYPARKWAY OSULTL201•Alit ()N.U11104 :i3:-;-t�:i(i4
(:3:30)(30d(37(37 •FAT(330)t36(i&334 •E NL4_IL dle"didev3 oom
P . 22. 2U)4 12: 4-PM SCHIMENTI CONSTRUCTI NO. 195 P. 1
Schimenti Construction Co., Inc.
118 North Bedford Road
Mount Kisco, New York 10549 &Ali
ti
Condruat:on Company
FAX Date- ZZ
#of pages inch ding cover sheet:
A �� C From: Joseph R. Schimenti
company: Phone: 914 244-9100 Ex 309
Fax Phone: �� �I ��� Fax hone: 914)244-9I30
REMARKS: ❑ Urgent ® For your review [] Reply ASAP
❑ Please comment ,
RE: l
Project#
i
Regard
i
I
Visit our website at Www-Schirnenti.corn
a..,-
,tSEP. 22. 200012:48PN 11 SCHIMENTI CONSTRUCTI (FA )330 �N0 �953Q P' 2 p, ODZ/QN
fi A- S S O C T :A, T E 9
Town of'Sourb Windsor '
1540 Ave.Sullivan September 21,2004. `
South Windsor,CC 06074
Attn: Chris Dusan
Rr-_ White House 1 Black M,adLet
$vergrem Walk
15I Bucklaad Rd,, Bldg 200 _
: South Windsor;CT 06074 -
Dm r Mr.Dugan, -_
We approve the change the Ceucr&Cons 2mr wpuld like to Mac
A monolithic pour of the footer is acceptable, m z the c6hcrat)'-footers
Should you have any questions or.coneCtns,please do not hesitate to contact me.
• Sincerely,"
: Facie Horvath ,
' Project Manager
A. It C H 1 'T P, (, ,,r I7 R r
:J-001 ,AMSSY VA-x-& AY •..sL;x77.2At R"
i•.� RA17()'gTO.td�;j�3• {�
crio)(i(s(i•(57(ii•IrAk (:i30)l3Cif3 S3J5ti F.-M,1�ZItdJevyrcdtlaJJUvyuurn
Electric # , I q f a a APPLICATION FOR BUILDING PERMIT
Plumbing# Mp I fbti3 225 Evergreen Walk Date:
HVAC #
Sprinkler# 11 31003 - Estimated Cost $
_ ---- - -FINAL APPROVALS - --- Permit Fee $
Building COMPLETE RED BOXED AREAS
Engineering TYPE OR PRINT ONLY Occupancy Fee $ /y
Affidavit Eng. Insp. Fee $
A r. for CO. ► SIGN ON REVERSE SIDE / Cb
PP - --- - _- Total Fee $ /'Y6 S.
TO THE BUILDING DEPARTMENT,TOWN OF SOUTH WINDSOR, CT (Additional Cost) $
The undersigned hereby applies to do work according to the following:
Applicants h o tr.� S�%�4ocation of Work Lot No. Z o (o
Applicant's Address f/f, !-rio r o
Town� Zip / o s y S lic.#
Owner G.i�.re 174-✓.le t?l -*' nr-KilArchitect
Owner's Address-//,;;0 1 jr- Architect's Address
Zip Zip
Sq. Ft. New Area: 1 st FI. 2nd FI. 3rd FI. Total New Area
Purpose of this permit e�-
City Watero Well❑ Septic System❑ SewerO
Ins: HO SP -Cert. 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 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 buildi g and its u is allowed.
Signed
I hereby apply for a Certificat Occupancy for the work desc in this application for the permit.
Signed
O NOT WRITE BELOW THIS LINE
INSPECTION COMMENTS
Inspection / Approval Date By Appl
Code Description Due Whom Code Comment
----------------------------------------------------------------- ------
**-31003-B 96,600
B03 FRAMING (ROUGH) 09/29/04 PJP D W/CONTRACTOR,FRAME DOES NOT CORRESPOND W/
PLANS
E03 ROUGH 10/07/04 PJP A CEILING ONLY IC CANS
P02 UNDERGROUND 09/22/04 CJD A
E02 UNDERGROUND 09/22/04 CJD A
P03 ROUGH 09/23/04 PJP D WET SLAB NO ACCESS'
B03 FRAMING (ROUGH) 10/01/04 CJD A
P03 ROUGH 10/05/04 JFF A PASSES AIR TEST
VENTS DRAINS CO
E01 SERVICE 10/11/04 PJP A
P02 UNDERGROUND 09/23/04 PJP D WET SLAB NO ONE ON SITE, NO ACCESS
B09 OTHER 10/28/04 JFF A WITH SUPER TED SHEPHERD COMPLETED EXCEPT ROOF
TOP UNITS
E01 SERVICE 10/11/04 PJP A
B10 FINAL 10/21/04 PJP D SECURE SHELVING,CLEAR EXIT ACCESS,SECURE FRON
ENTR TO CAUTION CONSTR@GAP,PULL DOWN GR DIST
PO4 GAS TEST 10/06/04 PJP A
B09 OTHER 12/03/04 PJP A RTU'S
Inspection / Approval Date By Appl
Code Description Due Whom Code Comment
-------------------------------------------------------------------------------
E03 ROUGH 10/01/04 CJD A INTERIOR WALLS
B10 FINAL 10/28/04 CJD A
B10 FINAL O1/12/05 CJD A CLOSEOUT
**-12309-H 18,500
**-11683-P 5,500
**-19122-E 18,000
**-11693-P 8,000
**-19233-E 7,625
**-19250-E 1,278
BUILDING INSPECTION DEPARTMENT
TOWN of S_QVTH W`1KBS R,---CQNNECTICUT
C E R T I CAT E P.„Q F 0,( C [1 A N C Y
ZONE:
January 12 2005
• y y ;wV." t �
f' .�'�,1;....;...<•t.4'`: �':c:�;'�;3iy Via.:;,y`•iC , .,y.L.� � .':�
This is to certify Chat 225 tF- ER'C� E. N.it ![:ti.,TSRED ui�de emit
No. 31003 conforRls suhsEai,tially to C6g..requiretCieatathe': Connecticut
Basic Building cots �arid iEh�;'zbniP90 F u at pnsx bf�'Yh`e: own of
South Windsor alid .ia here-V .approved^'for o Ctip3nCy as. nclicated below
Approved for OccupancyE`` ',T$NANI''BUI1.D{)FjT
HOUSE y ? .
.WNXTESA�r ,�. z
,oK'k �^�.%a .f;; �f,::�.' �.x-' 'Fy.:•a,. vt ::s Y^.e x.� bsza','
`� � 9 •�. ", :�s'sp�.4V '�'� Yse,.;3o-:•o{':,r�ay ,fra'�.�;..�-� �...: k
Use Group: a��
Constr. Type e';03
M.
ildiri Official
Notice: If this cert�fI 5e ltsat�or �estfoyea a duplicate should
be obtained iiittnedia e yY"' t.6 t}ie u1Yd#iig Department
Any change or extension of�tlid—Vge herein approved requires
a new certificate of occupancy.
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