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HomeMy WebLinkAbout149 Kent Lane G� 4d q17 s APPLICATION FOR PLAN EXAMINATION AND BUILDING PERMIT IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O L ^� ) ZONING I• AT (LOCATION) r A�r, � / DISTRICA: 5 io LOCATION NO.) '' (STREET) OF BETWEEN A`T&?.tl A,?S/p ./J r AND -'cRo STREET) BUILDING (CROSS STREET) (CROSS 5 )69 LOT `-7 x f SUBDIVISION ��to fi✓ Z[PfZ LOT���BLOCK SIZE ! " �! H ' II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use M M 1 [ 'New building Residential Nonresidential 2 ❑ Addition(If residential, enter number 12�ne family 18 ❑ Amusement, recreational of new housing units added, if any, in Part D, 13) 13❑ Two or more family — Enter 19❑ Church, other religious number of units— — — — •-jo. 20❑ Industrial 3 ❑ Alteration (See 2 above) 14❑ Transient hotel, motel, 21 ❑ Parking garage 4 ❑ Repair, replacement or dormitory — Enter number 5 ❑ Wrecking (If multifamily residential, of units ——————— — --io- 22 ❑ Service station, repair garage enter number of units in building in 15 ❑ Garage 23 ❑ Hospital, institutional Part D, 13) 16❑ Carport 24❑ Office, bank, professional 6 ❑ Moving (relocation) 17❑ Other — Specify 25❑ Public utility 7 ❑ Foundation only 26 ❑ School, library, other educational B. OWNERSHIP 27❑ Stores, mercantile 8 private(individual, corporation, 28 ❑ Tanks, towers nonprofit institution, etc.) 29❑ Other — Specify 9 ❑ Public (Federal, State, or local government) C. COST (Omit cents) Nonresidential — Describe in detail proposed use of buildings, e.g., food processing plant, machine shop, laundry building at hospital,elementary 10. Cost of improvement,,,•,,,,,,,,..,, school, secondary school, college, parochial school, parking garage for, department store, rental office building, office building at industrial plant. To be installed but not included If use of existing building is being changed, enter proposed use. in the above cost a. Electrical...................... b. Plumbing ...................... c. Heating, air conditioning......... d. Other(elevator, etc.)............ 11. TOTAL COST OF IMPROVEMENT $ III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — L; for wrecking, complete only Part J, for all others skip to IV. E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS 30❑Masonry (wall bearing) 40[�rPublic or private company 48• Number of stories................ 31 [?�]400d frame 41 ❑ Private (septic tank, etc.) 49• Total square feet of floor area, all floors, based on exterior 32❑ Structural steel dimensions .................... 33❑ Reinforced concrete H. TYPE OF WATER,SUPPLY 34 ❑ Other — Specify 42 Public or private company Total land area, sq. ft. ........... �5+� 43 ❑ Private(well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES 51. Enclosed ...................... F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 35 ❑ Gas Will there be central air 52. Outdoors....................... 36 �iI conditioning? L. RESIDENTIAL BUILDINGS ONLY 37❑ Electricity 44❑ Yes 45 E - o 53. Number of bedrooms.............. 38 ❑ Coal 39❑ Other — Specify Will there be an elevator? Full.......... 54. Number of 46 ❑ Yes 47 to bathrooms Partial........ NOTES and Data — (For department use) IV. IDENTIFICATION — To be completed by all applicants Name Mailing addr ss — Number, street, city, and State ZIP code Tel. No. Owner or Lessee Bui Ider's 2. License No. Contractor 3. Architect or Engineer I her by certify that the proposed work is authorized by the owner of record and that I have been authorized by the owner to make this application as his authorized agent and we agree to conform to all applicable laws of this jurisdiction. Signatur of applic t Address Application date DO NOT WRITE BELOW THIS LINE V. PLAN REVIEWRECORD — For office use Plans R view R uired Check Plan Review Date Plans B Date Plans B Notes q Fee Started y Approved y BUILDING $ PLUMBING $ MECHANICAL $ ELECTRICAL $ OTHER Is VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Permit or Approval Check O Date btained Number By Permit or Approval Check Date Obta ned Numb r By BOILER PLUMBING CURB OR SIDEWALK CUT ROOFING ELEVATOR SEWER ELECTRICAL SIGN OR BILLBOARD FURNACE STREET GRADES GRADING USE OF PUBLIC AREAS OIL BURNER WRECKING OTHER OTHER VII. VALIDATION Building FOR DEPARTMENT USE ONLY Permit number 12228 Bui Iding Use Group Permit issued June 3 19 81 Bui Iding Fire Grading Permit Fee $ 414.00 Live Loading Certificate of Occupancy $ Occupancy Load Drain Til- $ nt Plan Review Fee $ ::a� TIT VIII. ZONING PLAN EXAMINERS NOTES DISTRICT USE FRONT YARD SIDE YARD SIDE YARD REAR YARD NOTES IX. SITE OR PLOT PLAN — For Applicant Use a,$t.m-,f � ,«-a».� - �P, - '-a -�'�' ., -3-` -„�.>�-�z� a .," �-»_.� "� t-,»'e•s r��`: =ii _ ®-� "'-_�.rs,ra-'-� i{sE„.,,�, ,a.a»,»� �. .." 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' ,.-n..�.., -�."-_ a .,w»»a.�. .�-ter`«. r..s -..s_ � � q�� b-d- b §- a-.� a »•-a;fi �• � 4w--r --' 3 .--$- x--a-a-.s,»�.a-« h-.a_ $g-t-' ��»�s�»»,-r : w-k-'�" o�y-j4g'6_F--•Ya 'r~ ?- ».-. �q�6»�,, «,-.«r-r-d.' b 4 F a d--3-a - a-� -�_-t c& -.� p r 6¢e +` "�t_.. a.}-r-#-> 4 im BOCA FORM APEBP — 669 C1969 BUILDING OFFICIALS & CODE ADMINISTRATORS INTERNATIONAL, INC. I� ij TOWN OF SOUTH WINDSOR BUILDING PERMIT Date June 3 , 19 81 Fee Paid $. .414.00 Est. Value $.69 9 00MO i Permit N° 12228 ► on the -side of Lot #69 Kent Lane Street Street No. 149 Owner T & M Building Co. f Applicant Frank S t. Onge i CERTIFICATE OF OCCUPANCY ISSUED: Date i I No. 5931 3 } Fee Paid �$ •00 CLASSIFICATION Dwelling i r i BUILDING PERMiT N° 12228 OFFICE OF THE BUILDING INSPECTOR of the Town of South Windsor, Conn. South Windsor, Conn. J*ate 3 1981 dr#ia is to (fertt fg.. That T & M Building Co. is hereby granted permission to Dive l l ing at estimated value of $69,000.40 on the side of Lot #69 Kent Lare Street on land owned by 'f & M Building Co. Said Wo rk to be as described in Application No.12 2 5 8 and to conform to specifications and plans filed with said Application, and Building By- Laws of THE TOWN OF SOUTH WINDSOR. Issued June 3 19810 Building Inspector. Streets and sidewalks, obstructed by ezcavations or building materials, must be guarded by barriers during the day and by both barriers and colored lights by night. SECTION 1343, GENERAL STATUTES OF CONNECTICUT: "When any person shall place or keep building materials, or any obstacle in any highway (or any sidewalk) either with or without a license therefor from the city or borough in which such highway may be situated, he shall pay said city, town or borough all costs and damages which it shall sustain, or be compelled to reason therefor." Dwelling - Lot #69 Tim.Kn. IV 6/3/81 T & M Building Co. 149 Kent Lane Permit # 12228 Electrician D.J.Electric # 7499 Heating Contr. Norman Lutzen # 5375 Plumbing it Norman Lutzen # 5843 Oil Burner # Certificate of Occupancy # 5931 Plot plans apprd. per Engr. G K . , �'� INSPECTION REPORT Permit # Jo sY 1 Footing r 2 Foundation 3 Framing - t 4 Wiring �- 5 Plumbing 6 Heating 7 Lathing 8 C.O. �'S~ c Permit No. ry`� TOWN OF SOUTH WINDSOR SOUTH WINDSOR, CONN. Permit N 5931 Certificate of Occupancy THjS CERTI that the at in the To of South Windsor, Connecticut, has been erected and completed in accordance with the ding Code and Zoning Regulations of the Town of South Windsor, and is hereb prove f occuicy, V Building Inspector Owner, Builder Fee Paid �,J _ Date Q 19 U k 7499 ELECTRICAL APPLICATION Application No. 8611 on the side of Lot #69 'Kant Lane Street_ Street No. _ 149 a Owner T' & M building Electrician D-J, F1 ectri:c FILED IN OFFICE OF The Building Inspector july 22 19^81 I-NSPECTION. &ar No-Electrical Work shall be started until a Per- mit is granted by the Building Inspector. In New Buildings no wiring shall be started until the plumbing and heating pipes, and the fire stops (if of wood) are installed, without a special permit from the office of the Building Inspector. �u y" APPLICATION FOR PERMIT TO DO ELECTRICAI. WORK. No. ... ...... Permit No. . .... .3499.......... TO THE BUILDING INSPECTOR of the TOWN OF SOUTH WINDSOR, CONN. hereby make application tq perform Electr cal Work according to detailed c Uo below. All provisions of the Rules for Electrical Installation, Section 48, Building By-Laws, s all co lied with whether specified herein or not. % G / /� South Windsor, Conn., % Q 19 /Sign here f . ........... Address .... ... .... . ........ ... ... ...... Location / .. ...... 1.. � -�.. Side of ...... ......... .............. Natur of Building ,l How many 'stories ........... ...................... ................................ ................. New or oId Building ................ How many families ......................../......................................... .............. Kind of Installation . .. How many Stores e ............................ ............................................................ Owner ` ... . .. a�..1.�lr Address ....... _..............._...._.._......._.._......_....._...... Architect ........ ... .... .. Address . .. ......... .. .. . .. ................................................. �...__....._....._._.... Builder . ... .... ... W. .. ... Address .. ...... . .......... ...... ........ Electrician �-)'-v........ !G�-G..��c C-.. ..... ....... . .. ...... Address _......._....._�... Size of Main Wires . No. of Light Loops .. .... .... . . .... No. of Heat Loops . ..., No. of Power Loops ......................... No. of Light Outlets p .(1. ......... No. of Heat Outlets . No. of Power Outlets ................. ......... C � NoO of Light Circuits No. of Heat Circuits . No. of Power Circuits . No. of Sockets / .. .. No. of Heat Receptacles No. of Motors ................. . No. of Panels ....................... .../ .. ... . .. ... Size of Heat Circuit No. of Power Receptacles No. of Switches ...........c ...�. ... . Total Wattage .... ...... ..... . .. ... . Size of Power Circuit .. . ... Total Horsepower No. of Straight Electric Fixtures ... .. .. d. ........... .. No. of Combination Fixtures .... No. of Receptacles ........................ ....... Z).. ........... ...... No. of Cord Drops ...... .. ..................... .................... ....... . ... .... .. Remarks: For other kind of Installation ..... .......... ............................... ...................... ................................ . .... . ..... . . ............ ..... .......... ........................................................................................................................................... ..............._............................... ...................................................................... .. ...... . ....... ............................................................................................................. .................................... ....._................................................................................. ................... ..... .... ........... .. .. . ....................................................................... ............ ........ ...... ..................................................................... .. ..... ... ............. ... ....... . ..... ....I..... .... Estimated Cost Z�v....-Z ••." 7 5843 PLUMBING APPLICATION — . No. 6622 on the —A&of Lot #69 Kent Lane Sant No. 149 Owner T & M Home s Plumber Norman Lut zen Fled in Office of The Bwldrmg_]631 V 20 19-8-L 0 No pp-Inn --mr- add to or abet mty portion of the dnimp watm of my bAfing (except to rqm& 66) uma a Renak is Va d by the Building Lupomw. Application No...... 6.6.2.2.................. Permit .................. TO THE BUILDING INSPECTOR of the TOWN OF SOUTH WINDSOR, CONN. hereby make application to perform plumbing according to detailed description below. All provisions of the Rules for Sanitation, By-Laws, Sections 33 to 47 inclusive, shall be complied whether specified herein or not. '4 . ...........................South Windsor, . ...... 19 Sign here .............................. . . . ....... .. Address ............5..................... Location ....... .. ...........................I....... .... . .... side of -........................... ......... .................................................... Street Nature of Building ..................... . How many stones .. ............................................... ...................... �- k '2 Owner ........ ..... .. - -- ........................ ... Address . ./... . ...... ............. ............?........ ...............................I....... Architect .......... .. ... .......... e... ....... Address . ....... .. ...........7.. ............... Builder ........ .....f_. .......................................... Address . ............. ... .......&.o- t�- A Plumber ....... ................. Address .......... .4.14- ....... .......I...... .......... .............. DRAINAGE CESSPOOLS, How many Where located ....... ... ... ........................................................................ Are they water tight ............. . ... .. Of what materials are they built .. ............... ............................ Size of pipe from house to cesspool Kind of pipe ....- .. ................. .............................................................. MAIN DRAIN IN CELLAR, Material e Diameter .......... ............................................................................................ Above or below cellar bottom 0 f ....�'j .......... . . ... . ............I.........................................../....................................................... SOIL PIPES, Material Diameter WASTE PIPES, Material Diameter .............. ........................................ I............. TRAPS,Type proposed to use is .........7��................................................................................. ................ RAIN WATER LEADERS, where do they run to ................................................................................................................. REFRIGERATOR WASTES, where do they run to ............................................................................................... ............................... TANK OVERFLOWS, where do they run to . .. .......... ....................................................................................................... FIXTURES WATER CLOSETS, How many .. ......... Where located .................................................................................. Distance from trap to vertical soil pipe ................ Pattern ....... . ............I................................................. WASH TRAYS, How many . ..... .........../...... ......... Where located ................................................................................ SINKS, How many .... ......... .. ........................ ........ Where located .. . ..... .......................................................................6......... BUTLER'S SINKS, How many .............—.-77-777--Where located. . .. . . ..................................................................................6 REFRIGERATOR SINKS, How many.. ..................6.............. Where located . ............................................................6.6............................. LAVATORIES, How many ...... ...............',-1-7 .... ........................ Where located .............................6....................................6..........6..................... BATHTUBS,How many................................../.................6............. Where located ......................................................6.............................................. URINALS, How many ......... ...... .............................. Where located ............ .......6............................................................................. Are water closets and urinals to be local vented . If not, is there a window in outer wall ofroom where same are to be locat ...................................................6.......................6.................6...................................... Estimated Cost i PERMIT # Application For 6476 5375 DEPARTMENT DECISION o Heating Permit 3 APPLICATION IS HEREBY: w DEPARTMENT OF LICENSES AND INSPECTIONS N APPROVED ❑ DISAPPROVED TOWN OF SOUTH WINDSOR o ' DA E IEF INSPECTOR APPLICATIONS MUST BE PRINTED OR TYPED. BEGIN WITH NUMBER ONE NELO* o 1. LOCATION OF JOB I � � v NO. fTREET Cd W LOT NO. FLOOR APT. NO. � N C E 2. OWNERCd a o S. ADDRESS °0 3 E 4a > _ /�V 4.PHONE en � F --• s. APPLICANT- L*2 C� ao ad o Do / g '^+ 6. ADDRESS W 11 7.PHONE w e. LICENSE NO. 4s p w B. EXPIRATION DATE OF LICENSE-l — v 10. ESTIMATED COST S bo I I- 18 THIS A CONTRACT COSH LJ YEg ❑ . 12. FEE ENCLOSED = Po-rmi 12 2 2 8 K rA t f. TYPE ILDINQ 0..0 REfIDENTIAL ❑ COMMERCIAL a„"r 14. TYPE OF JO ❑ INDUSTRIAL 3 ; RIGINAL ❑ ALTERATION INSTALLATION ADDITION REPAIR APPLICATION FOR HEATING PERMIT (Continued from Reverse Side) 11. LOCATION OF JOB /'o (p `7 / y 9 �e A� �- NO. / STREET FLOOR APT.NO. � 12. TYPE OF INSTALLATION: E OIL BURNER ❑ ELECTRIC ❑ VENTILATION ❑ SPRINKLER ❑ GAS BURNER ❑ STACK ❑ INCINERATOR ❑ MISCELLANEOUS IDENTIFY SIZE LOCATION SIZE SIZEx/Y 13. OF TANK OF TANK / Se C`'v OF FILL 2 OF VENT 14. B.T.U. EQUIP. AT REGISTER FURNACE MAKE AND NO. AA BONNET FIRING RATE BOILER OR FURNACE MAKE AND NO. 612td Z B.T.U. OR SQ. FT. NETI OR SQ. FT. GROSS FIRING RATE FLOORS TO BE HEATED NEW OR OLD BUILDING C' INSULATED - YES OR NO !�ge 'e TYPE OF WALL 9INSULATION ROOF OR CEILING INSULATION L AVG. SYSTEM WATER TEMP. (R-0 -B.T.U./SQ. FT-LHR. EMISSION INDOOR-OUTDOOR TEMPERATURE DIFFERENCE 'FAHRENHEIT MAKE OF RADIATION: BA S BOARD. COPPER CONVECTORS. OR C.I. RADIATION. OUTPUT PER SECT,II N 0 LINEAL OF RADIATION. S FT. OR B.T.U. ►� O ' �/ Z � ��4_ DESCRIPTION OF WORK �+O lG ZL� d �- / La 15. TO BE DONE: ( �� S C 15. HEAT LOSS SCHEDULE. (TO BE INCLUDED FOR ALL JOBS): ROOM SIZE WINDOW! AREA - SQUARE FEET B.T.U. B.T.U. O DISTRIBUTION INSTALLED AND DOORS VOLUME TOTAL TOTAL �n NO. GLASS NET WALL CEILING FLOOR CU.FT. AT 70•F CORRECTED J 7 4 LL REGISTER ROOM GROSS t RAD. L W N AND TEMP. TO f TYPE AND SIZE OR LEADER f'L SIZE WALL t0 (INFILT.) DIFF. •F m W SQ. FT. FREE AREA TOTALS A. HEAT LOSS FROM BUILDING B.T.U./HR. B. DOMESTIC HOT WATER DEMAND B.T.U./HR. C. PIPING. OTHER THAN NORMAL B.T.U./HR. ALLOWANCE FOR HEAT VALVE OF FUEL (A B C)) FACTOR �' 17. ELECTRICAL WORK BY: �j'� �- NAME ADDRESS SUBCONTRACTORS AND 1a. THEIR TRADES ALL WORK COVERED BY THIS APPLICATION HAS BEEN AUTHORIZED BY THE (OWNER) OR (AGENT) OF THIS PROPERTY AND WILL BE DONE IN STRICT ACCORDANCE WITH THE BUILDING CODE. APPLICATION TO BE COMPLETELY FILLED IN. DATE SIGNATURE APPLICANT 0 0 _ ARGO CALCULATION SHEET OWNER ADDRESS—_ �� l � � DATE C3 DEALER__ �a fmA J �^ 1!{ KIND OF BUILDING- �—°/O'� CHIMNEY SIZE CONSTRUCTION: WALL y� �lkA WINDOWS S I Oy W 1,j tocil ROOF OR CEILING BASEMENT HEIGHT: A VE GRADE BELOW GRADE DESIGN WATER TEMPERATURE DESIGN TEMP. DIFF COL.1 2 1 3 4 5 1 6 7 1 8 9 10 11 12 13 14 15 16 17 18 ROOM SIZE WINDOWS AREA-SO. FT. FLOOR VOLUME AND DOORS TOTAL BASEeOARDS (fE[NOT[) CU.FT. TOTAL l.r T/'i AT 70 F CORRECTED WATER LENGTH ACCESSORIES GLASS NET WALL CEILING •OIL TO ROOM NUMBER GROSS TtMF. .O �Mp nR, L W H M AREA WALL c 018 DIFF. O o ENCLOSURE FIN Size , F L Its I.0 MISC. k o' 0-2 TUBE TEMP DIFF. 00 oo ©o I ? D — 237 '3 o A off, Do o10 00 y000 1/570 8 IT Ll? ,.J 16 00 / OD 700 5 y00 4/7 0 I/ fl r 11 h Fi 600 o o $00 a 510 s r a� 19 a o ' z )1196 >< W10 1000 qvo 1100 ys-o0 r g V g Goo 3 0o Soo 00 00 300 1/00 0 0 1320 3 L 00 i 8 1 oo,Z Iro y 1 b o o 00 00 0000 /5 o0 34 00 I F 13 z 1080 9 D0 2.00 �00_ Aloo 3-)0o LO30 10 ►3r 13 'IL 700 ©0 800 000 a 9 0 0 3310 6 k NOTE: FOR CONCRETE FL OR ON GROUND OR FILL AT GRADE LEVEL,USE LINEAR FEET OF EXr SED EDGE. TOTALS O F R ALL OTHER FLOORS USE SQUARE FEET OF AREA. 139730. /DJ` B ildLnIgNSPECTLONSU APPLICATION FOR BUILDING PERMIT Plumbing HVAC Date: Sprinkler 149 KENT LANE Electric Estimated Cost $ 3�� Zoning Permit Fee $ d — Affidavit NO. 17520 Occupancy Fee $ Eng. Dept. Fire Dept. COMPLETE RED BOXED AREAS. Total Fee $ Health Dept. TYPE OR PRINT ONLY Approved for CO: SIGN ON REVERSE SIDE. TO BUILDING DEPARTMENT, TOWN OF SOUTH WINDSOR, CT The undersigned, hereby applies to do work according to the following specifications: Job Locatio _ eat N Lot No. Side of Street Zone Applicant Oarl a ro Tel. # Address �a ' 0ar (�S V e r�a°h C , Zip 0 6 0 (0 6 Lic.# 027 Owner o�r � ' Q�ry Address q9` " n-'t $, w N c�S or Architect oar S re :7 ----Address �a' PRI we P/C V'e.-ryom Size New Area: Ft. Front Overall 3s Ft. Deep Overall 20 Total Area 5';U S4 �Garages Lavaiories No. of Families No. of Stories 1 Construction Bathrooms Rooms 1st 2nd 3rd Size of Lot Dist. from Street Line Dist. from Side Street Line Purpose of this Permit /Ve uJ 11Q0 0.5 P_e S n 1/ 00/ o Ay bra 44) 1/V 9 S City Water Well ❑ Septic ❑ Sewer 12'_� Approved by Date -7-`lAe" 72 BD1A 11/88 I h reby 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 a zone in which this building and its use is allowed. Signed OJ S�� I hereby apply for a Certificate of Occupancy for the work described in this application for permit. Signed —DO NOT WRITE BELOW THIS LINE— INSPECTION RECORD Footing Foundation Insulation Plumbing Permit# Inspections: HVAC Permit# Inspections: Electrical Permit# Inspections: Sprinkler Permit# Inspections: Electric# APPLICATION FOR BUILDING PERMIT Plumbing# 149 KENT LANE WAC # No. Dat : `1 Sprinkler# FKA.11, Estimated Cost fJ, Building 99 COMPLETE RED BOXED AREAS Permit Fee CkN Affidavit TYPE OR PRINT ONLY p�cy Fee $ A.W.for CO. SIGN ON REVERSE SIDE Total Fee $ TO BUILDING DEPARTMENT,TOWN OF SOUTH WP4DSOR,CT (Additional Cost) $ The undersigned hereby applies to do work occorcing to the fol6wing specifications; Jo6 Location_ %4-L _� Qom,j �i9.h Q Lot No. Side of Street Zone Applicant Fe j-A- S ,;` Tel.#_ 6��^g'7 gqri Address x D Zip Lic.# DD s o 7? Q 7 Own r c A.,*A, Address /.L* -P Architect Address Sq.Ft.N w Area: lst Fl. 2nd Fl. 3rd Fl. Total New Area #Rooms #Lavatories #Bathrooms #Garages Purpose of this permit: t City Water ❑ Well ❑ Septic System ❑ Sewer ❑ Ins. H.O. S.P. Cert. Area Basement Garage Approved by Date &P-41V 1, Group Construction Type Rwi od 1197 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 jic5hNs building and' use is Signe I hereby apply for a Certificate of Occupancy for the wortdein cation for the permit. Signed NOT WRITE BELOW THIS LI INSPECTION COMMENTS r Uat mo• -too HOME OCCUPATION FORM 1 Minor ZEO Approval Date ASSESSOR'S USE ONLY: R Major PZC Approval Date A5F ra 7'q 7 Home Occupation Type %4 Expiration Date ,/Q—o;2 9' �1 0 Code Name Pio bra !y' V kerx ri all Address of proposed occupation: ke4l-r Ldlyl& 1 ICI Sri 12 Telephone O&O W 4 (p 0q 0 Zone Description of Occu ation: , i � 15qq-)Lh���V OAJ` A r COWA) A. OPOSM SIGN _ 1 Please use the boxed ran att ed sheet to provide the following: p 1. Attach copy of plot plan if applicable. ( �n 2. Use box A (or attach sketch)to draw proposed signage. 3. Use box B (or attach sketch) to draw the floor plan of the home ?106 ned occupation area. 4. Architectural elevations for any proposed additions or modifications must be provided. B. FLOOR PLAN( Basement 1st Floo(i d Floor) Floor area of dwelling Floor area of ho a occupation a 0 it %of floor area 69 1 � I Oct OLIA � 1 I have read the regulations regarding home occupations and intend to comply with said regulations. I understand I must notify the Planning Depactm 'tin u t ation of this occupation at thisD t�� —Z��? Signature of Applicant Signature of Home Owner ADate 7 ZJ- 17 White = Assessor Yellow = Applicant Pink = Street File m/ vb tk,) doaA� -'x4) If f-p�Ar)A 4 a.��, dw � �'�w' u�� a i/r. eva�.f,,,) &•: D ax nuK���c ✓ ' 01'� � w ,� Ye UN/� �Yu- 61P+�a" ,�-aZ `�"'u, �z