HomeMy WebLinkAbout125 Burgess RoadALBNdnIgNSPEC io S:
APPLICATION FOR BUILDING PERMIT
Plumbing
HVAC Date: Z
Sprinkler 125 Ru rge s s Road
Electric ,/ L009 Foster Road Estimated Cost $
Zoning Permit Fee $ !/
Affidavit NO. 17752 Occupancy Fee $3
Eng. Dept.
Fire Dept. COMPLETE RED BOXED AREAS. Total Fee $ !/3
Health Dept. TYPE OR PRINT ONLY
Approved for CO:3 ter/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 cs of No. Side of Street Zone
Applicant /Fuse/l A7-eesP-t Tel. #
Address YW j'•'r"7 ST, S- u/!n'sor Zip o6 0> Lic.# .VOSY
Owner Aiss ell t476r 'a P, Address VVC Ae'001 1h!k Si SM "44~A40
Architect Ame ylekz SPr ;e'eAddress 122 J pig,i
Size New Area: Ft. Front Overall Ft. Deep Overall -S0 Total Area ZZZ Z-y
t#
Garages -
Lavatories
No. of Families No. of Stories L- Construction W Bathrooms . Rooms 1st 72nd 33rd
Size of Lot (ZS 3 Dist. from Street Line 1Sri Dis . from ide Street Line 27
Purpose of this Permit ew Mows P Er •-S t' 4:•rJ
City Water 0 Well Septic Sewer
Approved by Date BD1A 11/88
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 a zone in which this building and its use is allowed.
Signed l2e,0-6:11 0C
I hereby apply for a Certificate of Occupancy for the work described in this application for rmit.
Footlnc
Signed 12ZOO."o
Coe—
DO NOT WRITE BELOW THIS LINE—
JORAo .,... 'Fj"Iff tjAC..* INSPECTION RECO
fZ G 2
11)
Foundation Insul ion 6 ( '
Plumbing rmit# YND2-5 Inspections: O
HVAC Permit#_ Inspections:
Electrical rmit# Inspections:
C4 U
o
Sprinkler Permit# Inspections:
l
BUILDING INSPECTION DEPARTMENT
SOUTH WINDSOR, CONNECTICUT
FEE PAID: $3.00
CERTIFICATE OF OCCUPANCY
ZONE: DATED 1/2 3 19 91
This is to certify that 125 Burgos* Road
Erected under permit No. conforms substantially to the requirements of the building ordinances and the
a
zoning regulations of the Town of South Windsor and is hereby approved for occupancy as indicated below.
Approved for Occupancy—ppNOW single family dwelling Lot # aka L009 Fo$t r Road)
I
Use Group:R4
Constr. Type: 58
Building Official
Notice:If this certificate is lost or destroyed, a duplicate should be o tained immediately from the Building Department.
Any change or extension ofthe use herein approved requires a new certificate ofoccupancy.
PERMIT
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT Z
Application is hereby:
TOWN OF SOUTH WINDSOR
APPROVED DISAPPROVED BUILDING INSPECTION DEPT.
644-2511 Ext. 230
Application must be printed or typed .
Date Bui ding Inspector
1. LOCATION OF JOB
b
FEE SCHEDULE o . St eet
0 - $19000 - 10.00 Floor Apt . No.
Over $1,000 - 10.00
per $1,000 or 2 . OWNER L)
fraction thereof
3. ADDRESS E/'))// J'
2_0 LIT N W1 N C 6b07
OV
4. APPLICANT eCr/ . /Vi •
5. ADDRESS
f
6. ESTIMATED COST $
7 . IS THIS A CONTRACT COST y
Yes No
8. FEE ENCLOSED $ L E'/'I/ .-177.5"oZ.
9. TYPE UILDING:
RESIDENTIAL COMMERCIAL
10. TYPE 0 JOB:
Original Installation
Alteration/Addition/Repair
BD 3A 11/88
APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side)
11 . LOCATION OF JOB viPC r
NO . STREET APT. NO
12 . TYPE OF INSTALLATION 1'0 W
13 . SIZE OF MAIN FEEDER 2 o-V /-;L-
14 . NO. OF LIGHT LOOPS 15 . NO. OF HEAT LOOPS
16 . NO. OF POWER LOOPS 17 . NO. OF LIGHT OUTLETS
18 . NO . OF HEAT CIRCUITS [ 19 . NO. OF POWER OUTLETS
20. NO. OF CONVENIENCE OUTLETS 21. NO. OF HEAT CIRCUITS
22 . NO. OF POWER CIRCUITS 23. NO. OF LIGHT CIRCUITS
24. SIZE OF HEAT CIRCUITS 25 . NO. OF MOTORS
26. NO. OF PANELS 02— 27 . TOTAL WATTAGE
28 . NO. OF POWER FEEDERS 29 . NO. OF SWITCHES,
30. A/C LOAD 31. SIZE OF POWER FEEDERS
32 . NO. OF FIXTURES a 33. TOTAL HORSEPOWER
34 . NAME OF SUBCONTRACTORS AND THEIR TRADES
35 . REMARKS AND FURTHER DETAILS :
1
LICENSE NO.SIGNATURE OF APPLIC NT DATE
PHONE NUMBER: r
Lot No.
Building Permit
Temporary Service
Permanent Service
i
This Certifies that the ElectricalPursuant to Permit No. 5hasbeendulyins
Y approved.
Work for which the a
S
inspected and is hereby a above named Permit was grantedOwnerr
1
Street Electrician
19-
uil ng nspector
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wy;
e71 t V'"S"
4
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kt. •fit .,-.\ r _. ..
2-
PLUMBING APPLICATUN
N6.
S'. Ssaac
p6m6c
Ned in of
No pesos aw co. am in w mbw Mir
portion of 26 &06W symm of as ba&g
to upiow
1 66) Nag a Pank it fm j
by t6&dwmg b"*m
APPLICATION FOR PLUMBING PERMIT (Continued from Reverse Side)
TOWN OF SOUTH WINDSOR, CONN.
LOCATION OF JOBX 411. LOC NO. STREET fLOOA u".MO.
GENERAL PLUMBING
12. KIND OF INSTALLATION 13. SIZE OF MAIN DRAIN
14. NO. OF TOILETS=_STYLE 15. NO. OF URINALS STYLE
16. NO.OF BATHTUBS/17.NO.OF LAVATORIES__18. NO.OF SINKS 19. NO. OF WASHTUBS
20. NO.OF CONDUCTORS SIZE 21. NO. OF STACKS_SIZE --
22. AREA OF ROOF 23.NO. OF CATCH BASINS 24. NO. OF FLOOR DRAINS
25. NO. OF OTHER FIXTURES KIND
26. ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW? ' 27. SIZE OF WINDOW
61
28. IF NO WINDOW,WHAT KIND OF VENTILATION IS THERE?
29. SIZE OF DUCTS 30. ARE SEWAGE AND WATER FACILITIES AVAILABLE?
SIGNATUR ADDRESS
LICENSE NO. 0 1020? ESTIMATED COST `` --- TELEPHONE
OWNER ADDRESS
WATER HEATER
31. TYPE 32. MANUFACTURER
TANK SAFETY DEVICES
33. CAPACITY 37. TEMPERATURE RELIEF VALVE
34. TEST PRESSURE_ 38. MANUFACTURER
35. WORKING PRESSURE 39. PRESSURE RELIEF VALVE
36. TYPE 40. MANUFACTURER
ALL WORK COVERED B HIS APPLICATION HAS BEEN AUTHORIZED BY THE OWNER OF THIS PROPERTY
AND WILL BE NE RICT ACCORDANCE WITH THE BUILDING CODE.
C0962 f DATE SIGNATURE OF APPLICANT
1
J.
FOR OFFICE USE ONLY APPLICATION FOR HVAC PERMIT DATE:
NO. Z268i ) TOWN OF SOUTH WINDSOR EST.COST:
BLDG. PERMIT NO. / 7 V7. 1540 SULLIVAN AVENUE FEE I/R
SOUTH WINDSOR, CT 06074 FEES:
644-2511 - Ext. 230 0 - $10000 - $10.00
1000 or fraction
LOCA ION OF BUILDIN thereof - $10.00
OWNER ADDRE S TOWN PHONE NO.
S/j 3 i>
HVAC CONPWerOR ADD ESS TOWN PHONE NO.
TYPE OF SYSTEM: HEATING Lam-TYPE OF BUILDING: RESIDENTIAL
A/C COMMERCIAL
VENTILATION BUSINESS
INDUSTRIAL
IF HEATING: STEAM LOW PRESSURE LIMIT LBS. HIGH PRESSURE LIMIT LBS.
HYDRONIC WARM AIR
UNIT RADIANT HEATER (INCLUDING WOOD/COAL BURNING STOVE)
TYPE OF FUEL: OIL-GPM 4 00 GAS IN-PUT ELECTRIC KW
WOOD COAL
OIL TANK - SIZE & LOCATION: INSIDE OUTSIDE CAPACITY J"
LPG TANK - CAPACITY
EXISTING RADIATION ADDITIONAL RADIATION TOTAL RADIATION J c
DESIGN TEMP. OUTSIDE- OF INSIDE&d OF DIFFERENCE_ja°F
TOTAL HEAT LOSS (BTUH)_ 3 7 -d HEAT LOSS SHEET MUST CCO ANY AP ICATION),
DESCRIBE ALL HEATING EQUIPMENT (INCLUDING MAKE & MODEL NO.):
GROSS HEATING CAPACITY (INPUT-BTUH) NET RATING (OUTPUT-BTUH)
IF 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)
IF VENTILATION: DESCRIBE ALL AIR-HANDLING EQUIPMENT (INCLUDING KITCHEN EXHAUSE EQUIPMENT):
TOTAL SIZE OF SYSTEM (CFM) FRESH AIR INTAKE (CFM)
PLAN MUST ACCOMPANY APPLICATION)
The undersigned hereby applies for a permit to perform the following work and is to comply
with all local ordinances and State of Conn. Building C es i the performance of such work.
FURTHER DESCRIPTION OF WORK:
t3 V c 3 7 , /10r
STATE LICENSE - NAME & TYPE #DATE GNATURE OF APPLICANT
ROVED DATE
BD 4A 11/88
I - B - R CALCULATION SHEET 1W3 (Modern Method) Copyright 1977 by The Hydronics Institute
OWNER ADDRESS DESIGN TEMPERATURE DIFFERENCE—P. DATE
COL.A
W44 4/
COL.D COL.E COL.F COL.Q
1 ROOM QZIYyj
H L W H L W H L W H L Design Water Temp.
2 ROOM DIMENSIONS, FT.
STUH Per foot of
3 LENGTH EXPOSED WALLS,FT. U p pRadiation Selected
4 WINDOW AND OUTSIDE DOOR AREA 7
STUN STUN STUN STUN STUH
5 WALL CONSTRUCTION D ROOM LIN.FT.OF
CTable9,Line 3 x HI OJ L/ 0 D 0 1 6 TOTALS RADIATION
6 TYPE OF GLASS FROM LINE 12 SELECTED
Bottom of table used for Line 5) ov O"(Q o O Qb
7 CEILING CONSTRUCTION l
Table 9.L x WI D p V C/ OC/ Dv 1,50 0
9 FLOOR CONSTRUCTIONt D L%
Table 9, L x W or Lin. Ft.) E_-3 3 0Q
9 COLD PARTITION CONSTRUCTION F Fro0
Table 9,L x HI
G— Poo
10 _0 1 Well(with openings)0; p/Z / DU d v O Esc,
2W•HslWithOpeninga) DXis3Wells(With Openings)or Ent.Hall
J 1 V CO
3o D U aD o D
30 D11TOTALBTUHAT70FTEMP. DIFFERENCE
12 TOTAL BTUH AT DESIGN TEMP. DIFFERENCE a 00 O o K
L -------
3; 3 5 v S
COL.A COLS COL.H COL.I COL.J COL.K COL.L TOTAL STUH TOTAL
1 ROOM OF 8U ILDINQ RADIATIONL^C f AT SELECTED
O H L W H L W H L W H L W L W DESIGN TEMP.•
2 ROOM DIMENSIONS,FT.1.- 4, r— / p DIFFERENCE
U O
3 LENGTH EXPOSED WALLS, FT.
4 WINDOW AND OUTSIDE DOOR AREA LL b
STUN STUN STUH STUN STUN
5 WALL CONSTRUCTION INCREASE BATHROOM
Table 9,Lln•3 x H) 3 00 U 0 0 0 0 r TOTAL 20%
6 TYPE OF GLASS
Bottom of table used for Line 51 0c OoL V
7 CEILING CONSTRUCTION tFOR CONCRETE FLOOR ON
Table 8, L x W) GROUND OR FILL AT v GRADE LEVEL,USE LINEAR
B FLOOR CONSTRUCTIONt FEET OF EXPOSED EDGE
Table 9,L x W or Lin. Ft.)
9 COLD PARTITION CONSTRUCTION
Table 9,-L x H)
10 -C 1 wall(With Openings) kC± 2 Walls{With Openings( J Cv3Wells(With Openings)or Ent.Hail11TOTALBTUHAT70FTEMP. DIFFERENCE' CQ 1,4 0 Q
12 TOTAL BTUH AT DESIGN TEMP. DIFFERENCEa 6 0 / o 0 S
This form Is available from The Hydronlcs Institute,35 Russo Place,Berkeley Heights,N.J.07922 FORM 1503
DEPARTMENT DECISION APPLICATION FOR SPRINKLER PERMIT
MIT#TOWN OF SOUTH WINDSOR PERApplicationishereby:
BUILDING DEPARTMENT o
APPROV 1540 SULLIVAN AVENUE
644-2511 ext. 230 Bldg.Permit#
Date Building Inspector 7S Z
Application must be printed or typed
FEE SCHEDULE Location of Job:
AK?60-$1,000=$13.00 Street No. Street Lot No.Over$1,000
13.00 per$1,000 s`
or any fraction thereof Tena Desi nationg Apt.No.
APPLICANT L f
N
APPLICANT ADDRESS
APPLICANT PHONE#
0 W N $.
q
OWNER
OWNER ADDRESS D //1 v.-z i 1/ A iiS
C ram, ..L"//.r r...,j G. 2--
QOWNER PHONE
8Go
C ESTIMATED COST$U
IS THIS A CONTRACT COST? B'Ires O No
FEE ENCLOSED$ / pd
TYPE OF JOB:sOR- 0
ew Installation
13 Alteration/Addition/Repair Revised 8/99
APPLICATION FOR SPRINKLER PERMIT (Continued from reverse side)
TYPE OF BUILDING TYPE OF CONSTRUCTION=USE GROUP NO. OF STORIES
RESIDENTIAL IS THIS APPLICATION ASSOCIATED WITH A
USINESS BUILDING PERMIT APPLICATION? YES NO
ASSEMBLY
MERCANTILE CURRENT USE AND OCCUPANCY
EDUCATIONAL
INSTITUTIONAL FUTURE USE AND OCCUPANCY ' -
FACTORY
STORAGE ENGINEER'S NAME PHONE
GARAGE
MIXED USE ADDRESS
Other please specify) CITY STATE ZIP
KIND OF INSTALLATION
DRY WET COMBINATION CHEMICAL
SIZE OF MAIN DRAIN WATER PRESSURE AT STREET(PSI)
ARE SPRINKLER HEADS ALTERED? YES NO
IF YES,CHECK ALL THAT APPLY: ADDED DELETED ALTERED
IF MORE THAN 3 HEADS ARE ADDED HYDRAULIC CALCULATIONS ARE PROVIDED BY(CHECK ONE)
PROFESSIONAL ENGINEER INSURANCE COMPANY
WATER FLOW WATER PRESSURE AT SPRINKLER HEADS(PSI)
ARE PUMPS REQUIRED? YES NO IF YES,CHECK ALL THAT APPLY:
FIRE BOOSTER OTHER
ARE STANDPIPES PROVIDED? YES NO IS A SPRINKLER SYSTEM PROVIDED? YES NO
SPRINKLER SYSTEM MAIN WATER SUPPLY RATING GPM
TOTAL DYNAMIC HEAD(TDH)OF FIRE PUMP PSI
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.
1C)l9 -3 69 n -Z2 Z= 3
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT DATE i c
Bectric# APPLICATION FOR BUILDING PERMIT
Plumbing# 125 BURGESS ROAD
WAC # 25875 Date:
Sprinkler# ANO'
FINAL RO Estimated Cost $ D - DO
Building r b COMPLETE RED BOXED AREAS Permit Fee 12
Ong TYPE OR PRINT ONLY Occupancy Fee
Aff afor CO.
SIGN ON REVERSE SSE
Appr. Total Fee
TO BIALDING DEPARTMEW,TOWN OF SOUTH WHWk CT Additional Cost) $
The undersigned hereby applies to do work according to the following specifications:
Job Location s acl Lot No. Side of Street,20 u V --Zone
Applicant S+Hus-se# F' S P t'L Tel.# (R(o b)oaa
Address wo A Zip 6(" Lic.#
Owner Address
Architect Address
Sq.Ft.New Area: 1st Fl.s2l
I)(
2nd FI. 3rd Fl. Total New Area
Rooms lavatories Bathrooms Garages
Purpose of this permit: K1Q ifs 7 i1- f vrv U S
17-2 F w0 C 1+0 O 0
Water Well Septic System 0 Sewer
Ins. H.O. S.P. Cert. Area Basement Garage
Approved by 0&- Date--!KqK Use Group y Construction Type
Reybed l/97
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 wh' is building a allowed.
Sign
I hereby apply for a Certificate of Occupancy for the work in this application for the permit.
Sign e ----_
DO NOT WRITE BELOW THIS LINE
INSPECTION COMMENTS
Inspection / Approval Date By Appl
Code Description Due Whom Code Comment
99-25875-B 400
B10 FINAL 07/12/00 JFF A
B10 FINAL 07/12/00 JFF A CLOSED OUT.
PEP21IT CHECK LIST
Building Permit No. 7 75,2
Date Submitted
Reviewed by
Date
i
sion Regulations, prior to the building of
graphic Plot Plan shall be submitted for
ments sh clude .
dIS ? Z o _
ess & phone number of owner/
f 4 ?j&0 plicant.
met address & phone number of plan preparer.
ning information - i.e. zone, open space,
rzoodway, etc.
4 . Plot plan at 1" = 40 ' scale.
a. Subdivision reference, abutting
properties, etc.
b. Easements of record.
c. Lot description, bearings, distances,
building lines, area, etc.
d. Contours, existing & proposed,posed, 1 or 2 f t.
interval where appropriate.
e. Building location with dimensions.
Elevations of proposed finish floor,
garage floor & center line of road at
driveway.
f. Elevations of gravity drainage systems,
sanitary & foundation drain at the
house and the street.
g. Tentative utility location gas, electric,
water, etc.
h. Title block with name and address of
preparer, date appropriate certification,
r^ live seal and signature.
5 . Sedimentation and erosion control.
6 . Specialp Planning & Zoning, Inland/Wetlands
considerations. (Plans on file w/Town Clerk)
BUILDING DEPT.
PZC
IWA/CC
WPCA 1D? 7ZP /SS/,-c•% D'= 774 p=U
OTHERS
COMMENTS:
CORRECTING DEED
Cleaveland Legal Blank Service, Inc.
QUIT CLAIM DEEDaikixcsSl 135 East Hartford,Connecticut 06108
I Lois H. Petersen 0()?913
OF Town of South Windsor, County of Hartford, STATE OF CONNECTICUT
N
s for the 6fisideration paid
q
Grant To Russell H. Petersen and Susan C. Petersen of the
Town of South Windsor, County of Hartford and State of Connecticut
an undivided. one-half intere t
Ata6#nyfa as joint tenants, and with QUIT CLAIM COVENANTS, d that certain piecekfx
orparcelofland, with the improvements thereon, situaied in the Town of
South Windsor, County of Hartford and State of Connecticut containing
one acre more or less and being more particularly bounded and
described as follows :
Commencing at a point in the southerly side of Burgess Road,which
point is 435 .30 feet westerly as measured along the southerly line of
j Burgess Road from the beginning of the are of a curve connecting the
j southerly line of, Burgess Road with the westerly line of Foster Road,
and which point of beginning marks the northeast corner of the
premises herein conveyed; thence S 220 07 ' 39" W, 300 .00 feet to a
point marking the southeast corner of the premises herein described;
thence N 670 52 ' 21" W, 175 .00 feet to a point marking the southwest
corner of the premises herein described ;thence N 220 07 ' 39" E,
300 .00 feet to a point in the southerly line of Burgess Road, the
last three directions being along land now or formerly of
Lois H. Petersen; thence S 670 52 ' 21" E along the southerly line
of Burgess Road to the point of beginning.
Said premises are conveyed subject to any and all provisions of any
ordinance, municipal regulation or public or private law.
THE PURPOSE OF THIS DEED IS TO CORRECT PROPERTY DESCRIPTION IN
QUITCLAIM DEED RECORDED IN VOLUME 5489 PAGE 14 ON DECEMBER 309 1988 .
47 A;F LOCAL$NO
TOWN CLERK OF S U1W4yi DSOR
South Windsor
BUILDING DEPARTMENT.
Signed this 2nd day of June V 19 89
Si ned and delivered in the presence of:
ois H. Petersen
STATE OF CONNECTICUT, 19gg, South Windsor
COUNTY OF Hartford
Personally Appeared Lois H. Petersen
Signer(s) of the foregoing Instrument, and acknowledged the same to be her
free act and deed, before me.
Grantees Mailing Address Notary Publics'
440...Dem3n.g..S.t.ree.t.................................... My Commis ion Expires 3-31-94 .
South Windsor , CT. 06074
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To THE
is-,e i^d t h, t tI . .1:s Piail a7--, r U,
cop of the Proposed build: 0,- iiil be
erected at
ilc:1 'A p ri ;j (j
LV flie
tris EjpP;,CetjCF. '31IJ final of a
t C-nd!lion tf,3,,
id s:,e,!! be
Condition-a!ly Approved These filed wiih
BuiWing Inspector Clerii;
P4 S
L-AQERTIFICATIO,N OF ZONING COWIPUANCE
Proposed building(s), use(s) and/or structure(s)
is shown on this plan appear(s)' to be in
onformance with current South Wind:,-v
gulations. Variances and special exceptions
nay apply.
Date 3l3 s