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HomeMy WebLinkAbout15 Hitchcock WayAPPLICATION FOR BUILDING PERMITElectric# Plumbing# 15 HITCHCOCK WAY HVAC # 1 23447 Date: .' 3 Cj Sprinkler# No. FINAL APPR Estimated Cost $ 70 <) Building as 117 COMPLETE RED BOXED AREAS Permit Fee 7 oci Engineering 1 Z TYPE OR PRINT ONLY Occupancy Fee $ 3 Affidavit 9 SIGN ON REVERSE SIDE Appr.for CO. Total Fee Q 3 TO BUILD G ARTMENT, TOWN OF SOUTH WINDSOR,CT Additional Cost) $ — O — The under fined hereby applies to do work according to the following specifications: Job Location 15- It o Lot No. © I Side of Street 4wq 7.Qw- Applicant mil Tel. #L A Address S// O a(.c la AX A d, -S„. [.di.c1f IQ.,_Zip Q Lic.# Owner ldo1-f ass c,b o vZ Architect Xed12weina1?L1d C 1cTnc Address Sit_ .s Sq. Ft.New Area: Ist FI. --7 Z 2nd FI. ZY 3rd FI. Total New Area lVOO s Rooms g Lavatories 2 Bathrooms 2 #Garages I Purpos of this permit: /t/,ow -'5'ZqjgX mar i4i jAAS' k_ City Water Well C3 Septic System Sewer Use Group E:`'F Construction Type Area ZO62 / Basement 1 _ Garage CZq Approv d by Date R.vsed 6/95 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 b I ing and its use is alloyve gitKR/ s 9..d j r/7r I hereby apply for a Certificate of Occupancy for the work Irscribed in this application for the permit lU`(Signe DO NOT WRITE BELOW THIS LINE -- INSPECTION COMMENTS Location of Job: AFFIDAVIT Additional Fee S -0 State of Connecticut ss.South Windsor County of Hartford wner of 1 15.1. gent f the building erected 3 4 4 7 ractor under Permit No. issued by the Building Department of the Town of South Windsor beingdulysworn,make oath and say that the actual cost of the completed work authorized un said permit did notexceedthesubmittedestimatedcost $8 0, 8 0 0. 0 0 . Subcribed and sworn to before me this day of S UT A of A.D. 19, Estimated Cost Difference: S _n_ ry Public Inspection / Approval Date By Appl Code Description Due Whom Code Comment 96-23447-B 70,000 B01 FOOTING 08/07/96 JFH A B02 FOUNDATION 08/13/96 JFH A P03 ROUGH 09/04/96 JFH D LOW AIR TEST P02 UNDERGROUND 09/04/96 JFH A B03 FRAMING (ROUGH) 09/04/96 JFH A E03 ROUGH 09/04/96 JFH A B04 INSULATION 09/06/96 JFH A PO4 GAS TEST 10/23/96 JFF D NOT READY PO4 GAS TEST 10/23/96 JFH A B09 OTHER 10/24/96 JFH HOT WATER HEATERS VENTED WRONG B10 FINAL 08/29/97 JFH D NO HOT WATER B10 FINAL 09/03/97 JFH A APPROVED FOR CO (BLDG) APPROVED (ZONING) 9/17/97 96-9795-P 5,000 96-9568-H 3,000 96-14081-E 2,800 Total Est Value 80,800 Dwelling 1,400 57,288.00 Basement 672 8,332.80 Garage 264 3,273.60 Smoke Det 7 525.00 BOCA Value 78,443.92 Difference 2,356.08) SITE COMPLIANCE CHECKLIST TOWN of SOUTH WINDSOR, CONNECTICUT 15 HITCHCOCK WAY LOT # Reviewed By Engineering) MANNARINO BUILDERS INC. Date Revie ed Denied 41 OAKLAND ROAD,SOUTH WINDSOR,CT Reviewed By Planning) BP # 23447 Ph_# (860) 644-9000 Date Reviewe 7 '7 rov /Denied Date Submitted 09/04/97 FOR C of d ***** As required in the Zoning and/or Subdivison Regulations, no Certificate of Occupancy shall be issued until grading plans have been complied with and approved by the Town Engineer. The minimum requirements shall include: Approved Denied N/A 0n- 0< 1. Approved building permit plan 2. Finish grading per approved building permit plan 3. Site work; i.e. trees, shrubs, dumpsters, required parking 4. Utility location; a. sanitary sewer/septic system b. foundation drain C. electrical & telephone d. water e. other 5. Sewer connection charge paid 6. Appropriate certification 7. Bonding 8. Planning & Zoning/ Inland Wetlands Considerations Sewer Permit No.5-16 Pavement Excavation No. COMMENTS: SITE COMPLIANCE CHECKLIST TOWN of SOUTH WINDSOR, CONNECTICUT 15 HITCHCOCK WAY LOT_# / Reviewed By ' F eering) rMANNARINOBUILDERSINC. Date Reviewed Y Denied s' 41 OAKLAND ROAD,SOUTH WINDSOR,CT Reviewed By Planning) BP # 23447 Ph_# (860)644-9000 Date Revie 8 a rpove /Denied Date Submitted 07/31/96 FOR BUILDING PER In accordance with the Zoning and/or Subdivision Regulations, prior to the building of any structure on a lot, a Topographic Plot Plan shall be submitted for approval. The minimum requirements shall include: Approved Denied N/A 1 . Name, address & phone number of owner/applicant 2. Name, address & phone number of plan preparer 3. Zoning Information - i.e. zone, open space, floodway, etc. X`" Afr 4. Plot Plan at 1" = 40, scale a. Subdivision reference, abutting properties, etc. b. Easements of record c. Lot description, bearings, building lines, distances, area, etc. d. Contours, existing & proposed, 1 or 2 ft. interval where appropriate e. Building location with dimensions. Elevations of proposed finish floor, garage floor & centerline of road at driveway f. Elevations of gravity drainage systems, sanitary foundation drain at the house and the street g. Tentative utility location (gas, water, electric, septic system, etc. ) h. Title block with name and address of preparer, date, appropriate certification, live seal and live signature consistent with the Board of Registration requirements. (P.E. & L.S. ) 5. Sedimentation and erosion control 6. Special Planning & Zoning, Inland/Wetlands considerations (Plans on file w/Town Clerk) COMMENTS e- 0 r S P..-o/i„5 '.s .L ie Sr G's". w C,o/Y/' a/'C rrr eif 'G`/C A'4 6 P r v//'-0. 7/y= 57S AN /4 PERMIT 0 DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT Application is hereby : TOWN OF SOUTH WINDSOR BUILDING INSPECTION DEPT. APPR DISAPPROVED 1540 SULLIVAN AVENUE 644-2511 Ext. 230 datev Building Inspector Application must be printed or typed 1 . LOCATION OF JOB 7/- FEE SCHEDULE No . Street 0 - $19000 - 10.00 Floor Apt . No. Over $1,000 - 10.00 2 . 0WNER /Y,/l//l/jZj/Z-2per $1 ,000 or fraction thereof 3 . ADDRESS X"/ SC9 4 . APPLICANT 5 , ADDRES S S7 So c/Ti,e.001 6. ESTIMATED COST $ 7 . IS THIS A CONTRACT COST Yes No 8 . FEE ENCLOSED $ 3d 9 . TYP OF BUILDING : RESIDENTIAL COMMERCIAL 10. TYP OF JOB : Original Installation Alteration/Additi n/Repair RD 3A 11/88 APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side) 11 . LOCATION OF JOB X- '% 'G/C®G NO. STREET APT. NO , 12 . TYPE OF INSTALLATION y rZ4 13 . SIZE OF MAIN FEEDER 14 . NO . OF LIGHT LOOPS 15 . NO. OF HEAT LOOPS 16 . NO . OF POWER LOOPS 17 . NO. OF LIGHT OUTLETS -'70 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- 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 33. TOTAL HORSEPOWER 34 . NAME OF SUBCONTRACTORS AND THEIR TRADES 35 . REMARKS AND FURTHER DETAILS : zz=zc d LICENSE NO.SIGNATURE OF APPLICANT DATE PHONE NUMBER: PERMIT ":0. q r?99' DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT Application is hereby : TOWN OF SOUTH WINDSOR PPROVE DISAPPROVED BUILDING INSPECTION DEPT. 1540 SULLIVAN AVENUE 644-2511 Ext. 230 D to Building Inspector Applications must be printed or typed 1. LOCATION OF JOB:15 FEE SCHEDULE 2. OWNER:- Q 0 - $19 0 0 0 - 10.0 0 3. ADDRESS: Over $1 ,000 - 10.00 5. per $1 ,000 or 4. APPLICANT:fraction thereof 5. ADDRESS: 1 6. EST. COST: $ J O • 7. IS THIS A CONTRACT COST? ES NO 8. FEE ENCLOSED: $ 9. TYPE OF BUILDING:_ Z,-Y z RESIDENTIAL COMMERCIAL 10. TYPE OF JOB: ORIGINAL ALTERATION INSTALLATION ADDITION REPAIR BD 2A 11/88 APPLICATION FOR PLUMBING PERMIT (Cont. from Reverse Side) 11. LOCATION OF JOB: J 4xvu- V or 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 16A. NO. OF SHOWERS 17. NO. OF LAVATORIES l 18. NO. OF SINKS_ 19. DISPOSAL 19A. DISWASHER / 20. NO. OF CONDUCTORS SIZE -4 21. NO. OF STACKS__L___SIZE 22. AREA OF ROOF 23. NO. OF CATCH BASINS 24. NO. OF FLOOR DRAINS Y 25. NO. OF OTHER FIXTURES KIND 26. ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW? 27. SIZE OF WINDOW 28. IF NO WINDOW, WHAT KIND OF VENTILATION IS THERE? 29. SIZE OF DUCTS 30. SEWER OR SEPTIC TANK? cS pIY- 31. SIZE OF WATER MAIN 31A. SIZES OF WATER PIPING & RISERS 32. REMARKS AND FURTHER DETAILS WATER HEATER 33. TYPE - 34. MANUFACTURER i''1C'ZG j TANKS SAFETY DEVICES TEMPERATURE 35. CAPACITY V 39. RELIEF VALVE 36. TEST PRESSURE LBS. 40. MANUFACTURER 37. WORKING PRESSURE LBS. 41. PRESSURE RELIEF VALVE 38. TYPE 42. MANUFACTURER LICENSE NO. DATE SIE`NATUROF APPLIC NT PHONE NO. DEPARTMENT DECISION PER]MIT#APPLICATION FOR HVAC PERMIT cfsw , Application is hereby: TOWN of SOUTH WINDSOR BUILDING DEPARTMENT Bldg Permit# APPROVED 1540 SULLIVAN AVENUE 2.3 4f 7 644-2511 ext.230CdIx - Date Building Inspector Application must be printed or typed Location f Coy W, Street No. Street Lot No. FEE SCHEDULE Floor Apt. No. o - $1,000 - $10.00 Over $1,000 10.00 per$1,000 OWNERfD&(-_or any fraction thereof ADDRESS eoj_" S n OWNERS PHONE# APPLICANT 0 ADDRESS k V-\ ESTIMATED COST $Q IS THIS A CONTRACT COST? YES NO FEE ENCLOSED $ R 00 c WPE OF JOB: Original Installation Alteration/Addition Repair Revised 11/95 APPLICATION FOR HVAC PERMIT(Continued from reverse side) TYPE OF SYSTEM YPE OF BUILDING HEATING RESIDENTIAL A/C COMMERCIAL VENTILATION INDUSTRIAL HEATING STEAM LQW PRESSURE LIMIT LBS.HIGH PRESSURE LIMIT LBS. HYDRONIC WARM AIR UNIT RADIANT HEATER EXISTING RADIATION ADDITIONAL RADIATION TOTAL RADIATION DESIGN TEMP. OUTSIDE2OL F INSIDEZg:p F DIFFERENCE F TOTAL HEAT LOSS(BTUH) HEAT LOSS SHEET MUST ACCOMPANY APPLICATION DESCRIBE ALL HEATING EQUIPMENT (INCLUDING MAKE&MODEL NO.) Z CIOGROSSHEATINGCAPACITY (INPUT-BTUH) NET RATING (OUTPUT-BTUH) TYPE OF FUEL OIL-GPM GAS-INPUT ELECTRIC-KW OIL TANK SIZE&LO ATION INSIDE OUTSIDE CAPACITY LPG TANK CAPACITY 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 CONN. BUILDING CODES IN THE PERFORMANCE OF SUCH WORK. STATE LICENSE-NO.NAME&TYPE SIGNATURE OF APPLICANT PHONE NO. '5-j4-S 0,e7-9 0 DATE —/ Z- —9V P v ARGO CALCULATION SKEET OWn1ER Vt r` - `S 0 ADDRESS- DATE„ DEALER A g KIND OF BUILDING ev/0^1 f CHIMNEY SI3E CONSTRUCTION• WALL_ WINDOWS I'L gst-y 1 ROOF OR CEILSNG BASEMENT HEIGHT. ABOVE GRADE BELOW GRADE DESIGN WATER TEMPERATURE DESIGN TEMP OtFr r COL.S 2 3 4 1 3 6 1 7 8 9 10 21 12 13 14 3 ;B 17 ROOMM 512E I -m -6 AREA• SO. FT. FLOOM VOLUME r/1iEa0ARpf 0 ODOA1 CU. ".TvT` TOTit CL t[C MOT[3 wwT12 L[nGTMROOMau..wsw swoss GLASS r/wA4t CtiL KG AT?O foil. co j:sue TIYO, 1'E AR L lAr H ow ARIA WALL o Ja' oirv. w[tosu flu tsEsflust 2230 5 JO LL rL 1100 J 100 3 7D 1100 000 GaaY300 11 170 3Qo s00 3? ? Is o 0 1 4100o o 3 L 1118 1 C) 7VO 4- 0 zed 8 0700 70a 3"0o 19 oQ 250o , P2S10 300 SeT5ar 0o l oo A600 i i 10=9: 91" MCM In Ill OM 4MMUUD ON pnL AT 4WAM LJM96 9W 10nVe PM.OI L>POsfO sOOimAL;'Ofa.f.fi 000f ww*Guam.puff Or"aft. TOTALS aectr-'F--# APPLICATION FOR BUILDING PERMIT Plumbing# 15 HITCHCOCK WAY Date.HVAC # No. 24629 Sprinkler# FOM APPROV Estimated Cost Building COMPLETE RED BOXED AREAS Permit Fee aeg ngineer TYPE OR PRINT ONLY Occupancy Fee $ SIGN ON REVERSE SIDE Appr.for CO.Total Fee TO BUILDNC DEPARTMD4T,TOWN OF SOUTH WNDSOk CT Additional Cost) $ The undersigned hereby applies to do work accorcling to the following specifications: Job Location Lot No.J_Side of Street Zone F-z Applicant Tel# Addr ss Zip o g a-;-,f Lic.# Owner Address Architect Address Sq.Ft.N w Area: 1st Fl. 2nd Fl. 3rd Fl. Total New Ar—ea Rooms Lavatories Bathrooms Garages ' Purpose of this permit: b-'x t S 'tom V,E Wa City Water Well Septic System Sewer Ins. H.O. S.P. Cert. Area Basement Garage Approved by Dat l'Use Group Construction Type Revsed 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 which this building and its se is allowed. Signe I hereby apply for a Certificate of Occupancy for ihe work described in this application for the permit. Signed c. DO NOT WRITE BELOW THIS LINE INSPECTION COMMENTS Inspection / Approval Date By Appl Code Description Due Whom Code Comment 97-14629-B 1,500 B10 FINAL 09/03/97 JFH A APPROVED FOR CLOSEOUT Be .#ric#4 LA —" APPLICATION FOR BUILDING PERMIT Plumbing# Lt 15 HITCHCOCK WAY HVAC # Dot : ?- '7 - 9 -4- Sprinkler# No. 24440 FSK APPROVA Estimated Cost Building 7 COMPLETE RED BOXED AREAS Permit Fee Engineering TYPE OR MM ONLY Occupancy Fee Affklavit SIGN ON REVERSE SIDE Appr.for CO Total Fee 3 TO Bu ARTMENT,TOWN OF SOUTH WNDSOR,CT Additional Cost) The u hereby applies to do work according to the following specifications: Job Location le- ffi C Co ./ Lot No. !Side of Street Zone D R 2- Applicant MA#jW";Ja Aaildt4S JTr1C. Tel.# Addr ss /1&4 6h A g4-ri,_=RAt_ CC, Zip or-o-4,4 Lic.# Owner AcIdress s..+^ Architect Address S—*v—t Sq.Ft.New Area: 1st FL -6om 2nd FL 3rd FL Total New Area Rooms TjX1iAa lavatories Bathrooms Garages Purpose of this permit:A/0 SceaezU A Agl City Water Well Septic System Sewe! Ins. H.O. S.P. Cent. Area Basement Garage Approved by Date 7 Use Croup Construction Type T T Rev6W 1/97 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 inwhich this building and its use ys allowed. Sign G••r I hereby apply for a Certificate of Occupancy for the work described in this application for the permit. Signed DO NOT WRITE BELOW THIS LINE INSPECTION COMMENTS Inspection / Approval Date By Appl Code Description Due Whom Code Comment 97-24440-B 3,500 B03 FRAMING (ROUGH) 07/10/97 JFH A E03 ROUGH 07/10/97 JFH A P03 ROUGH 07/10/97 JFH A PO4 GAS TEST 07/10/97 JFH A B04 INSULATION 07/16/97 JFF A B10 FINAL 09/03/97 JFH A APPROVED FOR CO (BLDG) 97-14495-E 800 97-9975-P 1,300 1 DEPARTMENT DECISION PERMeAPPLICATIONFORELECTRICALPERMITM_ Application is hereby: TOWN of SOUTH WINDSOR BUILDING DEPARTMENT Bldg Permit# APPROVED 1540 SULLIVAN AVENUE 214q YD 644-2511 ext.230 Dat wilding Inspector Application must be printed or typed Location ofjob rlt- Street No. Street Lot No. FEE SCHEDULE tl 0 - $1,000 - $12.00 Floor Apt. No. Over $1,000 12.00 per$1,000 or any fraction thereof0 ADDRESS OWNERS PHONE# 0ep APPLICANT N 840 ADDRESS 4 ESTIMATED COST$ IS THIS A CONTRACT COST? YES NO Ica FEE ENCLOSED $ TYPE OF JOB:OR-CO zorigirw on JAMUIte Revised 11/95 APPLICATION FOR ELECTRICAL PERMIT(Continued from rcvcrse side) TYPE OF BUILDING 1S THIS APPLICATION ASSOCIATED WITH A V RESIDENTIAL BUILDING PERMIT APPLICATION YES / NO BUSINESS ASSEMBLY CURRENT USE AND OCCUPANCY MERCANTILE EDUCATIONAL FUTURE USE AND OCCUPANCY INSTITUTIONAL FACTORY STORAGE ENGINEER'S NAME PHONE GARAGE MIXED USE ADDRESS CITY STATE ZIP Othcr plcasc spccify) TYPE OF INSTALLATION/WIRING METHOD Z 00-1 SIZE OF MAIN FEEDERS AND RATING OF WIRE USED NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS NUMBER OF PANELS REMOTE DISCONNECT REQUIRED 7 YES/NO NUMBER OF LIGHT CIRCUITS NUMBER OF POWER CIRCUITS NUMBER OF SWITCHES T NUMBER OF OUTLETS NUMBER OF LIGHT FIXTURES NUMBER OF HEAT CIRCUITS NUMBER OF A/C CIRCUITS — SEPERATE 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 CONN.BUILDING CODES IN THE PERFORMANCE OF SUCH WORK. Z' NAME STATE LICENSE NO. TYPE SIGNATURE OF APPLICANT PHONE NO. DATE DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT PIERMIT 4 Application is hereby: TOWN of SOUTH WINDSOR BUILDING DEPARTMENT Bldg Permit 4 APPR07EE 1540 SULLIVAN AVENUER>, SK-Q-644-2511 ext. 2307 Date- Building Inspector Application must be printed or typed Location ofjob TJn C-,k wctq Street No. Street If Lot No. FEE SCHEDULE Floor Apt. No. 0 - $1,000 - $12.00 Over $1,000 12.00 per$1,000 OWNER d Vk r-[A 3 J2J, JJ CVS or any fraction thereof ADDRESS YZ Z)09k Rr OWNERS PHONE# APPLICANT /)r-J cf p 40* N S ADDRESS a77 q ESTIMATED COST$ IS THIS A CONTRACT COST? YES NO FEEENCLOSED $C_ 41 OR CO TYPE OF JOB: Original Installation Alteration/Addition Repair Revised 10/96 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 OCCUPANCYEDUCATIONAL INSTITUTION FACTORY ENGINEER'S NAME PHONE STORAGE GARAGE ADDRESS MIXED USE CITY STATE ZIP Other please specify) TYPE OF INSTALLATION SIZE OF MAIN DRAIN NO. OF TOILETS STYLE NO. OF URINALS STYLE NO. OF BATHTUBS I 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 1/ SIZE OF WATER MAIN 3 SIZE OF WATER PIPING&RISER WATER HEATER 9s G41to^ A TYPE Q, (_ ` L MANUFACTURE TANKS SAFETY DEVICES TEMPERATURE CAPACITY RELIEF VALVE TEST PRESSURE WORKING PRESSURE PRESSURE RELIEF VALVE TYPE MANUFACTURER 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 CONN.BUILDING CODES IN THE PERFORMANCE OF SUCH WORK. NAME STATE LICENSE NO. TYPE SIGNATURE OF APPLIC cc PHONE NO. J b " C O`l DATE TOWN OF SOUTH WINDSOR lipINLANDWETLANDS, WAXERCOURSES AND CONSERVATI APPILCATI% APPLICATION # /" DATE RECEIVED South Windsor INSTRUCTIONS Planning & Zoning Commission 1. THE APPLICATION, MAP AND PLANS MUST BE SUBMITTED IN DUPLICATE, TOGETHER WITH THE FEE SET FORTH IN THE INLAND WETLANDS, WATERCOURSES AND CONSERVATION REGULATIONS, TOWN OF SOUTH WINDSOR. (SEE REGULATIONS, SECTION VII). 2. THE SOUTH WINDSOR INLAND WETLANDS, WATERCOURSES AND CONSERVATION REGULATIONS SHOULD BE REVIEWED WITH RESPECT TO THE STANDARDS AND CRITERIA FOR APPLICATION EVALUATION. (SEE REGULATIONS, SECTIONS VII - X). 3. THE APPLICANT UNDERSTANDS THAT THIS ANDICATION IS TO BE CONSIDERED DOCUMENTS REQUIRED BY THECOMPLETEONLYWHENALLINFORMATION AGENCY HAVE BEEN SUBMITTED. THE APPLICANT SHALL ALSO COMPLETE THE STATE FILING FORM. A. APPLICANT'S NAME: C-- e v jQ 1 j rzS-, s fe z z s es 'r . ADDRESS: 7>4 1 ve. , .S O u f" jAj N d s-0 A , (--,t 4 G o 7 4- PHONE: (HOME) 44 - rr 0 s WORK) s t F z- <! B. LEGAL OWNER'S NAME: _ s aM , p I I C A Aj ADDRESS: PHONE: (HOME) WORK) List additional owners, addresses and to # s on back ofapplication C. IF THE APPLICANT IS NOT THE OWNER OF THE SUBJECT PROPERTY, A ACTIVITYEERBYTHEPROPERTYOWNER(S) AUTHORIZING THE PROPOSED CCOMPANY THIS FORM AND WILL BESETFORTHINTHEAPPLICATIONMUSTA PART OF THE APPLICATION. D. PROJECT NAME (if any) 1-' I t l l e.A ° `,. 1. Contact Person (if further information is needed). Phone # (work) G 4A4 - Fax* 6 4 4 - 73 z F E. THE GEOGRAPHICAL LOCATION OF THE PROPERTY WHICH IS TO BE AFFECTEDOFCTTED BY DTHEPROPOSEDREGULATEDACTIVITIESINCLUDINGOFTHEPROPERTYONTHEINSUFFICIENTDETAILTOALLOWIDENTIFICATION INLAND WETLAND AND WATERCOURSES MAP. Assessor's Map#Parcel Zone F. NAMES OF ALL ABUTTING PROPERTY OWNERS: (Use separate sheet if necessary) G. HAVE YOU NOTIFIED ALL ABUTTING PROPERTY OWNERS BY CERTIFIED LETM THAT AN APPLICATION IS PENDING BEFORE THE AGENCY? You are required to supply a copy of the letter with the list of the names of the abutters).** H. PURPOSE AND DESCRIPTION OF ALL PROPOSED REGULATED ACTIVITY(S) INCLUDING AMOUNT AND TYPES OF FILL AND THE TIME ELEMENT INVOLVED: Aut oQ1ZFt o J Rom 6A Jk v 0V r ^'SP,¢ figd F2,0/T4 A71 e-,d I. A CLASS A-2 MAP OF THE PROPERTY DRAWN TO 1" = 40', SHOWING THE AREA TO BE DEVELOPED, EXTENT OF THE WETLANDS AND WATERCOURSES AFFECTED, TOPOGRAPHY, EXISTING AND PROPOSED ACTIVITIES AND NAMES AND LOCATIONS OF ADJACENT PROPERTY OWNERS MUST BE SUBMITTED. J. ACREAGE OF WErLANDS AND WATERCOURSES TO BE ALTERED: K. ACREAGE OF WETLANDS AND WATERCOURSES TO BE CREATED: L. LINEAL FEET OF PROPOSED STREAM ALTERATION: M. TOTAL LAND AREA OF PROJECT AND PERCENTAGE WHICH IS WETLANDS N. IDENTIFY ALL OTHER PERMITS OR APPROVALS THAT HAVE BEEN ISSUED, APPLIED FOR, OR REQUIRED WITH RESPECT TO THE PROPOSED ACTIVITY SET FORTH IN THIS APPLICATION. (These may included but not be limited to, local Planning & Zoning, Zonin Board of Appeals, D.E.P., F.E.M.A., D.O.T., The Army Corps of Engineers, and any other State, Local or Federal Permits.) O. THE APPLICANT (OR DESIGNATED REPRESENTATIVE) HEREBY ATTESTS THAT A SIGN WILL BE POSTED AT THE FOLLOWING LOCATION(S) by NAME ON OR BEFORE THE FOLLOWING DATE: SIGNATURE: THESE SIGNS MUST BE DISPLAYED CONTINUOUSLY FOR AT LEAST TEN (10) DAYS PRIOR TO SCHEDULED MEETING (See Regulations, Section 7.3a). THE UNDERSIGNED HEREBY APPLIES FOR THE REGULATED AC LISTED IN PARAGRAPH H ABOVE, FOR A INLAND WETLANDS, WATERCOURSES AND CONSERVATION PERMIT FOR THE PROPERTY DESCRIBED HEREIN AND CONFIRMS THAT: 1. APPLICANT IS FAMILIAR WITH THE CURRENTLY EFFECTIVE INLAND WETLAND, WATERCOURSES AND CONSERVATION REGULATIONS OF THE TOWN OF SOUTH WINDSOR. 2. APPLICANT UNDERSTANDS THAT AT ANY TIME DURING THE REVIEW PERIOD, THE AGENCY MAY REQUIRE THE APPLICANT TO PROVIDE MORE INFORMATION ABOUT THE WETLANDS AND/OR WATERCOURSES IN QUESTION AND/OR ANY PROPOSED ACTIVITY. 3. ALL INFORMATION SUBMITTED IN THE APPLICATION FOR REVIEW SHALL BE CONSIDERED FACTUAL, OR IN THE CASE OF ANTICIPATED ACTIVITY, BINDING. A KNOWING FAILURE OF THE APPLICANT OR ANY OF HER/HIS AGENTS TO PROVIDE CORRECT INFORMATION, OR PERFORMANCE EXCEEDING THE LEVELS OF ACTIVITY ANTICIPATED, SHALL BE SUFFICIENT GROUNDS FOR REVOCATION OF ANY PERMIT UNDER THESE REGULATIONS. 4. BY MAKING THIS APPLICATION, THE APPLICANT GIVES PERMISSION TO THE INLAND WETLAND, WATERCOURSES AND CONSERVATION COMMISSION MEMBERS AND/OR ITS REPRESENTATIVE TO ENTER THE PORTIONS OF THE PREMISES WHICH ARE SUBJECT OF THE APPLICATION FOR THE PURPOSE OF INSPECTION AND INVESTIGATION AND OTHERWISE EVALUATING THE MERITS OF THE APPLICATION BOTH BEFORE AND AFTER A FINAL DECISION HAS BEEN ISSUED. igna of Owner of Property Date F (5 9 2 igna of Applicant Date j R 0%jN Sr9 r7awn Ole 40&&AatcU 1540 SULLIVAN AVENUE • SOUTH WINDSOR, CONN. 06074 soR co AREA CODE 860/644-2511 PERMTr TRANSFER INLAND WFILANDS AND WATERCOURSE PERMIT For the PRESENT P I, do hereby give permission to transfer South Windsor Inlands Wetlands Permit# 91-2 9P as it applies to Fitch Meadow John Fitch Boulevard Bank of Sou Windpor BY• P , Dated:;),( signature of mmi t For the PROSPECTIVE PERNMTEE: This is a request for the transfer of South Windsor Inland Wetlands Permit# 91-29P This request is made in full knowledge and understanding of the permit and -C & C Dev a1ra"n-tJ /Marsh Ent-erp rises LLC/J.V. idnsEdo hereby agree to comply with the permit as applied for and issued. Name and Address of PROSPECTIVE PERMITTEE: C & C Development LL•C 55- Sandra Drive T BY:a M rs Enter rises LLC29WedewoodpLane Southindsor, CT 06074 BY: Home Phone# 44-9188 Business Phone 528-7551 by: Dated: signature of prospective permittee) Transfer of permit authorized by: Chairman, IWA/CC Dated: