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HomeMy WebLinkAbout102 BRIDLE WOOD RD , t :: . :'. e :,. -, t. -. "'4 -._.•,< -'-1'� I"�. ', � t'J 4"q'"' _r•�. `� :> is r._ p w y.,,�', -'aA i .. f.,.L �,. :�, �,�' -e.. r-J,Q r •'.., :,�:'- ...:-i'... _... .. �'> .-t +, -_4: ,�-,� .5� �k,��,- �S. r-'�"�' .. �, ,���1',a 1? � ---:- >ls>' ) � $ �.- .. ''S d v_ - M1 a• .r �, _, iS :.+�^ "�'":Nf•d`... _ � 1 tr�t': :..,:9 d.h..s �..0'�.r#;-`2+:.',+l...:•-°i..,S.�c'd�'-.p.,.y^.a,:..,.,,Y _.�-.:..:-.,ry. ,f',.,.r.s,L.�r ...:.C.,-.e,r y.!.�_ ..-.e. 4°..a..,v,.rr -£,. ,,...:...��-33.i..:_, "hit i. 8n C 14 6 s;r, s YL5 � e. rtP t ,:•.%,' ^ Kma c - ,fix ^Ir''n .> .,r Q�. ... f-.K. t ...,'s ..^9 W f �,,�n, - -. ,� .. e -. _, ..r c. ..._. aP _ i� �R��- ,f ��¢', :. .' 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F- - .,a .. ,. ,`"A' .. -'�:. w - �-yu- -4R 1 'y.!�: .7r „ +, ,^r ..,� . 4ti , Y w. _ 1: •, r+,: ', °'r '°+'� t, ' M, r - ^d .. tr , :- .:. .r ,.:1� J�' ,,.,, .yy... :,-;;. -.•. 1!"i �,..,. -_� .q_,, _., ,. .,., - :- #� .rs: .- m �:�':'.N nc�'" �� �:rtr* -t a' �d .�. -.. .,. >� ,��'-::m <� .-°�`a';�'�'.. --:,.�. •. .;- 9 «r,P.. L,? x r z, .;.�,t�� �� _ 31 :"w� sr �>w� -�>a' •yw � . ,t `4 i u F b � x� F MOO, tr- �� , qw •.- - }ti ,;• �_., .aIys w or q c19 OPEN SPACE .E T OWN 0 F yL' SOUTH WINDSOR 41 \ t LOT#20 . \1 22.483 S f r ti 11 I N CAR.=245.08 4�` > t ASEMEN, t o z T D w..247-zT 1 F.F =246,42 y NOTES: j'' ,� �� �' �/ �� ,,,,r < � 2. SANITARY SEWER INVERT ELEVATIONS TAKEN FROM INSPECTION REPORT O �' • L� , .01 PROVIDED BY THE CONTRACTOR Y*� ,� a. 3. ALL ITEMS DEPICTED ON THE PLAN, UNLESS OTHERNASE NOTED, HAVE BEEN VERIFIED IN THE FIELD AS TO LOCATION, ELEVATION, AND COMPLETENESS. \ \ 4 FOUNDATION HAS BEFN EOUIPPFD NTH A SUMP HOIF IOR SUMP PUMP ♦ �" 1 ��0���,« O t Q \ , Si° � e" .� ' �a tv REEERENCF NOTE: � r.. ,E F BOUNDARY INF'ORMATtON TAKEN FROM PLANS ENTITLED BRIDLE WOOD ESTATES LEGEND---- SOUTH C ; PREPARED I ❑ MONUMENT OR UCCELLO t IRELAND BUILDERS, INC.: PREPARED L C EN pNEER LNG. ASSOC.. INC.; SHEETS THRU 17 Q r # 5d w PROPERTY CORNER MIS AIRWY AID MAR HAS BEEN PREPARED RI ACCORDANCE MM SECTIONS 20-JODD-+ THRI X1-pae.p --W-- WATER MAIN/SERVICE -° - '' `5�' �frt .� r^,,, ,,,,."df J - .T- x * s, . Of THE REDl1lATIONS Or CONICCTICUT SIATE AQLKIEs 'STANDARDS FOR 9URbEvS AND YAPS N THE y,:,4 +, ;� _ '� ;9, �_.- - �^ lipy .'rt" eN •- ; .�. f. >: STALE di CONIECTIWY AS ENDORSED BY THE OONIECT1CUt AssooAT10N Of SAND S7IRVEYORs. INC. ` `---�L ---A6k-4IA1N�'SERVICE ,,.`1� ''� ( �0;,w�' �-'J�• •, ��y. �a,a „, �4 qI'� .� `-% ._ � r r ^, r d-^ ' ; THIS SURaEr COIIEORwS To HDRI7dItM ACCURACv aA$S A 7 X 245.6 EXIST. SPOT GRADE } TO THE REST OF Nv KNOWLEDGE AND BC11F.7. THIS yA► rS 910$TANT1KLr CONNECT AS NOTED HEREON - - - EXIST CONTOUR UCCELLO h IRELAND BUILDERS, INC. 2dDt 1275 CROMWELL AVE.. A-12 - — ---- --- --- ROCKY HILL, CT. 0"7 RCNARD P. sM1E7 --- UC. No (880) 563-2877 UNICS OTW*WK NOTED. EX?STING UTIUTY REVISIONS (860) 291 -8755 SHEET GRAPHIC SCALE = PLAN °i LocATlvls AS SfIDeN ARE r)AED ON eEST ----------_. AS-BUILT AV AD B ��An01. ,�EA rO CONSTRUCTION 40 0 20 •� esign BRIDLE WOAD ESTA TF.S IMPROVEMENT LOCATION -A- - "AD �IM P�I`�T'"'C'�" rofessionals, Inc. 2 Au.UIILITRS ARE TO t STARED M ME FIELD C)F CONStRDCTIaN --- Lot __ A �q� Road -__I/I or AN _ .01 AG: M),7_70 Trs. W!. n.s FLAIL a MVMO w"'s It e(ARS t No. 20 ` bridle Wood w"I'MDN xk 40 ORIGINAL 7OMARTE I Inch — 40 feet civil engineers • planners A surveyors OF THE rRDEt9lIDIIAI 111OIIiDt/AlRtlr00. N0. DATE DESCIlopwN BY T65 south satellite rood. mouth wlndsor, connectrcut 06074 SOUTH WINOSOR CONIECTICUT o (gaily lu 1991 South Windsor BUILDING DEPARTMENT It) I— - . r'Usujs fhls t:nl.i d r I .:, and Sp'cifie.,ti ns are and of ute proposed budding c r altef`iJo � to 6. arldtged t GCMG(-tJ`.�q& St, v together with nrlendments stated in application filed with plan and I agree to comply with all z-m Building and st❑tc laws and such orders as sn Issued by the Building and -r.l during penti- lf this application and final issuance of a b:,ilil - parmit. Signed This plan Is approvod subtet to the condition t,.�- 1 orders and ordinances rcgul�ung building shall trt O complied with. �j Conditionally Approved These filad with � REc wE0 r --- / Building Insp,ctor Ciotti DEC 2 4 1997 N sour"wEpT �, Et7G.DEPL Q� \ v � ANNEDrT . ow ---230_. `T:ri<,r covrou,P � � G;t;`^� .� �' �'' � �•i`'�. �^� ^'I, 7I; --1 3=r-- YPr�i. co.vrouP _Y �' i.u' ,::�. �• '� I. SET POSTS AND 2, STAPLE ME SILT ANMI, POSTS EXCAVATE A 6'I18* TRENCH FOICING TO THE S' UPSIOPE -POST UPSLOPE FROM POSTS. SET END OF THE POST vl yd- �r ,yr, AJA•��y/ d`bL`f'✓iGf FOR STABI:ITV FENCING . AND SELF CLf ANING. Ak AL iNLA�/O/oVarLA./41 A 9S" - 12• MIN tN J�3 ATTACH FILTER FABMC TO 4, 8ACKFIU THE F ILIM THE W(MN POSTS ANI: EXTEND TRENCH AND COMPACT F= IT INTO TRENCH THE FXCAVATED SON COMPACTED-. ale BACT<FlLL. .01 $ .6 �9 OPEN SPACE I 6FTHE , O� `�� / TOWN OF '� SOUTH ONDSOR b CONSTRUCTION OF SYNTHETIC FILTER BARRIER 242 ����-�` LOT 20 \ 27,461 SF ` �lp f \ NOTES: FASEMF:NT �. •. s I. THE BUILDING LOT SHALL BE LOAMED, SEEULD, AND MULCHEO WITH STRAW PRIOR • a ,t?'`• A TO ISSUANCE OF C-0 (IF SEASON DOES NOT PERMIT SEEDING. THEN THE LOT MUST BE STABILIZED WITH STRAW OR EROSION CONTROL NETTING TO PREVENT WINTER' ► 1 t=� / AND SPRING EROSION-) PROPERLY INSTALLED EROSION AND SEDIMENT CONTROL ti MUST BE IN PLACE TO CONTROL ANY EROSION AND SEDIMENTATION PROBLEMS \_ THE BUILDER/OWNER IS RESPONSIBLE FOR ALL STABILIZATION PROBLEMS 000 2 ROOF LEADERS TO BE L45CHARGED ON SPLASHPADS. •' c � /�/ r` \ -NiSH C�tAtMyG AROUND THE HOUSE SHALL. ALLOW A J INCH CH DROP GRADE All y � \• �� �/�j A OtS4'AMM OF 6 FEET FROM THE FOUNDA" AS SPECIFIED IN THE STATE ` •' ♦ \ T'. ,� JF CONNECItCUT BASIC BUILDING CODE, 4 LONE x A--310. � t 5 MAXIIMW GRAD04G 15 TO BF 3.! O \I} / i 7 FOUNDATION TO HAVE- A SUMP HOLE FOR A SUMP PUMP O , I / �"'' pF CpH '�►� .�r�-�+lifrr �•� ,40P0.2 To c= � os- � �o..:..Oo- O � '56 , .• NfC� t.+b,.i t prl�P /�iL►f,-, gii!''F.('r c Ie �� ,�}jam J. •1 qS`'_ REFERENCE. NOIF- �y BOUNDARY INFORMATION TAKEN FROM PLANS ENTITLED 'BRIDI! WOOD ESTATES'. ; SOUTH WINDSOR, CT., PREPARED FOR UCCELLO & IREI AND BUILDERS, INC., PREPARED O B' LUCEK NGINEFRING, ASSOC, INC. SHEE TS ' rHRU 12. 11963 MIS SAINEv AND MAP HAS BEEN PgtPARED W ACCORDANt2 MTh YCTWNS 20-300D TMtU A.,3006-20 OF TI( REOULAYMS(IF COMPECTIC67 STATE AOD?ICIES - 'MNIMUM STANDARDS FOR SlJR%TYS AM MAPS IN 9, A E~g THE STATE Of CCNIECRMr AS F040ORStD By THE CONNECTICUT ASSOCIATION Or IAND SURVFTORS, DWI,. IT IS AN IuovrnoeNT RESURVEY Co 'ONWING To"OffilONvu Af)CLMAC" aAss A I ro THE BEST OF MY KNOIIE" MID BEL I:F Do%MAP 5 SLOS1Ari T• Y CORRECT AS NOTED HERtON UCCELLO tk IRELAND BU RS. INC. 1275 CROMWELL AVE. A- 12 C_ TY6C ROCKY HILL CT 06067 Lic No (Et6O) 563- 28E7 ..rvs onaRRg Moto,ow w unity REVISIONS .�,I' H,5., SHED OCAINOM AS ARE lMl M ON NW GRAPHIC SCALE PLAN of DEPENDENT RESURVEY --- AVAILAar WON&ADON. Au 001M UTILIM / I�.9 �,/ e�ttT T 40 D 20 AD esign BRIDLE WO OD ES TA TESL `AGATK>« MAP 1 All ALIVVS TO It V�10000TW nELD N. ;4V A�9F0 51„MV011„Mar, — -- - rofessionals. Inc. ]Lot N ��p - Mdle Wood�g� R 1 �+.. a W A OF RN or A,n ,As Ala I►9TF-lo LN 1 'o nAN rs NVALM UTAESS iT SEARS n! i inch = 4CJ feet I engineers A piannore • suro"ore — -- R/II[serMl W-"AMO OF6aR+A/-97WATVRE 7' M AROrE9O1At [NQI[EIt/lMIEyOT. NO. DA TF DESCRADPON! BY1 185 Routh satellite road. south rrindsor• connecticut 060741 SOUTH WINDSOR CONNECTICUT n er. Alav aAn X/7/i� .k % f . b Tpl B911-DING cEPT. TOWN Of SOUTH MIINDSOR Ibis eertlliFd that this Plan and specifications are ttue eoplea of the PrapoceO. buOlnlll R( alterations to tbW erected at L / / L p 1 � 4-y1 j le t.,/v-�0� street e� j together with amendments statap in epplieation enc .. - Iifed with Plan anq i agree to comply with all zoning. D V puilding and state laws and such ordat►as shall W issued by Ilu 8uiiding Oepnrtment du!jn# Widen" r M this appilcatlon ar1A 104V )aa4an'" qj a bu'loing 1991 p.rmit. JV,t L Signed h� tnia plan is approved subject tp Ahe CAn01110A Met South Windsor P Orders and ";nanees rlg4liting DuUding snail a pEPARTMEN C t urnptied with. flied trnh BUILDING Conditionall ovdr iblM fNf7r— ns�Data LC'vl..IG __egn_ , Ea�i.yr. coyrnu.e I SET POSTS AND 2. STAPLE THE SILT K I�ts.•f P.('c� �Or btAdL- ANGLE POSTS EXCAVATE A 6*06" TRENCH FENCING TO THE S'UPSLOPE POST UPSLOPE FROM POSTS. SILT END OF THE POST FOR STABILITY FENCING AND SEES'- —————— f�'OP �/t! ftNLE Qf ANNG 95' L 12' MIN `�� ivtAA/O/iJET.L.a�aNS I -- - - 3 BR ATTACH FILTER FABRIC TO ♦ BACI(FlU THE FlLTE77 THE WOODEN POSTS ANG EXTEND TRENCH AND COMPACT FAIC IT NM THE TRENCH THE EXCAVATED SOIL. COMPACTED-,BACK ILL 1 OPEN SPACE N / ~ TOWN OF 1 1.0SOUTH WlNDSOR CONSTRUCTION OF SYNTHETIC FILTER BARRIER s J�'• / - \ LOT#20 ��?' 22,463 S F. � s . f \ W MADE C.L.APP�� NOTES: EASEMENT � �� � � A� 4 1. THE BUILDING LOT SHALL BE LOAMED. SEEDED, AND MULCHED WITH STRAW PRIOR TO ISSUANCE OF C.O. (IF SEASON DOES NOT PERMIT SEEDING. THEN THE LOT MUST „/V.:PSs•5 —r� l �� �. ; i Z t� �JJ•v BE STABIUZED WITH STRAW OR EROSION CONTROL NETTING TO PREVENT MINTER �1w ♦ r CONTROL `a .� n c!'A AND SPRING EROSION.) PROPERLY INSTALLED EROSION AND SEDIMENTCON � efL0.0 MUST BE IN PLACE TO CONTROL ANY EROSION AND SEDIMENTATION PROBLEMS IAA \ _ 0 / THE BUILDER/OWNER IS RESPONSIBLE FOR ALL STABILIZATION PROBLEMS O` 4` I - r• 00, 2. ROOF 1FADERS TO BE DISCHARGED ON SPLASHPADS. 3. FINISH GRADING AROUND THE HOUSE SHALL ALLOW A 3 INCH DROP IN GRADE T FROM THE FOUNDATION AS SPECIFIED IN THE STATE ' ♦ \ \ \ �' /��/•W �T A DISTANCE OF 6 FEE ♦ � I 5 / 9 OF CONNECTICUT BASIC BUILDING CODE. �s ► ` \ /4 �yFA 4 LONE A-3C. � 00, o2 5 MAXIMUM GRADING IS TO BE 3:1 O \to /0// 6 FOUNDATION TO HAVE A SUMP HOLE FOR A SUMP PUMP. , O ' of CON N�►, d.tri—CAe r we. 4Or0,%1 Ta GA. s cr Z o.✓..iptT+ ', \` ' J. •1-�NfC yro.ir v�CP fitr�f' �.ad•c'ic � J `4 � � °�~OO�y'�t q`�f G REFERENCE NOTE BOUNDARY INFORMATION TAKEN FROM PLANS ENTITLED -BRIDLE WOOD ESTATES-• SOUTH WINDSOR. CT., PREPARED FOR UCCELL.O & IREIAND BUILDERS. INC., PREPARED V LUCEK ENGINEERING. ASSOC., INC SHEETS T THRU 12. � 11963 eo Ne E s .� `a• THIS SURKY AND MAP HAS KE14 PREPARED N ACCOROANQ MIT"SECTTONS 20-300p-I THRU 20--3000-20 f sr OF THE REDULADONS Or CONNECTIMI STATE AGENCIES- 'MINIMUM STANDARDS FOR SURVEYS AND MAPS IN THE STATE Of COMNECrCUY' AS ENDORSED By THE CONKCTICUT ASSOCIATION O LAND SURVFYORS. W. IT IS AN•O3,VIOCNT RE:9J V"COfoftdNG TO HOFNZONIAL ACnAkACY CLASS A-2 TO THE BEST OE NY K NOV&LDGE AND OELIET THIS MAP IS SUBSTANTI Y CORRECT AS NOTED HI REON UCCELLO R IRELAND BU R5. INC. 1275 CROMWELL AVE.. A-•12 t_ 126e2 ROCKY HILL CT. 06067 P MAIIt[1 — NO 563-2877 1. umIM a1,a,M„�NOTED,OUTING UIUYf REVISIONS GRAPHIC SCALE (860) 291-8755 PLAN �, SHEET LOCGAN"AS 9$O W AM GAMED ON EST tOVEMENT Tf>FAT*H Y AVALA&E NFORMATI�.ALL 01161 1G MTUTU , X0.9 4 .0 40 0 20 .D esign BRIDLE WOOD ESTATES urRo�c>rEHr 1ACA1T� tNur 1 �°°—^�ro SDK rofessionals� Inc. t Au LntlTlEs ARE ro SE STAI(ED w n[FIELD Lot f OF ca A LICENSED AAAn sLRnsTDR INsa TO I Lot N0. 20 — Bridle Wood R� —sr. R.FE "An:ns," 1�pm IS wvAW u LM IT SEAMS M 1 Inch = 40 feet clvH engineers . planners • surwpors 1 401KISON WAL AND OsoFNAL 20"ME 155 south sotellita Toad, south windsor, connecticut 06074 SOUTH WO OSOlt CONNECTICUT or. aw AMJe s/7/101 OF se PROFESM*m ENOstER/llrvtrWL Na DATE DESCRIPTION BY DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT PERMIT# TOWN OF SOUTH WINDSOR Applicat' reb : / ? BUILDING DEPARTMENT APPRO 1540 SULLIVAN AVENUE 644-2511 ext. 230 3I it# O�Co l Date Bufldi-nfinspector Application must be printed or typed FEE SCHEDULE Location of Job: FTenant B r,d le- w o-A& � - $0-$1,000=$15.00 Street Lot No. Over$1,000= $15.00 per$1,000 or any fraction thereof gnation Apt.No. APPLICANT , - -5- ` U-: APPLICANT ADDRESS �-D 6ocx I aE37 APPLICANT PHONE# 6 N S F,q OWNER ET W."f OWNER ADDRESS Djen OWNER PHONE 6 l/Y— 49-Y6 0 C = ESTIMATED COST$ 220op IS THIS A CONTRACT COST? o es _No 6 x FEE ENCLOSED$ 30. I��S - O�� TYPE O7ew OCInstallation _Alteration/Addition/Repair -7 5L J Revised 4/01//2002 APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A 6RESBUILDING PERMIT APPLICATION?BYES U NO IDENTIAL BUSINESS CURRENT USE AND OCCUPANCY ❑ASSEMBLY ❑MERCANTILE FUTURE USE AND OCCUPANCY ❑EDUCATIONAL ❑INSTITUTIONAL ❑FACTORY ENGINEER'S NAME PHONE ❑STORAGE ❑GARAGE ADDRESS ❑MIXED USE CITY STATE ZIP (Other please specify) 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? O 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. CONTRACTORS LI SE NO. TYPE STATE SIGNATURE OF APPLIC DATE DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT PERMIT# TOWN OF SOUTH WINDSOR Applica ' b : ( ( L( 7 a BUILDING DEPARTMENT PROVED 1540 SULLIVAN AVENUE Bldg.Permit# 644-2511 ext. 230 J i Date Building In ctor Application must be printed or typed Location of Job: FEE SCHEDULE F $0-$1,000=$15.00 Street Lot No.Over$1,000= $15.00 per$1,000 or any fraction thereof gnation Apt.No. APPLICANT ADDRESSA C1�cYa y �4.ia✓�/1 /F' APPLICANT PHONE# O W N S F,q OWNER OWNER ADDRESS /Ob�,49 OWNER PHONE C ESTIMATED COST$ -25 C7U IS THIS A CONTRACT COST? 61es No V FEE ENCLOSED$ 71J r Coly� TYPE OF JOB: SpR _New Installation __I/Alteration/Addition/Repair Revised 4/01//2002 APPLICATION FOR PLUMBING PERMIT (Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A UliESIDENTIAL BUILDING PERMIT APPLICATION? ❑YES ❑NO ❑BUSINESS CURRENT USE AND OCCUPANCY ❑ASSEMBLY ❑MERCANTILE FUTURE USE AND OCCUPANCY ❑EDUCATIONAL ❑INSTITUTIONAL U FACTORY ENGINEER'S NAME PHONE O STORAGE ❑GARAGE ADDRESS ❑MIXED USE CITY STATE ZIP (Other please specify) TYPE OF INSTALLATION SIZE OF MAIN DRAIN NO.OF TOILETS % STYLE NO.URINALS STYLE NO.OF BATHTUBS NO.OF SHOWERS I 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 W-M SIZE OF WINDOW IF NONE C.F.M.OF VENTILATOR SIZE OF DUCTS SEWER OR SEPTIC TANKry— SIZE OF WATER MAIN SIZE OF WATER PIPING&RISER WATER HEATER: TYPE MANUFACTURER DESCRIPTION OF WORK ��viSlnvu. IDGS,G'v✓1-�i17 jp�,`] �-ODYI� /YiQlv�4,I�y rOGnY�Y � THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFO THE WORK DESCRIBED AND IS TO 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 O d- Electric # li(o7Y APPLICATION FOR BUILDING PERMIT Plumbing# 102 Bridlewood Road Date: U 1,z� Zpo _q HVAC # Sprinkler# 30169 FINAL O Estimated Cost $ Building'/ 93 - Permit Fee $ IS-0 En nee ' COMPLETE RED BOXED AREAS Occupancy Fee $ /U Affidavit TYPE OR PRINT ONLY Eng. Insp. Fee $ A r. for CO�c o� ► SIGN ON REVERSE SIDE / 6a pp - -- Total Fee $ �(o�i'• TO THE BUILD G DEPARTMENT,TOWN OF SOUTH WINDSOR,CT (Additional Cost) $ The undersigned hereby applies to do work according to the following Applicantlk,Fuv nA✓ &o, Atz . Location of Work iv 2, 13,4x DZ6 �a AO. Lot No. Applicant's Address 1 QJ + aT- v6od� Tel.# 1,4, - �,;V-3v6 8 Town Aye6;y If%`L G-7• Zip AreaC 7 Lic.# 3 61 E g 9 Owner AP'E o GtPSX-1 Architect Owners Address 1 o 4d Architect's Address Zip Zip Sq. Ft. New Area: 1st FI. 2nd Fl. 3rd FI. Total New Area Purpose of this permit F-r-fl'6511- #jt21W— Pr cy Ar 6P6-6,n,5e0 i ,=-" C aterzr/ Well❑ Septic Systemo Sewer Ins: HO Cert. Area Basement Garage Approved by Date 3 Use Group Construction Type Revhwd 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 kocated in which t building and its use is allowed. v1Gt C�a .ice E Signed I hereby apply for a Certificate of Occupancy f he descc� ication for the permit. Signed DO NOT WRITE BELOW THIS LINE INSPECTION COMMENTS Inspection / Approval Date By Appl Code Description Due Whom Code Comment ------------------------------------------------------------------------------- **-30169-B 10,000 B03 FRAMING (ROUGH) 10/30/03 JFF A WITH CONTRACTOR E03 ROUGH 10/30/03 JFF A WITH CONTRACTOR P03 ROUGH 10/30/03 JFF A WITH CONTRACTOR B04 INSULATION 10/31/03 WNB A WITH CONTRACTOR B10 FINAL 11/20/03 JFF A WITH CONTRACTOR **-18674-E 2,000 --Of 97f�_ two,#�J. 2 7flo� South Windsor BUILDING DEPARTMENT erected at ��-r-2 together with amendment it,ted in tiled with plan and 1 agree to comply with Hulldtng and state laws and such nrders as > iasuod by the ©utldtn apartment during pena, Of this appNcatb� a Hnal iesuantz a yd' P"IM. 9ww L{ Two or 1s ea.- t0 tAe ttlon the• oftfsrta awd -Watipg tjbWj% shall Ae *Deep ltsc 'M Appftv" Niieso titled adli [unit 11t Wafts t�lwt BUILDING PERMIT STATE OF CONNEC=UT WORKERS'COMPENSATION COMMISSION Building Permit Affidavit for Property Owners or Sole Proprietors (Conn.Gen.Stat. §31-286b) Property located at t2 �. -.r AD In the town of S'!Jy y N L�,17.Sai.� Name of building permit applicant: 6kx—�4Lo 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 �e ..................................... 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"sworn notarized affidavit..• stating that.he will require proof of workers' compensation insurance for all those employed on the job site in ace'ordance with this chapter." Please check one: 1. I do not intend to act as a general contractor or principal employer. [Sign and stop here] , e Signature of applicant 2.✓I intend to act as a general contractor or principal employer.PaApplicant 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 t4igna verage, �df applicant Subscribed and sworn to before me this day of 200 (Notary Public/Commissioner of the Superior Court)