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115 PINE KNOB DR
DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT ERMIT# Appjication is hereby;_.____ TOWN OF SOUTH WINDSOR 00 BUILDING DEPARTMENT 1540 SULLIVAN AVENUE Bldg.Permit# ._-:7 644-2511 ext. 230 Date B ding Inspector Application must be printed or typed FEE SCHEDULE Location of Job: I t S pine Tree Lane C95 $0-$1,000=$15.00 Street No. Street Lot No. Over$1,000= $15.00 per$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANT R1 CV)0.rCt M l ktun APPLICANT ADDRESS l k� Pine T r r C to-ne S00"I WindSor APPLICANT PHONE# O W N s F,q OWNER R I(V)0,(A N1 k k tp n OWNER ADDRESS I kS P i o Tr c Q So - tOind5or , CT Cuo�y OWNER PHONE g(p o- Z I Lj - '�( L{ C ESTIMATED COST$ Z S oO ' 00 b +� IS THIS A CONTRACT COST? _Yes `,No lL o 0 /��! FEE ENCLOSED$ t l S'ce TYPE OF JOB: 4 e)k{T S�R C O New Installation Alteration/Addition/Repair Revised 4/01H2002 APPLICATION FOR PLUMBING PERMIT (continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A BUILDING PERMIT APPLICATION? U"fES ❑NO &RESIDENTIAL ❑BUSINESS CURRENT USE AND OCCUPANCY t f S (6?—n i Cd ❑ASSEMBLY ❑MERCANTILE FUTURE USE AND OCCUPANCY rif51(A-Q n-M CL- ❑EDUCATIONAL ❑INSTITUTIONAL ❑FACTORY ENGINEER'S NAME N' PHONE ❑ STORAGE ❑GARAGE ADDRESS ❑MIXED USE CITY STATE ZIP (Other please specify) TYPE OF INSTALLATION_ ryjath Y pQYYI + i.au, SIZE OFGMAIN DRAIN eX S�"1 Yl ►1(1 Gh v NO.OF TOILETS I STYLE NO.URINALS _STYLE VU 14 NO.OF BATHTUBS�_ NO.OF SHOWERS 1 NO.OF LAVATORIES NO.OF CONDUCTORS SIZE O NO.OF STACKS j SIZE AREA OF ROOF NO.OF CATCH BASINS N 1�C NO.OF FLOOR DRAINS _ NO.OF OTHER FIIXTURES�_ KIND ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW E YES ❑NO SIZE OF WINDOW 3 Z ►tr1 IF NONE C.F.M.OF VENTILATOR Z SIZE OF DUCTS SEWER OR SEPTIC TANK SC.\U Cf SIZE OF WATER MAIN SIZE OF WATER PIPING&RISER WATER HEATER: TYPE B ler YJIate MANUFACTURER C wi Plus Uo scoes 3 C -* R S Ilz DESCRIPTION OF WORK l nstat� r)-eu-) ho-t '- co cd lA)LO eC suPolu 17) (off t x C�6l! aSSDcl ck- C droatns THE UNDERSIGNED HEREBY APPLIES FOR A PERMI F TO PERFORM THE WORK DESCRIBED AND is TZT— COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE PERFORMANCE OF SUCH WORK. &weoWne-r) CONTRACTORS LICENSE NO. y� TYPE STATE SIGNATURE OF APPLICANT / sti �� DATE `117 1 ox 10 -roes S��D ... .�.. n... .. ..a. .. ter.. �..1.. ... .. �. _... .. _ _ _ _ ll South Windsor Online Property Viewer 4/22/2009 115 pine tree ' 8 a '96-8 o0 " - 100 NOIT/1 , d Id d QS flip gin, % b 166 b� i311 a Me \`'•., � ti^�` � '` :gib r��o. � • 1 I90 wry., / , 9•bg..__3a �pp 0 1 i '1 Arq•,/ � m M; p 4e 0 84 Q 0 feet Property Information towr st,r Property ID 72300115 r` Location 115 PINE TREE LANE MAP FOR REFERENCE ONLY r e �c � NOT A LEGAL DOCUMENT I Jo(to. , This data set/map is for panning purposes only and should - not be used for larger scale analysis.The Town of South Windsor shall not be held liable for any use of the data or 'a images shown on this map,nor is any warranty of accuracy - � expressed.All uses of this data set/map are subject to field verification. r4WIFICATION OF ZONING COMPU� ft"I"r; .r,"Ing(s), use(s) and/or sbVOAIW a shown un this plan appear(s) to be M fobrnai ice with current South WANOW fjgjh1ors. Variances and special exoql@M may apply. Date 3 G Zoning Enforcement OffWW rr S,� i ' N+ t < � t �y� f' ;y i•"�1= r�dy�t Rl'r� t i � ,�MI ,c:7�`{✓ Q� - 1 �{'! �y 1 {rr wt+ a.. - t'�������� �sw+ ... i pw. �� +'F t^� {�t'F�ic r �'Y° t •' t. ^i r�FY,�` '� rlS'4 JF{ '! t r it ,e rL:�= R r a .-�.t =5 r:? i�` ..tE '{r'}" rsy } 7 7* �j"• A - R -` •fa Ov A` `'tr rS,a' '� v t' -.� '���I ��d�rr�i=r-Y�r� .3`'ti+,� .. "'�-trry��rrl jr't t�:ra �q tr�" 4� �+'` � <,. 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' DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT PERMIT# Ap hereby: TOWN OF SOUTH WINDSOR' BUILDING DEPARTMENT ROVED 1540 SULLIVAN AVENUE 4 ,�b ( 7 644-2511 ext. 230 Bldg.Pe�'t# Date Bui mg Inspector Application must be printed or typed FEE SCHEDULE Location of Job: F P 1 ne Tr- Lavw ,$0-$1,000=$15.00 Street Lot No. Over$1,000= $15.00 per$1,000 or any fraction thereof gnation Apt.No. APPLICANT C l C.Vl a.rd M l J i 010 APPLICANT ADDRESS I (S Pine Tree L4..v1 C South WLndSdr, CT acgo7�j APPLICANT PHONE# 'k (P O SOW N g�q OWNER Etcho-rd M1 ItDn < OWNER ADDRESS l i �- Pine Trc e I-an.e S b0f U li dSAf CT nu Q Oo OWNER PHONE O U O - Z1'4- D 3 t 0L'I C = ESTIMATED COST$ SD O'00 r IS THIS A CONTRACT COST? _Yes '!No FEE ENCLOSED$ K 0c TYPE OF JOB: DSO R C�� New Installation ✓Alteration/Addition/Repair Revised 4/01//2002 APPLICATION FOR HVAC PERNHT (Continued from reverse side) TYPE I SYSTEM: TYPE O BUILDING: HEATING RESIDENTIAL A/C O COMMERCIAL ❑VENTILATION ❑INDUSTRIAL HEATING STEAM LOW P SSURE 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) LCIt DESCRIBE ALi �ING EQUIPMENT QUIPMENT(INCLUDING MAKE&MODEL NO.)� o - LO �A CO"Tyullr I 1 I er RS -1 I Z B u.rn ha.h-► GROSS HEATING CAPACITY(INPUT—BTUH) ZOO 000NET RATING(OUTPUT—BTUH) Qo loco TYPE OJFUEL OIL--GPM OIL TANK LOCATION : INSIDER OUTSIDE CAPACITY 2_77'�;_ ❑GAS—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.) ea+h I n e # 10 A — 37 1 0 90S ()9 T20 TONNAGE�ifOn COOLING CAPACITY(BTUH) VENTILATION -1 DESCRIBE ALL AIR LING EQUIPMENT(INCLUDING KITCHEN EXHAUST EQUIPMENT) e xiS-hna i �th P Khaus-t ECLn TOTAL SIZE OF SYSTEM(CFM) i,'�DO 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. homeoNncr CONTRACTORS LICENSE NO. TYPE STATE SIGNATURE SIGNATURE OF APPLICANT DATE 7 �� DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT PERMIT# Application' eby: TOWN OF SOUTH WINDSOR 'PERMIT BUILDING DEPARTMENT APP 1540 SULLIVAN AVENUE Bldg.Permit# Nov � A 644-2511 ext. 230 IQ Dale Wilding Inspect Application must be printed or typed FEE SCHEDULE Location of o jr $0-$1,000=$15.00 Street No. Street Lot No. Over$1,000= $15.00 per$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANT Zi APPLICANT ADDRESS U' P U a O APPLICANT PHONE# � O D O%N N SF OWNER r �f OWNER ADDRESS iy f-r e a`,e G U� c , OWNER PHONE * ESTIMATED COST$ •� IS THIS A CONTRACT COST? _Yes (/NO FEE ENCLOSED$ S O�� TYPE OF JOB: �R C New Installation v Alteration/Addition/Repair Revised 4/01//2002 APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH Aj BUILDING PERMIT APPLICATION? ❑YES Q"NO RESIDENTIAL ❑BUSINESS CURRENT USE AND OCCUPANCY ❑ASSEMBLY ❑MERCANTILE FUTURE USE AND OCCUPANCY ❑EDUCATIONAL ❑ INSTITUTIONAL ❑FACTORY ENGINEER'S NAME PHONE ❑STORAGE ❑GARAGE ADDRESS ❑MIXED USE (Other please specify) CITY STATE ZIP TYPE OF INSTALLATION/WIRING METHOD U c►��rG �C SIZE OF SERVICE 15�/U SIZE OF MAIN CONDUCTORS �4 NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS OG NUMBER OF PANELS REMOTE DISCONNECT REQUIRED? ❑YES ❑NO NUMBER OF LIGHT CIRCUITS L/ 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. (1105"Ooe-r Xle CONTRACTORS LICENSE NO. STATE SIGNATURE OF APPLICANT DATE G DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT ff"IT# TOWN OF SOUTH WINDSOR App ' ion is hereby: BUILDING DEPARTMENT APPROVE 1540 SULLIVAN AVENUE � 644-2511 ext. 230 Bldg.Permit#f�0l�f C� Date Bu ding Inspector Application must be printed or typed FEE SCHEDULE Location of Job: FT:enant P�rie Tree L -ne- $0-$1,000=$15.00 Street Lot No. Over$1,000= $15.00 per$1,000 or any fraction thereof gnation Apt.No. APPLICANT R ChCL("(A k 1ADYl APPLICANT ADDRESS t S Pine. Tr c c Lane. SD Lk+-h w� xAsnr ', CT' O u o-74 APPLICANT PHONE# 9 LP 0 - 21 q- 0 3 Lo L{ OW N SF,q OWNER RlGhGt�(-d M�ttZn < OWNER ADDRESS p I YLQ i r ee ! Cl C „ S0 , Windsor, cT can OWNER PHONE Z 1 y - l9 3 co y C ' - a ESTIMATED COST$ 3 , OOO w U .� IS THIS A CONTRACT COS17 _Yes No !� �G FEE ENCLOSED$ S`DD sO CO TYPE OF JOB: �} R New Installation ✓ Alteration/Addition/Repair Revised 4/0182002 APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATE WITH A IL BUDING PERMIT APPLICATION? 1YES ❑NO 01RESIDENTIAL ❑BUSINESS CURRENT USE AND OCCUPANCY r eS ►a e'yv- 1 ca_1 ❑ASSEMBLY ❑MERCANTILE FUIURE El EDUCATIONAL USE AND OCCUPANCY rfs ,d ,0-t7al ❑INSTITUTIONAL ❑FACTORY ENGINEER'S NAME N f K� PHONE ❑ STORAGE ❑GARAGE ADDRESS ❑MIXED USE CITY STATE ZIP (Other please specify) TYPE OF INSTALLATION/WERING METHOD no 01� ad dt bon Cyr rna5_� bed/b afh SIZE OF SERVICE I DO Lrn D SIZE OF MAIN CONDUCTORS NUMBER OF METERS I NUMBER OF DISCONNECTS AND RATINGS NUMBER OF PANELS REMOTE DISCONNECT REQUIRED? ❑YES t(NO NUMBER OF LIGHT CIRCUITS NUMBER OF POWER CIRCUITS NUMBER OF SWITCHES_(�'_ NUMBER OF OUTLETS b NUMBER OF LIGHT FIXTURES _NUMBER OF HEAT CIRCUITS NUMBER OF A/C CIRCUITS J SEPARATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED. DESCRIPTION OF WORK it'T 2 t - S u SJCM — See -N V AC P e-cw k+ 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. hc me_owvie-c CONTRACTORS LICENSE NO. .-TYPE STATE SIGNATURE OF APPLICANT l DATE ��� Shirley Wilhelm-CRS Approval Confirmation: Request No.384800 Page 1 From: <clpsvc@nu.com> To: <WILHEL@SOUTHWINDSOR.ORG> Date: 11/15/04 11:43AM Subject: CRS Approval Confirmation: Request No. 384800 Your approval of the following CRS Request has been successfully processed. CRS Work Request#: 384800 House No: 115 Lot No: Street Name: PINE TREE LN f Town Name: SOUTH WINDSOR,CT Inspector: CHRISTOPHER DOUGAN Approval Date: Nov 15, 2004 ********************************************************************** This e-mail, including any files or attachments transmitted with it, is confidential and intended for a specific purpose and for use only by the individual or entity to whom it is addressed. Any disclosure, copying or distribution of this e-mail or the taking of any action based on its contents,other than for its intended purpose, is strictly prohibited. If you have received this e-mail in error, please notify the sender immediately and delete it from your system. Any views or opinions expressed in this e-mail are not necessarily those of Northeast Utilities, its subsidiaries and affiliates(NU). E-mail transmission cannot be guaranteed to be error-free or secure or free from viruses, and NU disclaims all liability for any resulting damage, errors, or omissions. Electric# qwgc , APPLICATION FOR BUILDING PERMIT Plumbing# 115 Pine Tree Lane Date: y zZ1Oq HVAC # Sprinkler# 900140 FINAL APPROVALS Estimated Cost $ 4,7�GOG' Building COMPLETE RED AREAS_ Permit Fee $ 4S D B OXE Engineering TYPE OR PRINT ONLY OccupancOng.InspyF Fee 10$ ► SIGN ON REVERSE SIDE Affidavit Appr. for CO. _ Total Fee $ 36$ " TO THE BUILDING DEPARTMENT,TOWN OF SOUTH WINDSOR, CT (Additional Cost) $ The undersigned hereby applies to do work according to the following: Applicant R i chard M t itbn Location of Work l l S P t 0 C Tr L"e Lot No.� o Applicant's Address 115 P 111C Tree. LCLn e Tel.# $ CQ 0 - Z-1 LA -0 3LD-i Town_ S b LLth W i n d SO C 4 CT Zip 6 to 0 7 y Lic.# Owner___RtChard / M tCh ells Mt t f Dn Architect �j I A Owner's Address- I tS P I ne Tf• LCUI e Architect's Address ti So . ik) Indsor Zip 6 10 iA Zip_ Sq. Ft. New Area: 1st FI. 2nd FI. 3rd FI. Total New Area '17n0sq - �- Purpose of this permit a(A(Attc)0 �r)aS+c�c b-r_drUpm '+ hathVoom ) C y Wate Well❑ Septic System❑ Sewer Ins: HO SP rt. Area Basemen Garage Approved by Date ��O'v Use Gro Construction Type �^ Revised 0/02 alao`oo38't 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 Idin and its u e is al w Signed f I hereby apply for a Certificate of Occupan y for the ork described in is appl ation for the permit. Signed �l DO NOT WRITE BELOW THIS LINE INSPECTION COMMENTS DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT PERMIT# Application' re TOWN OF SOUTH WINDSOR BUILDING DEPARTMENT PRO 1540 SULLIVAN AVENUE Bldg.Permit# 644-2511 ext. 230 Date it mg nspector Application must be printed or typed Location of Job: FEE SCHEDULE 119 Pine K. b A. ��_ — $0-$1,000=$13.00 Street No. Street Lot No. Over$1,000= $13.00 per$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANT Kr1de 1 ELec�, Inc. APPLICANT ADDRESS 64 Field Pd. Wit 4D Somers, CI 06071 APPLICANT PHONE# 7494" OW N SF,q OWNER Mbdml FMn OWNER ADDRESS 115 Pine Kmb 9 S. Windsor, CI &0) +� OWNER PHONE 644-8392 C ESTIMATED COST$ 2,000.00 v� IS THIS A CONTRACT COST? 0 Yes ®No �CJ FEE ENCLOSED$ 30•0 r��sOR C'o TYPE OF JOB: 1 d�� PF 0 New Installation 0 Alteration/Addition/Repair Revised 8/99 APPLICATION FOR ELECTRICAL 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 FUSE USE AND OCCUPANCY Cl EDUCATIONAL ❑INSTITUTIONAL ENGINEER'S NAME PHONE ❑FACTORY ❑STORAGE ADDRESS ❑GARAGE ❑MIXED USE CITY STATE ZIP (Other please specify) TYPE OF INSTALLATION/WIRING METHOD C©►^ti� `� - '`meµ`��[ eC t��� SIZE OF SERVICE SIZE OF MAIN CONDUCTORS NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS NUMBER OF PANELS REMOTE DISCONNECT REQUIRED? r ❑YES NUMBER OF LIGHT CIRCUITS I NUMBER OF POWER CIRCUITS �I NUMBER OF SWITCHES 3 NUMBER OF OUTLETS H NUMBER OF LIGHT FIXTURES I NUMBER OF HEAT CIRCUITS NUMBER OF A/C CIRCUITS SEPARATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED. DESCRIPTION OF WORK S-kL (G'f-S afvb 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. IC49g1 A a cam. CONTRACTORS LICENSE NO TYPE STATE SIGNATURE OF APPLICANT DATE 8/3D/06 y:r. � 'K' Mrt)� a .it s ' ,a.��1��'•,,�t ,yl �y;�,,. 1 y '" 'E •- '. ` f � ,•J,t y • + r' r.'"S �, `F� � tl+?�...j���'+}���..l�C��/'L7LD� r. „����r' •^t�� y � .T.. ,. ��'1+,�.�'� •� �` •� 3 � � ��(�� `�• ; Fire .•Il ' . (r +;K di {5 4�fjN!�' j SY;, A iyK S•- t11A/ FF ,.�T Y r".%viN'n � •r ' h 7 a aiift»� f J-. e+!`•` t �y�� a t 3:a•+r�'` riM `no l +S' t ks[ �•iF a` a�y � AL �', < � i., .�,'` <+14:. �`.trSS ,•'l l�:t.i''. 1 d-;� '' '.�i.•i ri.: a7:s,'� V 4. , °F t c Y Q. ,if -`'v♦�+.i;;Q'+�x✓1- t-- �/O�._ .11�Sit���t. S)i�u.�.j- Lb<<� ewe•.•# .,�,' � �-� _'.���11 : 1 l.+s��q+y�� ,ems. }�: Sf(5. ' �/. 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Z' W'�?ref7 ` > � rY� :f{Yec"�S !;,'7�'g�ay,, ..1�'$•,. �. ,J:� .�• <' + 7 �� Xr.«,J .. -`�'' •r.,'•M�lttj'Ir�r•. 1t+-"'. '� ' t� V' a } 'tt•� 1�. `i?�tY� �., r� V, t �.«��y,, .^rr ,1+,-y„ 'p.'+• 1n; {�� •.{Ne'�I��AN�'•`i�yh'�k. 3M�;1r..J.. r• .'�'�� ��ttn���C�O, v. i �I1 N�'�'f �• ..w.• �yNA`, ',f 1 � t � .I. ,,,,.�'+ '.! Yet.T,••+ ., 61 . . ' ,, 8'f» � � 1 t r. .`tee.,. •y,.�' .• Jt•• \ �..r iT.-�. O 'N"..'A ••y'. i7 ..... .ars:T..+_•.::«i.b . .. . SEP 1 81"2 South Windsor BUILDING DEPARTMENT • TO THE BWLDING DEM. TOWN OF this ae"Mem Mac this Rian and s —Dias of the PmRAAed buhding u+ - •Wftmted at /r's, Wtth *m*mdw%evt% St.'%ed In 1ulj1 i ca dh anil t+fv.. •,.,,pctca F1 i. ..�,.nr.No++,c311(�.At�wstW liacas oak:.. bar ^7 7 �—1-. &ICAfION OF ZONING Proposed building(s), use(s) and,or struc e t i '• I /2xtb is shown on this l;'an appcar;s) to ba G444k :onformance with current South Vv'; �guiations. Variances and special eycc;-, nay apply. ate '/t • !2 icg �Enforcernant APPLICATION FO j i. I T46 PERMIT Electric W 115 Pine Kncb Lane Plumbing# 9 0 0 0 8 9 FH at HVAC # Sprinkler# ;e FINAL APPROVALS ------ ------ ---- — - Esd>p �tW'n�o69o0 -- --- ----- - — Perm', DEPARTMENT Building COMPLETE RED BOXED AREAS I ' Occupancy Fee $ Engineering TYPE OR PRINT ONLY Affidavit Eng. Insp. Fee $ Appr. for CO. NO" SIGN ON REVERSE SIDE Total Fee �'a6 TO THE BUILDING DEPARTMENT,TOWN OF SOUTH WINDSOR,CT (Additional Cost) $ The undersigned hereby applies to do work according to the following: Applicant Location of Work H S P'4c k Nod GA. Lot No. Applicant's Address 19 -(MbMAS Da, Tel.# Flo toS-9065' Town—rcwUao CT Zip 0608'yLic.# 6040/1 Owner N c iW J Architect Owner's Address I IS PIWE Km*g L• Architect's Address_ &JW ua 49son-. r-,-r ZipO6o71( Zip— Sq. Ft. New Area: 1 st FI. 2nd Fl. 3rd FI. Total New Area Purpose of this permit�'N s ill tZa-J 9--r- S 6Wkt . ZAC> L'Ay a iz I S'*i_- City Water❑ Well❑ Septic System❑ Sewer❑ Ins: HO SP Ce ea Basement Garage Approved by Use Group Construction Type Revised W02 ow'M. ark 1 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 anV its use is allowed. Signed 1 hereby apply for a Certificate of Occ()P cy for a work described in this application for the permit. Signed DO NOT WRITE BELOW THIS LINE INSPECTION COMMENTS TOWN OF SOUTH WINDSOR AFFIDAVIT OF ACTUAL COSTS PERMIT NO: '00n8S DATE u c J South Andsor BUILDING DEPAR11MW The undersigned, being a duly authorized representative of, M is� A�S f6e do by this statement, certify that the actual costs shown below, of the project referenced by the Permit Number shown above, are true and accurate. This statement is being made pursuant to the Town of South Windsor Ordinance, Article II, Section 14-31, (a)thru (e), (see attached). I understand that verification for accuracy of actual costs may be made at any time by the Building Official through an appraisal of the work at the expense of the property owner. I hereby certify that the actual cost of the work performed under this permit is: S Ov •O Signature of Permit Holder: Name(Please Print)_ icw Date: o ................................................................................. State of Connecticut] ] ss South Windsor Date: County of Hartford] Personally appeared , as aforesaid, Signer and sealer of the foregoing instrument and acknowledged the same to be his/her free act and deed, before me. Notary Public Commissioner of the Superior Court My commission expires on � . ' S ~ ,.�• •s ♦�• � • • •♦{♦f ♦ j l •i 1- `. r ,.`y INSPECTION FIELD SHEET O1/29/21 Printed by Middleton, Morgan 14 06 02 INSPECTION: 22303 FINAL PERMIT: STATUS: APPLICATION: 200900299 LOC: 115 PINE KNOB DRIVE SOUTH WINDSOR PROPERTY ID: 72000115 OWNER: EGAN MICHAEL J & DARLENE CONTRACTOR: REQUEST BY: PROJ DESC: 15 SQUARE ROOF WORK ORDER: INSPECTOR: ROSE RESULT: PASS REQUESTED: PRIORITY: SCHEDULED: COMPLETED: 06/11/09 UNPAID FEES: 00 Date Time MILEAGE: 00 TIME: TRAVEL ONSITE COMMENTS: INSPECTION FIELD SHEET O1/29/21 Printed by Middleton, Morgan 14 28 58 INSPECTION: 22303 FINAL PERMIT: STATUS: APPLICATION: 200900299 LOC: 115 PINE KNOB DRIVE SOUTH WINDSOR PROPERTY ID: 72000115 OWNER: EGAN MICHAEL J & DARLENE CONTRACTOR: REQUEST BY: PROJ DESC: 15 SQUARE ROOF WORK ORDER: INSPECTOR: ROSE RESULT: PASS REQUESTED: PRIORITY: SCHEDULED: COMPLETED: 06/11/09 UNPAID FEES 00 Date Time MILEAGE: 00 TIME: TRAVEL ONSITE COMMENTS: