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PRCPERTY OF
NO. TUMBL-IBROOK DR. SO. WINDSCRI
Being Lot No. 72 on map entitled "TIMHER RIDGE HOMES D
Ellington Rd. - South Windsor, Connecticut - Scale : Dart
= 401 Oct. 1c,018
Griswold Engineerings Inc. - S'heet 4 04 7%
I 3cale : 1" = Opt.
Date : MAY 16 '7
GRISWOLD ENGINEERING,
, INC .
Manchoster, Conn.
I hereby certify this map to to f c'
substantially correct and that no
zoning egulations are violated.
RECEIuFD
APR 'L 0 2015
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current 1, ,1 n,�G;?�ur(s) ri i
and gp::c;.1 h �vin' SOr f. 0_.fi�nc. V� iu
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PRCPERTY OF
NO. MMIL7-BROOK Da.
Being Lot No. 72 On map en:;itled "TIMBF.-it RIDGE HONLMS
Ellington Rd. - South Windsor, Connecticut - Scale : Vf = 40 ' Oct. 1c,65
Griswold Engineering, Inc. - Sheet 4 OA. 7". 1
Scale : 1 = 401- Date :
GRISWOLD ENGINEERING., INC .
Manchester, Conn.
I
CID hereby certify this map to to .A:
substantially correct and that no
zoning egulations are violated. V6;;
Isom
Jolt r ty9b
South Windsor
BUILDING DEPARTMENT
TO THE BUILDING OUT. TOWN C. `,• ..,. r
This certified that this plan and speciffc-li,, !"i,
copies of the proposed building or alterations to W�
erected at l� ��
/�4i1 L �f104( Sfnrt
together with amendments stated in application .a
tiled with plan and t agree to comply with all xon,ng,
dullding and state laws and such orders as sh di ue
issued by the Building Department during pendonrr
of this application and final issuance of a butld,n,
Dsrmit.
), gipned C. c
This plan is approved subject to the Conditionthat
orders and ordinances regulating building abate be
0omp14ed w.fh.
Conditionally Approved These tiled with
Guilding Inspector cte►k
Isle
CER i ii=i(A"f IC E OF ZCNi G COb°PLI A
Proposed bl ilding(s), uses) and/or struct.:l
as shown on this p,,an atop aarfs) to
conformance with cu,rerIt south ',
"c9ulations. Variances and saecial ex:;;sp-,
V b� may apply.
Date "��l►zlSsl _—
g a ement Officer
Electric # APPLICATION FOR BUILDING PERMIT
Plumbing# 117 Tumble Brook Drive _
H VAC# I Date:
Sprinkler# 11000225
Estimated Cost $
FINAL APPROVALS �si
Building COMPLETE RED BOXED AREAS Permit Fee $ 5- o
Occupancy Fee $
Engineering TYPE OF PRINT ONLY Eng.Insp. Fee $
Affidavit ► SIGN ON REVERSE SIDE t
Appr.forCO. �� Total Fee $
TO THE BUILDING D ARTMENT, TOWN OF SOUTH WINDSOR, CT (Additional Cost) $
The undersigned hereby applies to do work according to the following:
Applicant Location of Work , ,v Lot No.
Applicant's Ad�f ess Tel #
Town i/✓I t� "( Zip Lic.# T
Owner Architect
Owner's Add ess I IV 144A Architect's Address
it n Zip a C Zip
Sq. Ft.New Area: 1 st FI. 2nd Fl. 3rd FI. Total NewPea
Puroose of this Derrmt 1 0 Gc q /' - C;7
r Cj I 4
City Water❑ Well ❑ Septic System ❑ Sewer 0
Ins: HO SP Area Basement Garage
Approved by vc ate L ,3 /I Use Group Construction Type
Revised 1108
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 use is allowed.
Signed
I hereby apply for a Certificate of Occupancy for the work described in this applicatior•for the permit.
Signed
DO NOT WRITE BELOW THIS LINE
INSPECTION COMMENTS
BUILDItIG PERMIT. - 0
STATE OF CONNkMCUT
WORKERS'COMPENSATION COMMISSION
Building Permit Affidavit for Property Owners or Sole Proprietors
(Conn.Gen.Stat.§31-286b)
Pioperty located at � .Yr�P�l-�►�K UriyP
Inthetownof. �6Udl GZ�n �Sor
Name of building permit applicant:
/,P
PIease 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(F0N)
....................................................................................................................
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 accordance with this chapter."
Please check one:
I. I do net intcad to act as a general contractor or principal employer.
[Sign and stop here]
Signature of applicant
2..�L I intend to act as a general contractor or principal employer.Applicant must either
provide a certificate of workers'compensation insurance or sign the affidavit
below.
....................................................................................................................
Affidavit
I hereby swear and attest that I will re ju'rre 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 to accept co erage.. /
Signature of applicant
Subscribed and sworn to before me this day of ,200 .
(Notary Public/Commissioner of the Superior Court)
INSPECTION FIELD SHEET 06/14/11
Printed by Peart, Dayshell 09 20 13
•INSPECTION: 40336 FRAMING (ROUGH) PERMIT:
STATUS:
APPLICATION: 201100544
LOCATION: 117 TUMBLE BROOK DRIVE
SOUTH WINDSOR
PROPERTY ID: 90600117
OWNER: OLSEN JUDITH N TRUSTEE
CONTRACTOR:
REQUEST BY:
DESCRIPTION: TEAR OFF EXISTING ROOFING. INSTALL ICE AND WATER SHIELD ON
WORK ORDER:
INSPECTOR: DOUG RESULT: PASS
REQUESTED: PRIORITY:
SCHEDULED: COMPLETED: 06/08/11
UNPAID FEES 00 Date Time
TIME: TRAVEL ONSITE
COMMENTS
RE ROOF.
ALL INSPECTIONS
INSPECTED INSPECTOR RESULT INSP DESCRIPTION
06/09/11 ROSE PASS BO10 FINAL
CEK i iriC;A WN OF [UNii�G C0 ,VirLIANCE
Proposed building(s), use(s) and/or structure(s)
OcxK as shown on this plan a
conformance with current South t W ndso be o D
regulations. Variances and
may apply.may exceptions
Date *rEn=Tf�Vir�ccment
�Ofl'-:c�er �
iUL 1 3 1993
South Windsor
Zc BUILDING DEPARTMENT
i0 tHE Iwo..
Thb yrWW Mat this plai ,.nu sp.c.n�c u., •
PLpced building M allegations 1.• be
erected at
l 1 IV$CiI.G street
t.Ntltlfr
h amendments stated in application and
i t1W 1tf♦* 0" and I agree to eom0ly with all zoning.
Bum" so `te laws and such orders as shall be
isew • Wlilding Department during pendency
all ob roll and final issuance of a building
Thy job�,gopwved sublect to the fnn it"n that
orb dOd .gl1111"Ces regulating Wilding shall Ys
t.oT �� 11011 fheN filed wilt
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PRCPERTY OF �I
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NO• TUMBL,BROOK D2. SO . WiNDSOR, CON .
Being Lot No. 72 on map entitled "TIMBE' RIDGE HOMES - Dart H, 11
Ellington Rd. - South Windsor, Connecticut - Scale : 1 " _ 401 - Oct . 1968 -
Griswold Engineering, Inc . - Sheet 4 o: 711.
Scale : 1" _ 401. Date :
MAv ice,
GRISWOLD ENGINEERING, INC . °��1.� ��••,y��.
Manchester, Conn.
i ` 'o
hereby certify this map to Le �
substantially correct and that no 4` t
zoning ealations are violated.
FOR BUILDING PURPOSES ONLY
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PROPERTY Or
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NO. TUMBLEBROOK DR. S0. WINDSOR* CONN.
Being Lot No. 72 on map entitled "TIMBER RIDGE HOMES - Dart Hill Rd. &
Ellington Rd. - South Windsor, Connecticut - Scale : 1" = 401 - Oct. 1968 -
Griswold Engineering, Inc. - Sheet 4 of 7".
Scale : 1" = 40' Date : -L Z4 -7
����```�F11COIN' F���!�ii� GRISWOLD ENGINEERING, INC .
tiQ �� GR/ShC� Manchester, Conn.
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ND SURV�`°�
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Tankworks
April 20, 2001
Mr. and Mrs. Larry Olsen
117 Tumblebrook Drive
South Windsor, CT 06074
Re: Removal and Disposal of (1)- 1,000 gallon underground heating oil tank&
Installation of(1)-330 gallon exterior heating oil tank
At: 117 Tumblebrook Drive, South Windsor Connecticut, 06074
Dear Mr. and Mrs. Olsen:
Thank you for the opportunity to service the removal and replacement of the buried oil tank at the
above referenced address. The work was performed in accordance with E.P.A. Regulations and
N.F.P.A. 30 and 30A Requirements.
Before backfilling one(1) confirmation soil sample was collected and tested at an independent lab
for TPH(total petroleum hydrocarbons)by IR(Method 418.1). The soil sample result for the tank
grave bottom indicated 74 parts per million (ppm). This result is within the limit set forth by the
Connecticut Department ofEnvironmental Protection. The TPH limit in a GA Classification is 500
ppm.
This letter, along with the attached soil sample result, should be stored safely with all legal
documents pertaining to this property. This information, along with your Tankworks invoice and
cancelled check(s), will serve as verification for future reference.
Please feel free to call us if you have any further questions. It has been a pleasure working with
you. We hope that you are pleased with our services and that you will recommend us to others.
Very truly yours,
Ro emary Viola Rainville
Owner
cc: Fire Marshal, Town of South Windsor, 1540 Sullivan Ave., South Windsor, CT 06074
OFFICES IN MANCHESTER - MADISON - WILTON
:00 Office 360 East Center St. Manchester CT r
ix
Environmental Laboratories, Inc. %tA AccoR
587 East Middle Turnpike,P.O.Box 370,Manchester,CT 06040
Tel.(860)645-1102 Fax(860)645-0823
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Analysis Report FOR: Attn: Mr.Tim Lynch
Tankworks,Inc.
April 19, 2001 360 East Center Street
Manchester,CT 06040
Sample Information Custody Information Date Time
Matrix: SOLID Collected by: TL 04/09/01 10:00
Location Code: TANKWKS Received by: SW 04/17/01 16:00
Project Code: RUSH24HR Analyzed by: see below
P.O.#:
Laboratory
Client ID: 117 TUMBLEBROOK DR BOTTOM Phoenix I.D. AD24909
Parameter Result RL Units Date Time by Reference
Percent Solid 97 % 04/17/01 B/D E160.3
Tot.Petroleum HC 74 21 mg/Kg 04/18/01 GD E418.1
Comments: ND=Not detected BDL=Below Detection Limit RL=Reporting Limit
If there are any questions regarding this data,please call Phoenix Client Services at extension 200.
Ak&
Phyllis Shiller,Laboratory Director
April 19,2001