HomeMy WebLinkAbout16 DIGGINS CT � N
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\ \ 20' EASEMENT IN FAVOR OF
\ THE REDFIELD ASSOCIATION. INC.
WNERS
I
LEGEND
0s IRON PIN TO BE SET
MONUMENT TO BE SET
x 287.3 EXISTING SPOT GRADE -� '��+•°
_30n _ EXISTING CONTOUR ,.a; ea BA
—w—W— WATER MAIN I ; \
at.s'
—c—G— GAS MAIN 39 �� 5 \ ,
I � m
a` ro
' 5vr ion/,5o u
NOTE: 1 I F
I. SANITARY SEWER INVERT ELEVATIONS TAKEN FIRC44
INSPECTION REPORT PROVIDED BY CONTRACTOR. OB #68
2 ALL ITEMS'DEPICTED ON THIS f'tiAN'HAVE BEEN �� I �' f
VERIFIED IN THE FIELD AS TO LOCATK K'ELEVATION j � 97.oN I 11.143 �q. ft. ` I D
AND COMPLEIIENESS.
+ /.B
i d i e,
3 xm
R +o 58' z.o.w roa.s-,/ u• ° I{ I I \ �T R z
CD
T 2 . ;U va ioe..G4 ' \I r Z
O ` XIe AKA I)/ I I >
. ' +
REFM:NCE NOTE: ,s, •„t, i �, �� "io3•o •'• � I
BOUNDARY AND TOPOGRAPHIC INFORMATION ARE TAKEN FROM PLANS
ENTITLED 'REDFIELD—SITE PLAN OF DEVELOPMENT'. SHEETS 4 THRU 11 I ' 2 "o7• —S71'38'241
OF 30, SCALE 1'-40', LAST REVISION 2/20/92. PREPARED FOR .JMJ 141.04' /
CONSTRUCTION COMPANY, BY DESIGN PROFESSIONALS, INC.
ZONE: DESIGNED RESIDENCE
` o
THIS MAP AND SURVEY WERE PREPARED IN ACCORDANCE TO A-2 � ` I
STANDARDS OF HORIZONTAL ACCURACY AS DEFINED IN THE 107,
'RECOMMENDED STANDARDS FOR SURVEYS AND MAPS IN THE STATE
OF CONNECTICUr PREPARED AND-ADOPTED BY THE CONNECTICUT
ASSOCIA'dC#4 :OF'LAND SURVEYORS, INC., SEPTEMBER 24, 1992 0
TO THE BEST OF MY KNOWLEDGE AND BELIEF THIS MAP IS
SUBSTAN�ORREC�, NOTED HEREON. � I
i I
12882 CB #65
RICHARD P. MARTEL UC. No.
i.mm apiam woim.menm a umm� REVISIONS � (203) "1-8755 R D IELD SHEET
t�,,mm",,"„�"m�w sm GRAPHIC SCALE As—OMT PLM
AVM WO11 MMK,�t>�UW= — 20 0 10 20 esign
>�GE A"�F TO OONEWAIC1M SLOT No. 8 1
r ,A� POOR TO rofessionais, Inc. �� ��� COURT O.
omalkwIlICK i PLM NVAuo 1 ld"rr K#M fc a1tuN sr. ser .qe No wrrs f
eerfsaart eEsl AwD aieaww saulult 1 inch = 20 feet civil engineers a plonners s surveyors
a nE veorssaowK ammme/affivrtiar Na DATE DESCNPIIDN BY 441C governors highway, south windsor, conneetkut 06074 SOUTH WINDSOR CONNECTICUT armor er. mw w1e //1� 93
I n�
L3Li
NOV 5 M3
South Windsor
BUILDING DEPARTMEN f
t-!sis cc,T.v t tnis plan and spr-citle?tinns-.(e free
"pivs of inn proposed building of aft aUoas to be
ceeated
1 - --
together with amen � its' stun- in appnc^tion a—
ided wich Alin and 1 agree to comply with all tonic...
Building and state laws and such orders as Shan
issued by the Building Depawnent Burin; pendro
I'l this application and linal issuance of a build-:�.:
permit.
Signed .----
This plan is approved subject to the conditlnn that
orders and orN/lanCea regulating building shall be
c-implied with.
conditionally Approved These 'led with
Building Inspector Clerk
,eta o v o
'APPR0 D
TQWN 4F SOUTH V"rriNSQf3OR
s RECEDED ,GiNEER1NI3 cOPARTMENT
� 5 1993
OV _ 10 (' � DATr:t
► ,
Town o/South Nindsor
Engineering
Dept.
ti
c'
I
1 ly IN
m IC
1 rn \ S
1
I
I
20' EASEMENT IN FAVOR OF
THE REDF'IELD HOMEOWNERS
ASSOCIATION, INC.
LEGEND `,� yt
0s IRON PIN TO BE SET
0 MONUMENT TO BE SET
x287.3 EXISTING SPOT GRADE ,0Z'u
300 EXISTING CONTOUR t
—w—w— WATER MAIN
—a—G— GAS MAIN ��' /ror IS,ye \ 1
D %10
M f+
a u
I u
NOTE:
I. SANITARY SEWER INVERT ELEVATIONS TAKEN FROM 1
INSPECTION REPORT PROVIDED BY CONTRACTOR. Ce #68 I 4 1
2. ALL ITEMS DEPICTED ON THIS PLAN HAVE BEEN gq.tib w.y• je� I /
VERIFIED IN THE FIELD AS TO LOCATION, ELEVATION 4• ft.11,143 1 I >
AND COMPLETENESS. I iv.'9'l.Or/ ' 1
N 1
� rm
R 0 It.o c r.e.w. ies.6y w e I I \ I rn m z
r 2 es A = .o&.� 1 \� D z -n
L � 4�43AmeA ' .
I\ I ::E
AlrC 1 I r-
JrdU-95.5
REFERENCE NOTE (O ti `ioD•o , , 1
BOUNDARY AND TOPOGRAPHIC INFORMATION ARE TAKEN FROM PLANS
ENTITLED 'REDFIELD-SITE PLAN OF DEVELOPMENT'. SHEETS 4 THRU 11 oc �. 0'I——— /
OF 30, SCALE 1'-40', LAST REVISION 2/20/92. PREPARED FOR . J 571'36'24'E / I 5
JM
CONSTRUCTION COMPANY, BY DESIGN PROFESSICNALS, INC. �!'. / x I62.6 141.04' /
v 1 Ic 1 0
ZONE DESIGNED RESIDENCE
v
THIS MAP AND SURVEY WERE PREPARED IN ACCORDANCE TO A-2
STANDARDS OF HORIZONTAL ACCURACY AS DEFINED IN THE
'RECOMMENDED STANDARDS FOR SURVEYS AND MAPS IN THE STATE
OF CONNECTICUT' PREPARED AND ADOPTED BY THE CONNECTICUT I
ASSOCIATION OF LAND SURVEYORS, INC., SEPTEMBER 24. 1"2
o` r
TO THE BEST OF MY KN WLEDGE AND BELIEF THIS MAP IS �� I
SUBSTAN Y C AS NOTED HEREON.
/ I I
12682 CB #65 �
RICHARD P. MARTEL UC. NO. I
GRAPHIC
SCALE esi n R EDFI EILD SHEET
1.�o,AMUM�.�� REVISIONS (203) 291-0755 I!i-BI T PLAN
IOCATOHS M 910M1 ME 9AlD ON rESr
AVA"B MORIIvw ,�EIrSToC UWMousTwu �.®� ®e 1
��; r o„°�"°""°" rofesslonale, Inc.
I ALL UTUM ME TO K STNED N THE M.D
D01t D11G�1FI S COURT wumver. .per Mott Off" OF
1 THE RIM a NVAJD UNLESS R BEARS DE civil engineers • planners • sury eyo n
WEMM MAL AND 01MOL s101ATUE 1 inch = 20 feet 9'
o>:THE PMOiE "M.0er@lt/9RNEYOR [ENal)ATE DESGRIPRON BY I I 441C yovemors highway, south windsor, eonnectIcut 06074 SOUTH WINDSOR CONNECTICUT arleaaen or mw PAW //•4•9-'Fl
. 5 �943
South Windsor
BUILDING DEPARTMENT
TO : ._ _ AM OF SOUTH *7NDSok
This certilild that tuts plan and speaifiaatlons are taw
copies of tha ro posed buifding or •Iterstlon• N ffA
erected at ,.
6Jt 9"10111
r�gethe► with amend en stated 114 appticiition sue
I.led with plan and I agree to eomlfls with all zonin,,.
r eliding and st 1e laws and such orders as shall 1,-
1"surd by the Building Department during prndenc.
tnis application and final issuaOte of a buildut,
Permit.
maned
ts plan is apprnred subject to Nhe condition that,
erdrrs and crdinuncea llopu+atf(W building shall bill
r , plied w,th.
1—usitionalle AlfMcNeW tiheas fh ifff
("i4ding inspector
c9 �
No v G
Town of Sou 1993 10 A P P R O V �'
Engigeeh.Wiodsor --_._�_ _...�.._.
Dept nq �y TO%IVN Or S">IJ r q Vll°�',. :
J ��
LEGEND
ARCHITECTURAL INFORMATION Os IRON PIN TO BE SET CLARK REALTY, INC. I N
HOUSE STYLE o MONUMENT TO BE SET 658 ELLINGTON ROAD
GL 94K SOUTH WINDSOR, CT. 06074 u
_ _Z-00 _ _ EXISTING CONTOUR (203)282-0628
SQUARE FOOTAGE /s97 30o PROPOSED CONTOUR 9
HOUSE COLOR —w—w— WATER MAIN ` I rn
ti Z � s
TRIM COLOR O ;
—G—G— GAS MAIN /� M`t of?. ' M
G�7 e•C 4t6E / \ } 1
g�DJ ` I /
X 287.3 PROPOSED SPOT GRADE V)
ROOF COLOR SILT FENCE
NOTE: 3. ALL UTILITIES IN THE ROADWAY ARE TO
1. ROOF LEADERS TO BE DISCHARGED ON BE INSTALLED IN COMPLIANCE WITH THE
SPLASH PADS. APPROVED REDFIELD PLANS.
2. FOUNDA11ON LANDSCAPING PER SHEET I \
L5 OF THE REDFIELD PLANS. 20' EASEMENT IN FAVOR OF j GCB #67
\ THE REDRELD HOMEOWNERS \ 7.0':/0/.70 r
ASSOCIATION, INC.
_ I
1. SET POSTS AND 2 STAPLE THE MIRE
ANGLE POSTS EXCAVATE A G'x6* MESH FENCING TO
FOR STAENUTY POST UPSLOPE FROM POSTS FENCING THE END OF THE POSTAND
CLEANING
� os' �1 Y MIN.
Ln
O J I II I 8 cc
3. ATTACH FILTER FABRIC TO 4. BACKFILL THE y�
FILTER THE MIRE FENCING AND EXTEND TRENCH AND COMPACT CB #6 8 I I I
FABRIC IT TO THE TRENCH THE EXCAVATED SOIL.
COMPACTED a 11,143 sq. ft. 1 y
BACKFlLL CIi I C v. I
rn
R 6 b F F - /OG.�S \ , m Tr Z
T 2 6 a J I \ D *1 z�
L - 4 .43 N `� o' // �j I r- R'
CONSTRUCTION OF SYNTHETIC FILTER BARRIER + i\\ D
�' J MIX// � �-•� I fTt
REFERENCE NOTE. (O i� N I \
BOUNDARY AND TOPOGRAPHIC INFORMATION ARE TAKEN FROM PLANS ; V o� 4 ''o4.a
ENTITLED 'REDFIELD-SITE PLAN OF DEVELOPMENT", SHEETS 4 THRU 11 2 - S71'38'24'E i ` I / S
OF 30, SCALE 1'-40', LAST REVISION 2/20/92 PREPARED FOR JMJ �.PAOE ro o4•ti v CONSTRUCTION COMPANY, BY DESIGN PROFESSIONALS, INC. (� / 141.04' \ I I
V /I
ZONE: DESIGNED RESIDENCE �r i
2
`s-
THIS MAP AND SURVEY WERE PREPARED IN ACCORDANCE TO A-2 ra vssl"
STANDARDS OF HORIZONTAL ACCURACY AS DEFINED IN THE ZI 1 I ! Of NNF�'+.
'RECOMMENDED STANDARDS FOR SURVEYS AND MAPS IN THE STATE
OF CONNECTICUT" PREPARED AND ADOPTED BY THE CONNECTICUT 44 1 PROPOSED
ASSOCIATION OF LAND SURVEYORS, INC., SEPTEMBER 24, 1992 U 1 HOUSE
TO THE BEST OF MY KNO AND BELIEF THIS MAP / I 1 7 I
SUBSTAN Y CORREC S OTED HEREON. L _ _ __ L - -
/ 1 I rD llt 3
• � 1 1 I � o� � cv,i ti6 es
` 12882 - 1 I I ci i Tt
�� a•��
RICHARD P. MARTEL UC. No. CB 5
' �oT *101 ��.BASED
ON
EST REtiISJONs GRAPHIC SCALE 1 (203) 291-8755 RIEDIFRIELD m/ ®Mp SHEET
toGTBLE AS 9MMN ARE L EXtS ON BEST - p 10 20 es1�n 1L 11I" u� uJ' �I�IN�F'U�V V
SHOULD B FIELD VERI ALL PRIOR
TOO NSTRM ®T No.>�TI �P,ST -_-�-- Sofesslonals, inc.BY 2 ALL UTil1nE5 ARE to BE SfN®N TIE FlE1D �7(��'�1�1 �T�r �1 7� � r�OONSiRUCCT10K uND sURVF`rVR PRIOR ro �ll�ll�lL.��1�7Jt COURT OF
auw sr. sro
i THIS PUN�INVALID uwtFss�T BE/Jts 1FIE .A7b Na asyr.t-i
WIRES.701I SEAL AND ORKMAL SIGNATURE -- 1 Inch = 20 feet civil engineers a planners a surveyors -- ---
aF tHE PROFESf ENOe1ffFRt/g�tVEWR N0. DATE DESCRP770M BY 441C governors highway, south windeor, Connecticut 06074 SOUTH WINDSOR CONNECTICUT rWlEarm er. za aye &-31 93
1
1
EVEN
AUG 3 1 1993
South Windsor
BUILDING DEPARTMENT
ft MF-AJf►OIYS D[Qii TOWN Jf SQUTM WWDSM
llhls Certified that this plan and specifications are tress,
•ogles of the proposed building or al one to aq,
aracted at+�//J
le ether with amend stated in applieat/ow moo.
fflld with plan and 1 agree to comply with all zewirlso,
Flulldins and st its laws and such orders as shall be
issued by the Building Department during peedlerrq
of this as Beat on and ttnal, issuance ob a buildlilalt a
perimi t
sMtaed 1
I his N a is appw,.w the i. an re tllrs�
aM ordin.eces reep al g lwlwahnt. alsaft so
h/ with.
`wW�lMwalle APMr+ei isnsa lit--
•urWaj I.-10 tear Coosa
-- -, --- >ti G,,?a 4
CEK I ii-ICA I ION OF ZONING CUIVirLiANCE
Proposed building(s), use(s) and/or structure(s)
as shown on this plan appear(s) to be in
conformance with current South Winds( -
regulations. Variances and special exception:_.
may apply.
Date - 3
PA c
`o Zoning Enk6rcernent Officer
RECEIVED
1993 1
r�
rifts ,9
ti
LEGEND
ARCHITECTURAL INFORMATION S CLARK REALTY, INC.
c IRON PIN TO BE SET
o MONUMENT TO BE SET 658 ELLINGTON ROAD CAI N
GLlV4{ SOUTH WINDSOR, CT. 06074 '
HOUSE STYLE
SQUARE FOOTAGE ,59� UD
EXISTING CONTOUR (203)282-0628 \ o g , C I
30o PROPOSED CONTOUR � I `
\ m IC
HOUSE COLOR w,�,c�c —w—w— WATER MAIN �, t Z
rn 1 S
TRIM COLOR r —c—c— GAS MAIN +"1; IN>ha I
x 287.3 PROPOSED SPOT GRADE \/ ��O V,
ROOF COLOR NN..n.eceo ',��o I. SILT FENCE �� w D // f \
NOTE: 3. ALL UTILITIES IN THE ROADWAY ARE TO \ /' \ \ \
1. ROOF LEADERS TO BE DISCHARGED ON BE INSTALLED IN COMPLIANCE WITH THE
SPLASH PADS. APPROVED REDFIELD PLANS.
2. FOUNDATION LANDSCAPING PER SHEET
20' EASEMENT IN FAVOR OF 1
t_5 OF THE REDFIELD PLANS. THE REDFIELD HOMEOWNERS \ ///�F./ #67
ASSOCIATION, INC. }/ /-o 1
1. SET POSTS AND 2 STAPLE THE WARE
ANGLE POSTS EXCAVATE A S'I18' MESH FENCING TO
5' SLOPI1TY
POST UPSLOPE FROM„POSTS- �pRE THE END OF THE POSTFOR ABI
ST
AND SELF-
LEANING.
Bs' 12' MIN.
o Do
1D
�..ylr S• 5 N Do
(,A9 =ioy.5 (A I I I Gs
3. ATTACH FILTER FABRIC TO ♦. BACKFILL THE I I
FILTER THE MARE FENCING AND OnI ND TRENCH AND COMPACT CB #68 V
FABRIC IT TO THE TRENCH THE EXCAVATED SOIL 'oo .s� \ I t
oa.o �.: 9zo •
O a 11,143 sq. ft. ` y
EIP
4-.:. I s I / c
COACTED r
BACKFlLL QI '� I 1 I ✓
C.ag,o
3 - SS 2S 1 fi 58 Z, p T.O.W.:JO I I J� rri
R = 8 8 F F ob.5 I \ I 00 M z
f
T 2 6 f D Z
L - 4 .43 a I \i I O 1Z'
CONSTRUCTION OF SYNTHETIC FILTER BARRIER o — - d"'
rl
REFERENCE NOTE. (0
BOUNDARY AND TOPOGRAPHIC INFORMATION ARE TAKEN FROM PLANS }low —4
ENTITLED 'REDFIELD-SITE PLAN OF DEVELOPMENT', SHEETS 4 THRU 11 3 = m S71'38'24'E r 1 I S
OF 30, SCALE 1'-40', LAST REVISION 2/20/92. PREPARED FOR JMJ h pgpe ro oP.AiN 141.04'
CONSTRUCTION COMPANY, BY DESIGN PROFESSIONALS, INC. VV /
II I I
ZONE: DESIGNED RESIDENCE
_ _ ______ __ __ I fN� rtrr.►rsr
THIS MAP AND SURVEY WERE PREPARED IN ACCORDANCE TO A-2 f _ O IV
STANDARDS OF HORIZONTAL ACCURACY AS DEFINED IN THE 4 1 1 I e�t4'�6
'RECOMMENDED STANDARDS FOR SURVEYS AND MAPS IN THE STATE 3 /a. 1
OF CONNECTICUT* PREPARED AND ADOPTED BY THE CONNECTICUT � 1 PROPOSED
ASSOCIATION OF LAND SURVEYORS, INC., SEPTEMBER 24, 1992 1 HOUSE
TO THE BEST OF MY KNOWLEDGE AND BELIEF THIS M S
SUBST ALLY CORR AS NOTED HEREON.
12882 CB #65 I 1 I ',�yti v L.
RICHARD P. MARTEL UC. No.
1. UNLESS OTt"WISE NOTED.ENISIYNO UMUTY REVISIONS 203 291-8755 �• SHEET
LOCATIONS AS SHOWN ARE BASED ON BEST --- ----- -- GRAPHIC SCALE RIEDIFEEILD A �$®HI V
AVAAABLE WOVMATM. ALL EXWIM UTILITIES 20 TI IT /TII� f��VT
WOULD BE FIELD VQFlED PRIOR TO CONSTRUCTON. - W® L 1 V®o � 1
2. ALL UTILITIES ARE TO BE STALQD IN THE FIELD 0 ,0 rof e sional8 Inc. ���MM �
BY A LICENSED LAND SNRVEYOR PRIOR TO 1f 7}n TT T}r T ®Tr T T}n/�}� OF
CONSwtUCTION. --- JI Il jl'1R IIII,f��Vl COURT
II IL wuw er. seB .ram Ma•es9rs-e
J THS PLAN IS INVALID UNLESS IT BEARS THESKkATLW _ __ _ civil engineers 0 plOnMns 9 surv* oro ----
r oF�><ssTO1 o�ianNEnl tioa ka DATE DESORIPnoN er 1 inch = 20 feet 441C governors hphwoy, south Windsor, connec2icut 0807E SOUTH WINDSOR CONNECTICUT aAEorm or Ru wre B-31-93
� C�gII
AUG 31 1993
South Windsor
BUILDING DEPARTMENT
TO THE WILDING DEPT. TOWN OF SOUTH WII0500
This certified that this plan and specifications are trw
Copies of the proposed building or alterations N iM
meted at
tognther with amendments I on appMcatbn one
tiled with plan and i agree to c<"m>tey wit*aF KOM 46
11nOding and stale laws and sudr orders as shalt Im
issued sy the BuNdinq Dellervnent during pendene7
1 this applicasiaas and e/1a11 isswerNt of' of bu"d6"9
PcttnL%.. /t
pt" Is'00mv" *ludidcr lb, a db"tAllbM t*es
..n, N and 09&n+nces relp111M.311{ tUHt1t sort be
1k d *{Rh.
..,wirlioevslW rllY TIMN l"d a"
.I
�,;trl l irit,Ai wii Ur LUt iNG Wivir UAili;t
Proposed building(s), use(s) and/or structure(s)
as shown on this plan appear(s) to be in
conformance with current South Wind er
`n �O regulations. Variances and special exceptions
1 may apply.
��
RECEIVED Datet" --
F 8
SFp Q 1 1993 — Zt7ni, , Enfnrcement Officer
Z� Town of Sootl rfilwoT 8
�� Engineering
PPLICATION FOR BUILDING PERMIT
Electric # mAY
Plumbing# Di �,iUU t Q
HVAC # 16 g n Court C'}'1�t(xL Date: _
Sprinkler# BUILDING DEPARTMENT 730840
FINAL APPROVALS -- _ -- — -- - —- Estimated Cost $
Building COMPLETE RED BOXED AREAS j Permit Fee $
En neerin Occupancy Fee $ a n
g TYPE OR PRINT ONLY Eng. Insp. Fee $
Affidavit for CO. SIGN O
A r. for REVERSE SIDE Total Fee
_
TO THE BUILDING DEPARTMENT,TOWN OF SOUTH WINDSOR,CT (Additional Cost) $
The undersigned hereby applies to do work according to the following:
Applicant 11 r A �� Location of Work lb Lot No.
Applicant's Addr ss � N Tel.#
Town �yc_c C,�.~1 Zip U(,Q7 Y Lic.#
Owner S r=t r^t M-m- h4'.60 Architect
Owner's Address Architect's Address
Zip Zip-
-Sq. Ft. New Area: 1st FI. 2nd A. 3rd A. Total New Area
Purpose of this permit , .11 c.(t., ;„i
S -
t�y 1�aWr, C' ell �`'�'S ptic System❑ Sewer❑
Ins: HO SP Cert. Area Basement Garage
Approved by ate Use Group Construction Type
Revised 8102
ys
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 al wed.
Signed
I hereby apply for a Certificate of Occupancy fo work described in thi pplicaf n for the permit
Signed
DO NOT WRITE BELOW THI INE
INSPECTION COMMENTS
BUILDING PERMIT
STATE OF CONNECTICUT
WORKERS'COMPENSATION COMMISSION
Building Permit Affidavit for Property Owners or Sole Proprietors
(Conn.Gen. Stat. § 31-286b) II
Property located at ( DI <�o c,✓ t
In the town of d S y,-- U
Name of building permit applicant: J y I`
Please check one:
1. dam the owner of the above property.
2._I am the sole proprietor of a business.
2A.Name of business
2B.Federal Employer Identification Number(FEIN)
..........................................................................................................:.........
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"swom 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:
1. ; I do not intend to act as a general contractor or principal employer.
[Sign and stop here] 01
Signature of applican
2._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 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 to accept coverage.
Signature of applicant
Subscribed and sworn to before me this day of ,200_.
(Notary Public/Commissioner of the Superior Court)
DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT
PERMIT#
Application is hereby:
TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT 110 oo T_
APPROVE ,:,, 1540 SULLIVAN AVENUE Bldg. Permit#
W-2511 ext. 230
l II
Date Building Inspector
Application must be printed or typed
FEE SCHEDULE Location of Job:
F
$0-$1,000=$15.00 Street Lot No.
Over$1,000=
$15.00 per$1,000
or any fraction thereof gnation Apt.No.
APPLICANT -T b 1�e rr
APPLICANT ADDRESS 62 I
APPLICANT PHONE#
OWNER i 2 Ju v' (�
(O W N St-4
OWNER ADDRESS 16 Dfy51- .5 Coin+
�oN w�n�sor I LT 06G7
OWNER PHONE 06,,I 16 ' USG
C ESTIMATED COST$ �1 r 7S^F�
IS THIS A CONTRACT COST? _Yes _No
a � FEE ENCLOSED$ 75 - 0 0
s . . O�� TYPE OF JOB: �2$�-�
O R C New Installation C'C( � U 7
'Alteration/Addition/Repair
Revised 4/01//2002
APPLICATION FOR HVAC PERMIT(Continued from reverse side)
TYPE OF SYSTEM: TYPE ql BUELDING:
,Z(HEATING ARESIDENTIAL,
❑A/C ❑COMMERCIAL
❑VENTILATION ❑INDUSTRIAL
HEATING
❑ STEAM LOW PRESSURE 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) °F(HEAT LOSS SHEET MUST ACCOMPANY
APPLICATION)
DESCRIBE ALL HEATING EQUIPMENT(INCLUDING MAKE&MODEL NO.)
GROSS HEATING CAPACITY(INPUT—BTUH) 1 Z0,oa NET RATING(OUTPUT—BTUH)
TYPE OF FUEL
❑OIL—GPM OIL TANK LOCATION :❑INSIDEO OUTSIDE CAPACITY
)KGAS—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.)
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 �eM v l e ex 3{,N3 y 4 J 'i
L702 el-Ie— L.-<
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 LICENSE NO. TYP STATE
SIGNATURE OF APPLICANT DATE
1100044 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER HVAC PERMIT
DATE: 02/04/11
GIS ID:28400016 FEE: 75.00
MUNIS APPLICATION# 201100076 BUILDING DESCRIPTION:
APPLICANT LOCATION
NAME: KENNEDY'S PLUMBING AND HEATING CO. ADDRESS: 16 DIGGINS COURT
ADDRESS: 624 WETHERSFIELD AVENUE OWNER: JAVIT DEBRA M
HARTFORD,CT 06114 - 16 DIGGINS COURT
SOUTH WINDSOR,CT 06074
3
DESCRIPTION OF WORK: REMOVE EXISTING GAS BOILER AND INSTALL I-QUIETSIDE DPW-120.
EVERGENCY JOB--OLD BOILER CRACKED.
SPECIAL CONDITIONS: `
ALL WORK TO BE DONE IN ACCORDANCE,WITH THE APPLICATION AND PLANS APPROVED BY THE BUILDING DEPARTMENT.
CONSTRUCTION TYPE:
OCCUPANCY GROUP: BUILDING OFFICIAL
2/4/2011 12:44 PM THE FEE ABOVE INCLUDES A$0.26 PER THOUSAND CT STATE EDUCATION SURCHARGE