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Home My WebLink About170 DIANE DR APPLICATION FOR ELECTRICAL PERMIT DEPARTMENT DECISION TOWN OF SOUTH WINDSOR PERMIT# Application is hereby: BUILDING DEPARTMENT 4 Dc� t l2 APPR v 1540 SULLIVAN AVENUE i Bldg. Permit# 644-2511 ext. 230 Da' to Building Inspector - Application must be printed or typed FEE SCHEDULE Location of Job: $041,000=$15.00 130 0 ETA NC A U Over$1,000= I Street No. Street Lot No. $15.00 per$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANT /4 APPLICANT ADDRESS P D B(9X 7a3 yERW- 0 e7 vEG66 APPLICANT'S PHONE# �?60 " �?79 'o6 b6 OWNER WAYP SoNtR0 �(�W N S fq< OWNER ADDRESS 1 80 QL 19Ak DR S®_ w Z 1Q�jk C T OWNER PHONE R6003 - y O , j ESTIMATED COST$ 13co• 00 IS THIS A CONTRACT COST? _Yes No FEE ENCLOSED$ /Jr.&() �! TYPE OF JOB: *I�Q Z A/-s0 R•Co New Installation Alteration/Addition/Repair c2clwoIraq Revised 03/05/10 APPLICATION FOR ELECTRICAL PERMIT(Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A BUILDING PERMIT APPLICATION? ❑ YES ❑ NO ❑ RESIDENTIAL CURRENT USE AND OCCUPANCY ❑ BUSINESS ❑ ASSEMBLY FUTURE USE AND OCCUPANCY 0 EDUCATIONAL ❑ INSTITUTIONAL ENGINEER'S NAME PHONE ❑ FACTORY ❑ STORAGE ADDRESS ❑ GARAGE ❑ MIXED USE CITY STATE ZIP (Other please specify) TYPE OF INSTALLATION/WIRING METHOD r SIZE OF SERVICE SIZE OF MAIN CONDUCTORS NUMBERS OF METERS�_ NUMBERS OF DISCONNECTS AND RATINGS NUMBERS OF PANELS NUMBERS OF DISCONNECTS REQUIRED? ❑ YES ❑ NO NUMBERS 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 Igo A YR a OyIE i rn COA NCB AQ C k011NJTfi)6 THE UNDERSIGNED HEARBY 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 PERFOR- MANCE OF SUCH WORK 16 35� C) j C`7- CONTRACTORS LICENSE NO. TYPE STATE SIGNATURE OF APPLICANT `I — ^ A DATE j(�t(� j Ott (gyp �p�� :}{��^�+ �}'P.+TX:r; 1:')Ti4t?y._1_^TIo..•:ro-..,,. -ram HIS liIA i OR i1F1ii�� tY� ;"�at�r C�:T:J,'� � ��'~`,�gi�':r f;Fi` ''-a�_{` �{��y, /+�� Sri .♦ <t - `¢^. .. •'. _ . <F-'< M �.t•.♦T";Q� i � D 6 D � r r . iq t� .a• hj} 'c r ! a 'N —70 t �a \t� . P IANI; D1.' IVE SOUTH CON,, }ieing Lot No. 18 on map entitled "Map of HIGH I'AttMS Kelly Road South 4•indsor, C01111. Property p v of ..s� dward, Joseph & William Kelly Subdividers Robert Stone 0 Jack Goldberg Scale Ir' — 50 ' April b, 11159 Hayden L. Gri 1963 to show change of builaiw�lt} C 't,n Sheet 1 of 2 Rev . Jan. 8, Scale I " = 5� � g lines HAYDEN L. GRIS'•,'OIl) C.E. . r :T Rome Occupation Information and Application Form ASSESSOR S USE ONLY Minor Approved by Date b v Major Home Occupation Type a Code Name e DBA uu Caii ns5- � Address of Proposed Occupation: I 1 D Di ane- bri TukA VT I u 6c! ; G D(00'1 N Telephone 8(P-D *N V a 1$5 Zone Fes{l 1 Wff (Note:in DRZ.W zones only minor home occupations are allowed,approval letter from homeowners assn required Description of Home Occupation: At-eir Go Please use the boxes below or an attached sheet to provide the following. A.Proposed Sign 1. Attach copy o1`plot plan if available. 2. Use Box A(or�attach sketch)to draw proposed signage. 3. Use Box B(or attach sketch)to draw the floor plan of the Home Occupation area 4. Architectural elevations for any proposed additions or modifications must be provided: FLOOR PLAN Basement ❑ 1"floor 2ad floor Floor area of dwelling Of Floor area of home occupation of floor area devoted to home occupationMAL .5t* 4 IUD I have read the regulations regarding home occupations and will comply with said regulations.I understand that I must notify the Planning Department in writing upon terminaUion of this occupation at this address.This permit is not transferable or assignable to another person.In the event of relocation,the permit holder must notify the Planning Department in writing to transfer the permit to the new location. Signature of ApplicantC Date (0-as ' Signature of Owner Date KM JUN 2 0 2008 D South Windsor BUILDING DEPARTMENT _ .,, C OMPLIANCE CERTIFiCAT10N ,. proposal bulld►ng(s)- " �,. on "i.� pan as �ti,�i� current con'.- . unres and Date �-- zoning orcec►ent Officer l'nv 13 NO D South Windsor BUILDING DEPARTMENT 10 THE BDllfA.fL i3Epi, i':r.s ;t W.H! a•oir*f,. rh is certifiad tnet this plan +,d s,ci'ic_I,.,.,s_,lr: copies of the proposed Wilding or alterations to b, erected at 1—J O I,G '� b� ttr^c together with amendments ctrted in appiicatlon riled with plan and I afire.: to comply with all zonl=-,.. Building and stote laws and su^h .;rd,rs as snip !_ issued by the uild g .i•p,,r.m:n< ing pander. ,1 this appltc on n firai s• n of a buH;llni permit. Signed )his plan i v.d subi,•et to the condition the! ord;rs and .ncus ragul:sting building shall be / can Condition.lily Appr,uved These filed with Building la.sp.ctor —- CI., CERTIFICATION OF ZONING re "APLIANCE Propos-_, ,�r(s), uss(S) (S) as sh� f r2r ; 4r rec''.0Gt y l:, VC rm., Date l r3 C)Co ni � Enforoement offiW "'� .0,0 M -CV 1 N 1.6 ' 1 pp. 9 Town of South Windsor General Map N Connecticut 0 PARCELS Date Printed: November 13,2006 ROAD NAMES 0 70 Feet ROADS . . Property boundaries are derived from the Town of South Windsor Tax Assessor maps,digitized at a scale of i inch=100 feet,and include the same data limitations and disclaimer as the Assessors maps. All other data portrayed is representation only and,due to inherent mapping limitations,should be used as a guide only. The intent of this map is to present a graphical representation of property boundarie and selected data,and the map is subject to change as more accurate surveys may disclose. Property boundaries mapped as of June 4,2001, t3U1LL1Nli Yr.itMl'1' ' STATE OF CONNECT ICUT WORKERS'COMPENSATION COMMISSION Building Permit Affidavit for Property Owners or Sole Proprietors (Conn.Gen.Stat. §31-286b) Property located at - In the town of Name of building permit applicant: Please chec one: 1. I am the owner of the above property. _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 g... statin 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. [Sig an p he J Sie�r of applicant 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) Electric # APPLICATION FOR BUILDING PERMIT Plumbing# 170 Diane Drive Date: HVAC # Sprinkler# 30144 /s FINAL O —_-- _— Estimated Cost $ 1 Buildings b� !l Z'i"` j COMPLETE RED BOXED AREAS Permit Fee ginee n TYPE OR PRINT ONLY Occupancy Fee $ En /a• �" ginei Eng. Insp. Fee $ AffiffidavAppr. for C o` c"��- SIGN ON REVERSE SIDE Total Fee $ O o TO THE U L NG DEPARTMENT,TOWN OF SOUTH WINDSOR,CT (Additional Cost) $ The undersigned hereby applies to do work according to the following: G Applicant Location of Work 110 Lot No. Applicant's Address t Tel.# - 7 Town 0 d r Zip ' ' 07 Lic.# Owner Architect Owner's Address /-7O a,6ive Architect's Address Zip Zip Sq. Ft. New Area: 1st FI. 2nd FI. 3rd FI. Total New Area Purpose of this permit -%14,e �O City Watero Well❑ Septic S stemo Sewer❑ Ins: HO SP Cert. ea Basement Garage Approved by Date —4 'O Use Grou Construction Type Revised 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 b located the pr p stance from all street lines,side yard lines,and required distances from all other zones and is located in wY h t buildi its use is allowed i Signed I hereby apply for a Certificate of n or the or scribed in this application for the permit. Signed i DO OVIRITE BELOW THIS LINE INSPECTION COMMENTS Inspection / Approval Date By Appl Code Description Due Whom Code Comment • ------------------------------------------------------------------------------- ++-30144-8 2,815 B10 FINAL 03/26/09 JFF A