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HomeMy WebLinkAbout172 FAIRVIEW DR DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT PERMIT# Application is hereby: TOWN OF SOUTH WINDSOR -71 12M BUILDING DEPARTMENT APPROVE 1540 SULLIVAN AVENUE Bldg.Permit# 4' c 644-2511 ext. 230 Date Buil ing Inspect Application must be printed or typed FEE SCHEDULE Location of Job: .� a F41ryieL.J Or dQ� $0-$1,000=$15.00 Street No. Street No.Over$1,000$15.00 per$1,000 or any fraction thereof Tenant Designation ::Lot APPLICANT SLk v-r %ui (\Qr -- APPLICANT ADDRESS 994 tiUr 1d —7--e .. P.O. $max (o() Ver nyn CT UU ow Lo APPLICANT PHONE# —7 OW N SF,q OWNER 61-%&ce- � r4� OWNER ADDRESS t rI Z Fes,%t y GvJ O f ye-- 'r O « OWNER PHONE (V(A'U) (0 4$-9 I U C ESTIMATED COST$ I SOU• co IS THIS A CONTRACT COST? _Yes _No �L FEE ENCLOSED$ 30.C- TYPE OF JOB: sOR•CO ✓ Nation New Installation Alteration/Addition/Repair Revised 4/01//2002 I�3? APPLICATION FOR PLUMBING 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 FUTURE USE AND OCCUPANCY ❑EDUCATIONAL ❑INSTITUTIONAL ❑FACTORY ENGINEER'S NAME PHONE ❑ STORAGE ❑GARAGE ADDRESS ❑MDCED 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 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 ❑YES ❑NO SIZE OF WINDOW IF NONE C.F.M.OF VENTILATOR SIZE OF DUCTS SEWER OR SEPTIC TANK SIZE OF WATER MAIN SIZE OF WATER PIPING&RISER WATER HEATER: TYPE MANUFACTURER DESCRIPTION OF WORK LL fr 'tcA n t- *0 be- 'ks c a "�i C, -R i QP\aCC_ k yO► ce.tr a nck C OC 1LT4 9-%A n n t nA a Opp c x S a G QJ 0-� ll0. k A,� �1� THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORMI HE WORK DESCRIBED AND COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE PERFORMANCE OF SUCH WORK. CT CONTRACTORS LICENSE NO. // FTYP STATE SIGNATURE OF APPLICANT G� '/ DATE 'i? 31 -VARDNER & PETERSON ASSOCIATES 576 OLD POST ROAD TOLLAND, CONNECT/CUT 06084 �7 O ►J �08'- z6-54. W \ I O \ q 7 0 a \ I T 39 Q le, {. T• a N + was'l lv�O �i� ice— � .— ^� ^ •^ / 5 at- S`i•' 1 1� Nip 0 a C2/1rv/euv PERMIT PLAN LAND OF U. & R. HOUSING CORP. LOT #40 TIMBER RIDGE SEC. V / TOWN OF SOUTH WINDSOR, CONNECTICUT / SCALE: 1 " = 40' Certfied ;substantially correct `� -- L. S. 10839 January 18, 1982 y"r' Elev. base, M.D.C. Datum PROFESSIONAL ENGINEERS LAND SURVEYORS a/a.3 17;� ,R O v S D A p - SOUTH WINDSOR TOWN O� .G DEPARTMENT EN GIh�ZIP Z DATE: 2 slw GARDNER it PETERSON ASSOCIATES—526 OLD POST RO.AD—TOLL4MO, CONN6Cricuro6od4 °• o (ar4eack_ 1L me--i 0 0 0 gbh W (U Tw 1sqj.A, in 1) -1q. 47 lei f�z SZ!, C & V MORTGAGE SURVEY LOT 40 TIMBER RIDGE SEC. V LAND OF U. & R. CONSTRUCTION CO. TOWN OF SOUTH WINDSOR, CONNECTICUT To be conveyed to BRUCE J. & BARBARA C. MACLEAN SCALE: 1" = 401 I hereby certify to Connecticut Attorney's Title Guaranty Fund, Inc. and Hartford Home Savings & Loan Association that the location of the building as shown is substantially correct and that there are no zoning violations of the same. L. S. # 10839 November 15, 1982 'may,=� ..��...�.�...: .._. ���ti29y. PROFESSIONAL ENGINEERS —LAND SURVEYORS MAR 929 South Windsor BUILDING DEPARTMENT f0 THE kft)fNC DEPT. TOWN OF SOUTH WINDSOR This certified that this plan and spacific tuns are true copies of the proposed building or alterations to be ,rected at All a El 1 E VY ��l r t-atrert P-; r` ^ rog=ther t in ipoiic-�tion and .;� •�\' sled wit'' -•i � t r.tv�,Ith It zoning. & WIWI m. t I I r� ,.r' rs & shall be .�9 ,\C7 ts+.Ied I D.o t it d-raring pendency , 1y' Q 1 this _ta,,n nd tln..l 1 ::nce of a building ,ermit. pis p— It V" subject to that aces r.qul..tang shall be .,pu, It d with �` \ J `,� •�; '�;' 1 CGj `[> /Q` a•IsP ctor Cler �cr,• Oyu 3;� 1��� �^v / /G�� G Q�OQ C`�� 00 Qa / GARDNER £t PETERSON ASSOCIATES 576 OLD POST ROAD TOLLAND, CONNECTICUT06084 , 3l •3� i I ko a,rec` a 3b'i^ 3sc,z 389.4. 361.2 �`3�A,� 0 o g Lo. O M m V 0 „ V 1�Z.•I.v •F N4zvet 389•c QB4 6 3a 6 386.a 3 ea.S sz, mo.00 v/Ew MORTGAGE SURVEY LOT 40 TIMBER RIDGE SEC. V , LAND OF U. & R. CONSTRUCTION CO. TOWN OF SOUTH WINDSOR, CONNECTICUT To be conveyed to BRUCE J. & BARBARA C. MACLEAN SCALE: 1" = 40' I hereby certify to Connecticut Attorney's Title Guaranty Fund, Inc. and Hartford Home Savings & Loan Association that the location of the building as shown is substantially correct and that there are no zoning violations ' of the same. • � I L. S. # 10839 i f�Nove er 15, 1982 I PROFESSIONAL ENGINEERS LAND SURVEYORS ti29y-�Ip //117/7 z APPR0VE' D OWN OF SOUTH h�INDSC ENGINEERING DZPARTMENT DATE -/rj- 8 7/ SIG:;- WORKERS Westport Insurance Corporation INSURANCE POLICY ATION EMPLOYERS LIABILITY P.O. Box 50457 .•::•::•:::....:. :::•::.::::I..............:::::....:..... .....1.......:................................. _... Ft►l cy period:.;::::::......:.: Sarasota, FL 34232 0303 ::::. .Q1 Cy.....uM...�C .................... •': 1=rOrtl:;;•::•:;:::; :;•:::::.:::::::::::TD:::::::::_::.: WCX 0011295 05/13/2007 05/13/2008 12:01 A.M.Standard Time at the described location : :.:<:;:::T6 sactIon�:::;:..:::;:.::: :;:::.:;: ': :;Renewal\Rew:rite of:pr ICY.::�la RENEWAL, DECLARATION WCX 0011295 DIRECT BILL . ...... .......... ......:..:;..;...;iVamed:insured;and:.:Address:;: :is f: :... ..:.:.. `gen.:`.:; SUPERIOR ENERGY LLC CHARLES G MARCUS AGENCY INC PO BOX 60 PO BOX 290756 VERNON CT 06066 WETHERSFIELD CT 06129 Telephone: 860-563-9353 0002293 Carrier# FEIN # Risk ID # Entity of Insured 13714 481198163 060064881 LTD LIAB CO Additional Locations: See Site Location Schedule 2.The Policy Period is from05/13/2007 to 05/13/2008 12:01 a.m. Standard Time at the Insured's mailing address. 3.A. Workers Compensation Insurance: Part ONE of the policy applies to the Workers Compensation Law of the states listed here: CT B. Employers Liability Insurance: Part TWO of the policy applies to work in each state listed in Item 3A. The limits of our liability under Part TWO are: Bodily Injury by Accident $ 1,000,000 each accident Bodily Injury by Disease $ 1, 000,000 policy limit Bodily Injury by Disease $ 1,000,000 each employee C. Other States Insurance: Part THREE of the policy applies to the states, if any, listed here: ALL STATES EXCEPT NORTH DAKOTA, OHIO, WASHINGTON, WEST VIRGINIA, WYOMING, STATES DESIGNATED IN ITEM 3.A. D. This policy includes these endorsements and schedules: See attached schedule. 4.The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates, and Rating Plans. All information required below is subject to verification and change by audit. SEE EXTENSION OF INFORMATION PAGE Minimum Premium Total Estimated Annual Premium Expense Constant Assessments and Taxes Premium Discount , Deposit Premium ❑This is a Three Year Fixed Rate Policy Premium Adjustment Period: ® Annual; ❑ Semiannual; ❑ Quarterly;❑ Monthly Countersigned this Day of Issued Date: 04/24/2007 tt u r tentative Issuing Office Sarasota,FL os SP001407 Ed.(02-01) WC000001A (05-88) INSURED COPY Page 1 of 4 r r " 46 i, STATE OF CONNECTICUT ♦ DEPARTMENT OF CONSUMER PROTECTION Be it known that EVEARD S LANGLEY i 148 MAPLE STREET ELLIN,CT,©N;-jf-T jg6029 has been certified by the'•; eparhnenf'ofC 'n' mer Protection as a HEATING, PIPING & COQ 'I�fiG�' 11tTED CONTRACTOR Jg _ . s Effective: 09/01/2006 Expiration: 08/31/2007 H H �