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APPLICATION FOR ELECTRICAL PERMIT
TOWN OF SOUTH WINDSOR BUILDING DEPARTMENT
1540 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074(PHONE) 860-644-2511 EXT. 230
DEPARTMENT DECISION Z07027
R'APPLICATION IS HEREBY: `}
APPROVED: BLDG.PERMIT NUMBER:
DATE INSPECTOR
LOCATION OF WORK: ! 76, 1�e L`�
APPLICANT: OWNER: TYPE OF STRUCTURE:
& O ck / - NEW BUILDING
NAME: J�a I C�hfl F1�c Z"�C C NAME: GKy JJY;Cct cx�L�f ❑ADDITION
PHONE NUMBER: llf k7C r PHONE NUM 3ER:Q t -6 ISTING BUILDING
ADDRESS:l �'l� Uk/6i' ADDRESS:
,y TYPE OF USE:
Inn G l
dRESIDENTLAL ❑COMMERCIAL
ELECTRICAL INFORMATION: FURTHER DESCRIPTION OF WORK:
TYPE OF INSTALLATION: 14,2 pole CY I /AJ i %F/�✓/_./�/�i<1/�/G
SIZE OF SERVICE:
SIZE OF MAIN SERVICE:
NUMBER OF METERS:
NUMBER OF PANELS:
NUMBER OF LIGHT CIRCUITS: ESTIMATED COST:S /�'w
NUMBER OF SWITCHES: c/ J
NUMBER OF LIGHT FDCI JRES: FEE ENCLOSED:S
NUMBER OF A/C CIRCUITS: 'j(t-L, cl t\-f r
FEE SCHEDULE:SIB PER$1,000 OF THE ESTIMATED COST.
NUMBER OF POWER CIRCUITS: ROUND UP TO THE NEXT THOUSAND ONCE THE PROJECT
IS$1.00 OVER (.26 CENT EDUCATIONAL FEE INCLUDED AS
NUMBER OF OUTLETS: PART OF THE PER-NUT FEE)
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 PERFOMANCE OF SUCH WORK.
CONTRACTORS LICENSE NO.: ef TYPE: l STATE:
SIGNATURE OF APPLICANT: DATE: , O
10/12/21,12:44 PM
06 74 Town of South Windsor Planning Department
c~_D 1540 Sullivan Ave
South Windsor, CT 06074
CJ Action Photography
28684
Home Occupations(Minor)
178 SCOTT DR
South Windsor,CT 6074
• Location of Business:Basement
• Business Description:Photography services,on-line sales only
By receiving this p rmi, he a ipl n gives consent to searches and inspections as required and shall operate in accordance with
the regulations of the South Windsor Zoning-egulations.
&I.J. G. OAS j A.
October 12,2021
Pamela Oliva,Zoning Enforcement Officer DATE SIGNED
*`*PERMIT ONLY VALID IF SIGNED BY ZONING OFFICIAL***
1/1
e
P
Home Occupation Information and Application Form t)
�cf Minor Approved t�a�rG(r],�,. Date 10 31 ASSESSOR'S USE ONLY
$25 fee
o Major Zoning Fee: $ 4c'.00 Home Occupation Type
$360 fee Munis Application Code
Applicant Name:
DBA: `'c� J�.t ha�u LL hr- r
Address of Proposed Occupation: 17
Telephone: VU v—79 8--5'Z-S—I Zone:
Property Owners Name: ( UrC.�i� aQelL rn pf— b"J: s
NOTE: In DRZ and MF zones only minor home occupations are allowed.Approval letter from homeowners association is required.
Description of Home Occupation:
'le dES OV1111 ! 0 C i, 4
Please use the boxes below or an attached sheet to provide the following:
1. Attach copy of plot plan if available Box A: PROPOSED SIGN
2. Use Box A(or attach sketch)to draw proposed signage(limit 1 sign,2 sq ft area)
3. Use Box B(or attach sketch)to draw the floor plan of the Home Occupation area o %et✓1
4. Provide Architectural Elevations for any proposed additions or modifications
FLOOR PLAN (Basement _ I'floor _2°d floor)
1. Floor area of dwelling —60 U
2. Floor area of home occupation
3. %of floor area devoted to home occupation
Box B: FLOOR PLAN
Omf'?,
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 termination 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 Applicant Date JIL I-Q
PRINT Name of Applicant Ai ne.14 3. lknl'')
Signature of Owner Date /0 z2
PRINT Name of Owner (' �', 1 pyu� Revised 6115118
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LOT #134, "BIRCH HILL �S`PATES" , SECTION #7
TOWN OF SOUTH WINDSOR, CONNECTICUT
SCALE : 1" = 50 '
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SCOTT
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LOT #134 . "BIRCH HILL ESTATES" . SECTION �7
TOWN OF SOUTH WINDSOR , CONNECTICUT
SCALE t 1" = 50 '
BUILDING PERMIT.-?
STATE OF CONNECTICUT
WORKERS' COMPENSATION COMI USSION
Building Permit Affidavit for Property Owners or Sole Proprietors
(Conn.Gen.Stat. §31-286b)
Property located at Soo al--
In the town of i vt d S o/—
Name of building permit applicant:
Please check one:
1. I am the owner of the above property.
2._L/I am the sole proprietor of a business.
2A.Name of business C-ed
213.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"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:
1. I do not intend to act as a general contractor or principal employer.
[Sign and stop here]
Signature of applicant
21 /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.
— 0,_ei_
Si0aivre of applicant
Subscribed and sworn to before me this/Q�4day of g, 200�
(Notary Public/Commissioner of the Superior Court)
Electric# APPLICATION FOR BUILDING PERMIT
Plumbing# Date:
HVAC #
Sprinkler
FINAL# P Estimated Cost $
Permit Fee $ err
Butldi4l Ob COMPLETE RED BOXED AREAS Occupancy Fee $
Enginee TYPE OR PRINT ONLY Eng. Insp. Fee $
Affidavit ► SIGN ON REVERSE SIDE
Appr. for CO. 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 �r,H" f I ij I Location of Work f- 5 0 n 1)/,-- Lot No.
Applicant's Address 1-l our,-11w K k2 I C/ / Tel.#
Town S , w i 1-7 6/sc/,— Zip D 4r o 71/ Lic.#
Owner F✓i✓t 7<, /,o A 3 t i:Z-- Architect
Owner's Address 7 g Sro Architect's Address
S oy76, w h d S Z�/, Zip a o x/ Zip_
Sq. Ft. New Area: 1 st FI. 2nd FI. 3rd FI. Total New Area
Purpose of this permit e r i ' "
— C %
City ater❑ Well❑ Septic System❑ Sewer❑
Ins: HO SP Cert. Area Basement Garage
Approved by Date `� � Use Group Construction Typv_---
oil
Revised 6/02
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 application for the permit.
Signed
DO NOT WRITE BELOW THIS LINE
INSPECTION COMMENTS
Inspection / Approval Date By Appl
Code Description Due Whom Code Comment
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**-32432-B 6,500
B10 FINAL 11/08/06 JFF A
1800218 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER ELECTRICAL PERMIT
DATE: 07/05/2018
GIS ID: 81600178 FEE: 18.00
MUNIS APPLICATION# 201801111 BUILDING DESCRIPTION:
APPLICANT LOCATION
NAME: BEAUDOIN ELECTRIC LLC. ADDRESS: `178 SCOTT DRIVE
ADDRESS: 195 MORT VINING OWNER: SITILIDES HARILAOS&
SOUTHWICK,MA 0107T 178 SCOTT DRIVE
SOUTH WINDSOR,CT 06074
DESCRIPTION OF WORK: INSTALL GFI IN 1 ST FLOOR BATHROOM
INSTALL A CEILING FAN IN 4 BEDROOMS
SPECIAL CONDITIONS:
ALL WORK TO BE DONE IN ACCORDANCE WITH THE APPLICATION AND PLANS APPROVED THE B G DEPARTMENT.
CONSTRUCTION TYPE:
OCCUPANCY GROUP: BUILD AG OFFICIAL
7/5/2018 9:51 AM THE FEE ABOVE INCLUDES A$0.26 PER THOUSAND CT STATE EDUCATION SURCHARGE