HomeMy WebLinkAbout20 PLUM LN Electric# E C E APPLICATION FOR BUILDING PERMIT
Plumbing# 20 P 1 U 7 310 6 3 Date:
HVAC # - -
Sprinkler#
FINAL APPROVALS -F100, SIGN
- -- Estimated Cost $ vsUltu7NGOE tt�— Permit Fee $Building PLETE RED BOXED AREAS 1 1 Occupancy Fee $ 1Engineering YPE OR PRINT ONLY Eng. Insp. Fee $
Affidavit
A r. for CO. ON REVERSE SIDE
PP -- - - --- - - Total Fee 6
66 - $
TO THE BUILDING DEPARTMENT,TOWN OF SOUTH WINDSOR, CT (Additional Cost) $
The undersigned hereby applies to do work according to the following:
Applicant :r0-;&1) Location of Work --'70 A—III L19-� S. '--I, Lot No.
Applicant's Address v90 Tel.#
Town So &Aj/ --o.So.2 GT Zip Lic.# S bn
Owner Th/.*J �`1� +-�Sk Architect
Owner's Address 4PLo PL---*► Architect's Address_
Zip Zip
Sq. Ft. New Area: 1st FI. 2nd FI. 3rd FI. Total New Area
Purpose of this permit 2L_ _5. 4-- S/?�i-✓G
City WaterL� %Nell❑ Septic System[-] Sewer❑
Ins: HO SP Cert Area Basement Garage
Approved by qDate f 0 Use Group Construction Type
Revised 6/02
13��
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 looted in which this building and its use is allowed.
I/gn ---
I hereby apply for a((((((Certificate of ccu ancy for the work described in this application for the permit.
ign �-
DO NOT WRITE BELOW THIS LINE
INSPECTION COMMENTS
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Lot numbers refer to map
entitled, "Subdivision ?tap,
Farnham Estates, Property of
I. h. Stich :Associates, Inc. ,
Rye Street, South Windsor, Conn.
Scale 1" - 401 , Sept. 19, 19570
Sheets, certified Substantially
Correct, -brton S. Fine)
�oE C o rr tiF PROPOSED LAYOUT
ON S. FARNIM ESTATES
I hereby certify that this v~,� '`' �". �, PLUM►LANE
map is substantially cor- * {. . ` x SOUTH WINDSOR, CONNECTICUT
rest and no zoning regula- 'mac No. 2931 ��o
tioas have been violated . ,r; �� SCALE 1" = 401 OCT. 280 1958
\°Eo LAO MORTON S. KNF, C.E. -L. S.
������ HARTFORD, CONN.
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South Undsor
BUILDINIG DEPARTMENT
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to l:F %'[L. ..: 1. ivt,.d CF lH vewpsw • n r
This certifi d to-•t has FI•q "d sp leeUoos are •° yy
eoptes of the Vropnsetl 6ullding orr a ctM b.lterns !o D- ,ars!j
erected at
r.•'.r
Street
together with amendments stated in application and
filed with pl.•n and I —!rra to rrmply with all zoning, _
Budding and stite le-vs and su:h orders as shall be _
Issued by the ❑ul'rhng Dopartm^nt during
_ g pendency
of this appl;cati,,n and final issuance of a buUding
Permit.
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w
This .�n s opprpv^d sub)ect to the condition that
orders ..ad ordinances r�gulathng ouilding shall b-
COmpiied •eith ...
pondItionally Appnwed These filed with "
Building Insn ctor Clerk
Vat-
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CEE'Tr17ICl1TION OE ZONING CnaeoL.IAMCE
Prop;
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i►uly irorcement Or;�c�r �"
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BUILDING PERMIT
STATE OF CONNECTICUT
WORKER 'S COMPENSATION COMMISSION
Building Permit Affidavit for Property Owners or Sole Proprietors
(Conn.Gen.Stat. § 31-286b)
Property located at cP-q
In the town of .�
Name of building permit applicant:_77,, -1 /`�cl�,g-c,✓J/G
Please ch one:
I'fJ 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(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
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.
'J
Si ature of applicant AUG
Subscribed an om to before me this day of Soutri w� ,200 .
buiLUING DEPARTMENT
(Notary Public/Commissioner of the Superior Court)
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South Windsor
BUILDING DEPARTMENT
10 THE BUILD1146 DEFT. TOWN OF 5 „TH WJK950h
This certified that this plan and speciricatlnns are true
erected at
copies Of the proposad building or atteraUora to be
ttroet
together with emendmon.< �i"--
Sint" in arpNeatlOn n^p
fried with plan and I epree to romoly with of; =ore:g,
Building and state la•»s and ;•n_h orders ss ahwtl Ce
Issued by the Eal!ding Department During pnndaney Of this application and final Issuance during
a bacfency Permit.
S1gr)
Thi pia Is apprnoed subject to the crn1N*or.
Orders ad ordtnanccs regulatingthat
Compiled with. baddln8 shall b;
Pondttioerally Approved Tbase W-
d Wlt.'J
Building Inspcctof
rcl�ftli
Date
Ho'
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
TOWN OF SOUTH WINDSOR PERMIT#
ApplicaF* .
BUILDING DEPARTMENT
AP 1540 SULLIVAN AVENUE
la,� 644-2511 ext. 230 Bldg.Permit#
Date mg Inspector
Application must be printed or typed
FEE SCHEDULE
Location of Job:
Rol, I-AnP
$0-$1,000=$15.00 FTenant
Street Lot No.
Over$1,000=
$15.00 per$1,000
or any fraction thereof gnation Apt.No.
APPLICANT W>A p, If
APPLICANT ADDRESS
nip y;
APPLICANT PHONE# Vo - 72a q Z/f
OWN S F,q OWNER �O�i n 177of A gs k,
OWNER ADDRESS
n r�o7V
CIO) a F" OWNER PHONE F(C) •oZ g9 ' ��D C7
C ESTIMATED COST$ ?OO O.��
xIS THIS A CONTRACT COST? _Yes _No
FEE ENCLOSED$
TYPE OF JOB:
SOR•CD New Installation
1,--A'Iteration/Addition/Repair
Revised 4/0I//2002
APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH
RESIDENTIAL BUILDING PERMIT APPLICATION? ❑YES ENO
❑BUSINESS CURRENT USE AND OCCUPANCY
❑ASSEMBLY
❑MERCANTILE FUTURE USE AND OCCUPANCY
❑EDUCATIONAL
❑INSTITUTIONAL
0 FACTORY ENGINEER'S NAME PHONE
❑ STORAGE
U GARAGE ADDRESS
O MIXED USE
CITY STATE ZIP
(Other please specify)
TYPE OF INSTALLATION/WIRING METHOD (D,1f kKd
SIZE OF SERVICE 3 -jo SIZE OF MAIN CONDUCTORS �O D /w ctl,
NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS
NUMBER OF PANELS REMOTE DISCONNECT REQUIRED? L YES ❑NO
NUMBER 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.
L l � 1 DESCRIPTION OF WORK
�'+ ^
l /l Agi I.n /yl�e7"Pr �� �.(T Anal ye,$7Pl 6n 74-P-e- Floor—
/o/OS�7
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. � TYPE STATE
SIGNATURE OF APPLICANT DATE /0— 9- a 7
Cop ore
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y
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South Windsor
BUILDING DEPARTMENT
M THE BUILDINC DEPT. TOWN OF SOUlm WIlibigi
this Certified that this plan and specifications are t—
copies of the proposed building or alterations to L-
erected at n
tkU
Sir
together with amendments stated in applic tion
liled with plan and I agree to comply with all
Building and state laws and such orders as
issued by the Building Department during peso,
If this application and final issyance of a build,n.
permit.
Signe
This Vn , approved subject to the Condition th
orders and ordinances regulatrng building shall b
complied with.
Conditionally Approved These filed with
Building Inspector Clerk
011t! lLM: bS 4-
4313
CERTIFICATION OF ZONING COMPLIANCE
Proposed buiiding(s), use(s) andjor structure(
7 sho,,n on 'h;s pion a � . , .sj .o ce
with cu.-remth ivlii;;
,-da Ions. Variances and spec;::.l exceptic,
,y apply.
.ate
Vfihiing P#ccement Officer
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NDMAGR SURvsg
WENMIAS J. & C. FRAWXS SlXmMD
FARNHAX ESTATM
PLUM T-w
soum fiINDSOR* CONNECTICUT
zv CON ryF PROPOSED LAYOUT
FARNHAM ESTATES
r
L hereby certify that this �� ° ��► PLiJNVANE
tag is sahatantiallg car— ,k : . �. SOIITfi WINDSOR* CONNECTICUT
rect anti as zoning regula- �c NaL MI �Si SCALE 1"` = 40P OCT. 20, I.958i
tions have heea vialated. s,F�fn LA140 KGRTON S. FINE, C.R..-L.S.
— HARTFORD, CONY.
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t numbers refer to map
entitled, "Subdivision Map,
Farnham Estates, Property'of
I,. R,.'Stieh'`Aaqociates, ,Inc.,,: t. eta Sot�tl. 11ISOT,-CQI}A.•1
Scale .i" 40 t, Segt., 14, 1957, � i ,. •°t �
Sheet5, Certified Substantially
Correct, Morton,S. Fine, C.E. . .\ j
ar NORTCACdS.QR -
IvT.NCESLAS 3 '', 6 C: F ?.x
FARNHAW ESTAT `
PLUM.LANE
SOUTH WINASOR'�CONNECTICUTpk
Corr yF PROPO=' LAYO
t o N s e� FARNHA2f ESTATES?,., .
I hereby ,certify: that this co
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x C. SOUTH WDD.SOR CON;ECTICUT ,"
map,-.is, substantially .cor- x
r.ect and no zoning regula- No. 293i ��o ', SCALE. I"' �I O%r.4 28�}195 'i
t'ions have been violated.
vat - - -
0 UKus ' "+�ORTON.
HARTFORtr CO