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Home My WebLink About20 ROBERT DR I� LICATION FOR BUILDING PERMIT Electric # Q Plumbing# RHrZ V 8 0 017 9 Date: HVAC # .0 outh Sprinkler# Ifl sor FINAL RQV S T Estimated Cost $ 61 q g - - ------ - - -- -- — Buildin o COMPLETE RED BOXED AREAS Permit Fee $ 9O Engineering TYPE OR PRINT ONLY Occupancy Fee $ 1 Affidavit SIGN ON REVERSE SIDE Eng. Insp. Fee $ Appr. for C=DING I Total Fee $ TO THE PARTMENT,TOWN OF SOUTH WINDSOR, CT (Additional Cost) $ The undersigned hereby applies to do work according to the following: �� Applicant Location of Work Lot No. Applicant's Address E CG Oro e r+ 1 r.�, Tel.# 96,�-�� ow3 Town ' Iry- Zip (e) (e o 7 L( Lic.# Owner Architect KwTz'e- F4M y S [Sq. r's Address Architect's Address .214 We Zip �!( f a-c i Zip�� . New Area: 1 st FI. Cox Z 2nd FI. 3rd FI. Total New Area 3 ijse of this pe it j City Water❑ Well❑ Septic System❑ Sewer❑ Ins: HOSP Cert. Area Basement Garage Approved'�6y Date O Use Group Construction Type Revised 6/02 <Oco511 I hereby agree to conform to all the requirements of the Laws of the State of Connecticut and the Ordinances of the Towi`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 locae proper distance from all street lines,side yard lines,and required distances from all other zones and is located in whic�buding Use is allowed. Signed I hereby apply for a Certificate of cup ,�i ribed in this application for the permit. Signed )) N. T WIkli EL04tirTHIS LINE i INSPECTION COMMENTS BUILDING PERMIT STATE OF CONNECTICUT WORKERS'COMPENSATION COMMISSION Building Permit Affidavit for Property Owners or Sole Proprietors (Conn.Gen.Stat. §31-286b) Property located at_ JO f-o�c r4- t r In the town of , ' �,{-c►� „ti�c,�,r Name of building permit applicant: y 0-- r.t� ,(C- Please check one: 1.-41 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"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._CI do not intend to act as a general contractor or principal employer. [Sign nd sto here] Si a o licant 2._I int nd to act as a general contractor or principal employer.Applicant must either p ide 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 ELECTRICAL PERMIT T# Application is hereby: TOWN OF SOUTH WINDSOR PERMIT� ERMI BUILDING DEPARTMENT APPROVE 1540 SULLIVAN AVENUE Bldg.Permit# 644-2511 ext. 230 �bptlCt Date 'ding Inspector Application must be printed or typed FEE SCHEDULE Location of Job: $0-$1,000=$15.00 Street No. Street :IL-ot No. Over$1,000= $15.00 per$1,000 or any fraction thereof Tenant Designation A APPLICANTyle �honc� APPLICANT ADDRESS APPLICANT PHONE# C 82'O l 0 "S pW N S j , OWNER Lju OWNER ADDRESS i OWNER PHONE 0 3 C ESTIMATED COST$ OQ ..� x IS THIS A CONTRACT COST? Yes _No L FEE ENCLOSED$ , rSO CO TYPE OF JOB: R New Installation _Alteration/Addition/Repair Revised 4/01//2002 APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A BUILDING PERMIT APPLICATION? 51 YES ❑ NO ❑RESIDENTIAL ❑BUSINESS CURRENT USE AND OCCUPANCY ❑ASSEMBLY ElMERCANTILE FUTURE USE AND OCCUPANCY 3- i &V ❑ EDUCATIONAL ❑ INSTITUTIONAL -- ❑FACTORY ENGINEER'S NAME r 4Z&c,,^5 PHONE *STORAGE (l ❑GARAGE ADDRESS a�te aJ c, ni- ` .,S ❑MIXED USE CITY (`�.�, ti STATE L� ZIP d (�_D 2-9( (Other please specify) TYPE OF INSTALLATION/WIRING METHOD SIZE OF SERVICE SIZE OF MAIN CONDUCTORS NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS NUMBER OF PANELS REMOTE DISCONNECT REQUIRED? ❑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. DESCRIPTION OF WORK 40 1 tti 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 qzzkag> j,u t_v.j A-4- 'Loll 200.6 0 � 179.15 21 .45 0 w � 0 SKfD Z M Z` 0 L6 �� Legend N r J Parcels Buildings ■ Co Co 170.86 M "' c0,m SF� Lo � r C � a r M T-- �Cb GO cb-�/ � `South Windsor rQ 00 s GIS 142.35 00.0 72.6 •� I 3 2 �, MAPPING PROVIDED BY SBC UNDER CONTRACT. DATA MANAGED BY THE SOUTH WINDSOR o 35 70 140 ENGINEERING DEPARTMENT AND IT TECHNOLOGY F" DEPARTMENT. i C� OdC� APR 2 2 200e D South Windsor BUILDING DEPARTMENT ,n •rd , t t•' s of the propcsra oull,l.ng r-ctcd at ;2_6 (� U-1- r b.gether with amendments elel d in aap;;c,,tton �.nt filed with plan and I agree to cc,,ply with at, zoninc Pudding and state laws and sech orders as rh,Ii b, issued by the Building Department during -f this eppljeat on and fj p 6 Dend.-n�•, issuance of a bultdini permit. Signed I pla I pprov- subject to the eondltlon that order and i. ees regulating building shell be complied with. Conditionelly Approved These filed with Building Inspector Cllleri "tat• CERTIFICATION OF ZONING COMPLIANCE in c _ ;s r. Date J t,,, i:r; rceMent Oificer DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT PERMIT# Application is hereby: TOWN OF SOUTH WINDSOR BUILDING DEPARTMENT APPROVED 1540 SULLIVAN AVENUE Bldg.Permit# 644-2511 ext. 230 Date Building Inspector Application must be printed or typed FEE SCHEDULE Location of Job: FTenant goPC--,�T b e$0-$1,000=$15.00 Street Lot No.Over$1,000$15.00 per$1,000 or any fraction thereof gnation Apt. No. APPLICANT Z2� / t, l n APPLICANT ADDRESS �D �oX � g 1,5dZ 0ILDAU �- B PA A�> i3rz�o�c, APPLICANT PHONnE�# OW N SF4 OWNER OWNER ADDRESS 3 7 SC 2 /A(ago,t 6(al OWNER PHONE ;> O C = ESTIMATED COST$ IS THIS A CONTRACT COST? _Yes _No _ Grp FEE ENCLOSED$ eb TYPE OF JOB: OR•C New Installation Alteration/Addition/Repair APPLICATION FOR HVAC PERMIT (Continued from reverse side) TYPE,OF S STEM: TYPE OF B LDING: OF OF ❑COMMERCIAL 0 VENTILATION ❑ INDUSTRIAL HEATING 0 STEAM LOW PRESRE LIMIT LBS. HIGH PRESSURE LIMIT LBS. ❑HYDRONIC U'WARM AIR O UNIT RADIANT HEATER EXISTING RADIATION ADDITIONAL RADIATION TOTAL RADIATION DESIGN TEMP. OUTSIDE OF INSIDE OF DIFFERENCE OF TOTAL HEAT LOSS(BTUH) OF(HEAT LOSS SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL HEATING EQUIPMENT(INCLUDING MAKE&MODEL NO.) GROSS HEATING CAPACITY(INPUT—BTUH) /6 0 NET RATING(OUTPUT—BTUH) Z,2 Q TYPE OF FUEL Cl OIL—GPM OIL TANK LOCATION :O INSIDE❑ OUTSIDE CAPACITY EFdAS—INPUT LPG TANK CAPACITY ELECTRIC—KW 41/ Tu 4 f 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.) Co[L-- L p1) �x 9ee, - ;L- 13 SE�F-k— TONNAGE 5 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 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. 50 CONTRACTORS LICENSE NO. TYP STATE SIGNATURE OF APPLICANT DATE )qlo T DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT E Application is hereby: TOWN OF SOUTH WINDSOR BUILDING DEPARTMENT APPROV DF., 1540 SULLIVAN AVENUE Bldg.Permit# 644-2511 ext. 230 tD'at�, Building In Application must be printed or typed FEE SCHEDULE Location of Job: __ Zeoiek 7- D`P• $0-$1,000=$15.00 Street No. Street Lot No. Over$1,000= $15.00 per$1,000 _ or any fraction thereof Tenant Designation Apt.No. APPLICANT APPLICANT ADDRESS 3 Sri' ✓c-a&I 7-1L /,? A) �Q 5 4J� iL/pSO� APPLICANT PHONE# �Z�- /SZ Z OW Ni S4. OWNER OWNER ADDRESS Ob $; �, OWNER PHONE C ESTIMATED COST$ . , w IS THIS A CONTRACT COST? AWYes No o (" �G FEE ENCLOSED$ 1� TYPE OF JOB: Cato-__ R CON New Installation ,c�Alteration/Addition/Repair Revised 4/01//2002 n� r APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A BUILDING PERMIT APPLICATION? ❑YES SLNO -RESIDENTIAL ❑BUSINESS❑ASSEMBLY CURRENT USE AND OCCUPANCY ❑MERCANTILE FUTURE USE AND OCCUPANCY ❑EDUCATIONAL ❑INSTITUTIONAL ❑FACTORY ENGINEER'S NAME PHONE ❑ STORAGE ❑GARAGE ADDRESS ❑MIXED USE CITY STATE ZIP (Other please specify) TYPE OF INSTALLATION/WIRING METHOD SIZE OF SERVICE SIZE OF MAIN CONDUCTORS NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS NUMBER OF PANELS REIVNOTE DISCONNECT REQUIRED? ❑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. DESCRIPTION OF,WORK GrpA /xe�e 4u7-i�Pl S �'G �4.`%C�/p r/ - B�%�/��/J2 S 6 TZ-e,-&C o e �k 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 N STATE SIGNATURE OF APPLICANT DATE /i BUILDING PERMIT , STATE OF CONNECTICUT WORKERS' COMPENSATION COMMISSION Building Permit Affidavit for Property Owners or Sole Proprietors (Conn.Gen.Stat.,§31-286b) Property located at ZO Rc xet r <� • In the town of Name of building permit applicant: i� � /C-y,I-- Please check one: 1. D 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._�o do not intend to act as a general contractor or principal employer. [Sign and stop here] c 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. Signature of applicant Subscribed and sworn to before me this day of ,200_. (Notary Public/Commissioner of the Superior Court) 1 DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT TOWN OF SOUTH WINDSOR PERMIT# Application is hereby: BUILDING ��- DEPARTMENT APPR VE 1540 SULLIVAN AVENUE Bldg.Permit# 644-2511 ext. 230 Date —Bu' ng Inspector Application must be printed or typed FEE SCHEDULE Location of Job: $0-$1,000=$15.00 F=TenantDesignation Street Lot No. Over$1,000= $15.00 per$1,000 or any fraction thereof Apt.No. APPLICANT -S C-d t4 Sc 1 C APPLICANT ADDRESS S 3 Mcq c r t4h r d APPLICANT PHONE# a ( 0 O W N S F,q OWNER tn( ke -t 4 U 7 11eQ a OWNER ADDRESS 0 o ff e r t- s t- Sc,v.-�. O , OWNER PHONE (Q aG 2- 3 c s Z 2 C = ESTIMATED COST$ 2 O d U w IS THIS A CONTRACT COST? 8� ✓Yes _No FEE ENCLOSED$ �JIJ S . • ONE TYPE OF JOB: OR C _New Installation hU _Alteration/Addition/Repair Revised 4/01//2002 ��) APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A BUILDING PERMIT APPLICATION? ❑ YES GMO ❑RESIDENTIAL 0 BUSINESS CURRENT USE AND OCCUPANCY ❑ASSEMBLY ❑MERCANTILE❑EDUCATIONAL FUTURE USE AND OCCUPANCY ❑INSTITUTIONAL 0 FACTORY ENGINEER'S NAME PHONE ❑ STORAGE ❑GARAGE ADDRESS ❑MIXED USE CITY STATE ZIP (Other please specify) TYPE OF INSTALLATION/WIRING METHOD SIZE OF SERVICE 2G G SIZE OF MAIN CONDUCTORS O G NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS NUMBER OF PANELS RENOOTE DISCONNECT REQUIRED? ❑YES ANO NUMBER OF LIGHT CIRCUITS NUMBER OF POWER CIRCUITS NUMBER OF SWITCHES � NUMBER OF OUTLETS NUMBER OF LIGHT FIXTURES `7 NUMBER OF HEAT CIRCUITS NUMBER OF A/C CIRCUITS SEPARATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED. DESCRIPTION OF WORK C.0 V , -2-00 A 01P 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 6"Z 2 20,02