HomeMy WebLinkAbout26 KRAWSKI DR Revised 4/01//2002
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
TOWN OF SOUTH WINDSOR PERMIT#
Applicatiogis hereby: I G00�l2
BUILDING DEPARTMENT
APPRO 1540 SULLIVAN AVENUE
Bldg.Permit
dq 644-2511 ext. 230 #
Date B ilding Inspector
Application must be printed or typed
FEE SCHEDULE Location of Job:
$0-$1,000=$15.00 Street No. Street Lot No.
Over$1,000=
$15.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT 0 ,
APPLICANT ADDRESS
APPLICANT PHONE#
1�0 W N St-4
t-4 OWNER �✓ �� •�h �/D N c h y
t: OWNER ADDRESS .24 /� ,-G.,✓5�c i r,'vt-
r. OWNER PHONE % 1l 0
C ;D ESTIMATED COST$ 16 do
t IS THIS A CONTRACT COST? _Yes �Io
FEE ENCLOSED$ UJ
fI� TYPE OF JOB:
�S p R-C 0 �New Installation
_Alteration/Addition/Repair
APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
BUILDING PERMIT APPLICATION? 0 YES 0 NO
P4ESIDENTIAL
U BUSINESS CURRENT USE AND OCCUPANCY
❑ASSEMBLY
Cl MERCANTILE FUTURE USE AND OCCUPANCY
❑EDUCATIONAL
O INSTITUTIONAL
0 FACTORY ENGINEER'S NAME PHONE
❑ STORAGE
0 GARAGE ADDRESS
0 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 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
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.
/a spy S
CONTRACTORS LICENSE YPE rSTATE
�i
SIGNATURE OF APPLICANT DATEL—f—v
r
INSPECTION FIELD SHEET 08/24/16
Printed by Peart, Dayshell 12 03 35
INSPECTION: 87850 PERMIT:
STATUS:
APPLICATION: 201601112
LOC: 26 KRAWSKI DRIVE
SOUTH WINDSOR
PROPERTY ID: 50700026
OWNER: DONAHUE DAVID W & JEANNE M
CONTRACTOR:
REQUEST BY:
PROJ DESC: REMOVE EXISTING ROOFING. INSTALL 6FT. ICE AND WATER SHIELD,
WORK ORDER:
INSPECTOR: CBiMM& RESULT: ARABS=.
REQUESTED: 08/18/16 PRIORITY:
SCHEDULED: 08/22/16 PM COMPLETED: y'r'26—*
UNPAID FEES 00 Date Time
MILEAGE: 00 TIME: TRAVEL ONSITE
COMMENTS
GARDNER & PETERSON ASSOCIATES'-"-'I749 NMTFORD TU%FPE TOLLAND, CONNECTICUT MW
N)F- LA CAVA C.0tAST9,UCT%C1"
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PERMIT PLAN
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LOT #29 - RIDGEFIEID �
o �
PREPARED FOR U & R aMMUCTION CO..9 INC. U)
TOWN OF SOUTH WINDSOR, CONNECTICUT a o
SCALE: 1" = 40'
I hereby declare that this map and survey were prepared in accordance with the
standards of a Class A-2 survey as defined in the Code of Practice For Standards
of Accuracy of Surveys and Maps, adopted December 10, 1975 as amended by the
Connecticut Association of Land Surveyors, Inc.
a '"' zQbqo
DATE: October 20, 1987 L.S. #10839
REFERENCE: Subdivision Plan Ridgefield Property of LaCava Construction
Company Felt Road South Windsor, Connecticut Close, Jensen & Miller
Wethersfield, Connecticut Scale 1" = 40' Date July 20, 1984 Revisions 8-10-8 J
ti�:
PROFESSIONAL ENGINEERS LAND SURVEYORS aZZ9- Z51 Q
p 0 v E D an
!" G; ;'^i ►'t".' ! �. ._. .FOR
r-.ATE: !���~o'7 _
Ccc.:- /�
Electric # APPLICATION FOR BUILDING PERMIT
Plurrbing# I
HVAC# It Knll Mkt 4�Y►V� Date: —41901"
Sprinkler# 1 (000511 Estimated Cost $
FINAL APPROVALS Permit Fee $ ,
Building COMPLETE RED BOXED AREAS Occupancy Fee $
Engineering — - TYPE OR PRINT ONLY Eng. Insp. Fee $
Affidavit
Appr.forCO. — I ► SIGN ON REVERSE SIDE Total Fee $
TO THE BUILDING D ARTMENT, TOWN OF SOUTH WINDSOR, CT (Additional Cost) $
The undersigned hereby applies to do work according to the following:
Applicant VAA90ww., Lis � R.r �.� C* -r Location of Work LotNo—
Applicant's Address C 5 (11A1?�ST Tel
Town C-t-A S Zip Er AD3 Z Lic.#
Owner r Architect
Owner's Address a?C.V [LA"4w- ' DM Architect's Address
Zip Zip-
Sq. Ft. New Area: 1st Fl..� 2nd FI. 3rd FI. Total New Area
Purpose of this permit 1�: -,—C e'X►=AC. .e�5�►��� �. 1.< f- 1Cc-/-,6 i.fqm 415'
F T Pr yvxp ">, Esat..s ''Zrz r
City Water J Well J Septic System J Sewer J
Ins: HO SP Area Basement Garage
Approved by I Date 9 ► t Use Group Construction Type
Revised 1108
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
APPLICATION FOR PLUMBING PERMIT (Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
(A RESIDENTIAL BUILDING PERMIT APPLICATION? ❑ YES 0 NO
❑BUSINESS CURRENT USE AND OCCUPANCY
❑ASSEMBLY
❑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_( 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
o
THE UNDERSIGNED HEREBY APPLIES FOR
A
PERMIT TO PERFORM THE WORK DESCRIBED AND IS T7--
COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE
PERFORMANCE OF SUCH WORK.
h7l,-c 975Yi 6-1
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT � ` '? _ DATE 5-11 VIP,�
DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT
TOWN OF SOUTH WINDSOR PERMIT#
Application is hereby: oo 1.
BUILDING DEPARTMENT
APPRO D 1540 SULLIVAN AVENUE Bldg.Permit#
�< 644-2511 ext. 230
Date Building Inspector
Application must be printed or typed
FEE SCHEDULE ,,// Location of Job:
$0-$1,000=$I5.00 Street No. kt c to sk i nA Street Lot No.
Over$1,000=
$15.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT EDCZ4,S
APPLICANT ADDRESS
_t F o Z31
APPLICANT PHONE# �LnC� " o?�S - 6 7
SOW N St-4 OWNER [�-t'�r < pwiC'.- v e
OWNER ADDRESS 2 1c rc�CyS D J2 -QQ
,l T
(107 OWNER PHONE
C ESTIMATED COST$ ys'&
•� ,� U
•�; IS THIS A CONTRACT COST? _Yes �No
�G FEE ENCLOSED$�S'
Oly� TYPE OF JOB: 91 -
OR-CO New Installation
Alteration/Addition/Repair
Revised 4/01//2002
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ACORD,N, CERTIFICATE OF LIABILITY INSURANCE 11/1/2009 DA 11/11/2008 YY)
PRODUCER Lockton Companies,LLC-1 Kansas City THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
444 W.47th Street,Suite 900 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Kansas City MO 64112-1906 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
(816)960-9000
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE NAIC#
INSURED INERGY,LP INSURER A: ACE AMERICAN INS CO NAIC#02257
1059799 2 BRUSH CREEK BLVD. INSURER e: AEGIS AM BEST 85055
SIUTE#200 INSURER C:
KANSAS CITY,MO 64112
INSURER D:
INSURER E .
COVERAGES INERGOI YA THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING
INSURER 3,AUTHORED RE►RESENTATNE OR PRODUCER AND THE CERTIFICATE HOLDER.
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING
ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADM POLICY EFFECTIVE POLICY EXPIRATION
LTR INSRt TYPE OF INSURANCE POLICY NUMBER DATE(MMIDDIM DATE MM/D LIMITS
GENERAL LIABILITY EACH OCCURRENCE 1,500,000
TED
A X COMMERCIAL GENERAL LIABILITY XSLG23743528 11/1/2008 11/1/2009 PREMSET Ea�oecurence s 100,000
CWMS MADE r-'OCCUR MED EXP(Any one person) S X)0=XX
X (500K SIR) PERSONAL A ADV INJURY s 1,500,000
GENERAL AGGREGATE S 2,000,000
GENL AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG S 2,000,000
X POLICY JECT n LOC
AUTOMOBILE LIABILITY , COMBINED SINGLE LIMIT S 2,000,000
A X ANYAUTO ISAH08249015 11/1/2008 11/1/2009 (Ea ardent)
ALL OWNED AUTOS
BODILY INJURY $
SCHEDULED AUTOS (Per p—)
X HIRED AUTOS BODILY INJURY S X)O XXXX
X NON-OWNED AUTOS (Per accident)
X MCS 90 INCLUDED
PROPERTY DAMAGE
(Per accident) S XXX XXKX
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S XXX)DCCK
- RANY AUTO NOT APPLICABLE OTHER THAN EA ACC S )DODO=
AUTO ONLY: AGG S )Q{XXXXX
EXCESSAIMBRELLA LIABILITY EACH OCCURRENCE S 4000,000
B OCCUR ❑X CLAIMSMADE X2045AIA08 11/1/2008 11/1/2009 AGGREGATE s 4000.000
UMBRELLA S XXX)O'(XX
DEDUCTIBLE 0 FORM S XXXXXXX
RETENTION S S )OCXXXXX
WORKERS COMPENSATION AND X WC STATU- OTH-
A WLRC44356090(AOS) 11/1/2008 11/1/2009 TORv LIMITS ER
A ANY PROPRIETORIPARTNER/EXECUTNE EMPLOYERS LI RY SCFC44356132(WI) 11/1/2008 11/1/2009 EL EACH ACCIDENT S 1,000,000
RJP
A OFFICER/MEMBER EXCLUDED? NO NEW YORK INCLUDED IN 3A EJ_DISEASE-EA EMPLO S 1,000,000
If
describe under
SPECIAL PROVISIONS below EJ-DISEASE-POLICY LIMB I s 1,000,000
OTHER
A CARGO ISAH08249015 11/1/2008 11/1/2009 $100,000
DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION
3959865 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
REPRESENTATIVES.
AUTHOR RESENTATIVE
ACORD 25(2001/08) Faroe amWd w cunc.%k b.NsWinV.W.&.r..aan.eo...w p--re,.dwilille6ft iWItraw. CACORD CORPORATION 1988 i
I
REMOVALTankworks
February 12, 2001
Ms. Jeanne Donahue
26 Krawski Drive
South Windsor, CT 06074
Re: Removal and Disposal of(1)- 1000 gallon underground heating oil tank&
Installation of(1)-330 gallon interior heating oil tank
At: 26 Krawski Drive,South Windsor,Connecticut 06074
Dear Ms. Donahue :
Thank you for the opportunity to service the removal and replacement of the buried oil tank at the above
referenced address. The work was performed in accordance with E.P.A.Regulations and N.F.P.A.30 and
30A Requirements.
William Lanning,the Fire Marshal for the Town of South Windsor,was on site at the time of the removal
and inspected the tank and the tank grave. The soil in the grave showed no signs of contamination and
was backfilled. The inspection records remain at the Town of South Windsor, should you need to
reference them.
Before backfillin 1 g one( )final confirmation soil sample was collected and tested at an independent lab
for Total Petroleum Hydrocarbons(TPH)by IR(Method 418,1). The sample result for the bottom of the
tank grave indicated that any trace of TPH was Below Detection Limit(BDL). This result is within the limit
set forth by The Connecticut Department of Environmental Protection. The TPH limit in a GA Groundwater
classification is 500 parts per million(ppm).
This letter, along with the attached soil sample result, should be stored safely with all legal documents
pertaining to this property. This information,along with your Tankworks invoice and cancelled check(s),
will serve as verification for future reference.
Please feel free to call us if you have any further questions. It has been a pleasure working with you. We
hope that you are pleased with our services and that you will recommend us to others.
Very truly yours,
TANKWORKS REMOVAL& REPLACEMENT LLC
�iiw�LLa�
�f C (OPYRosemary Viola Rainville
Owner
cc: William Lanning,Fire Marshal,Town of South Windsor
OFFICES IN MANCHESTER - M A D I S O N - WILTON
v:wadPtrta,sa%ff'Us
Office 360 East Center St. Manchester CT 0604 a
•,---; �
''�f 1 a � e ���
��� •�
EmMmmentcd Labomtories.ht
587 East Midde Tumpike. P.O Box 418.Mwichesier.CT 06040
Tel.(880)645.1102 Fax(860)845-=3
Analysis Report FOR: Attn:Mr.Tim Lynch
Tankworks,Inc.
October 27,2000 360 East
Center Street
Manchester CT 06040
Sample Information Custody Information Date Time
Matrix: SOLID Collected by: TL 10/23/00 10:00
Location Code: TANKWKS Received by: SW 10/24/00 15:00
Project Code: RUSH# Analyzed by: see below
P.O.#:
Laboratory Data
Client ID: 26 KRAWSKI DR S WINDSOR BOTTOM Phoenix I.D. AC96720
Parameter Result RL Units Date by Reference
Percent Solid 90 % 10/24/00 B/D E160.3
Tot.Petroleum HC BDL 22 mg/Kg 10/25/00 GD E418.1
Comments: ND--Not detected BDL=Below Detection Limit RL=Reporting Limit
If there are any questions regarding this data,please call Phoenix Client Services at extension 200.
I
Phydler,Laboratory Director
October 27,2000
1600511 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER BUILDING PERMIT
DATE: 08/17/2016
GIS ID: 50700026 FEE: 120.00
MUNIS APPLICATION# 201601112 BUILDING DESCRIPTION:
APPLICANT' LOCATION
NAME: HARMONY HOME IMPROVEMENT, ADDRESS:' 26 KRAWSKI DRIVE
ADDRESS: 2389 MAIN STREET„ OWNER: DONAHUE DAVID W&JEANNE M
GLASTONBURY,CT 06033 -- 26 KRAWSKI DR
SOUTH;WINDSOR,CT 06074
DESCRIPTION OF WORK: REMOVE EXISTING ROOFING.INSTALL 6FT.ICE AND WATER SHIELD,
15LB. FELT PAPER,F5 DRIP EDGE,STARTER STRIPS,GAF
TIMBERLINE HD SHINGLES, RIDGE VENT AND RIDGE CAP SHINGLES.
SPECIAL CONDITIONS:
ALL WORK TO BE DONE IN ACCORDANCE WITH THE APPLICATION AND PLANS APPROVED BY THE BUILDING DEPARTMENT.
CONSTRUCTION TYPE:
OCCUPANCY GROUP: BUILDING OFFICIAL
8/17/2016 3:03 PM TILE FEE ABOVE INCLUDES A$0.26 PER THOUSAND CT STATE EDUCATION SURCHARGE