HomeMy WebLinkAbout268 SAND HILL RD Electric# APPLICATION FOR BUILDING PERMIT
Plumbing# 268 Sand Hill Road
HVAC # Date:
Sprinkler# No. 13000275
FINAL APPROVALS Estimated Cost
Building COMPLETE RED BOXED AREAS Permit Fee $ yS
Engineering TYPE OR PRINT ONLY Occupancy Fee $
Affidavit147
SIGN ON REVERSE SIDE " �l
Appr.for CO. Total Fee S
TO BUILDING DEPARTMENT,TOWN OF SOUTH WINDSOR,CT (Additional Cost) $
The undersigned hereby applies to do work according to the following specifications: *1�3�9
Job Location -44,FJ" *Z//40,.14�a1j'4 <v,CT.0(,,c7y Lot No. Side of Street Zone
Applicant kf,?,hkW1SCa Tel#9& &4&Y1`X
Address gkc.Ce J- f2 Lr i p&V vp Lic.# 9 T6 f 7 3 CI-1 Co Q-.3'�
Owner De/) M/ -k Address: f.Sdirl % �� �✓Lt. 0�`�
Architect 6A Address
Sq. Ft.New Area: 1st FL 2nd FI. 3rd Fl. Total New Area
#Rooms #Lavatories_ #Bathrooms #Garages
Purpose of this permit: Ad.22p✓ J17 /-SSU JS T d.- Le4h & - wZ
1—a 7-5 ROTH 5-7— &Q/ rsn S A 13,
City Water ❑ Well 0 Septic System ❑ Sewer ❑ 2al 7p
Ins. H.O. S.P. Area Basement Garage
Approved by �'c Date Use Group Construction Type
Revised 9/01
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
pI.NNSSPECTION COMMENTS
c>
DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT
TOWN OF SOUTH WINDSOR PERMIT#
Appl' ti is reby-
BUILDING DEPARTMENT
APPRO 1540 SULLIVAN AVENUE
Bldg.Permit#
� 644-2511 ext. 230
Date rldi,6
Inspector
Application must be printed or typed
FEE SCHEDULE Location of Job:
$0-$1,000=$15.00 FTenant
Street Lot No.
Over$1,000=
$15.00 per$1,000
or any fraction thereof gnation Apt.No.
APPLICANT C k^vt t C E I
APPLICANT ADDRESS 1 5
o
APPLICANT PHONE# Z--7
OWN Ste: OWNER z-I4A.
q� OWNER ADDRESS
Q
OWNER PHONE Co 44 —O 3
C ESTIMATED COST$ ��
N
IS THIS A CONTRACT COST? ""Yes _No
(J FEE ENCLOSED$
TYPE OF JOB:
SO C0 New Installation
..-'-Alteration/Addition/Repair
Revised 4/01//2002
APPLICATION FOR HVAC PERMIT (Continued from reverse side)
TYPE OF SYSTEM: TYPE VELDING:
❑HEATING SIDENTIAL
Q,r'A/C ❑ COMMERCIAL
❑ VENTILATION Cl INDUSTRIAL
HEATING
❑ STEAM LOW PRESSURE LIMIT LBS. HIGH PRESSURE LIMIT LBS.
❑HYDRONIC ❑WARM AIR ❑ 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) NET RATING(OUTPUT—BTUH)
TYPE OF FUEL
❑OIL--GPM OIL TANK LOCATION :❑ INSIDE❑ OUTSIDE CAPACITY
❑GAS—INPUT LPG TANK CAPACITY ELECTRIC—KW
AIR CONDITIONING
DESIGN TEMP.OUTSIDE OF INSIDE -7 5' OF DIFFERENCE OF
TOTAL HEAT GAIN(BTUH) (HEAT GAIN SHEET MUST ACCOMPANY APPLICATION)
DESCRIBE ALL FOOL G EQUIPMENT(INCLUDING MAKE&MODEL NO.) i
21 C Ci"L w TC V\- i (a 5 c'-K-- S"e,1L
TONNAGE p3 COOLING CAPACITY(BTUH)
VENTILATION N�'Q t- (% h�`� �G '� �'` a '2 '�'" \+
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.
3()3 . \ 0 5 C -i- < Y/:;'l b �'
CONTRACTORS LICENSE NO. STATE
SIGNATURE OF APPLICANT DATE Iq to �,
Page 1 Residential Heat Loss and Heat Gain Calculation 3/8/2006
In accordance with ACCA Manual J
Report Prepared By:
John S. McCarthy Oil Co.
For: Peter D'Amato
t268_Sand_Hill Rd?
South Windsor, CT 06044
Design Conditions: Hartford
Indoor: Outdoor:
Summer temperature: 75 Summer temperature: 105
Winter temperature: 80 Winter temperature: -25
Relative humidity: 50 Summer grains of moisture: 100
Daily temperature range: High
Building Component Sensible Latent Total Total
Gain Gain Heat Gain Heat Loss
(BTUH) (BTUH) (BTUH) (BTUH)
Whole House 1,578 sq.tL 21,600 2,413 24,013 58,984
(2tons)
First Floor 21,600 2,413 24,013 58,984
Family Room 336 sq.-ft. 10,425 1,121 11,546 21,762
Infiltration 1,511 1,121 2,632 10,579
-Tightness:Avg.,_Winter ACH: .87, Summer ACH: .44
Floor 336 sq.ft. 249 0 249 1,305
-Over garage or open crawl space; Hardwood; R-30(8-9 inch)
N Wall 149 sq.ft. 256 0 256 939
-Wood frame,with sheathing, siding or brick; R-19 5 1/2 in., none
Window 40 sq.ft. 1,080 0 1,080 2,083
-Double pane; Vinyl frame; Clear glass
-No inside shading; Coating: None(clear glass); No outside shading.
E Wall 120 sq.ft. 206 0 206 756
-Wood frame,with sheathing, siding or brick; R-19 5 1/2 in., none
Window 24 sq.ft. 1,824 0 1,824 1,250
-Double pane; Vinyl frame; Clear glass
-No inside shading;Coating: None(clear glass); No outside shading.
W Wall 83.3 sq.ft. 143 0 143 525
-Wood frame,with sheathing, siding or brick_;_R_-19 51/2 in., none
Window 24 sq.ft. 1,824 0 1,824 1,250
-Double pane; Vinyl frame; Clear glass
-No inside shading; Coating: None(clear glass); No outside shading.
Window(2) 36.7 sq.ft. 2,789 0 2,789 1,911
-Double pane; Vinyl frame; Clear glass
-No inside shading;_Coating: None_(clear glass); No outside shading. _
Ceiling 336 sq.ft. 543 0 543 1,164
Page 2 Peter D'Amato 3/8/2006
Building Component Sensible Latent Total Total
Gain Gain Heat Gain Heat Loss
(BTUH) (BTUH) (BTUH) (BTUH)
-Under ventilated attic; R-30(8-9 inch); Dark
Dining Room 143 sq.ft. 391 0 391 1,084
Infiltration 0 0 0 0
-Tightness:Avg., Winter ACH: .87 , Summer ACH: .44
Floor 143 sq.ft. 0 0 0 0
-Over conditioned space
E Wall 93.5 sq.ft. 160 0 160 589
-Wood frame,with sheathing, siding or brick; R-19 5 1/2 in., none
Ceiling 143 sq.ft. 231 0 231 495
-Under ventilated attic; R-30(8-9 inch); Dark
Living Room 280 sq.ft. 2,976 449 3,425 14,188
Infiltration 604 449 1,053 4,231
-Tightness:Avg.,Winter_ACH: .87 , Summer ACH: .44
Fireplace 0 0 0 5,209
-Average-glass doors, damper
Floor 280 sq.ft. 0 0 0 0
-Over conditioned space
E Wall 119 sq.ft. 204 0 204 750
-Wood frame,with sheathing, siding or brick; R-19 5 1/2 in., none
S Wall 120 sq.ft. 206 0 206 756
-Wood frame_,with sheathing, siding or brick; R-19 5 1/2 in., none
Window 32 sq.ft. 1,344 0 1,344 1,667
-Double pane;Vinyl frame; Clear glass
-No inside shading; Coating: None(clear glass); No outside shading.
Door 18 sq.ft. 165 0 165 605
-Wood; Solid; Metal storm
Ceiling 280 sq.ft. 453 0 453 970
-Under ventilated attic; R-30(8-9 inch); Dark
Kitchen 154 sq.ft. 790 81 871 2,458
Infiltration 109 81 190 762
-Tightness:Avg., Winter ACH: .87 ,__Summer ACH: .44
Floor 154 sq.ft. 0 0 0 0
-Over conditioned space
N Wall 110 sq.ft. 189 0 189 693
-Wood frame,with sheathing, siding_ or brick; R-19 5 1/2 in., none _
Window 9 sqA 243 0 243 469
-Double pane;Vinyl frame; Clear glass
-No inside shading; Coating: None(clear glass); No outside shading.
Ceiling 154 sq.ft. 249 0 249 534
-Under ventilated attic; R-30(8-9 inch); Dark
Bedroom 121 sq.ft. 1,404 179 1,583 3,617
Infiltration 242 179 421 1,693
Page 3 Peter D'Amato 3/8/2006
Building Component Sensible Latent Total Total
Gain Gain Heat Gain Heat Loss
(BTUH) (BTUH) (BTUH) (BTUH)
-Tightness:Avg.,Winter ACH: .87, Summer ACH: .44
Floor 121 sq.ft. 0 0 0 0
-Over conditioned space
S Wall 73.5 sq.ft. 126 0 126 463
-Wood frame,with sheathing, siding or brick; R-19 5 1/2 in., none
Window 20 sq.ft. 840 0 840 1,042
-Double pane;Vinyl frame;Clear glass
-No inside shading_;_Coating: None__(clear glass); No outside__s_h_a_ding.
Ceiling 121 sq.ft. 196 0 196 419
-Under ventilated attic; R-30(8-9 inch); Dark
Bedroom (2) 154 sq.ft. 2,339 278 2,617 6,499
Infiltration 375 278 653 2,623
-Tightness: Avg_.,Winter ACH: .87, Summer ACH: .44
Floor 154 sq.ft 114 0 114 598
-Over garage_or open crawl space_; Hardwood; R-30(8-9 inch)
S Wall 108.3 sq.ft. 186 0 186 682
-Wood frame,with sheathing, siding or brick; R-19 5 1/2 in., none
Window 10.7 sq.ft. 449 0 449 557
-Double pane;Vinyl frame; Clear glass
-No inside shading;Coating: None(clear glass); No outside shading.
S Wall (2) 73.5 sq.ft. 126 0 126 463
-Wood frame,with sheathing, siding or brick; R-19 5 1/2 in., none
Window 20 sq.ft. 840 0 840 1,042
-Double pane;Vinyl frame; Clear glass
-No inside shading; Coating: None(clear glass); No outside shading.
Ceiling 154 sq.ft. 249 0 249 534
-Under ventilated attic; R-30(8-9 inch); Dark
Bedroom (3) 210 sq.ft. 2,593 278 2,871 7,126
Infiltration 375 278 653 2,623
-Tightness:Avg.,Winter ACH: .87, Summer ACH: .44
Floor 210 sq.ft. 155 0 155 816
-Over garage or open crawl space; Hardwood; R-30(8-9 inch)_
W Wall 116.8 sq.ft. 200 0 200 736
-Wood frame,with sheathing, siding or brick_; R-19 5 1/2 in., none
Window 10.7 sq.ft. 813 0 813 557
-Double pane;Vinyl frame; Clear glass
-No inside shading; Coating: None(clear glass); No outside shading.
N Wall 99 sq.ft. 170 0 170 624
-Wood frame,with sheathing, siding or brick; R-19 5 1/2 in., none
Window 20 sq.ft. 540 0 540 1,042
-Double pane; Vinyl frame; Clear glass
-No inside shading;Coating: Non_e_(cle_ar_g_ lass_); No outside-shading.
Ceiling 210 sq.ft. 340 0 340 728
Page 4 Peter D'Amato 3/8/2006
Building Component Sensible Latent Total Total
Gain Gain Heat Gain Heat Loss
(BTUH) (BTUH) (BTUH) (BTUH)
-Under ventilated attic; R-30(8-9 inch); Dark
Bathroom 80 sq.ft. 446 27 473 1,515
Infiltration 36 27 63 254
-Tightness:A_vg_.,Winter ACH: .87, Summer ACH: .44
Floor 80 sq.ft. 59 0 59 311
-Over garage or open crawl space; Hardwood; R_-30(8-9 inch)
N Wall 82 sq.ft. 141 0 141 517
-Wood frame,with sheathing, siding or brick; R-19 51/2 in_., none
Window 3 sq.ft. 81 0 81 156
-Double pane;Vinyl frame; Clear glass
-No inside shading_;_Coating:_None_ (clear glass); No outside shading.
Ceiling 80 sq.ft. 129 0 129 277
-Under ventilated attic; R-30(8-9 inch_); Dark
Bathroom(2) 100 sq.ft. 236 0 236 735
Infiltration 0 0 0 0
-Tightness_:Avg.,Winter ACH: .87, Summer_ACH: .44
Floor 100 sq.ft. 74 0 74 389
-Over garage or open crawl space; Hardwood; R-30_(8-9 9 inch)
Ceiling 100 sq.ft. 162 0 162 346
-Under ventilated attic; R-30(8--9 inch); Dark
Whole House 1,578 sqA 21,600 2,413 24,013 58,984
(2 tons)
HVAC-Calc Residential 4.0 by HVAC Computer Systems Ltd. 888 736-1101
Load calculations are estimates only,actual bads may vary due to weather and construction differences.
DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT
PERMIT#
Applicati ereby: TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
APPRO 1540 SULLIVAN AVENUE
Bldg. Permit#
644-2511 ext. 230
bate B it t nspector
Application must be printed or typed
FEE SCHEDULE Location of Job:
FTenant
S
$0-$1,000=$15.00 Street Lot No.
Over$1,000=
$15.00 per$1,000
or any fraction thereof gnation Apt.No.
APPLICANT u N x( S M C-CA 7r NY c t^1 0
APPLICANT ADDRESS 1 Co 0 X k( 11 f t�2
(') L T f{Irr-,:�r +'1 L--,- i d Off, 1 e
APPLICANT PHONE#
OW N St. OWNER Ato
OWNER ADDRESS ,2 cCS S A 4"S
OWNER PHONE
C ESTIMATED COST$ C-0
. +e
It * IS THIS A CONTRACT COST? Yes —No
FEE ENCLOSED$�Q,
TYPE OF JOB:
�SO R COS New Installation
Alteration/Addition/Repair
Revised 4/01//2002
APPLICATION FOR HVAC PERMIT (Continued from reverse side)
TYPE OF S M: TYPE OFF BWDING:
2'HEATING O RESIDENTIAL
❑A/C ❑COMMERCIAL
❑VENTILATION ❑INDUSTRIAL
HEATING
❑ AM LOW PRESSURE LIMIT LBS. HIGH PRESSURE LIMIT LBS.
O HYDRONIC Q WAJ M AIR ❑UNIT RADIANT HEATER
EXISTING RADIATION 6 C `'-'-ADDITIONAL RADIATION TOTAL RADIATION(v o
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.)
ct°{' ocrc
GROSS HEATING CAPACITY(INPUT—BTUH) J-! '4 NET RATING(OUTPUT—BTUH) %/
TYPE OFF EL �� _
OIL—GPM J' / OIL TANK LOCATION :❑ INSIDEIdOUTSIDE CAPACITY A'S
❑GAS—INPUT LPG TANK CAPACITY ELECTRIC—KW
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.)
TONNAGE 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 Q I l 1� R tiFCA ctN��r" X�J;/.,/6
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.
:3-07673 S -- � �'-
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT �� `^ DATE
W • 1 A QRO
T
s:
�- I35.4 5
_ f
LOT rf
Q
30 B75_ -16 It F
FOUNDAi/ON CERTIFIED AS
S HOWN NAY 13, 19 TP
to
'1 -SEPTIC TK, y pd - O
= ex! r!Nc o
q
RANCH SO
---- ;
50 BUILDING I LINE t+
192,37r 50.00
Proper/y dine
t "SAND NILI ESTATES
PLOT PLAN FOR :
y SAND HILL ROAD- SOUTH W,INOSOR, C 1NlIl�•; I'
- SCALE E /" = 40" MARCH Z B, /9 T s.
.
:V/AMES E. SHWHY L.S.7034 CERTlriEO IifAr !3, /97P Y
h
~�
ECEIVE
Talftkw���orks JUN 1 0 2013
BY:
RemoVal : Replacement
06/06/2013
Deb D'Amato
268 Sand Hill Rd
South Windsor, CT 06074
Re: Removal and Disposal of(1) 550 Gallon Underground Heating Oil Tank and
Installation of(1)-275 ROTH tank outside on a concrete slab.
At: 268 Sand Hill Rd.
Dear Mrs. D'Amato
Thank you for the opportunity to service the removal of the buried oil tank at the above
Referenced address.
The soil in the grave showed no signs of contamination and was backfilled. Before
backfilling one final confirmation soil sample was collected and tested at an independent
lab for CTETPH(extractable petroleum hydrocarbons). The results of the soil sample
we obtained indicated that any trace of oil was Not Detected(ND).
This letter, along with the attached soil sample results, should be stored safely with all
legal documents pertaining to this property. This information, along with your
Tankworks invoice 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.
Rosemary Viola Rainville
Owner
CC: Town South Windsor FM William Summers 1540 Sullivan Ave South Windsor
South Windsor, CT 06450
r
p
I_nt-Ir111111P(ntal I aboratorles. Inn
Monday, June 03, 2013
Attn: Mrs. Rose Rainville
Tankworks Removal & Replacement, LLC
360 East Center Street
Manchester, CT 06040
Project ID: 268 SAND HILL RD S WINDSOR
Sample ID#s: BD85480
This laboratory is in compliance with the NELAC requirements of procedures used
except where indicated.
This report contains results for the parameters tested, under the sampling conditions
described on the Chain Of Custody, as received by the laboratory.
All soils, solids and sludges are reported on a dry weight basis unless otherwise noted
in the sample comments.
A scanned version of the COC form accompanies the analytical report and is an exact
duplicate of the original.
If you have any questions concerning this testing, please do not hesitate to contact
Phoenix Client Services at ext.200.
Sincerely yours,
Phyllis Shiller
Laboratory Director
NELAC -#NY11301 NJ Lab Registration#CT-003
CT Lab Registration #PH-0618 NY Lab Registration#11301
MA Lab Registration #MA-CT-007 PA Lab Registration#68-03530
ME Lab Registration #CT-007 RI Lab Registration#63
NH Lab Registration #213693-A,B VT Lab Registration#VT11301
587 East Middle Turnpike,P.O.Box 370,Manchester,CT 06040
Telephone(860)645-1102 Fax(860)645-0823
Ask
ffo
�� 1 :'i
Environmental Laboratories, Inc.
587 East Middle Tumpike,P.O.Box 370,Manchester,CT 06045
Tel.(860)645-1102 Fax(860)645-0823
Analysis Report FOR: Attn: Mrs. Rose Rainville
Tankworks Removal &Replacement, LLC
June 03, 2013 360 East Center Street
Manchester, CT 06040
Sample Information Custody Information Date Time
Matrix: SOLID Collected by: 05/30/13 0:00
Location Code: TANKWKS Received by: SW 05/31/13 15:15
Rush Request: 24 Hour Analyzed by: see"By"below
P.O.#: 2013-4940 SDG ID: GBD85480
Laboratory Data
Phoenix ID: BD85480
Project ID: 268 SAND HILL RD S WINDSOR
Client ID: BOTTOM
RU
Parameter Result PQL Units Date/Time By Reference
Percent Solid 91 % 05/31/13 JL E160.3
Extraction of CT ETPH Completed OM1113 NSN 3545
TPH by GC (Extractable Products)
Ext.Petroleum HC ND 54 mg/Kg 06/01113 JRB CT ETPH/8015
Identification ND mg/Kg 06/01/13 JRB CT ETPW8015
QA/QC Surrogates
%n-Pentacosane 79 % 06/01/13 JRB 50-150%
RUPQL=Reporting/Practical Quantitation Level ND=Not Detected BRL=Below Reporting Level
Comments:
All soils,solids and sludges are reported on a dry weight basis unless otherwise noted in the sample comments.
If there are any questions regarding this data,please call Phoenix Client Services at extension 200.
This report must not be reproduced except in full as defined by the attached chain of custody.
/,�
AOL
Phyllis hiller,Laboratory Director
June 03,2013
Reviewed and Released by:Deb Lawrie,Project Manager
Page 1 of 1 Ver 1
PHOEN)X%���
Environmental Laboratories, Inc.
587 East Middle Turnpike,P.O.Box 370,Manchester,CT 06045
QA/QC Report Tel.(860)645-1102 Fax(860)645-0823
June 03, 2013 QA/QC Data SDG I.D.. GBD85480
LCS LCSD LCS MS MSD MS Rec RPD
Parameter Blank % % RPD % % RPD Limits Limits
QA/QC Batch 232919,QC Sample No:BD84629(BD85480)
TPH by GC (Extractable Products)-Solid
Ext.Petroleum HC ND 68 56 19.4 71 80 11.9 60-120 30 i
%n-Pentacosane 72 72 56 25.0 85 102 18.2 50-150 30
1=This parameter is outside laboratory ics/lcsd specified recovery limits.
If there are any questions regarding this data,please call Phoenix Client Services at extension 200.
RPD-Relative Percent Difference
LCS-Laboratory Control Sample_
LCSD-Laboratory Control Sample Duplicate
MS-Matrix Spike Phylli Shiller, Laboratory Director
MS Dup-Matrix Spike Duplicate June 3.2013
NC-No Criteria
Intf-Interference
Page 1 of 1
Electric # APPLICATION FOR BUILDING PERMIT
Plumbing# 268 Sand Hill Road Date: y�//2:/0 '
HVAC #
Sprinkler# "7 31.5.62—_,_�—__ -------, Estimated Cost
FINAL P O �----- _ -- -
Building!• aG COMPLETE RED BCUCED AREAS Permit Fee $
Occupancy Fee $
Enginee ' g TYPE OR PRINT ONLY I
Affidavit Eng. Insp. Fee $
► SIGN ON REVERSE SIDE � � 6C
7
Appr. for CO. -- ----- - - - ---- J Total Fee $ �O S-
TO THE BUILDING DEPARTMENT,TOWN OF SOUTH WINDSOR, CT (Additional Cost) $
The undersigned hereby applies to do work according to the following:
Applicant L Q iµi7 j) 1A RA S E'/! 'location of Work Id_&i L C Lot No.
Applicant's Address Z3 G o1?6t- `7el.#960 - 9 7/7-7O 9--
Town V CB ti o K Zip tj 0 6 `Wc.# 5�V
Owner &TE/4 0/4MH 7 0 Architect
Owner's Address ,' ( �� 5;6Ac N iL L Architect's Address
SOS 1`N �iIA�td So/� Zipr' 1- Zip
Sq. Ft. New Area: 1 st FI. 4 2nd FI. 3rd FI. Total New Area
Purpose of this permit %/�1/� �}nc LAY /70 4,Ar Ili i_-trr f eco r -_
City Water❑ Well❑ Septic System❑ Sewer❑
Ins: HO SP Cert. Area, Basement—Garage
Approved by Date Use Group Construction Type
Revised 6/02
1
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
1 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
-------------------------------------------------------------t---------- ------
**-31562-B 7,000
B10 FINAL 10/26/06 JFF A
Electric # APPLICATION FOR BUILDING PERMIT
Plumbing# 268 Sand Hill Drive Date:
HVAC #
Sprinkler# _ _32046
. . _____
FINAL P O ----- Estimated Cost $77 b'A
Permit Fee $
Building- COMPLETE RED BOXED AREAS I Occupancy Fee $
Enginee n TYPE OR PRINT ONLY Eng. Insp. Fee $
Affidavit
CO. SIGN ON REVERSE SIDE ��
PP - - - - 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 1'¢r� 'fi S i •� Location of Work c>�(c ( Lot No.
Applicant's Address r i 4 e w i4,s 9 Tel.# 8'vo ^ co S12 9 a
Town G d V 2 Zip D 6 .2 3 q Lic.# ,S6 3�/ C ej
Owner v?er � in AT d _Architect
Owner's Add!Jress ok 57A1W.1 14;I Architect's Address
Sn --1W _i„� : df e Zip_e,Lo BSc Zip—.
Sq. Ft. New Area: 1 st FI. 2nd FI. 3rd FI. Total New Area
Purpose of this permit V i " v �-
City Water❑ Well❑ Septic System❑ Sewero
Ins: HO SP Cert. Area Basement Garage
Approved by Date �` — Use Group'-77=Construction Type
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 i Ilowed.
i
Signed
I hereby apply for a CertificatE of Occupancy for the work escribed in this application for the permit.
Signed
DO NOT WRITE BELOW THIS LINE
INSPECTION COMMENTS
r �
Inspection / Approval Date By Appl
Code Description Due Whom Code Copent
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••-32046-B 0
B10 FINAL 10/26/06 JFF A
LOT 6
135.4 5
: uB,o-I AM 1ALLY C �iii? 'GT & I
LOT 4 0
L. `H ENY �_.�. ivy`4 30,B75. 16 sq. ft..
1 aTl.
CO
WI
I 3
h
O I
I000 GAL.
h �
SEPTIC TK. 0. I
p _5/_00
V r PROPOSED O � O
3 B.R. RA15ED N ' v
RANCH
30.00
50 BUILDING LINE
o�
hl I
h�
I
192.37to 150.00
Property line
SAND HILL ROAD
BEING LOT 4 ON MAP
ENT/T L ED .'
"SAND HILL ESTATES
MAY 2, 1970
PLOT PLAN FOR
L / P M A N
SAND HILL ROAD - SOUTH W INDSOR, CONN.
SCALE /" = 40' MARCH 28, /972
✓AAIES E. S HEEHY L.S.70J 4
13000275 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER BUILDING PERMIT
DATE: 06/06/2013 :.��_. ,. ;
GIS ID: 79800268 FEE: 45.00
MUNIS APPLICATION# 201300709 - ..; ":BUILDING DESCRIPTION:
APPLICANTS �- , °z� `= '°-v_ LOCATION
NAME: TEDDY'S OIL&ENERGY LLC. ADDRESS: 268 SAND HILL ROAD
ADDRESS: 360 EAST CENTER STREET" � OWNER:' DAMATO PETER J&DEBRA K
MANCHESTER,CT 06av < y - " 268;SAND HILL ROAD
SOUTH WINDSOR,CT 06074
DESCRIPTION OF WORK: REMOVE 550 UST AND REPLACE WITH 1-275-ROTH AST WITH COVER ON
SLAB OUTSIDE: ~'
SPECIAL CONDITIONS:
ALL WORK TO BE DONE IN ACCORDANCE,WITH THI;APPLICATION AND PLANS APPROVED BY THE BUILDING DEPARTMENT.
CONSTRUCTION TYPE:
OCCUPANCY GROUP: Y �T.A �� '�f BUILDING OFFICIAL
6/6/2013 2:43 PM THE FEE ABOVE INCLUDES A$0.26 PER THOUSAND CT STATE EDUCATION SURCHARGE