HomeMy WebLinkAbout178 Palmer Drive APPLICATION FOR BUILDING PERMIT
Electric# .
Plumbing# 1 7 R Palmer Drive Date: Nov
HVAC #
Sprinkler# 29316
Estimated Cost O
B FINAL APPROVALS permit Fee
�� COMPLETE RED BOXED AREAS � Occupancy Fee $
Engineering TYPE OR PRINT ONLY E Ins Fee ;
Affidavit � SIGN ON REVERSE SIDE � �� P� �
Appr.for CO w' Total Fee $ 6 S. G
TO THE BUILDING DEPARTMENT,TOWN OF SOUTH WINDSOR,CT (Additional Cost) i
The undersigned hereby applies to do work according to the following:
Applicant o Location of Work 1 7 1? /0Ol m e ti P.A-�vt°Lot No. /7,e
Applicant's Address v Tel.# _
Town u kd� Zip l9 I CJ Lic.# 6 �S
Owner SeA vi ��fic- g n Gl' Architect
Owner's Address j 7 le oQAa j hitect's Address
Zip Zip
Sq. Ft. New Area: 1 st FI. 2nd FI. 3rd FI. Total New Area
Purpose of this permit o - � 2 B
City Water❑ Well❑ Septic Systemo Sewer❑
Ins: HO SP Cert. Area Basement Garage
Approved by Date Use Group Construction Type
Rwbad M2
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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**-29316-B 900
B07 TANK INSTALL/REMOVE 12/09/02 WNB A WITH OWNERS FATHER
B10 FINAL 12/09/02 WNB A CLOSEOUT