HomeMy WebLinkAbout103 Jacques Lane eectric,# APPLICATION FOR BUILDING PERMIT
Plumbing#
1 O l ,Tacc-rues Lane
Dot . 3/Slp 2
HVAC #
2 8 615
Sprinkl r# No.
FINAL P ROM Estimated C _3ost $ a 0
Building / oe COMPLETE RED BOXED AREAS Permit Fee $
Kneen TYPE OR PRINT ONLY Occupancy Fee $
Affidavit SIGN ON REVERSE SIDE
Appr.for CO. Total Fee o?.
TO BIALDING DEPARTMI T,TOWN OF SOUTH WNDSOR,CT (Additional Cost) $
The undersigned h reby applies to do work according to the following specifications:
Job Location I o3 '3ac g vej L6,,%t Lot No. Side of Street Zone
Applicant M D Ztn ,lc n��'^5 Tel.# .0-9- y6 6 D
Address 1 Y r T. Zip d /o Lic.# .S D. t l
Own r A i` e,I ten h Wc.A Address 1a�C
Architect Address
Sq.Ft.New Area: 1st FI. 2nd FL 3rd Fl. Total New Area
#Rooms #Lavatories #Bathrooms #Garages
Purpos of this permit: prpDf offer e��ff�^ i 14xcr v-T Sk,:.s/e f.
City Water ❑ ell ❑ Septic System ❑ Sewer ❑
Ins. H.O. S.P. Cert. Area Basement Garage
Approved by Date 3 Use Group r Construction Type
ReYbW 1197
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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**-28615-B 3,100
B10 FINAL 12/31/02 JFF A
B10 FINAL 12/31/02 JFF A CLOSED OUT.