HomeMy WebLinkAbout160 Kelly Road Electrit# APPLICATION FOR BUILDING PERMIT
Plumbing# 160 Kelly Road
HVAC # Dat . e
Sprinkler# NO' 28798
FINAL RO Estimated Cost $ �`
Building i �3 "�'` COMPLETE RED BOXED AREAS Permit Fee $
End ng TYPE OR PRINT ONLY Occupancy Fee $
�ikit SIGN ON REVERSE SIDE
Appr.for CO. Total Fee
TO BUILDNG DEPARTMEW,TOWN OF SOUTH WNDSOR,CT (Additional Cost) $
The undersigned hereby applies to do work according to the following specifications:
Job Location 16 0 r<<Y lerl Lot No. Side of Street Zone
Applicant A�E F L e S Tel#
Address /G /�c Cf y xv. Zip o 6 y 75( Lic.#
Own r S m e Address
Architect Address
Sq.Ft.N w Area: 1st Fl. 2nd Fl. 3rd Fl. Total New Area
#Rooms #Lavatories_ #Bathrooms #Garages
--Purpose of this permit: AP, ce
City Water ❑ Well ❑ Septic System ❑ Sewer ❑
Ins. H.O. S.P. Cert. Area Basement Garage
Approved by .I K-Z-- 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 b it g and its use is allowed.
Signe
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
r
Inspection / Approval Date By Appl
Code Description Due Whom Code Comment
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**-28798-B 1,000
B10 FINAL 01/23/03 JFF A
B10 FINAL 01/23/03 JFF A CLOSED OUT.