HomeMy WebLinkAbout167 Ayers Road (2) Electric# APPLICATION FOR BUILDING PERMIT
Plumbing# 16 7 Ayers Road Date: /
HVAC #
Sprinkler# 29399
FINAL APPROVALS Estimated Cost $
Building F/(dO7, JjZL Permit Fee $
COMPLETE RED BOXED AREAS Occupancy Fee $
En davitneerin g TYPE OR PRINT ONLY Eng. Insp. Fee $
AffAppr. for C.O. ► SIGN ON REVERSE SIDE , 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 Location of Work Tm 5 Lot No.
Applicant' Address I`5Q Tel.# 100 [A-:10,-
Town Zip �11J Lic.# s 8� k9
Owner Architect
Owner's Address � ,����� ffo Architect's Address
Zip Zip
Sq. Ft. New Area: 1 st FI. 2nd Fl. 3rd FI. Total New Area
Purpose of this permit
City Water❑ Well❑ Septic System Sewer❑
Ins: HO SP Cert. Area Basement Garage
Approved by J f�— Date 0 Use Group Construction Type
Revised W02
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 aReration 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 ich this building aV its upe 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
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**-29399-B 375
PO4 GAS TEST 02/11/03 CJD A W/OWNER
B10 FINAL 06/18/03 JRC A CLOSEOUT