HomeMy WebLinkAbout118 Berle Road (12) Sectric# APPLICATION FOR BUILDING PERMIT
Plumbing#
118 BERLE ROAD
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HVAC # Date:25032
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Estimated Cost $ Sya 9 COMPLETE RED BOXED AREAS Permit Fee $ ?�
Engineers TYPE OR PRINT ONLY Occupancy Fee
Affidavit SIGN ON REVERSE SIDE
Appr.for CO. IFTotal Fee $ 72
TO BLALDM DEPARTMENT,TOWN OF SOUTH Wt4l)SOR,CT (Additional Cost) $
The undersigned hereby applies to do work according to the following specifications:
Job Location W BcrI c R�• Lot No. Side of Street Zone
Applicant A, Dpp2t✓� Rovp r-4 Tel.# -r2F- y«y
Address_ 7 /�4me y Sf• �,/-�• p6�a Zip Lic.# S-0/ff
Owner Af Vx S4a'4 Address S4�
Architect Address
Sq. Ft.N w Area: 1st FI. 2nd FL 3rd FL Total New Area
#Rooms #Lavatories #Bathrooms #Garages
Purpos of this permit: keqj c l- 2&Yb�, g %► /eI. 7�-�•
City Water ❑ Well ❑ Septic System ❑ Sewer ❑
Ins. H.O. S.P. Cert. Area Basem nt Garage
Approved by Date Use Group Construction Type
Revsed 1/97
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