HomeMy WebLinkAbout19 Birch Road (11) Elea,'c# APPLICATION FOR BUILDING PERMIT
Plumbing# 19 BIRCH ROAD
HVAC # 23826
Date: =T S G
Sprinkl r# No.
C
FINAL APPROVAL ? Estimated Cost $ as= o
Building COMPLETE RED BOXED AREAS Permit Fee $ j L
Engineerin OOF
TYPE OR PRINT ONLY Occupancy Fee $
Affidavit SIGN ON REVERSE SIDE
Appr.for CO. I I Total Fee $ /Z-
TO BUILDING DEPARTMENT,TOWN OF SOUTH WINDSOR,CT (Additional Cost) $
The undersigned hereby applies to do work according to the following specifications:
Job Location RIP<4 Lot No. Side of Streeii5l • Zone
Applicant SO Tel. #
dp
Address Zi W r Lic. #
Own r ,%�' obi ddress kar S-
Architect Address
Sq. Ft.New Area: lst FI. 2nd A. 3rd FI. Total New Area
#Rooms # Lavat vies #Bathrooms _ #Garages ?
Purpose of this permit:
City Water C Well ❑ Septic System ❑ Sewer
Use Group N Construction Typ '4 Area / Basement Garage
Approved by Date f 1 S 7(0
Revised 6/95
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 prop . tance from#11 street lines,side yard lines and required
distances from all other zones and is located in zon in h thi buildin and its a 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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96-23826-B 350
B10 FINAL 02/25/97 JFH D NOT DONE
B10 FINAL 08/06/97 JFF A APPROVED FOR CLOSEOUT