HomeMy WebLinkAbout160 Brook Street (11) Electric# APPLICATION FOR BUILDING PERMIT
Plumbing# 160 BROOK STREET
HVAC # No.
Lo'— /�
Sprinkler# 2 27
14
FINAL APPROVALS Estimated Cost $
Building COMPLETE RED BOXED AREAS Permit Fee $ �d
Engineerin TYPE OR PRINT ONLY Occupancy Fee $
Affidavit SIGN ON REVERSE SIDE
Appr.for CO. Total Fee $ jo
TO BUILDING DEPARTMENT,TOWN OF SOUTH WINDSOR,CT (Additional Cost) $
Th and rsigned hereby applies to do work according to the following specifications:
Job Location IA(n boy-, G)M� Lot No. Side of Street Zone
Applicant Y& r Y, c d Tel.# 6qq 269
Address L40 a&xz Zip D Lic. #
Owner Sa,-m� -- Address s
Architect Address
Sq. Ft.New Area: 1st Fl. 2nd Fl. 3rd Fi. Total New Area
#Rooms # Lavatories #Bathrooms #Garages
Purpose of this permit: —S
City Water ❑ Well ❑ Septic System ❑ Sewer
Use Group jVA Construction Type Area / Basem nt Garage
Approved by Date NUAL
If I 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 proper distance from all street lines, side yard lines and required
distances from all other zones and is located in a zone in w h this building and i 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