HomeMy WebLinkAbout169 Brookfield Street (12) 6ectric# APPLICATION FOR BUILDING PERMIT
Plumbing# 169 Brookfield Drive
HVAC # 27308
Sprinkler# NO'
FINAL APPROVALS Estimated Cost $ *Ira
Building C1 L-zl 00 COMPLETE RED BOXED AREAS Permit Fee $ �
Engineering TYPE OR PRAT ONLY Occupancy Fee $ 5
Affidavit SIGN ON REVERSE SIDE
Appr.for CO. O Total Fee $
TO RU ILIX-C DEPART ,TOWN OF SOUTH WMDSOR,CT 1Additional Cost) $
The undersigned hereby applies to do work according to the following specifications:
Job Location r (c o o V-% %F k-,q s - Lot No. Side of Street Zone
Applicant D(-,io-r-3 e,3`t c i `{ v�Z Tel# Co y%-k—ti'-i 'i;- ti
Address l\O'N �cL o o v�,C= Zip Qle,-3 y Lic.#
Own r s Address S cvn `,
Architect Address
Sq.Ft.New Area: 1st Fl. 2nd Fl. 3rd Fl. Total New Area
#Rooms #Lavatories #Bathrooms #Garages
Purpose of this permit:
1fl ' tom' S ��� L40%-:E� �rZR
City Water ❑ Well 0 Septic System ❑ Sewer ❑
Ins. H.O. ✓ Cert. Area Basement Garage
Approved by Date 0) co Use Group Construction Type SEP
R*vW 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 this building and its use is allowed.
Signed �.�� 0 .
I hereby apply for a Certificate of 7(t
y for the work described in this application for the permit.
Signed �-
DO NOT WRITE BELOW THIS LINE
INSPECTION COMMENTS
I
Inspection / Approval Date By Appl
Code Description Due Whom Code Comment
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**-27311-B 10,000
B10 FINAL 09/29/00 DCJ A