HomeMy WebLinkAbout178 Old Farm RoadH4ctric#.APPLICATION FOR BUILDING PERMIT
Plumbing# 178 Old Farm Road
HVAC # Date: .
28750
Sprinkler#
FINAL O Estimated Cost $
Buildings ° FCOMPLETE RED BOXED AREAS Permit Fee
Engineer TYPE OR PRINT ONLY Occupancy Fee $ /G.
Affkkra GN ON REVERSE SIDE
Appr.for CO. o Total Fee O.
TO BLA MH I',TOWN OF SOUTHWNDSOR,,CT Additional Cost) $
The undersigned hereby applies to do work according to the following specifications:
Job Location 4 t 44yL l&d SttAJ,, Lot No. Side of Street Zon
Applicant LO k VIN U . (_,v 1 4 firn Tel 60 q_-f i
Address_ (? O l a Cci v So.'I.x uJ t"'hc { —C Zip Lic.#
Owner_jot, r j y Address_ t 7 Oil r^vYr . l S lrtJ_ G
Architect Address
Sq.Ft.N w Area: 1st Fl. 2nd Fl. 3rd Fl Total New Area
Rooms Lavatories Bathrooms Garages
Purpose of this permit:_ :S h eir , w- Ion XI?
City Water Well Septic System Sewer
Ins. H.O. S.P. Cert. Area Basement Garage
Approved by l' Dot -` Zr Use Group Construction Type _'M
Revised 9/01
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 his building ants use is allowed.
Signe
I hereby apply for a Certificate of ccupancy f e work described in this application for the permit.
Signed r
d0 NOT WRITE Btu OW THIS LINE
INSPECTION COMMENTS
Inspection / Approval Date By Appl
Code Description Due Whom Code Comment
T
28750-B 4,000
B10 FINAL 05/13/03 JFF A
B10 FINAL 05/13/03 JFF A SHED LOCATION OK PER JOY ZONING
B10 FINAL 05/13/03 JFF A CLOSEOUT