HomeMy WebLinkAbout240 Brookfield Street (9)Electric# APPLICATION FOR BUILDING PERMIT
Plumbing# 240 BROOKFIELD STREET
WAC # Date:
Sprinkler# No. 25600
FIM Estimated Cost $D• oBwl&g 95 COMPLETE RED BOXED AREAS Permit Fee
TYPE OR PRINT ONLY Occupancy Fee $AffidOVit
SIGN ON REVERSE SIDE aoAppr.for CO.Total Fee 1
TO BUILDNG MARTMEW,TOWN OF SOUTH WMSM CT G4dditional Cost) $
The undersigned hereby applies to do work according to the following specifications`
Jo6 Location J/ Lot No. Side of Street Zone
Applicant ,/9i .s i¢ y /,r Tel.
Address y ,r' .,C i L,,y ' n. .li.y1[ Zip 010?P Lic.#
Owner .S,¢CtAV= Address
Architect Address
Sq. Ft.New Area: 1st Fl. 2nd Fl. 3rd Fl. Total New Area
Rooms Lavatories Bathrooms rages
Purpose of this permit: r o KE' L..A d A_ Q evo t-Y
City Water Well Septic System Sewer
Ins. H.O. Cert._ Area i Bit Garage
Approved by Date 3 1b Use Group Construction Type
Rwked 1197
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 s 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