HomeMy WebLinkAbout19 HENRY RD Electric # APPLICATION FOR BUILDING PERMIT
Plumbing# 19 Henry Road v`r
HVAC # Date: / d
Sprinkler# 31145 DOQ
FINALIROEstimated CostBuildingyxV COMPLETE RED BOXED AREAS Permit Fee $ �7U
En nee n Occupancy Fee $
TYPE OR PRINT ONLY
Affidavit Eng. Insp. Fee $
Appr. for CO. SIGN ON REVERSE SIDE / Total Fee $ U. �'
TO THE BUILDING DEPARTMENT,TOWN OF SOUTH WINDSOR, CT (Additional Cost) $
The undersigned hereby applies to do work according to the following:
Applicant R e n tW wk,"d o W S location of ork I� er\r y Lot No.
Applicant's Address c29 3 Old M00e,+a: K 'Tel.# 560
Town lF(:*-rfvN y to e., CT Zip 01003 )L-- tic.# .5-5�U C666
Owner L-c,—rry CA(5—k C y Architect
Owner's Address 1 Ot I+e-he RA' Architect's Address
Sp.;}_k U3% C)I- CT' Zip0607Y Zip
q. Ft. New Area: 1st FI. 2nd FI. 3rd FI. Total New Area
urpose of this permit 00
V
City Water❑ Well❑ Septic System❑ Sewer❑
Ins: HO t. // Area Basement Garage
Approved by to (' Use Group(�—f_ �struction T
Rsvksd 6102
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 ted the proper distance from all street lines,side yard lines,and required
distances from all other zones and is located in this building a its use is allowed.
Signed
I hereby appty for a Certificate of O for the work dascnbed in this application for the permit.
Signed 6-
DO T WRITE BELOW THIS LINE
INSPECTION COMMENTS
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