HomeMy WebLinkAbout260 SULLIVAN AVE Electric # AA�rpeCATION FOR BUILDING PERMIT
Plumbing# 260 Sullivan
HVAC# 11000642 Date:
Sprinkler# Estimated Cost $
FINAL APPROVALS Permit Fee $
Building COMPLETE RED BOXED AREAS
Occupancy Fee $
Engineering TYPE OF PRINT ONLY Eng. Insp. Fee $
Affidavit Ar.forCO. ► SIGN ON REVERSE SIDE
pp - Total Fee $
TO THE BUILDING DEPARTMENT, TOWN OF SOUTH WINDSOR, CT (Additional Cost) $ r �q
The undersigned hereby applies to do work according to the following: 1
Applicant Location of Work Lot No.
Applicant's Address l� j/��/ �,L(ley►►n , r—io Tel #
Town '�►���Ur Zip ®r®?-�f Lic.#
Owner� A57 Shc1/4,/�.-0'to0`- (" Architect
Owner's Address .��' cSd��ifi'�IO-V''�- Architect's Address
Zip Zip
Sq. Ft.New Area: 1st A. nd FI. _ 3rd FI. Total New Area
Purpose of this permit O
City Water❑ Well 0 Septic System 0 Sewer❑
Ins: HO Cert. Area Basement Garage
Approved by Date b Use Group,% Construction Type .r—
Revised 1108
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.
J Signed
I hereby apply for a Certificate of ccupancy for the work described in this application for the permit.
Signed
DO NOT WRITE BELOW THIS LINE
INSPECTION COMMENTS