HomeMy WebLinkAbout1739 Ellington Road (16) Electric# 1?0(0 0 APPLICATION FOR BUILDING PERMIT ,
Plumbing# 1 739 p1 1 i nrr+-nn Pnarl
HVAC # Date:
Sprinkler# 29314 N
FINAL APP ALS Estimated Cost $ OWN
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Building J' COMPLETE RED BOXED AREAS Permit Fee $ Sv
Engineering Occupancy Fee
g TYPE OR PRINT ONLY
Affidavit ► SIGN ON REVERSE SIDE , Eng. Insp.Fee $ �
Appr. for CO. Total Fee $ �
TO THE BUILDING DEPARTMENT,TOWN OF SOUTH WINDSOR,CT (Additional Cost) $
The undersigned hereby applies to do work according to the following:
Applicant Location of Work C11t 1--z41 r1 1 Pylwc,11 A P. • Lot No.
Applicant's Address �n..'� �i�. ,-�� i.. Tel.# � - -'�
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Town ', Zip OG�-'--t Lic.#
Owner Architect �9 V3 e-s C
Owner's Address Z�a � .��,� �� C(111.0 �W• Architect's Address &L M4 7Sfi'
0t rt°ryAo.,-T W rA, Zip Lo A �, � . Zip I t3 .
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Sq. Ft. New Area: 1 st FI. 2nd FI. 3rd FI. Total New Area
Purpose of this permit _ ^s f 3,e 0 0c. :'•�°� ztls
City Watery Well❑ Septic System❑ Sewere(,
Ins: HO SP Cert.�� Area Basement Garage
Approved by cj Date L. Use Group M_ Construction Type
Revised W02
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' thi building and its use is allowed.
Signe clt���- -
I hereby apply for a Certificat o pa y f the work desc'bed in this application for the permit.
Signer
O NOT WRITE BELOW THIS LINE
INSPECTION COMMENTS