HomeMy WebLinkAbout15 Benjamin Way Electric# APPLICATION FOR BUILDING PERMIT
Plumbing# 15 Benjamin Way
HVAC # Date: 26 o/
r,40. 28216
Sprinkler# '
FINAL RO Estimated Cost 3 S�
Buildi JL COMPLETE RED BOXED AREAS Permit Fee $ 104. uv
Engineer 0 TYPE OR PRWT ONLY Occupancy Fee � w
Affidavit SIGN ON REVERSE S®E 11
Appr.for C d Total Fee $ 1 dq.yo
TO BLA MB�T,TOWN F SOUTH W�SOR,CT (Additional Cost)
The undersuied hereby applies to do work according to the following specifications:
Job Location I.S t3iffVD1 410V W*Y Lot No. Side of Street Zone
Applicant auf-t c0 3q M AfiAi MI1V Tel# C
Address Z 3 q t1QLAm rv+r N 1W C5u-t/Vf-i7A,4 f GT ---zip 6%02 9 Lic.# 5'&3 2 y c
Owner MietM2S NfM Address S 13 N.J�31ni/Ir L.u4Y
Architect Address
Sq.Ft.New Area: lst Fl. 2nd Fl. 3rd Fl. Total New Area
#Rooms #Lavatories #Bathrooms #Garages
Purpose of this permit: lbXIq 54te'rIVl0 rcwld
City Water' Well ❑ Septic System ❑ Sewerfi�r
Ins. H.O. S.P. C rt. Area Basement 4 Garage
Approved by CDate Use Group Construction Type O13
Revked 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 this bu ding 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