HomeMy WebLinkAbout1765 Ellington Road Sectric# APPLICATION FOR BUILDING PERMIT
Plumbing# 1765 Ellington Road
HVAC # 28551 Dat : A640
Sprinkler# No.
FINAL RO Estimated Cost
Build' og COMPLETE RED BOXED AREAS Permit Fee $ cis-
TYPE OR PRINT ONLY
Occupancy Fee $
Affidavit
SIGN ON REVERSE SIDE`
Appr.for CO. Total Fee $ &6—
TO BUILDNG DEPARTMENT,TOWN OF SOUTH WMSOR,CT (Additional Cost) $
Th undersigned hereby applies to do work according to the following specifications:
Job Location C �5^' lfi of No. Side of Street Zon
Applicant & _S_Tel# — —
Address S,>, ��� ��z Zip Alm Lic.# `�'�zo .4 zg�
Owner f Address 7
Architect Address
Sq.Ft.N w Area: 1st Fl. 2nd Fl. 3rd Fl. Total New Area
#Rooms #Lavatories— #Bathrooms #Garages
Purpose of this permit:___ ,T �_�T ��(�
City Water ❑ Well ❑ Septic System ❑ Sewer ❑
Ins. H.O. S.P. Cert. Area Basement Garage
Approved by DatesIAL62--,Use Group Construction Type
Revised 9/01
I hereby agree to conform to all the requirements of the Laws of the tate of Connecticut and the Ordi nces of the Town of
South Windsor and to notify the Building Inspector of any alteratio i e plans or specifications of wilding for which this
permit is asked,and agree that this building is to be located the p distance from all street li de yard lines,and required
distances from all other zones and is located in whi i uildi its u,-o is alloWed.
Signed
I hereby apply for a Certificate of ccupancy for the work described in this appli 'on for the permit.
Signed
DO NOT WRITE BELOW THIS LINE
INSPECTION COMMENTS
Inspection / Approval Date By Appl
Code Description Due whom Code Comment
-------------------------------------------------------------------------------
**-28551-B 5,000
B10 FINAL 03/28/02 JRC A CLOSEOUT
B10 FINAL 07/10/02 JFF A
B10 FINAL 07/10/02 JFF A CLOSED OUT.