HomeMy WebLinkAbout177 Benedict Drive (8)FI P s I s
g APPLICATION FOR BUILDING PERMITBuildinildin
Plumbingr31-
HVAC Date: D l
Sprinkler 177 BENEDICT DRIVE
ao
c
Electric Estimated Cost $
Permit Fee $ JaZoning
Affidavit NO. 18084 Occupancy Fee $
Eng. Dept.COMPLETE RED BOXED AREAS. O0
TYPE OR PRINT ONLYFireDept. Total Fee $ 0
Health Dept. SIGN ON REVERSE SIDE.
Approved for CO: Additional Cost) $
TO BUILDING DEPARTMENT, TOWN OF SOUTH WINDSOR, CT
The undersigned, hereby applies to do work according to the following specifications:
Job Location Lot No. 3 Side of Street Zone
Applicant C' ,ZiS f7o y/!: Tel. # 6y4-3 s7'
f]7 .( So, to,t, Sod °y''• Zip 0 d 02 Lic.#
Address STREET CITY STATE
Owner Jq A'1 E Address
Architect Address
Size New Area: Ft. Front Overall `Ft. Deep Overall Local Area Garages
No. of Families _No. of Stories Construction Bathrooms Rooms 1st 2nd 3rd
Size of Lot Dist. from Street Line 4!;r O Dist. from Side Street Line
Purpose of this Permit To /N S Q aH -fiJ Q 4 q eq v
City Water Well Septic Sewer X
Approved by2 Date a-/0 r eD1A 1iias -
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 th 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 a zone in which this building and its use is allowed.
Signed
I hereby apply for a Certificate of Occupancy for the work described in this application for permit.
Signed
DO NOT WRITE BELOW THIS LINE—
6 INSPECTION RECORD aFootingFramin
Foundation Fireplace/Chimney Insulation
Plumbing Permit# Inspections:
HVAC Permit# Inspections:
Electrical Permit# Inspections:
Sprinkler Permit# Inspections: