HomeMy WebLinkAbout20 Benjamin Way (9)Electric# APPLICATION FOR BUILDING PERMIT
Plumbing# 20 BENJAMIN WAY
WAC #
4
Date: ZZ%y2575
FNAL Estimated Cost
COMPLETE RED BOXED AREAS Permit Fee
TYPE OR PRINT ONLY OccupancyilFee $
Affidavit
SIGN ON REVEAppr.for CO. RESIDE
Total Fee
TO BLMU*4G DEPARTMENT,TOWN OF SOUTH W )SM CT Additional Cost) S
The unders4iod hereby applies to do work occorcling to the following specifications;
Jo6 Location Lot No. Side of Street Zone
Applicant it Tel#FM
Addr ss Zip oul q A3 Lic.# -5' &7'6
Owners Jt s 1^U`j/ ,',_SD t/ Address -a
Architect Address Zoe-
Sq.Ft.New Area: 1st FI. 2nd FI. 3rd Fl. Total New Area
Rooms Lavat ries A Bat brooms Garages
Purpos of this permit:
City Water Well Septic System Sewer
Ins. H.O. S.P. V Cert. Area I I Basement Garage
Approved by Date .515116 Use Group Construction Type
Rovi«i 1197
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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 building and its use is allowed.
Signed-'J -
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