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INSPECTIONS:
APPLICATION FOR BUILDING PERMITBuilv
Plumbing
HVAC FDatf 16
Sprinkler 248 CHAPEL ROAD
Electric Estimated Cost $ 0-h
Zoning Permit Fee$id 1.0'
Affidavit NO. 18389 Occupancy Fee $
Eng. Dept. dv
Fire Dept. COMPLETE RED BOXED AREAS. Total Fee $
Health Dept. TYPE OR PRINT ONLY
Approved for CO: SIGN ON REVERSE SIDE.Additional Cost) $
TO BUILDING DEPARTMENT, TOWN OF SOUTH WINDSOR, CT
The undersigned, hereby applies to do rrk according to the following specifications:
Job Location s Lot No. Side of Street Zone
Applicant 01 Ce w Tel. # n (ir_i/01
Address 0 C 1'_LkjdC1 RK 5j ali Arcs( G ip 76 y Lic.#
STREET CITY STATE
Owner Address
Architect Address
Size New Area: Ft. Front Overall Ft. Deep Overall Total Area Garages
Lavatories
No. of Families No. of Stories Construction Bathrooms Rooms 1st 2nd 3rd
Size of Lot Dist. from Street Line Dist. from Side Street Line
Purpose of this Permit CuTwu S
L V
City Water Well Septic Sewer
Approved by Date L eD 1 A>>isa
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 t Building for which this permit is asked,and agree
that this building is to be located the prop r distance from all street lin s,si and lin and required dista s 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—
INSPECTION RECORD
Footing Framing
Foundation Fireplace/Chimney Insulation
Plumbing Permit# Inspections:
HVAC Permit# Inspections:
Electrical Permit# Inspections:
Sprinkler Permit# Inspections: