TOWN OF ELLINGTON, CONNECTICUT
DEPARTMENT OF TOWN FIRE MARSHAL
57 Main St. P.O. Box 187 06029
Tel: 870-3126 Fax: 870-3158
APPLICATION and PERMIT to PRODUCE:
A BONFIRE ANYWHERE; or
AN OPEN COOKING FIRE or CAMPFIRE ANYWHERE,
EXCEPT on Single or Two-family Residential Property; or
AN ENCLOSED COOKING FIRE in FOREST or WOODLAND, or
ANY OTHER TYPE OF OPEN FIRE, ANYWHERE. Rev: 1/19
The fee is waived for civic, governmental, educational and religious organizations.
Complete Section 1 of this application and return to the Fire Marshal’s Office. In the processing of this application
additional information may be necessary. Failure to provide the necessary information may be cause to deny this
application. Upon approval by this office a permit will be issued to the Applicant.
Type of Fire: 1. BONFIRE (Any Property) 2. OPEN COOKING FIRE/CAMP FIRE (on other than single or 2-family residential property)
3. ENCLOSED COOKING FIRE (Forests or Woodlands) 4. OTHER (Explain):
Organization
Represented:
Relationship of Applicant
to Organization:
Specific Address of Property Upon
Which the Fire is Proposed:
Name of Owner(s)
of Above Property:
Name of Owner(s)
of Above Property:
Specific Location of
Proposed Fire Upon
Above Property:
NOTE: For Type 1 and Type 2 Fires, a diagram must be submitted showing proposed fire pit in relation to all property lines,
buildings within 250 feet and all overhead utilities. For Type 3 and Type 4 Fires, a diagram must be submitted showing the
above and including GPS coordinates.
Date and Time
of Ignition:
Date and Time of
Extinguishment:
Specific Materials to be Burned:
(Processed wood NOT PERMITTED.)
Specific Equipment to be Available On-Site
for Controlling and Extinguishing this Fire:
Anticipated Number of
Attendees:
Fire to be at All Times
Under Control of (Print Name):
As owner(s) of the property as described above I (we) hereby authorize such a fire as described hereupon.
Signature of Property Owner:
Signature of Property Owner:
I hereby represent that the information above is accurate and truthful to the best of my knowledge. I understand
that no ignitable liquid may be used to assist ignition or propagate flame; that if 100 or more attendees are
anticipated the Ellington Outside Public Assembly ordinance may be applicable; that as the Applicant I have full
and complete responsibility for all aspects of this fire; and that I am legally bound by the requirement(s) set out as
conditions of approval of this application and of the respective requirements of the local Open Burning Ordinance.
