HomeMy WebLinkAbout145 Abbe Road DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT
TOWN OF SOUTH WINDSOR PERMIT#
Application is hereby: r�o2 6d
BUDDING DEPARTMENT
APPROVED 1540 SULLIVAN AVENUE Bldg.Permit#
644-2511 ext. 230
a e Building Inspector
Application must be printed or typed
FEE SCHEDULE L/ /Location o Job:
F�� 6 iS� O'7 e G GZ�
$0-$1,000=$15.00 Street No. Street Lot No.
Over$1,000=
$15.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT C/V • V _ C �<
APPLICANT ADDRESS /v -C,a
APPLICANT PHONE# Ll 3 3
W
N S OWNER i /�0 c� �i r�tw ���� O�
OWNER ADDRESS
r
OWNER PHONE
C ESTIMATED COST$ (�
� IS THIS A CONTRACT COST? K Yes No
FEE ENCLOSED$ ��
�1
TYPE OF JOB:
OR C New Installation
Alteration/Addition/Repair
Revised 4/01//2002
APPLICATION FOR PLUMBING PERMIT (Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
BUILDING PERMIT APPLICATION? ❑YES ❑NO
RESIDENTIAL
❑BUSINESS CURRENT USE AND OCCUPANCY
❑ASSEMBLY
❑MERCANTILE FUTURE USE AND OCCUPANCY
❑EDUCATIONAL
❑INSTITUTIONAL
❑FACTORY ENGINEER'S NAME PHONE
❑ STORAGE
❑GARAGE ADDRESS
❑MIXED USE
CITY STATE ZIP
(Other please specify)
TYPE OF INSTALLATION /40 LV SIZE OF MAIN DRAIN
NO.OF TOILETS J STYLE R NO.URINALS STYLE
NO.OF BATHTUBS l NO.OF SHOWERS NO.OF LAVATORIES
NO.OF CONDUCTORS SIZE NO.OF STACKS 2- SIZE
AREA OF ROOF NO.OF CATCH BASINS NO.OF FLOOR DRAINS
NO.OF OTHER FIXTURES KIND re`" s�A--/<� -
ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW jXYES ❑NO
SIZE OF WINDOW IF NONE C.F.M.OF VENTILATOR
SIZE OF DUCTS SEWER OR SEPTIC TANK
SIZE OF WATER MAIN SIZE OF WATER PIPING&RISER
WATER HEATER: TYPE MANUFACTURER
DESCRIPTION OF WORK
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS TU"
COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE
PERFORMANCE OF SUCH WORK.
P-0 el y? (41 P ( C-7-
CONTRACTORS LICENSE NO. E STATE
SIGNATURE OF APPLICANT DATE `J G'—O-3