HomeMy WebLinkAbout16 Green Lane (8) PERMIT NO.
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DEPARTMENT DECISION A P P L I C A T I O N F
APPLICATION IS HEREBY: PLUMBING PERMIT
APPROVED DISAPPROVED TOWM OF SOUTH WINDSOR
BUILDING INSPECTION DEPT.
644-2511 Ext. 230
DATE PLUMBING INSPECTOR Application must be printed or typed.
1. LOCATION OF JOB:
2. OWNER: (Do v,_ �a ,P/ ITS S .
3. ADDRESS:
FEE SCHEDULE S6 Wei'5'
0 - $1,000 - $10.00 4. APPLICANT:
Over $1,000 - $10.00 5. ADDRESS:
per $1,000 or
Fraction Thereof S. c� S eCT0601
6. EST. COST: $ 9,F00. 0 U
T
7. IS THIS A CONTRACT COST? _YES NO
8. FEE ENCLOSED: $ l�70
9. TYPE OF BUILDING:
}C) RESIDENTIAL COMMERCIAL
10. TYPE OF JOB:
ORIGINAL ALTERATION
INSTALLATION ADDITION
REPAIR
BD 2A 11/88
APPLICATION FOR PLUMBING PERMIT (Cont. from Reverse Side)
11. LOCATION OF JOB: G c e w L-n " f / z-
GENERAL PLUMBING
t/
12. KIND OF INSTALLATION: lle..> 13. SIZE OF MAIN DRAIN
14. NO. OF TOILETS STYLE Tc"L 15. NO. OF URINALS STYLE
16. NO. OF BATHTUBS_ 16A. NO. OF SHOWERS z 17. NO. OF LAVATORIES
18. NO. OF SINKS / 19. DISPOSAL 19A. DISWASHER
20. NO. OF CONDUCTORS SIZE 21. NO. OF STACKS_ SIZE
22. AREA OF ROOF 23. NO. OF CATCH BASINS 24. NO. OF FLOOR DRAINS
25. NO. OF OTHER FIXTURES KIND
26. ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW?
27. SIZE OF WINDOW 3 f Zi
28. IF NO WINDOW, WHAT KIND OF VENTILATION IS THERE? ram,
29. SIZE OF DUCTS 30. SEWER OR SEPTIC TANK?
31. SIZE OF WATER MAIN / 31A. SIZES OF WATER PIPING & RISERS f
/ r
32. REMARKS AND FURTHER DETAILS 42 1 L
b�,� 4-c
WATER HEATER
33. TYPE 1 ; ��- 34. MANUFACTURERS-e i-/?-i pjp
TANKS SAFETY DEVICES
TEMPERATURE
35. CAPACITY 0 39. RELIEF VALVE 5
36. TEST PRESSURE 00 LBS. 40. MANUFACTURER ( G
37. WORKING PRESSURE / j� LBS. 41. PRESSURE RELIEF VALVE Lr� S
38. TYPE j � �� 42. MANUFACTURER
Z0q 139
LICENSE NO. DATE SIGNAtUREkOF APPLICANT
PHONE NO. (Q�e 4�