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Home My WebLink About168 Strong Road FISCAL INSPE Ns: Building APPLICATION FO� BUILDING PERMIT Plumbing 1'HVA � 1 ►�� f Q� Sprinkler ,I-n STRONG ROAD Date: ofoo C) Electric FOUNDATION ONLY --Estimated Cost $ Z Zoning P3 Permit Fee$ Affidavit NO. 21767 Occupancy Fee $ Eng. Dept. COMPLETE RED BOXED AREAS. Fire Dept. 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, here_y applies to do work accordi g to the following specifications: Job Location Lot.No. Side of Street Zone Applicant $r-1 by r-V-Z�-cL Tel. # Z'��"85'8(0 Address /c)7- 0LX> W.,41>n o oe aZ�,a"' �w , Cr Zip d(c no Z�_ Lic.# STREET CITY STIATE Owner L'4 mot•`• Address Architect '6L-M wEme 49. L-DA,ss Address /07 CL,u Size New Area: Ft. Front Overall -70 Ft. Deep Overall e_Total Area Z:c'04 51, #Garages Size of Lot 17•IS- k- "Dist. from Street Line zT o Lavatories Bathrooms Rooms 1st 2nd 3rd Purpose of this Permit +J of�_ � o 0.4 'T'.t-=7 City Water JK Well 0 Septic 0 Sewer . Use Group iC/ Construction Type & &,2za; Approved by Date BD1A 11/88 �Y I h reby agree to conform to all the requir m nts of the Laws of the Stat 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 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: Location of job AFFIDAVIT Additional Fee .....4�............ State of Connecticut ss. County of Hartford ;� Owner I . .��...... ; (C C............... .. .. .. .of r'��S'............ t for building erected under Contractor—, Permit Na ...... ........... . .. .... ..J' sued by the Dept of Building of the Town of South Windsor being duly sworn,make oath -2► a39 / �1 -l6 � and say that the actual cost of the completed work authorized under said permit did not exceed the submitted estimated cost K/Signed A. .............. TCI �- Subscribed and sworn to before me this ... . . . . . . . . . . . . . . . day of . .. . `�J'r�a.`." . .. ... . ........ A.D.19 .� Estimate Cost:$ a`Z��COU ... . . . . . . . . .. . ...... .. . . . . .. . . .... Difference: $ �J Nota..Public. -• +s Inspection / Approval Date By Appl Code Description Due Whom Code Comment ------------------------------------------------------------------------------- 94-21634-B 102, 7.08 BO1 FOOTING 07/27/94 JFF A 1LINEBTOFLINE5MIDDTOFLINEF1T05 BO1 FOOTING 07/29/94 JFF A ALINEENTIRElT055LINEMIDDTOF E01 SERVICE 08/01/94 JFH D NO PERMIT E01 SERVICE 08/15/94 JFH A RELEASE ISSUED P02 UNDERGROUND 09/12/94 JRC A E03 ROUGH 09/29/94 JFF A BATHFRONTWALLONLY B03 FRAMING (ROUGH) 09/30/94 JFH A P03 ROUGH 09/30/94 JFH A AIR TEST P02 UNDERGROUND 10/06/94 JFF A STEAMLINEMILLTOBOILER E02 UNDERGROUND 10/07/94 JFF A MILLTOKILN PO4 GAS TEST 10/07/94 JFF A MILLTOKILN P02 UNDERGROUND 10/07/94 JFF A MILLTOKILN PO4 GAS TEST 10/25/94 JFF A INTERIOR H03 ROUGH 11/01/94 JFF D NO PRESSURE H03 ROUGH 11/01/94 JFF D TEST FAILED H03 ROUGH 11/03/94 JFH A AIR TEST B10 FINAL 11/14/94 JRC A TCO-FOR FINANCING PURPOSES ONLY 94-1062-S 14,800 94-9452-P 3, 413 94-8994-H 22, 575 94-13139-E 11,000 Cd Total Est Va I u e 154, 496 ��C7 1 Connecticut Engineers in Private Practice Structural Engineers Coalition Statement of Special Inspections ��Y Ltwlovsr�v� Project: LlrvO Location: 576 e.OA0 SvvTH Owner: r`l li(A Al Owners Address: Arch itect of Record: go Q)A A I A S TAB u�`� �� wIG� ural En F�e,�� c �'�� P►�� Struct Engineer of Record:g This Statement of Special inspections is submitted as a condition for permit de. It issuance s a Schedule of with the special inspection requirements of the BO s wellt s thegnaming e of he Special Inspector, and the identity Special inspections applicable to this protect of other approved agencies intended to be retained for conducting these inspections. The Special inspector shall keep records of all inspections, and shall scovered ish inspection ectionne reports to the he code official and to the structural engineer and architect of record. brought to the immediate attention of the contractor for correction. If such dis structural engineer andepancies are not cted, the discrepancies shall be brought to the attention of the code official and t architect of record.The special inspection program does not relieve the contractor of his or her responsibilities. Interim reports shall be submitted to the code official,owner,structural engineerand architect of record.A schedule of interim reports shall be approved by the Code Official prior to permit e. A final report.of inspections documenting compketion of all required specia l inspections and correction of any discrepancies noted in the inspections shall be submitted prior to the issuance of a certificate of use and occupancy. _ Interim Report Frequency: or CzJ per attached schedule Prepared by Design Professional: FIEA,v L lR.r�t wS I P, ;��, :. •c"BOR.,T%G-; -(type or print name) _ • . 0 . ,o No. 13422 '.�O ''- Date ZCENSEa- Signature S/p N AL•`��`�`� Design 1'woSStLal's Sea! Own ris Authorizatio : Building Official's Acceptance: Signa re ate Signature Date CEPP/SEC Form 101 .Statement of Special Inspections.aCEPP/SEC 1993 -- - t -- sneers In Private Practice Sheet Z of ConnecticLiL Engineers L/ wt D Structural engineers Coalition Project: L t nip 5i � Schedule of -Special inspection Services The following sheets comprise the required schedule of special inspections for this specific project.The construction divisions which require special inspections for this project are as follows. ❑ Soils and Foundations ❑ Cast-in-Place Concrete ❑ Precast Concrete ❑ Masonry f�Structural Steel ❑ Wood ❑ Special Cases Inspection Agents I=lrm Address 1.Special Inspector A4-V 5 K S-& t i I G 2.Testing Laboratory 2! TbeN �t1w i t l r f5-r v& L�6 0 3.Testing Laboratory 4.Other Note:-The qualifications of all Personnel performing Special Inspection activities are subject to the approval of the Building OfficiaL CEPP/SEC Form 1a, •Stadement of Special Inspections•OCEPP/SEC 1993 . 04/03/97 THU 09:22 FAX 860 242 8587 PDS ENG.& CONSTRUCTION 10002 A' CORD LI 1;' DATE(MhII/LID/YY} �+ ��E;RT1:F��C�l�['��F'�::LIA►Ei� 02/14/1997 rrL'Ir:{:.T::r'•Ci.,,ly'R•'.L:aat.'a i>;11': .:nt... ...i...... ..,, l: .'1,.i i.i - •.t .. _ PRODUCER (860)674-9445 FAX (860)676-8172 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dill, Joyce & Thresher, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 19,Ens'i gn Drive ALTER THE COVERAGE AFFORDEE,BY THE POLICIES BELOW. P. C. BOX 7775 COMPANIES AFFORDING COVERAGE i , CT 06001 COMPANY PEERLES5 'xNSURANCE - Attn: Marie white Ext: 133 A INSURED COMPANY PDS Engineering & Construction, Inc. B 107 Old Windsor Road Bloomfield, CT 06002 COMPANY C COMPANY D COVERAG �/�� ES. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABCVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REECUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR 07HER DOCUMENT WIT I I RESPECT TO WHICH T-115 CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DEESCR-BED HEREIN IS SUE'JECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO 'HYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION, LIMITS LTR DATE(MWDD/YY) DATE(MWDD/YY) GENERAL LIABILITY ; GENERAL AGGREGATE S 2,000,00 X ; COMMERCIAL GENERAL LIABILITY ' PRODUCT S•COMPiOP,AGG S 21000,000 A CLAIMS MADE X 'OCCURIC8P9104266 08/2$/1996 08/28/1997 I PERSONA.&ADV INJURY $ 11000,000 OWNER"3 8 CONTRACTOR'S PROT EACH OCCURRENCE S 11000,000 FIRE DATA 1GE(Any one Are) s 50,000 MEd EXP I Any one persoi} $ 10,000 AUTOMOBILE LIABILITY x 'ANY AUTO COMBINED SINGLE LIMtt $ 11000,000 ALL OWNED AUTOS BODILY IN.It IRY Sl:IiEULR_EG AUTOS (Per pera�r} 5 A :BA9109065 08/28/1996 08/28/1997 ; HIRED AUTOS BODILY IN.URY NON-OWNED AUTOS ; (Per acdde it) 5 PROPERT"DAMAGE $ I GARAGE LIABIUTY AUTO ONL P•EA ACCIDENT S ANY AUTO OTHER TH 4N AUTO ONLY: .a'. EACH ACCIDENT S AGGREGATE 5 EXCESS LIABILITY EACH OCC LIRRENCE a 51000,000 A X UMBRELLA FORM CU9103067 08/28/1996 08/28/1997 AGGREGATE S S1000,000 OTHER THAN UMBRELLA FORM 'Retention S 10,000 WORKERS COMPENSATION AND TORY LIMITS _•• ERI.. .............:..,`_.,rS i�:i��y�•` EMPLOYERS'UAB1LITY EL EACH A'C(D5NT S 100,000 A THE PROPRIETOR/ INCL WC9103366 08/28/1996 08/28/1997 : EL WEAsr.POLICY LIMIT , S 500,000 PARTNERS/EXECUTIVE OFFICERS ARE. EXCL Et.nISEASI i•EA EMPLOYEE. S 100,000 OTHER DESCRIPTION OF OPERA'IONSLOCATONSIVEHICLESISPECIAL ITEMS CERTIFICATE:HOLDER'• CANCELLATION` I',•,,,,;; ,.. ; .. .�'`":_,... ... ' ... .. .. .......v,i...., .... ...1 .. .., ,..r.. ,. I ,�LL..r Y 1:6«•y,•:i::.%f i,i r :.C'S_'._ ;r.S.' t•:u. :�. SH04JLD ANY OF THE ABOVE DESCRIBED POLII:IES BE CANCELLED BEFORE TM EXPIRATION DATE THEREOF,THE ISSUING CON IPAMY WILL ENDEAVOR TO MAIL 30 DAYS rVRITTEw NOTICss T'O THE CERTI{7CATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SH/LLL IMI-08E NO OBLIGATION OR LUIDIUTY OF ANY KIND UPON RF.R$E9_ TATi1VEs. AUTHORIZED REPRESENTATIVE John Kycia B : ACORD 254(119S) URpORA'TiOt�t yes i it dg n 6 Building s: APPLICATION FOR BUILDING PERMIT Plumbing jL�Q�' Date: 10/11/9 4 HVAC Sprinklers STRONG ROAD Electric �s� Estimated Cost $ ?0'00-J" g Zonin 3 Permit Fee $ O Affidavit NO. 219 3 9 Eng. Dept. Occupancy Fee $ COMPLETE RED BOXED AREAS. Fire Dept. TYPE OR PRINT ONLY Total Fee $ Health Dept. SIGN ON REVERSE SIDE. Approved for CO: 6 (Additional Cost) $ TO BUILDING DEPARTMENT, TOWN OF SOUTH WINDSOR, CT The undersigned, hereby applies to do work acc rding to the following specifications: Job Location 420a Lot No. Side of Street Zone Applicant S LNG-i.vEE/Li�t/G— �c�+57`11"c7`t41 Tel. # Z4l-SfB� Address /07 o10 I J114sa2 2v( 'e� CT Zip 06602- Lic.# STREET CITY STATE Owner KAA#-/ Address 13go j!oAA) (3C.U.D Sa, W4 Sot C 7` ArchitectP�� w� �N9 4)^s7`4'tr,u..� Address /o� o�01.�� e� �� loaH .'N%( tT" Q02- Size New Area: Ft. Front Overall'Z0�b Ft. Deep Overall Total Area 7oa #Garages Lavatories Size of Lot Dist. from Street Line Bathrooms Rooms 1st 2nd 3rd Purpose of this Permit gUi1 0'-va 0--) V . F0Uj,4—.'oN IefM%r ct,(r-ea v i1S y,Pw City Water 13 Well 0 Septic 0 Sewer 0 Use Group 5---1 Construction Type ZG Approved by Date �� '� BD1A 11/88 i I hereby agree to conform to all th requir ments of the Laws of the Stat of Connecticut and th 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 sked,and agree that this building is to be located the proper distance from all street lines,side yard lines and required distances from a I they zones and is located in a zone in which this building and its use is allowed. . -; / % Signed 31""y� 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: . •t;INAIl INSPECTION • z� Building APPLICATION FOR BUILDING PERMIT Plumbin HVAC 16 STRONG ROAD [D7ate: �-S- : - Sprinkler 9,51000 Electric 3 $ Estimated Cost $ Zoning Permit Fee$ Affidavit J�'L Dz&O.- 24113 Occupancy Fee $ Eng. Dept. Fire Dept. COMPLETE RED BOXED AREAS. Total Fee ; 3d� 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 work according to the following specifications: Job LocationJill Lot No.--Side of Street Zone —,®,.,lc,,. ..�� c-T�o� T e I. # .Z-"' �BCo Applicant�y.��y ��-� """ Q� �,,��• , w y �y Ia/� CIK.�• STATE ZIp vW� LIC.# Address STREET Owner ,Vg;--- L,S..j --Address Architect -%>� aEI'' )'� et#L—L Address `- Size New Area: Ft. Front Overall 3 Ft. Deep Overall �--o'� Total Area z�' ` #Garages r Lavatories Size of Lot Dist. from Street Line Al -Bathrooms I -Rooms 1st 2nd 3rd Pur ose of this Permit i4city Water Ad Well 0 Septic 0 Sewer Use Grou Jill Construction Type Approved byKJL- Date BD1 A 11/8B I h reby 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 lin s and required di nces from a other zones and is located in a zone in which this building and its use is allowed. Ysigned— I hereby apply for a Certificate of Occupancy for the work described in this appl'cati f ermit. 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: Inspection / Approval Date By Appl Code Description Due Whom Code Comment ------------------------------------------------------------------------------- 97-24113-B 25,000 B01 FOOTING 04/09/97 JRC A P02 UNDERGROUND 04/29/97 JFF A E03 ROUGH 05/16/97 JFF A OFC & MECHANICAL ROOM ONLY B04 INSULATION 05/22/97 JFH A B03 FRAMING (ROUGH) 05/22/97 JFH A P03 ROUGH 05/27/97 JFH A B10 FINAL 06/26/97 JFH A 97-9946-P 500 97-9929-P 900 97-14398-E 4,500 Total Est Value 30,900 i i SITE COMPLIANCE CHECKLIST TOWN of SOUTH WINDSOR, CONNECTICUT 16 8 STRONG ROAD t LOT_# Reviewed By O/1 a&4 e ngineering) PDS ENG/CONST/WM JODICE Date Reviewed 77 !S 97 prove /Denied 107 OLD WINDSOR ROAD,BLOOMFIELD,CT Reviewed By anning) BP #_24113_ Ph_# (203)242-8586 Date Review s pprov /Denied Date Submitted 07/15/97 ***** FOR C WO ** As required in the Zoning and/or Subdivison Regulations, no Certificate of Occupancy shall be issued until grading plans have been complied with and approved by the Town- Engineer. The minimum requirements shall include: Approved Denied N/A 1. Approved building permit plan 2. Finish grading per approved building permit plan 3. Site work; i.e. trees, shrubs, dumpsters, required parking 4. Utility location; a. sanitary sewer/septic system b. foundation drain C. electrical & telephone d. water e. other 5. Sewer connection charge paid (� 6. Appropriate certification 7. Bonding 8. Planning & Zoning/ Inland Wetlands Considerations 6/7 Sewer Permit No. Pavement Excavation No. COMMENTS: oIc die 6 e(N Al PDS Engineering & Construction, Inc. 107 Old Windsor Road, Bloomfield,Conn.06002 Phone: (203)242-8586 Fax: (203)242-8587 INN tl- /tlulllllu►�/•. � IF a �Illlllllladld�lillnn, I October 24, 1994 d POS ENGINEERING & CONSTRUCTION Town of South Windsor 1540 Sullivan Avenue South Windsor, CT 06074 ATTN: John Collins RE: Linkwood Kilns Strong Road, South Windsor Dear Mr. Collins, We are classifying the Linkwood Manufacturing kilns as S-1 and the construction type as 2C. The allowable size, per the BOCA code, for these buildings is 8,400 S.F. This far exceeds the actual building size of 11325 S.F. Should you have any questions or comments, please do not hesitate to call. Very Tr You ,\ 5 Frank C. Boraws i, P•E• Vice President PDS Engineering & Construction, Inc. yeg S97nC4AB FCB/ab R OCT 27 1994 -� 41 South_ Windsor w��`""�' t� ' BUILDING DEPARTMENT DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT 24 3 T Application is hereby: TOWN of SOUTH WINDSOR BUILDING DEPARTMENT Bldg Permit# APPROVE 1540 SULLIVAN AVENUE 6.14-2511 ext.230 Date Building Inspector Application must be printed or typed F Location ofjob No. Street Lot No. FEE SCHEDULE Floor Apt.No. $0 - $1,000 - $12.00 Over $1,000 $12.00 per$1,000 OWNER or any fraction thereof ADDRESS 5"-pw c, OWNERS PHONE# c? ] 1 7 -1 2 APPLICANT r r' a r 1^4 C +'t OWN S� ADDRESS C, i �•yr r..r �r: •'r r . 00 ` ESTIMATED COST$_L1 , �;L' O IS THIS A CONTRACT COST? �1 V YES NO C1 FEE ENCLOSED $ b-AP TYPE OF JOB: OR-Co Original Installation _ Alteration/Addition/Repair . Revised 11/93 APPLICATION FOR ELECTRICAL PERMIT(Continued from reverse side) TYPE OF BUILDING 1S THIS APPLICATION ASSOCIATED WITH A RESIDENTIAL BUILDING PERMIT APPLICATION YES / NO BUSINESS ASSEMBLY CURRENT USE AND OCCUPANCY MERCANTILE EDUCATIONAL FUTURE USE AND OCCUPANCY � ccr 1 ,�n� /- �,' �+ tvI Ile t INSTITUTIONAL FACTORY STORAGE ENGINEER'S NAME PHONE GARAGE MIXED USE ADDRESS CITY STATE ZIP (Other please specify) TYPE OF INSTALLATION/WIRING METHOD SIZE OF MAIN FEEDERS AND RATING OF WIRE USED �C�L�,/� cjt?t`4C ir, NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS Ll OU• ' NUMBER OF PANELS REMOTE DISCONNECT REQUIRED?YES/NO NUMBER OF LIGHT CIRCUITS NUMBER OF POWER CIRCUITS NUMBER OF SWITCHES NUMBER OF OUTLETS NUMBER OF LIGHT FIXTURES NUMBER OF HEAT CIRCUITS NUMBER OF A/C CIRCUITS SEPERATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED. DESCRIPTION OF WORK c� r l �C Oi�� X�=�,i-: 7 f` 'u r e A e THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONN.BUILDING CODES IN THE PERFORMANCE OF SUCH WORK. NAME STATE LICENSE NO. TYPE SIGNATCRE OF APPLIC PHONE NO. 56 q-�",Jb DATE l 5r �I DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT P Ij,�v1IT APPLIC �.? Application is hereby-: TOWN of SOUTH WINDSOR BUILDING DEPARTMENT Bid Permit# APPRO 1540 SULLIVAN AVENUE r I� 644-2511 ext. 230 Date Building Inspector Application must be printed or typed Location of job FAC �s��,�o�6 FEE SCHEDULE Street No. Street Lot No. FEE SCHEDULE Floor Apt. No. $0 - $1,000 - $12.00 Over $1,000 $12.00 per$1,000 OWNER or any fraction thereof ADDRESS A4 OWNERS PHONE# APPLICANT W N S ADDRESS io ESTIMATED COST$ C ; - IS THIS A CONTRACT COST? YES NO FEE ENCLOSED $ TYPE PE OF JOB: OR-Co Original Installation Alteration/Addition/Repair Revised 10/96 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 INSTITUTION FACTORY ENGINEER'S NAME PHONE STORAGE GARAGE ADDRESS MIXED USE CITY STATE ZIP (Other please specify) TYPE OF INSTALLATION bD/ T7_14v/\/ SIZE OF MAIN DRAIN 3 NO. OF TOILETS_�STYLE 7�/k-_ NO. OF URINALS STYLE NO. OF BATHTUBS -- NO.OF SHOWERS NO.OF LAVATORIES NO. OF CONDUCTORS --SIZE NO. OF STACKS / SIZE '` AREA OF ROOF -- NO. OF CATCH BASINS NO.OF FLOOR DRAINS NO. OF OTHER FIXTURES KIND ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW YES/NO SIZE OF WINDOW IF NONE C.F.M. OF VENTILATOR SIZE OF DUCTS SEWER OR SEPTIC TANK SIZE OF WATER MAIN k SIZE OF WATER PIPING&RISER WATER HEATER TYPE MANUFACTURE l TANKS SAFETY DEVICES TEMPERATURE CAPACITY RELIEF VALVE "�-4 FT5 210 TEST PRESSURE IS6 WORKING PRESSURE_1_S PRESSURE RELIEF VALVE TYPE T4 p MANUFACTURER ViATTS DESCRIPTION OF WORK Dc) TO THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CO DING CODES PERFORMANCE OF SUCH WORl. NAME STATE LICENSE NO. TYPE SIGNAItRE OF APPLI PHONE NO. — (9 DATE4-2-,9:-�7 DEPARTMENT DECISION LICATION FOR PLUMBING PERMIT PE1 qc(!�?o # �P Application is hereby: TOWN of SOUTH WINDSOR BUILDING DEPARTMENT BPermit 11 # APPROVED 1540 SULLIVAN AVENUE 644-2511 ext. 230 Date B ' ng Inspector Application must be printed or typed Location of job etao� Street No. Str Lot No. FEE SCHEDULE F loor Apt.No. $0 - $1,000 - $12.00 Over $1,000 rn $12.00 per$1,000 OWNER 'e- or any fraction thereof ADDRESS OWNERS PHONE# �qu;J APPLICANT in ADDRESS o Cd d G i r-(j °w 0�� ESTIMATED COST$ C ; IS THIS A CONTRACT COST? YES NO rL v;N FEE ENCLOSED $ TYPE OF JOB: �R'CO Original Installation Alteration/Addition/Repair Revised 10/96 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 INSTITUTION FACTORY ENGINEER'S NAME PHONE STORAGE GARAGE ADDRESS MIXED USE CITY STATE ZIP (Other please specify) TYPE OF INSTALLATION SIZE OF MAIN DRAIN NO. OF TOILETS _STYLE ti NO. OF URINALS STYLE MM NO. OF BATHTUBS NO. OF SHOWERS NO. OF LAVATORIES 1 NO. OF CONDUCTORS SIZE NO. OF STACKS SIZE AREA OF ROOF NO. OF CATCH BASINS NO. OF FLOOR DRAINS NO. OF OTHER FIXTURES KIND ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW YES/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 MANUFACTURE TANKS SAFETY DEVICES TEMPERATURE CAPACITY 1 RELIEF VALVE TEST PRESSURE WO-RpKING PRESSURE PRESSURE RELIEF VALVE TYPE fi ` MANUFACTURER WR r t s 1 DESCRIPTION OF WORK or wa �r I i n -ems c f-ys and b r ent I t red THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONN.BUILDING CODES IN THE PERFORMANCE OF SUCH WORK. NAME STATE LICENSE NO. TYPE C SIGNATURE OF APPLICANT PHONE NO. Sa� 0�0 r DATE 5 �`3 q