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HomeMy WebLinkAbout145 Rockledge Drive rwycx 3 TO THE BUIULDING INSPECTOR (� 3 of the APPLICATION FOR PLAN EXAMINATION AND 'A s'3/.od TO" (W SOTH WIPIDSM 00MBUILDING PERMIT IMPORTANT — Applicant to complete all items in sections: 1, It, III, IV, and IX. O ZONING Q • AT (LOCATION) DISTRICT(`- LOCATION (NO.) (STREET) OF BETWEEN "C_iz , u AND /�,�•C��%� �/ BUILDING (CROSS STREET) (CROSS STREET) LOT pp SUBDIVISION 5;, a jr LOT � BLOCK SIZE II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D A. TYPE F IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use � 1 New building Residential Nonresidential 2 ❑ Addition(l/residential, enter number 12 Q'One family 18 ❑ Amusement, recreational of new housing units added, if any, 13 ❑ Two or more family - Enter 19 ❑ Church, other religious in Part D, 13) number of units- - - - -)w 20❑ Industrial 3 ❑ Alteration (See 2 above) 14 ❑ Transient hotel, motel, 21 ❑ Parking garage 4❑ Repair, replacement or dormitory - Enter number 5 ❑ Wrecking (1/multifamily residential, f units ------- - -! 22❑ Service station, repair garage enter number o/units in building in 15 Q Garage 23 ❑ Hospital, institutional Part D, 13) 16 ❑ Carport 24❑ Office, bank, professional 6 ❑ Moving (relocation) E] Publicutility 17❑ Other - SpeciJy 25 7 ❑ Foundation only 26❑ School, library, other educational B. OWN RSHIP 27❑ Stores, mercantile 8 [Private(individual, corporation, 28 ❑ Tanks, towers nonprofit institution, etc.) 29❑ Other - Specify 9 ❑ Public (Federal, State, or local government) C. COST (Omit cents) Nonresidential - Describe in detail proposed use of buildings,e.g., food processing plant, machine shop, laundry building at hospital, elementary 10. Cost of improvement,,,,,,,,,,,,,,,, S v school, secondary school, college, parochial school, parking garage for, department store, rental office building, office building at industrial plant. To be installed but not included If use of existing building is being changed, enter proposed use. in the above cost a. Electrical...................... b. Plumbing ...................... c. Heating, air conditioning......... d. Other(elevator, etc.)............ 11. TOTAL COST OF IMPROVEMENT $ SPDot) III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — L; for wrecking, complete only Part J, for all others skip to IV. E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS 30 S M my(wall bearing) 40[ublic or private company 48• Number of stories................ 31Wood frame 41 ❑ Private (septic tank, etc.) 49• Total square feet of floor area, all floors, based on exterior' 32❑ Structural steel dimensions .................... 7 33❑ Reinf reed concrete H. TYTPublic F WATER SUPPLY 50. Total land area, sq. ft. ...........34❑ Other - Specify 42 or private company 43 ❑ Private(well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES F. PRINCI AL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed ....................... 35 Gas Will there be central air 52. Outdoors....................... !t/ 36❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY 37❑ Electricity 44❑ Ye 45 Ef�N 53. Number of bedr ms............. 38❑ Cool 39❑ Other- Specify Will th re be an elevator? 54. Number of Full.......... 2 46❑ Yes 47 /No bathrooms ........L. I I IV. IDENTIFICATION — To b complet d by all applicants Name Mailing address — Number, street, city, and State ZIP code Tel. No. i. LaGAVA l: iiJli'bu.lvi, Owner or 185 All AS DEANE HIGHWAY Lessee yYETNMFIELD, CONN. 06109 2. LaCAVA CONS.c���{,: Contractor 185 SILAS DEANE HikvHWAY 3. Architect or Engineer The owner of this building and t-he undersigned agree to conform to all applicable laws of this jurisdiction. Signatur of applicant Address Applic tion ate LA CA $0`���CTION CO. 00 NOT WRITE BELOW THIS LINE V. PLAN REVIEW RECORD — For office use Plans Review Re uired Check Plan Review Date Plans B Date Plans B Notes 9 Fee Started y y Approved BUILDING $ PLUMBING $ MECHANICAL $ ELECTRICAL $ OTHER $ VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Permit or Approval I Check Date Number B Permit or Approval I Check Date Number By pp Obtained Y pp Obto fined BOILER PLUMBING CURB OR SIDEWALK CUT ROOFING ELEVATOR SEWER ELECTRICAL SIGN OR BILLBOARD FURNACE STREET GRADES GRADING USE OF PUBLIC AREAS OIL BURNER WRECKING OTHER OTHER VII. VALIDATION Building �^ Permit number Building Permit issued 19 Building Permit Fee Aipprokvdy: TITLE i p I i t TOWN OF SOUTH WINDSOR BUILDING PERMIT Date- Aug. 22 , 1984 4► Fee Paid $ 5 2.8 .0 0 Eat. Value $. .8 80 0 0 Permit NV 14028 4 1 on the aide of Lot #4 Rockledge Drive Street s Street No. 145 Owner LaCa va Construction Co. Applicant G. A. LaCa ya CERTIFICATE OF OCCUPANCY ISSUED: Date No. 6869 Fee Paid $ 3 .00 CLASSIFICATION Dwelling BUILDING PERMIT N'�' 14028 OFFICE OF THE BUILDING INSPECTOR of the Town of South Windsor, Conn. South Windsor, Conn. Aug. 2 2 1984 941a is to Cerfifig, That T.a _ava ConintrLctinn Co is hereby granted permission to Dwelling at estimated value of $ on the side of Lot #4 Rockledge Drive Street on land owned by T•aCa ya Construction Co Said Work to be as described in Application No. 14 12 S and to conform to specifications and plans filed with said Application, and Building By- Laws of THE TOWN OF SOUTH WINDSOR. Iss ed Aug, 22 19 84. AA ding Inspector. Streets and sidewalks, obstructed by excavations or building materials, must be guarded by barriers during the day and by both barriers and colored lights by night. SECTION 1343, GENERAL STATUTES OF CONNECTICUT: "When any person shall place or keep building materials, or any obstacle in any highway (or any sidewalk) either with or without a license therefor from the city or borough in which such highway may be situated, he shall pay said city, town or borough all costs and damages which it shall sustain, or be compelled to reason therefor." DWelling - Lot #4 LaCa v..- Construction Co Sa v.Wd. 1 145 Rockledge Drive ' 8/22/f PerMlt # 14028 Electrician David Heats n Garber S Contr. D. # 8 5 8 0 � . Plumbs it Bartone p & H# 6044 D. Bartone p Oil Burner & H 6565 Certificate of occupancy Sewer Penn i t # 6869 Plot plan a - PArd. Pe V Permit Nd. TOWN OF SOUTH WINDSOR SOUTH WINDSOR, CONN. Permit ` 6869 Certificate of Occupancy THIS TO CER Y e at Nov in th own of South Windsor, Connecticut, has been erected and completed ' accordance wi the B ' irg Code and Zoning Regulations of the Town of South Windsor, and is hereby app ved or occup SAILA Buil in nspec or Own r, Bui der Fee Paid Date 19 )401?111144� "ft,_;,,, au. M�►t: "Sarin Woods, Section I, An Q"o Space Subdiyisioo ,,yy ✓� Q�J t` to as is Zone, Property of the salt Company, Meyers and Abbe load, South Yiodsor, ?I(P !' 2-344, Sheet ♦ of S. Scale 1%W', Map prepared by Lucsk tmgineerins Asaoc. Inc., 40 Sucklaad ad., Soutb Ylsdser, Cr. -p 5c> LOT LOT L-O r / `\Y r r \ �`• f v n MAN L ` -ll� 9,`1 _ � y � -��,.x..nr► :nay" r�c Li CA5 _ r � —- --goo *Awr. CO+r031tXI-P A N ,` L O T P L Wy p R o P E R T Y O F I n roo: v Fj',tr. '► C-qRAdC, 10-i I N d 5C4 , , C-. j HERE&r CERr1rr THAT TM/S Amp IS SIINSTANT/AL L Y CORRECT AND ZON/N6 REGULAMNS ARE NOT VIOLATED S'CAL E 1 ti 40 T DA TE 8/7/E?'i cy 8580 ELECTRICAL APPLICATION Application No. 9991 on the side of Lot #4 Rockledge Dr. Street Street No. 145 Owner LaCava Construction Co. Electrician David Garber FILED IN OFFICE OF The Building Inspector Nov. 13 19 84 INSPECTION. m No Electrical Work shall be started until a Per- mit is granted by the Building Inspector. In New Buildings no wiring shall be started until the plumbing and heating pipes, and the fire stops (if of wood) are installed, without a special permit from the office of the Building Inspector. Electrical Permit No. .....gfp....................................... Master License No. ...................... TOWN OF SOUTH WINDSOR Building Permit No. ..... .............. BUILDING DEPARTMEN'r Date Filed ... 7.............................. Date Final Approval ..... ...... .................... APPLICATION FOR ELECTRICAL WORK Electrical Inspector jQoc�4 le A e- Dr. -Ot(62 JOBLOCATION. .. ........**3�??�. JOB OWNER: J .. ............. ......................................................... Sideof Between .......... ... .. . and . .............................................................................. .4 Name of Building Owner 4acq��k .... . ............... Address If work is for Lessee—Give name Address .................. ....................................... ........ ........ ...... Building now occupied as (unless new) /Ve No. of family units now . ....... . Building to be occupied as ....... .. ... ...... . . .. ....... ... Number of family units to be ...... .... ................ Is this work included in a Building Permit? -ej Permit Fee .. . . ....... ........ ....................................... .................... (If no Building Permit) Permittee Business Address .... Garber- 'Clephone Doran,Inc. ..... ............. 80 Carpenter Rd. COST OF INSTALLATION: . . .. .......................... .............. 11 Manchester,CT 06040 .......................................................... TO BE FILLED OUT BY PERMITTEE TO BE WIRED 31-70 Number of convenience outlets to be installed '4 EXISTING APPLIANCES Number of light outlets to be installed * * * ' - ' Number of present Appliance Circuits .. .. .... ............. ......... . Number of switches to be installed . . . . 3 0 Do these include Range ❑ Water Heater E] Number of appliances to be installed . . . (as listed below) Dryer ❑ Air Conditioner ❑ Oil Burner ❑ TYPE RATING NO. Range . . . . . . . . Dish Washer F] Gas Burner ❑ . . . . . . Well Pump [:] Elec. Heaters ❑ Range Top Oven . . . . . . . . REMARKS: Water Heater Clothes Washer . . . . Clothes Dryer . . . . . y A0 Dish Washer . . . . . . Air Conditioning Motor Oil Burner Motor . . . . Gas Burner . . . . . . Circulator Motor . . . . Attic or Large Fan Well Pump . . . . . . Electric Heat . . . . . Other p i.51 0. . . . . . Number of new Lighting Circuits . . . . ...........1.y............. Number of new Appliance Circuits . . . .............................. Number of Heating Circuits . . . . . . .......................... Number of Motor Circuits Size of present service ............ .................. Size of service to be . . ................................................. 6565 PLUMBING APPLICATION Appliotion No, 7 3 41 on the_._ side of �&�A-oefvcp - s- - Street Pit. _ < Plumber Mad in Office of The Bn-hdmg Lrpcctor Nov. 14 19 8 4 r No person shall oos In r- add m or alter my portion of the &aimp system of my bua'16g (ezoept to repair 66) uma a Pk:mit is gtaated by the Building Lopedor. APPLICATION FOR PLUMBING PERMIT (Continued from R v rs Sid TOWN OF SOUTH WINDSOR, CONN. 11. LOCATION OF JOB vr �?'zi�alce ae'no/-5� NO. SL7ET FLOOR APT.NO. GENERAL PLUMBING 12. KIND OF INSTALLATION 13. SIZE OF MAIN DRAIN 14. NO. OF TOILETS STYLE 15. NO. OF URINALS STYLE 16. NO.OF BATHTUBS 17.NO.OF LAVATORIES 18. NO.OF SINKS�_ 19. NO. OF WASHTUBS 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 28. IF NO WINDOW,WHAT KIND OF VENTILATION IS THERE? 29. SIZE OF DUCTS 30. ARE SEWAGE AND WATER FACILITIES AVAILABLE? yes SIGNATURE ADDRESS •5 aau LICENSE NO. ��� 633 ESTIMATED COST 22000 , TELEPHONE &-�F-3/Z� OWNER PADDRESS g!'! 62" /I.A& WATER HEATER 31. TYPE 32. MANUFACTURER O TANK SAFETY DEVICES 33. CAPACITY 37. TEMPERATURE RELIEF VALVE L"� 34. TEST PRESSURE 38. MANUFACTURER 9 t 35. WORKING PRESSURE 39. PRESSURE RELIEF VALVE 36. TYPE 40. MANUFACTURER ALL WORK COVERED BY THIS APPLICATION HAS BEEN AUTHORIZED BY THE OWNER OF THIS PROPERTY AND WILL BE DONE IN STRICT ACCORDANCE WITH THE BUILDING CODE. CD962 D E SIGNATURE OF APPLICANT PERMIT # r~ Application For 6435 6044 DEPARTMENT DECISIONCl Heating Permit 0 3 APPLICATION IS HERESY:o DEPARTMENT OF LICENSES AND INSPECTIONS N APPROVED ❑ DISAPPROVED 4j TOWN OF SOUTH WINDSOR o " 11/14/84 Thomas P. D' Auria 00 DATE CHIEF INSPECTOR APPLICATIONS MUST BE PRINTED OR TYPED. BEGIN WITH NUMBER ONE BELOW O O v 1. LOCATION OF JOB o 0 I~ NO. V STREET v Cd COT NO. FLOOR APT. NO. O 0 � N 79 4) O p 2. OWNE (e; 1A' cc : 0 > 3. ADDRESS C7 lD / 4.PHONE Cn .� S. APPLICANT m � •� ,� d. ADDRESS / 7.PHONE 4 S. LICENSE NO. ��� Z o Z 0 w 9. EXPIRATION DATE OF LICENSE - /0 c� O 10. ESTIMATED COST '~ 11. IS THIS A CONTRACT COST? ES ❑ NO bo .a •� .� 12. FEE ENCLOSED 3-- P P rm i t 1 4 0 .E sv � (1) 13. TYPE OF BUILDING: rA O � R[fID[MTIAL ❑ COMMERCIAL C 3 14. TYPE OF JOB: ❑ INDUSTRIAL C; IL L ❑ ALTERATION INSTALLATION ADDITION REPAIR APPLICATION FOR HEATING PERMIT (Continued tr m Reverse Side) 11. LOCATION OF JOB 6E06 NO. STPOR FLOOR APT.NO. 12. TYPE OF INSTALLATION: ❑ OIL BURNER ❑ ELECTRIC Cl VENTILATION ❑ SPRINKLER BOOOGAS BURNER ❑ STACK ❑ INCINERATOR ❑ MISCELLANEOUS IDENTIFY SIZE LOCATION SIZE SIZE 13. OF TANK OF TANK OF FILL OF VENT 14. B.T.U. EQUIP. AT REGISTER FURJ ACE MAKE AND NO. AT BONNET FIRING RATE BOILER OR FURNACE MAKE AND NOAz B.T.U. OR SQ. FT. NET I?T.U. OR SQ. FT. GROSS FIRING RATE FLOORS TO BE HEATED 2-I NEW OR OLD BUILDING I/J eA.Al/ INSULATED - YES OR NO s TYPE OF WALL ��d_INSULATION ROOF OR CEILING INSULATEO AVG. SYSTEM WATER TEMP. B.T.U./SQ. FT./HR. EMISSION INDOOR-OUTDOOR TEMPERATURE DIFFERENCE o -7 d tl °FAHRENHEIT MAKE OF RADIATION: BASEBOAg. CCO CONVECTORS, OR C.I. RADIATION. OUTPUT PER SECTION OR LINEAL OF RADIATION. SQ. FT. OR B.T.U. DESCRIPTION OF WORK 15. TO BE DONE: 16. HEAT LOSS SCHEDULE. (TO BE INCLUDED FOR ALL JOBS): ROOM SIZE WINDOWS AREA - SQUARE FEET B.T.U. B.T.U. O< DISTRIBUTION INSTALLED AND DOORS VOLUME TOTAL TOTAL VI ROOM NO. GROSS GLASS NET WALL CEILING FLOOR CU.FT. AT 70•F CORRECTED J j 4 4 REGISTER L INN AND TEMP. TO F TYPE AND SIZE RAD. OR LEADER SIZE < WALL f'Ct0 (INFILT.) DIFF. •F O m'ASQ. FT. FREE AREA 75< 75< TOTALS A. HEAT LOSS FROM BUILDING B.T.U./HR. B. DOMESTIC HOT WATER DEMAND B.T.U./HR. C. PIPING. OTHER THAN NORMAL B.T.U./HR. ALLOWANCE FOR HEAT VALVE OF FUEL (A B C) FACTOR 17. ELECTRICAL WORK BY: NAME ADDRESS SUBCONTRACTORS AND 1a. THEIR TRADES ALL WORK COVERED BY THIS APPLICATION HAS BEEN AUTHORIZED BY THE (OWNER) OR (AGENT) OF THIS PROPERTY AND WILL BE DONE IN STRICT ACCORDANCE WITH THE BUILDING CODE. APPLICATION TO BE COMPLETELY FILLED IN. ATE SIGNA UR[ OF APPLICANT x � _ �.z � ye -yam �- s '-�°r ,�; - +S_ €• - - - i:.- -- _ - '!.•--4-"�"�v r�"'�+-.:�cr - 1`` _'`'� i `wa •°�»-=,�� .a. -ram_ v _ '+ 'i' _ ;�°_a'� i�_ • ,� `'i, _K''- _ '.:�, _ �_- _ ,r � _ s/ _ _ ." _�� ''_.r•' _ �.,_ ,.. ,} _ °.v - :�•� _ _ - _ - .�".ram; `..}:-s:":--1'"s�i• - - `; - - - - - - - - - - - - "`'u• ,�• `��h�Z"„; pii'f•.� - .4. - tip:"K^;' - - _ Y•�4+ - _ _ .�.. s�'+ a s K r� - A i1 - J d - - �ta" - - � _ =fin:,�LF'•. - _ _ - - - - -- +` - -- �'� IFAte - - • ,` r _ems y' y' -. .y{ `y JS UL AO Am own" . q� "► i� L. � . —-------- IW use 00"TRUCT110" LsPb � � -, ....-r...W..►ww,...r.ra a.ti- ....�rwrw.^�Fw a..•w. �..oa+.,fws...m � Y ����� •M - 1Q • *l&U%LLjWITN KAu OR WITUM Ae TN v%ALLS OR EMTMOCII HALL �;z 11 TOTA T 70F T CUP.a F F EIKIMGt• '" f ;1 . i ;r, }� ,,�, �- x '�. 12 ITOTAL 9TUN AT DMOM TUMP.Oil FE/1E11C[ COL. A COL. a COL.M COL. 1 COL.i COL.x COL. L L 1 ROOM ofr C_ ,•.. `Ap W � M L M M L- M k L r M L • M L w r 2 NO"OIM[Ni10N3. FT. I.- V �� '6 t t?, 3 T TAL STUN TOTAL V OF WWWAG RADIATION TO Exroi80 WALLS. FT. < " AT SELECTED S wwom ANO OuTsrOE Omm ARIA ; ! OIFRESINCE STUN STUN STUN TUN STUN S �.' IL emm"tus Ion t W ►GLASS ,� LINS 7 REA:[ EATMROOM �IIETIIUCTMIN03 e ';" n {«.� TOTAL I01 1 FOR CONCRETE FLOOR ON *' O PAATtTw*CSmTRt1CTtOM __ 6PAW"0661 FILL A T G"VE VEL..US9►rIN1CAN FeZT fltTN K4/t-!RR�M!afOR1 _0 OM EIcIEO tQrQ join # T1RA !�: �-'{;.•.,� -.,r-_,��°ae yR.- .:r4+.d"^'y'_ _-:L%- s 'K�.r;' ._y..._" - _s�_..,.,..._f awww� _ �-_-v -. _� x,-�."e`-_,,z-�.� -r5`3+"z'?"c�':1.g,s-�_y. _s. - -. _•4^-.C-`�.�-s-a b.,.- __ -_ -> ,__ ��+F.zw, ��'���; •t�.•_'•"�e"�'�ti;: .>r -;.ri"f__.F pa i � --.- ,.,�„� " c' S.1 :T' _.��{y� � � •,��- J.f 35'tT.d»!!98'� :96��� A'trKS�6A@iR, P� � ����'jt'r� _ y �'il� Apr ,tp -i?"•�i� e1� •�iF - �� - 3'Fr _ _ "'(`� r-�+r LY ..°QI• �. 'f� •.fir-" hsz�` __- .. - .T - fif: - ��'� _ Y _- _ '?'F� 'A, - _�_ _ - Asx. - _ �'.'G -•..F" '���'' 'ate ,- .rS-:'s- ra _ ..... T+ fY.,fist x+' -- `+;_ - - � - _ - - 3_ - `f- ._ :yy "i �- .x^"•''s' .Q,�.5.=' .A i _ - - _ yµ r� F .- .,- 'w r w. x F01�1TOn x �•= =ill. .�- -�'�� !E 4 M L' M M• . Ar CC D. Ma, WEMML C�M&TiMICT14N '"" iTMACTION I 6 1T10N�b11STRtXt'PtOM N 0 J NALLfiM1TN iL�IN ts<Tit10M Mm I k' 1 *1iMt 1.L! It GWTIWNCIF HALL " t, • ryA'""• ••'"�"� - ! TOTA41 1t1lRT70FTEfAt.©of� t• ' ' = TOTAL�N14 AT OEi18/i TRMt.01i IrER[IIGt ��'' '� � COL. A toL. & CDL.M CAL.I COL.! toy.. K COL. L waor Ir 0 " VR N L M N L • M L D N L V N L M 2 R0011 OgIEN!<IOM3. RT. I- V TOTAL &TUN TOTAL L) < OF &UILOING RADIATION ! T!/1EXPOS90 W%16LS. RT. < d AT SELECTED 0 NDOD AND OUTf10E ODOIt AMA DESION TEMP. DIf I:ER ENCE dT1Ri �TOII ST##!1 BTU" �TtIM i LL OOI/ETItuC •s 4w '� •1MCIKASIK DATNROOK ' TAYIrT10N TOTAL m �LOOItUNOTRUCIM"t ` I FOR CONCHIME FLOOR 0" # ftNTiTION Coaln@cTv" r G tOU*0QRFILLAT GRAM LIEWIM.AM UNCAR BEET ox sapa o coca IVAv,.x, - - -•e- :r ter''' _ _ - -,. - - 5 7` _ �a._r k„ _ - - ,.r_- '-s•- Wit!:- :,5-_ _ - ;-,1" qX: .k•F, - ,- a x- __,- .,. :si�'�.e" .: - .- _ .- - � .w .- `{3`'x''f- - `=- -� -. •'�•• - - ., - DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT 161 V# Application is hereby: TOWN of SOUTH WINDSOR BUILDING DEPARTMENT B1d Pgrmit# APPRO 1540 SULLIVAN AVENUE 644-2511 ext. 230 Date Building Inspector Application must be printed or typed Location of job Iy� KLc �9� Street No. Street Lot No. FEE SCHEDULE Floor Apt.No. $0 - $1,000 - $12.00 Over $1,000 $12.00 per$1,000 OWNER or any fraction thereof ADDRESS � �S �,���Z c� g c Cf G g Q 7� OWNERS PHONE# —7 1 U APPLICANT ,/11/ f MA RA N OW N S� ADDRESS 411 P/U M Aj cf a C/) EST MATED COST$ 53090 C IS THIS A CONTRACT COST? 9z YES NO FEE ENCLOSED $ 1 f R.CO O TYPE OF JOB: Sp 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 Q,S 1 d c, A ASSEMBLY MERCANTILE EDUCATIONAL FUTUREUSE AND OCCUPANCY INSTITUTION FACTORY ENGINEER'S NAME PHONE STORAGE GARAGE ADDRESS MIXED USE CITY STATE ZIP (Other please specify) 1 TYPE OF INSTALLATION ��t(A SIZE OF MAIN DRAIN NO. OF TOILETS STYLE 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 SIZE OF WATER PIPING&RISER WATER HEATER TYPE Ni►'y�^L MANUFACTURE S.J� f ctin/ln Q{ TANKS SAFETY DEVICES TEMPERATURE / CAPACITY RELIEF VALVE TEST PRESSURE 3<3" WORKING PRESSURE 75 PRESSURE RELIEF VALVE V- TYPE MANUFACTURER DESCRIPTION OF WORK C4 J('75 �s AJ. -150 A,).,A qA� 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. �UYgsS P-- 1 ?F�e - NAME STATE LICENSE NO. TYPE SIGNATURE OF APPLICANT PHONE NO. 7 70" 3,P5 DATE