HomeMy WebLinkAbout185 Benedict Drive (4) PERMIT NO.
DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT
Application is hereby : TOWN OF SOUTH WINDSOR
APPROVED DISAPPROVED BUILDING INSPECTION DEPT.
1540 SULLIVAN AVENUE
(� ' 644-2511 Ext. 230
a e ng Inspector Applications must be printed or typed
1. LOCATION OF JOB:
106215 �� � �rc74 U�
FEE SCHEDULE 2. OWNER: Cc h� ah
$ 0 - $19000 - $10.00
3. ADDRESS: e
Over $1 ,000 - $10.00
per $19000 or
4. APPLICANT:
fraction thereof
5. ADDRESS:
Ara
6. EST. COST:
o �
7. IS THIS A CONTRACT COST? YES NO
8. FEE ENCLOSED: $ O
9. TYPE OF BUILD .
RESIDENTIAL COMMERCIAL
10. TYPE OF JOB:
ORIGINAL ALTERATION
INSTALLATION ADDITION
BD 2A 11/88
APPLICATION FOR PLUMBING PERMIT (Cont. from Reverse Side)
11. LOCATION OF JOB: Z25
GENERAL PLUMBING
12. KIND OF INSTALLATION: zl-tl6z l2 `jtom .- 13. SIZE OF MAIN DRAIN
14. NO. OF TOILETS STYLE 15. NO. OF URINALS STYLE
16. NO. OF BATHTUBS 16A. NO. OF SHOWERS 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
28. IF NO WINDOW, WHAT KIND OF VENTILATION IS THERE?
29. SIZE OF DUCTS 30. SEWER OR SEPTIC TANK?
31. SIZE OF WATER MAIN 31A. SIZES OF WATER PIPING & RISERS
32. REMARKS AND FURTHER DETAILS
WATER HEATER
33. TYPE mac .' 34. MANUFACTURER7;74 70�--
C
TANKS SAFETY DEVICES
TEMPERATURE
35. CAPACITY �� 39. RELIEF VALVE p�
36. TEST PRESSURE 3, �J LBS. 40. MANUFACTURER GUI S
37. WORKING PRESSURE ��2 ,S LBS. 41. PRESSURE RELIEF VALVE
38. TYPE !e�-.-�r- ,-„' 42. MANUFACTURER C'� � S
ix
LICENSE NO. DATE SIGNA E OF APPLICANT
PHONE NO.