HomeMy WebLinkAbout19 Blueberry Circle (4) 79 4-:�
PLUMBING APPLJCA110N
Appfimfm M, :�Z/09
on the ....__.__ aide of
)4`
street No. _. -- =
Owner L� .
Plumber .....^_
Filed in Office of
The Buidmg Idpector
2Z/.3
n�se�c�o�ir.
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No person shall ooewruct, add w or alter my
portion of the &aim p system of my bml og
(cW ept to repair leaks) until a Plenmit is gm mud
by the Building Inspector.
APPLICATION FOR PLUMBING PERMIT (Continu d from Reverse Side)
TOWN OF SOUTH WINDSOR, CONN. —�
�
l l 9
11. LOCATION OF JOB STREET FLOOR APT.NO.
NO.
GENERAL PLUMBING
r
12. KIND OF INSTALLATION_�A 13. SIZE OF MAIN DRAIN
14. NO. OF TOILETS STYLE AM �• 15. NO. OF URINALS STYLE
16. NO.OF BATHTUBS-17.NO.OF LAVATORIES_�18. NO.OF SINKS C 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
Lj J A
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? r-04i
29. SIZE OF DUCTS 30. ARE SEWAGE AND WATER FACILITIES AVAILABLE?
SIGNATURE ADDRESSa
LICENSE NO. A03 D d ESTIMATED COST—Vq�a� TELEPHONE
OWNER (j'0_1wADDRESS 61S
WATER HEATER
31. TYPE 32. MANUFACTURER
TANK SAFETY DEVICES
33. CAPACITY 37. TEMPERATURE RELIEF VALVE
34. TEST PRESSURE_ 38. MANUFACTURER
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 DE.
CD962 DA E SIGNATURE OF APPLICANT