HomeMy WebLinkAbout171 Bourbon Street (8) PERMIT No
DEPARTMENT DECISION ��
APPLI ATION IS HEREBY: A P P L I C A T I O N F O R
7APPROVED DISAPPROVED
PLUMBING PERMIT
TOWN OF SOUTH WIIJDSOR
XO _Z/ BUILDING INSPECTION DEPT.
DATE PL I G INSPECTOR 6 4 4 -2 511 Ext. 230
IApplication must be printed or typed.
1. LOCATION OF JOB:
171
FEE SCHEDULE
1). OWNER:
0 - $1,000 - $10.00 3. ADDRESS: y 11_?� _
I
Over S1,000 _ $10.00 �J� £-CS AGE
per $1,000 or -
Fraction Thereof
4. APPLICANT: �t. R,S, 7'k�c��cc� Ctje�tcatr•rs
5. ADDRESS: A3 a, y�
� r r c E c D C�C
6. EST. COST: $ '0 Oo
7. IS THIS A CONTRACT COST? YES Nb
8. FEE ENCLOSED: $
_&_/� z 2 1 1
9. TYPE OF 'BIJILDING:
ESIDENTIAL _ COWIERCIAL
10. TYPE OF JOB:
ORIGINAL ALTERATION
INSTALLATION P- ADDITION
__REPAIR
rut( rLL:biNu iLr. l tLont. from tteverse oiae)
11. LOCATION OF JOB: 71 '13 o`."'?ct, 1 �S
GENERAL PLMIB ING
12. KIND OF INSTALLATION: 13. SIZE OF MAIN DRAIN
14. NO. OF TOILETS STYLE zv 15. NO. OF URINALS STYLE --
16. NO OF BATHTUBS I 17. NO. OF LAVATORIES 18.NO. OF SINKS 19. DISPOSAL_
16A. NO. OF SHOWERS 19A.DISHWASHER
20. NO. OF CONDUCTORS_SIZE 21. NO. OF STACKS SIZE
22. AREA OF ROOF 23. NO. OF CATCH BASINS 24. N0. OF FLOOR DRAINS
25. NO-OF OTHER FIXTURES KIND
26. ARE TOILET COMPAFM4ENTS VENTILATED TO OUTER AIR BY A WINDOW? �,5
27. SIZE OF WINDOW 7�2.a-A,%d
28. IF NO WINDOW, WHAT KIND OF VENTILATION IS THERE?
29. SIZE OF DUCTS 30. SEWE R SEPTIC TANK?
31. SIZE OF WATER MAIN / 31A. SIZES OF WATER PIPING & RISERS
32. REMARKS AND FURTHER DETAILS
WATER HEATER
33. TYPE 34. MANUFACT WR lJ -'�'1l
TANKS SAFETY DEVICES
TEMPERATURE
35. CAPACITY �-�� �� 39. RELIEF VALVE X L 1-48
36. TEST PRESSURE LBS. 40. MANUFACTURER [.c'ubte
i �
37. WORKING PRESSURE LBS. 41. PRESSURE RELIEF VALVE
38. TYPE 42. MANUFACTURER
l
S-- 3� - ��
LICENSE NO. DATE SIGNATURE I T
PHONE NO. (0 3 ^ 33