HomeMy WebLinkAbout17 Brookhaven Lane (3) PERMIT NO
DEPARTMENT DECISION lzz�
APPL TION IS HEREBY: a P P L i C A T i 0 N F o R
PLUMBING PERMIT
PROVED DISAPPROVED TOWN OF SOUTH WINDSOR
BUILDING INSPECTION DEPT.
DA NG INSPECTOR 6 4 4 -2 511 Ext. 230
Application must be printed or typed.
1. LOCATION OF JOB:
^) E rOO K j 2 eJ L ABC
FEE SCHEDULE
2. 06TNER: A- 6W&I C&V\& + -
o - $1,o00 - $10.oo � �u�e
. 1�y _
Over S1,000 - $10.00 �, f-r )6 1 n ft_
per $1,000 or ,
Fraction Thereof 4. APPLICANT: p to i 14&..f'
5. ADDRESS: q S l��oe c�
SO Cr ry Cf, V
6. EST. COST: $ o?500 .
7. IS THIS A CONTRACT COST? "'TES NO
8. FEE ENCLOSED: $ 70
9. TYPE OF BUILDING:
t---RESIDENTIAL _ COtDIERCIAL
10. TYPE OF JOB:
4,jDRIGINAL ALTERATION
INSTALLATION ADDITION
—REPAIR
A2FLi,.Aiiu.N ZUc( �Lonr, , rjLl, :cc.�c Jit1@j
11. LOCATION OF JOB: 3 ro o IN �)cl tj E ri
GENERAL PLtDIB ING
12. KIND OF INSTALLATION: (- ll fj.y �. 13. SIZE OF MAIN DRAIN q
14. NO. OF TOILETS 3 STYLE 15. NO. OF URINALS STYLE
16. NO OF BATHTUBS_17. NO. OF LAVATORIES .3 18. NO. OF SINKS,__.L _19. DISPOSAL l
16A. NO. OF SHOWERS_ 19A.DISHWASHER
20. NO. OF CONDUCTORS SIZE 21. NO. OF STACKS _SIZE 3
22. AREA OF ROOF 23. NO. OF CATCH BASINS 24. N0. OF FLOOR DRAINS
25. NO-OF OTHER FIXTURES KIND
26. ARE TOILET COMPARaMNTS VENTILATED TO OUTER AIR BY A WINDOW?
27. SIZE OF WINDOW X Z
28. IF NO WINDOW, WHAT KIND OF VENTILATION IS THERE?
29. SIZE OF DUCTS 30. SEWER OR SEPTIC TANK? S ewe r
31. SIZE OF WATER MAIN �" 31A. SIZES OF WATER PIPING b RISERS Ll
32. REMARKS AND FURTHER DETAILS
WATER HEATER
33. TYPE - 34. MANUFACTURER Or\O dW
TANKS SAFETY DEVICES
TEMPERATURE
35. CAPACITY '�1 39. RELIEF VALVE l�
36. TEST PRESSURE 600 LBS. 40. MANUFACTURER
37. WORKING PRESSURE 1 5b LBS. 41. PRESSURE RELIEF VALVE `0/
38. TYPE S S 42. MANUFACTUREROF
LICENSE NO. DATE SIGNATURE
PHONE NO.