HomeMy WebLinkAbout10 Abbe Road (10) DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT PERMIT#
TOWN OF SOUTH WINDSOR /O 5-9G
Application is hereby: BUILDING DEPARTMENT
APPROVED 1540 SULLIVAN AVENUE Bldg.Permit#
644-2511 ext. 230 26,S'YQ
pt) �j6Q--
a e Building Inspector
Application must be printed or typed
Location of Job:
FEE SCHEDULE E
17/�j ,3 G 1,o t17$0-$1,000=$13.00 StreetLot No.
Over$1,000$13.00 per$1,000 Apt.No.
or any fraction thereof ation
APPLICANT �,-p�� /� F A
APPLICANT ADDRESS Z �� U �� a
APPLICANT PHONE# �� 6
OWNER /Tiv v n r' -#-A 9
'C OWN S�-4� OWNER ADDRESS � U A 13 /3 -
�.~, V / N// .5
OWNER PHONE /6
C
ESTIMATED COST$ U
maw
IS THIS A CONTRACT CST? ,Yes 13 No
FEE ENCLOSED$ 1
TYPE OF JOB:
SOR-0) A New Installation
0 Alteration/Addition/Repair Revised 8/99
APPLICATION FOR PLUMBING PERMIT (Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
BUILDING PERMIT APPLICATION? q YES ❑NO
❑RESIDENTIAL
❑BUSINESS CURRENT USE AND OCCUPANCY
❑ASSEMBLY
❑MERCANTILE FUTURE USE AND OCCUPANCY S� O AOA-G-E �F_ c l?e At to N
❑EDUCATIONAL \ /
❑ y INSTITUTIONAL ENGINEER'S NAME — U L-C A G— PHONE
❑FACTORY /�
STORAGE ADDRESS /:0,
�f,GARAGE
❑MIXED USE CITY/u A-N G 4 F_ S STATE ZIP
(Other please specify)
TYPE OF INSTALLATION SIZE OF MAIN DRAIN /
NO.OF TOILETS_ Z STYLE CLOY G. NO.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 2- KIND SC 7- f /3/q R S /A//--t
ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW 0.YES ❑NO
SIZE OF WINDOW 2— >/ 3 IF NONE C.F.M.OF VENTILATOR
SIZE OF DUCTS (/ -4-3 'y-- Z n SEWER OR SEPTIC TANK SQL
SIZE OF WATER MAIN 11 SIZE OF WATER PIPING&RISER
WATER HEATER: TYPE MANUFACTURER A7-
DESCRIPTInON OF WORK
c) ,F C mac. G)-j
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS TO
COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE
PERFORMANCE OF SUCH WORK.
CONTRACTORS LICENSE NO , TYPE STATE
SIGNATURE OF APPLICANT . /4 DATE 2-06)0