HomeMy WebLinkAboutMisc Correspondence 151 Birch Hill Drive DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT
Application is hereby:
TOWN OF SOUTH WINDSOR PERMIT#
BUILDING DEPARTMENT
APPROVED 1540 SULLIVAN AVENUE Bldg.Permit#
644-2511 ext. 230
Date Building Inspector
Application must be printed or typed
FEE SCHEDULE Location of Job:
$0-$1,000=$15.00 Street No. Street Lot No.
Over$1,000=
$15.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT
APPLICANT ADDRESS C O' `D. Gam,
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APPLICANT PHONE# -6O
�OW N A'St-4 OWNER � w.,, o, i '
OWNERADDRESS I JYj ,"J
A. OWNER PHONE 3 0 O
C `' ►� ESTIMATED COS
IS THIS A CONTRACT COST? 4- Yes No
FEE ENCLOSED$_
O�� TYPE OF JOB: Cam. D I � 23��6
O •C �
R v New Installation
—Alteration/Addition/Repair
Revised 4/01//2002
APPLICATION FOR PLUMBING PERMIT (Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
RESIDENTIAL BUILDING PERMIT APPLICATION? ❑YES ❑NO
U BUSINESS
❑ASSEMBLY CURRENT USE AND OCCUPANCY 1 Pe'r)J
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❑MERCANTILE❑EDUCATIONAL FUTURE USE AND OCCUPANCY fe'fI 'de-A�G.�
❑INSTITUTIONAL
❑FACTORY ENGINEER'S NAME PHONE
❑STORAGE
❑GARAGE ADDRESS
❑MIXED USE
CITY - STATE ZIP
(Other please specify)
TYPE OF INSTALLATION SIZE OF MAIN DRAIN
NO.OF TOILETS STYLE 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 KIND
ARE TOILET COMPARTMENTS VENTILATED TO OUTER_AIR BY A WINDOW ❑YES ❑NO
SIZE OF WINDOW IF NONE C.F.M.OF VENTILATOR
SIZE OF DUCTS SEWER OR SEPTIC TANK
SIZE OF WATER MAIN SIZE OF WATER PIPING&RISER
WATER HEATER: TYPE MANUFACTURER
DESCRIPTION OF WORK
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HE UNDER SIGNED HEREBY APPLIR D AND Is TO
COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE
PERFORMANCE OF SUCH-WORK. - - - - - -
C3L�S3�--2 G'- l 6--- / C `
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT DATE ( 0 < ' O
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PROPERTY a
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R0. BIRCH HILL DRIVE SUU'CN tdI`II�StIt�, CO:�IY..
Facing Lot No.. 14 oh .mnap entitled "BIRCH. HILL ESTATES Foster Street
South Windsor, Conn . Property .of U R Iiousin; Corp, Seal-e_- 1.:n:-3.-lOC 1z<-
Date: Jan . 21 , 1963 Hayden L. Griswold C .X.
Scale 1" , k r ' .
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PROPERTY OF
NO. BIRCH HILL DRIVE SO1JT14 WINDSOR, COON .
Being Lot No. 14 on map entitled "NI£,CJI HILL L' TA 'j',S Foster Street
South Windsor, Conn . Property of U & Jt Nousing Corp, Scale 1 " = 100 ,
Date: Jan . 21 , 1963 Hayden L. Griswold C .F ."
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Scale 1 " — SO ' W ,,
HAY1 E,N I. . GRISI'OT D k. . F.
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