HomeMy WebLinkAbout103 Benedict Drive (7)PERMIT ":0.
DEPARTMENT DECISION
APPLICATION FOR PLUMBING PERMIT
Application is hereby :
TOWN OF SOUTH WINDSOR
APPRO ISAPPROVED BUILDING INSPECTION DEPT.
1540 SULLIVAN AVENUE
644-2511 Ext. 230
a e Building Inspector
Applications must be printed or typed
1. LOCATION OF JOB:
1v3 4-ee
FEE SCHEDULE 2. OWNER: rcl,v% rC
0 - $19 000 - 10.00 3. ADDRESS: 63
Over $1 ,000 - 10.00 Su w` 54•' '
per $19000 or a
fraction thereof 4. APPLICANT:
5. ADDRESS: 910, %%C X (o
6. EST. COST: $
7. IS THIS A CONTRACT COST? ES
8. FEE ENCLOSED: $
9. TYPE OF BUILDING:
RESIDENTIAL COMMERCIAL
10. TYPE OF JOB:
ORIGINAL ALTERATION
INSTALLATION ADDITION
REPAIR
BD 2A 11/88
APPLICATION FOR PLUMBING PERMIT (Cont. from Reverse Side)
11. LOCATION OF JOB: Q n e')-1 1r:
GENERAL PLUMBING
r. 3'I
12. KIND OF INSTALLATION: 13. SIZE OF MAIN DRAIN
14. NO. OF TOILETS STYLE 15. NO. OF URINALS / STYLE
16. NO. OF BATHTUBS 16A. NO. OF SHOWERS 17. NO. OF LAVATORIES
18. NO. OF SINKS_ 19. DISPOSAL 19A. DISWASHER 1
i
20. NO. OF CONDUCTORS SIZE 21. NO. OF STACKS .z SIZE
22. AREA OF ROOF 23. NO. OF CATCH BASINS 24. NO. OF FLOOR DRAINS
25. NO. OF OTHER FIXTURES KIND
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?
29. SIZE OF DUCTS 30. SEWER OR SEPTIC TANK?
31. SIZE OF WATER MAIN 3-41 31A. SIZES OF WATER PIPING & RISERS
32. REMARKS AND FURTHER DETAILS
WATER HEATER
33. TYPE 34. MANUFACTURER
TANKS SAFETY DEVICES
TEMPERATURE
35. CAPACITY 39. RELIEF VALVE
36. TEST PRESSURE LBS. 40. MANUFACTURER
37. WORKING PRESSURE LBS. 41. PRESSURE RELIEF VALVE
38. TYPE 42. MANUFACTURER
o a
LICENSE NO. DATE S&GNATURE OF APPLICANT
PHONE NO. l 2`q