HomeMy WebLinkAbout1350 Sullivan AvenueC o C,
0
Ar `o TO THE BUILDING INSPEMR
of the APPLICATION FOR
Irolim OF SCK TH WINDS' CCOM PLAN EXAMINATION AN D
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, III, IV, and IX.O
ZONING
AT (LOCATION) Z96-0 nn yy
r
S,4 (.i//1 a dU rf DISTRICTfi!O
LOCATION NO.) STR Eff
OF BETWEEN D l///Y r] b%U4?i-
BUILDING CROSS STREET)
R
LOT
SUBDIVISION / Q LOT BLOCK SIZE
N
II. TYPE AND COST OF BUILDING — A11 applicants complete Parts A — D v
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking"most recent use
1 New building Residential Nonresidential
2 Addition(If residential, enter number 12 One family 18 Amusement, recreational
of new housing units added, if any,
in Part D, 13)13 Two or more family — Enter 19 Church, other religious
number of units— — — — -- 20 Industrial3 Alteration (See 2 above)
14 Transient hotel, motel, 21 Parking garage4 Repair, replacement or dormitory — Enter number
5 Wrecking (f multifamily residential, of units ——————— —-i 22 Service station, repair garage
enter number of units in building in 15 Garage 23 Hospital, institutional
Part D, 13)
16 Carport 24 Office, bank, professional6 Moving (relocation)
17 Other — Specify 25 Public utility710Foundationonly26 School, library, other educational
B. OWNERSHIP 27 Stores, merconfile
8 [A Private(individual, corporation,28 Tanks, towers
nonprofit institution, etc.) 29 Other — Specify
9 F-1 Public(Federal, State, or
I cal government)
C. COST Omit cents) Nonresidential — Describe in detail proposed use of buildings, e.g., food
processing plant, machine shop, laundry building at hospital,elementary
10. Cost f improvement,,,,,,,,,,,,,,,, school, secondary school, college, parochial school, parking garage for,11 department store, rental office building, office building at industrial plant.To be installed but not included If use of existing building is being changed, enter proposed use.
in the above cost
a. El ctrical......................ibrial Rij, in" __A be use,I Id j
b. Plumbing ......................
c.Heating, air conditioning.........
d. Other(elevator, etc.)............
11. TOTAL COST OF IMPROVEMENT $
III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — L;
for wrecking, complete only Part J, for all others skip to IV.
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS
30 EJ Masonry(wall bearing) 40 Public or private company
48• Number of stories................2i
31 ® W ad from 41 Private (septic tank, etc.)
49• Total square feet of floor area,
all floors, based on exterior
32 Structural steel dimensions ....................00
33 Reinforced concrete H. TYPE OF WATER SUPPLY
34 Oth r — Specify 42 m 50. Total land area sPublicorprivatecompanyq'ft. ...........
43 Private(well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
51. Enclosed .......................
35 Gas Will there be central air 52. Outdoors.......................
36 Oil conditioning?L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 gj Yes 45 No 53. Numb of b dro me..............
38 Cal
39 r7l Other— Specify arag2 Will there b an elevat r? Full..........
54. Number f
46 Yes 47 5] No bothr ms
Partial........
NOTES and Data — (For department use)
IV. IDENTIFICATION — To b c mpl t d by all applicants
Nam Mailing addr ss — Number, street, city, and State ZIP code Tel. No.
1.
Owner or • 0&0'7,( p7LesseeD7&
dC95KContractor
87101
3. I P.S;rde Gt
Architect or
Engineer
The owner of this building and t-he undersigned agree to conform to all applicable laws of this jurisdiction.
Signature of applicant Address Application date
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans R view Required Check Plan Review Date Plans By Date Plans By NotesFeeStartedApproved
BUILDING
PLUMBING
MECHANICAL
ELECTRICAL
OTHER s
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date
Obtained Number By Permit or Approval Check Obtaateinedned Number By
BOILER PLUMBING
CURB OR SIDEWALK CUT ROOFING
ELEVATOR SEWER
ELECTRICAL SIGN OR BILLBOARD
FURNACE STREET GRADES
GRADING USE OF PUBLIC AREAS
OIL BURNER WRECKING
OTHER OTHER
VII. VALIDATION
Building
P rmit number _1.2740
Bui Iding
P rmit issued June 1 19 82
Bui Iding
Permit Fee $ 900.00
Ap roved by:
p
TITLE
ZONING
FRONTDISTRICT
SIDE - .SIDE YARD
REAR YARD
IX. SITE OR • Applicant
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f
TOWN OF SOUTH WINDSOR
BUILDING PERMIT
Date June 1 1982.
Fee Paid $. .9 0.0.00 Est. Value $.150,000.00
Permit ® 12740
on the side of
Sullivan Avenue Street
Street No. 1350 (Bld Z=#3)
Owner Westggte Associates
Applicant Mr-hard S. Kelley
CERTIFICATE OF OCCUPANCY ISSUED:
Date
No. 6058
Fee Paid $ 3.00
CLASSIFICATION
Profess?nnnl R»i ldin—
REM SEPTIC PAYMENT
BUILDING PBRbffr
oMCE of
N° 12740
THE BUILDING INSPECTOR
of the
Town of South Windsor, Conn.
South V`indsor, Conn. Jame s.
il4io to to Cerfifg, That RSrsontractors T ae.
is hereby granted permission to Professional Building
at estimated value of Q
on the of. 1150 Sul 1 ivan Am&.(aI A&- 41) Street on land
owned by WAst atle ASSOCIAtes
SaiMark to be as described in Application
N13040 and to conform to specifications and plans filed with said Application, and Building By-
Laws of THE TOWN OF SOUTH WINDSOR.
Issued hwe W2.
Building Inspector.
Streets and sidewalks, obstructed by ezcavations or building materials, must be guarded by barriers
during the day and by both barriers and colored lights by night.
SECTION 1343, GENERAL STATUTES OF CONNECTICUT: "When any person shall place
or keep building materials, or any obstacle in any highway (or any sidewalk) either with or without a
license therefor from the city or borough in which such highway may be situated, he shall pay :aid city,
town or borough all coasts and damages which it shall sustain, or be compelled to reason therefor"
INSPECTION REPORT
Permit Job
1 Footing 1,5,1±-
2 Foundation
3 Framing f
4 Wiring y-,IA-1
5 Plumbing
6 Heating
7 Lathing
8 C.O.
Westgate)
6/1/82
rofessional Buiedin
Bldg. #3)
L350 Sulli torsan V Inc. Perzait # 12740
ASK Contra
7692
Electrician Petersen Elect. &
Pis 5499
Heating Contr. Mellen White
7595
Plumbing Mellen White & Pal
Oil Burner 6058
C rtificata of Occupancy
D
Permit No. TOWN OF SOUTH WINDSOR
SOUTH WINDSOR, CONN.
Permit lr o 6058
Certificate of Occupancy
THIS IS TO CERTIFY that the
f-'' ._ *.s _ .-{' in the Town of South/Vindsor, Connecticut, has
been erected and completed in accordance withVhe Bui ing Code and Zoning Regulations of
the Town of South Windsor, and is hereby appr ed r occupry.
y Building Inspector
Owner, Builder
X•i
r
Date 198 f 19 83
Fee Paid `
ri
l
7692
i
ELECTRICAL APPLICATION
Application No.9903
on the side of
Il 3RullfvanAvenueStreet
i Street No. _ 1_350
Owner RSK Contractors, Inc.
I
Electrician Petersen Electric
FILED IN OFFICE OF
The Building Inspector
June 25 19 82
INSPECTION.
r3r No Electrical Work shall be started until a Per-
mit is granted by the Building Inspector.
In New Buildings no wiring shall be started
until the plumbing and heating pipes, and the fire
stops (if of wood) are installed, without a special
permit from the office of the Building Inspector.
1
x
APPLICATION FOR PERMIT TO DO ELECTRICAI. WORK.
No. . ..$.$0.3.......... ......
Permit No. . .7.6.9 2 ....... . ..
TO THE BUILDING INSPECTOR
of the
TOWN OF SOUTH WINDSOR, CONN.
hereby make application tq perform Electr cal Work according to detailed description below. All
provisions of the Rules for Electrical Installation, Section 48, Building By-Laws, shall be complied with
whether specified herein or not.
Z3 ZSouthWindsor, Conn., j 19 Sign here . . . . . . . . ...... ....•..•••..
all e?beKJ& Address j GfJ Z. B ...Xol3
Location . .. .. .../l!. . . ...... .. Side of .. . ... .. . . .. . ................. ....... ..... ................ .........................
Nature of Building How many stories ............ ............................................................. .................
New or oId Building w . ....... ..... . How many families ....................................................................... .. .............
Kind of Installation .. . .1007_ A15. ....... How many Stores ..................................................................................................
Owner ........4.)46S..7 .t.7 •. ...... Address ...... . .......... ............. ...............................__.._.._......._.._....._....._......
Architect Address
C5Builderw/CJI., .... . . .. Address
Electrician ..... .. .. bv . . . .. ddress ... .... ...... ...................................._................................................
Size of Main Wires
Q1
z j4q
No. of Light Loops . ... No. of Heat Loops .. ., No. of Power Loops .........................
No. of Light Outlets ....... . . . .... No. of Heat Outlets .... No. of Power Outlets .................. ...........
No? of Light Circuits 2 d...... .... No. of Heat Circuits No. of Power Circuits ..
No. of Sockets No. of Heat Receptacles No. of Motors
No. of Panels ...................... ... Size of Heat Circuit No. of Power Receptacles
No. of Switches ............... Total Wattage ... ............. .... . .... .. . Size of Power Circuit .. . . . . .
Total Horsepower
No. of Straight Electric Fixtures ... . . ..... . No. of Combination Fixtures ...
No. of Receptacles ..................Ke.. ........... ....................... . . ......... No. of Cord Drops ....... ................ ... ............................. ... ... ...
Remarks: For other kind of Installation ... . ....... i i{Jl e J
oee-................la 1c.6........ s S... .........
Estimated Cost .... . .2f........ .... .......................... ....
5957
PLUMBING APPUCATION
Appa 6736
on the................. aide of
1350. S eec
Street No.
I
Owner .... .
Plumber-)"rr k 1464.
Filed in Office of
The
June 2 5 ig 82
n se criox.
No person:ball commuct; add to or ahw ay
portion of the drainage system of any buiLfiog
ezoept to repair leans) until a Pmnits granted
by the Building Inspector.
ti
1
Application No. .......6..7..3.6................... Permit N ......59-51...............
TO THE BUILDING INSPECTOR
of the
TOWN OF SOUTH WINDSOR, CONN.
hereby make application to perform plumbing according to detailed description blow. All
provisions of the Rules for Sanitation, By-Laws, Sections 33 to 47 inclusiv 1 be complied with whether
specified herein or not.
South Windsor, ........................... x.'e .l.................................. 19FL,. Sign here
Address .49. ..
Location ...................................... .. ....................................................... side of Street
Nature of Buildm* . How many stories ........:--................................... ..................................
Owner`/..:... Address.........
Architect Address ......................................................................................................................_
Builder .... Address ......................................................................................................................
Plumber )W.4. .....:-....u./............... Address .. :..... ... . .............................................................................
DRAINAGE
CESSPOOLS, How many ................................................ ................... Where located ......
Are they water tight .. .........1. .............`...... ...................... Of what materials are they built .. .
Size of pipe from house to cesspool . ............ ........................... Kind of pipe ...... f...........................................
MAIN DRAIN IN CELLAR, Material ...;... Diameter ......... ........ ...3..y.........................................................................
Aboveor below cellar bottom ...
SOIL PIPES, Material . .G l d v-r............................... Diameter ...........1....'...3....,..........
WASTE PIPES, Material ..... Diameter .....- ....-.. ......................................I....................
TRAPS,Type proposed to use is ..................................... .. ... ..............................................................................................................................................
RAINWATER LEADERS, where do they run to . ................................................................................................................................................
REFRIGERATOR WASTES, where do they run to .................................................................................................................. ...............................
TANKOVERFLOWS, where do they run to .
FIXTURES
WATER CLOSETS, How many ................ .................................. Where located Z!K.'.....e:....... r .... ....
Distance from trap to vertical sod pipe .............. ..................... Pattern . . ... ...........................................................
WASH TRAYS, How many .. Where located .....
SINKS, How many ................ ...... ..................................................... Where located u ./-", .......................................
BUTLER'S SINKS, How many ............. .................................. Where located ....................................................................................................
REFRIGERATOR SINKS, How many...........f....................... Where located ...................................................................................................
LAVATORIES,How many.................. ........................................... Where located x/4'..........
BATHTUBS,How many.................................................................... Where located .....................................................................................................
URINALS, How many ................................................................................. Where located ....................................................................................................
Are water closets and urinals to be local vented If not,is there a window in outer wall
ofroom where same are to be located .......... .. ..... ,/, / ...............................................................................................................................................
Estimated Coat Y .... ........CV..................
PERMIT #
Application For 6600 5499
4j
DEPARTMENT DECISION Heating Permit
Cd En
3 APPLICATION IS HEREBY:DEPARTMENT OF LICENSES AND INSPECTIONS
O a
N +' APPROVED DISAPPROVED
TOWN OF SOUTH WINDSOR
o Cd 8/5/82
00 w DATE I IEF INSPECTOR APPLICATIONS MUST BE PRINTED OR TYPED. BEGIN WITH NUMBER ONE BELOW
O
w A
E -p 1. LOCATION OF JOB
O a
O
NO. STREET
O
co Q 1dQ. 3
LOT N0. FLOOR APT. N
O
V
w
J`O Qe-2. OWNERs~
as
b O ADDRESS
E c
4.PHONEC
4j >
Cd
U2j '= S. APPLICANT_/,A„/,1 n
05 cc Z ,0 c 6. ADDRESS >
7.PHONSWIP
w
S. LICENSE NO.
a S
w R. EXPIRATION DATE OF LICENSE
O
V
l
10. ESTIMATED COST s
O
I1. IS THIS A CONTRACT COSTY YES 0 NO
bo
Permit 12740
7 12. FEE ENCLOSED S
Q
ar'is. TYPE OF BUILDING:
RESIDENTIAL l4! COMMERCIALbo
O .9
14. TYPE OF JOB: INDUSTRIAL
ai RIGINAL ALTERATION
INSTALLATI N ADDITION
REPAIR
APPLICATION FOR HEATING PERMIT (Continued tr m Reverse Side)
11. LOCATION OF JOB 13 o
No. 7 STREET FLOOR AFT.NO.
12. TYPE OF INSTALLATION: OIL BURNER 0 ELECTRIC VENTILATION SPRINKLER
GAS BURNER STACK INCINERATOR MISCELLANEOUS /7 V°:16a l- r-
IDENTIFY
SIZE LOCATION SIZE SIZE13. OF TANK OF TANK OF FILL OF VENT
14. B.T.U. EQUIP. AT REGISTERP FURNACE MAKE AND NO. !' AT BONNET ` FIRING RATE
BOILER OR FURNACE MAKE AND NO. "` B.T.U. OR SQ. FT. NET B.T.U. OR SQ. FT. GROSS FIRING RATE
FLOORS TO BE HE TED ,2 NEW OR OLD BUILDING 11dd 1 I SULATED - YES OR NO
TYPE OF WALL INSULATION ROOF OR CEILING INSULATION
AVG. SYSTEM ATER TEMP. BA./SQ. FT./HR. EMISSION
INDOOR-OUTDOOR TEMPERATURE DIFFERENCE U FAHRENHEIT
MAKE OF RADIATION: BASEBOARD. COPPER CONVECTORS, OR C.I. RADIATION. OUTPUT PER SECTION OR LINEAL OF RADIATION. SO.
FT. OR B.T.U.
La wP 2 L'-vQc_-w•
11 - a r-0/P2 61 a-r A,,H+p S dv,.p 1000 &t U
DESCRIPTION OF WORK aK c d t J S y-`JD J Gu 6J mac. /,,o a-'-_J -
15. TO BE DONE:V e' C.1/e i Y P u,-S 1s JLy.C
16. HEAT LOSS SCHEDULE. (TO BE INCLUDED FOR ALL JOBS).
ROOM SIZE ANDIN DOORS AREA — SQUARE FEET
VOLUME
a.T.U. a.T.U. i DISTRIBUTION INSTALLED
TOTAL TOTAL n
ROOM NO•GROSS GLASS NET WALL CEILING FLOOR CU. AT 70•F CORRECTED -j 4 LL
RAD. REGISTER
L W N AND TEMP. TO f TYPE AND SIZE OR LEADER
SIZE < WALL 'to INFILT.)
DIFF. F m a SO' FT. FREE AREA
t,awe
f 3 192 3
085
1 3 a 2 17 4 d 67
TOTALS A233 y
A. HEAT LOSS FROM BUILDING—3 31 B.T.U./HR.
B. DOMESTIC HOT WATER DEMAND B.T.U./HR.
C. PIPING, OTHER THAN NORMAL oZ 3 B.T.U./HR.
ALLOWANCE FOR HEAT VALVE OF FUEL (A B C) FACTOR
17. ELECTRICAL WORK BY: QJJ;g0-4at___, SZ4C,.
NAME ADDRESS
SUBCONTRACTORS AND
1s. THEIR TRADES
ALL WORK COVERED BY THIS APPLICATION HAS BEEN AUTHORIZED BY THE (OWNER) OR (A ENT) OF THIS PROPERTY AND WILL
BE DONE IN STRICT ACCORDANCE WITH THE BUILDING CODE.
APPLICATION TO BE COMPLETELY FILLED IN. L
J `r0
DATE N TI 9 OF APPLICANT
FINAL INSPECTION
Building yS:APPLICATION FOR BUILDING PERMIT
Plumbing 4
HVAC Date:
Sprinkler
4r141350 Sullivan Ave
Electric Estimated Cost $/L,;Cam-)
Zoning Permit Fee $ IeV.OZ)
Affidavit NO. 17763 Occupancy Fee $
Eng. Dept.
Fire Dept. COMPLETE RED BOXED AREAS. Total Fee $ /•
Health Dept. TYPE OR PRINT ONLY
Approved for CO: SIGN ON REVERSE SIDE. Additional Cost) $
TO BUILDING DEPARTMENT, TOWN OF SOUTH WINDSOR, CT
The undersigned, hereby applies to do work according to the following specifications:
Job Location 50 Sv (VC4 "l e__ Lot No. Side of Street Zone
Applicant V Cn i 13 7{91) t2k Y Tel. # G `/Y- 45"a Z3
Address 5-50 130c-14 k;6/ 'Z4 1 S.c'SQZ G V Zip aGU S 91" Lic.#
STREET CITY STATE
Owner J:X Re(3eg_ - M,04I?64 Address 5U44- IIV-t "-A ci U 2
Architect Address
Size New Area: Ft. Front Overall Ft. Deep Overall Total Area Garages
Lavatories
No. of Families No. of Stories Construction Bathrooms Rooms 1st 2nd 3rd
Size of Lot Dist. from Street Line Dist. from Side Street Line
Purpose of this Permit
iu'tti'O/C glfFr/a Tl4o^,- QGr c.c/
City Water Well Septic Sewer
Approved by Dat S_g- BD1A 11/88
I hereby agree to conform to all the requirem nts of the Laws of th State of Connecticut and the Ordinances of the Town of South Windsor
and to notify the Building Inspector of any alteration in the plans or specifications of the Building for which this permit is asked,and agree
that this building is to be locat d the proper distance from all street lines,side yard lines and required distances from all oth r zones and is
locat d in a zone in which this building and its use is allowed.
S
Signed
I hereby apply for a Certificate of Occupancy for the work described in this application for permit.
Signed
DO NOT WRITE BELOW THIS LINE—
INSPECTION RECORD
Footing Framing
Foundation Fireplace/Chimney Insulation
Plumbing Permit# Inspections: 4 J//V
HVAC Permit# Inspections:
Electrical Permit# D f Inspections:
Sprinkler Permit# Inspections:
i
i
PERMIT #
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
Application is hereby :
TOWN OF SOUTH WINDSOR
APPROVED DISA
a
BUILDING INSPECTION DEPT.
644-2511 Ext . 230
Application must be printed or typed.
Date Buil ing Inspec o
F
1 . LOCATION OF JOB
i
3_570
FEE SCHEDULE No . Street
0 - $19000 - 10 . 00 Floor Apt . No.
j Over $1 , 000 - 10 .00
5r,-n(2_kper $1 ,000 or 2 . OWNERG sPC,,,
i fraction thereof
3 . ADDRESS l3 ,Svffen,_%A ut-:7
II4 . APPLICANT 0%YV'Las So ddc-lr 01
5 . ADDRESS 3 lSJ-
6 . ESTIMATED COST $ 2L)CjO
7 . IS THIS A CONTRACT COST l-
Y s No
c,o
8 . FEE ENCLOSED $ O
9 . TYPE OF BUILDING :
RESIDENTIAL COMMERCIAL
10. TYPE OF JOB :
Original Installation
Alteration/Addition/Repair
BD 3A 11/88
APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side)
11 . LOCATION OF JOB 13S"'O I(c S, , A"e
NO. STREET APT. NO,
12 . TYPE OF INSTALLATION a o
13. SIZE OF MAIN FEEDER Cc>r,ne
14 . NO. OF LIGHT LOOPS 15 . NO. OF HEAT LOOPS
16. NO. OF POWER LOOPS_ 17 . NO. OF LIGHT OUTLETS
18. NO. OF HEAT CIRCUITS 19 . NO . OF POWER OUTLETS
20. NO. OF CONVENIENCE OUTLETS 21 . NO. OF HEAT CIRCUITS
22 . NO,, OF POWER CIRCUITS 23 . NO. OF LIGHT CIRCUITS
24. SIZE OF HEAT CIRCUITS 25 . NO. OF MOTORS --
26 . NO. OF PANELS '--^27 . TOTAL WATTAGE
28 . NO. OF POWER FEEDERS_ `—' 29 . NO. OF SWITCHES
30. A/C LOAD 31 . SIZE OF POWER FEEDERS
32 . NO. OF FIXTURES 33 . TOTAL HORSEPOWER
r
34 . NAME OF SUBCONTRACTORS AND THEIR TRADES S_ (eC+{ . C
35 . REMARKS AND FURTHER DETAILS :
a.0,3
LICENSE NO . SIGNATURE OF APPLICANT DATE
PHONE NUMBER:7_
PERMIT NO.
DEPARTMENT DECISION
A P P L I C A T I O N F O R
APPLICATION IS HEREBY:
PLUMBING PERMIT
APPROVED DISAPPROVED TOWM OF SOUTH WINDSOR
BUILDING INSPECTION DEPT.
644-2511 Ext. 230
DATE PLU INSPECTOR Application must be printed or typed.
1. LOCATION OF JOB:
2. OWNER: Dr 0,6Pr I C ^ YCL
3. ADDRESS:
FEE SCHEDULE SOr/ fiYl S'O
0 - $19 000 - $10.00 4. APPLICANT:
Over $1,000 - $10.00 5. ADDRESS: /0-7
per $1,000 or
Fraction Thereof vV r 3
6. EST. COST: $ 2061 OCC
7. IS THIS A CONTRACT COST? X YES NO
8. FEE ENCLOSED: $
9. TYPE OF BUILDING: 7 71o3
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: /3 S D tl V t--
GENERAL PLUMBING
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
20. NO. OF CONDUCTORS SIZE 21. NO. OF STACKS 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 31A. SIZES OF WATER PIPING & RISERS
32. REMARKS AND FURTHER DETAILS L[ gau'SIA "Al P/vt"' LN;;4, 40- f%v S
Q r S Al C,c /- h lei ';'W/c-
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
LICENSE NO. DATE SIGNATURE OF APPLICANT
PHONE NO. C3 3 y/