HomeMy WebLinkAbout145 Abbe RoadDEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT
TOWN OF SOUTH WINDSOR
PERMIT#
Application is hereby: r o2 6dBUDDINGDEPARTMENT
APPROVED 1540 SULLIVAN AVENUE Bldg.Permit#
644-2511 ext. 230
a e Building Inspector
Application must be printed or typed
FEE SCHEDULE L/
Location o Job:F 6 iS O'7 e G GZ
0-$1,000=$15.00 Street No. Street Lot No.
Over$1,000=
15.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT C/V • V _ C <
APPLICANT ADDRESS v C,a
APPLICANT PHONE# Ll 3 3
W N S OWNER i /0 c i r tw O
OWNER ADDRESS
r
OWNER PHONE
C ESTIMATED COST$
IS THIS A CONTRACT COST? K Yes No
FEE ENCLOSED$
1 TYPE OF JOB:
OR C 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
BUILDING PERMIT APPLICATION? YES NO
RESIDENTIAL
BUSINESS CURRENT USE AND OCCUPANCY
ASSEMBLY
MERCANTILE FUTURE USE AND OCCUPANCYEDUCATIONAL
INSTITUTIONAL
FACTORY ENGINEER'S NAME PHONE
STORAGE
GARAGE ADDRESS
MIXED USE
CITY STATE ZIP
Other please specify)
TYPE OF INSTALLATION /40 LV SIZE OF MAIN DRAIN
NO.OF TOILETS J STYLE R NO.URINALS STYLE
NO.OF BATHTUBS l NO.OF SHOWERS NO.OF LAVATORIES
NO.OF CONDUCTORS SIZE NO.OF STACKS 2- SIZE
AREA OF ROOF NO.OF CATCH BASINS NO.OF FLOOR DRAINS
NO.OF OTHER FIXTURES KIND re`" s A--/<
ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW jXYES 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
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS TU"
COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE
PERFORMANCE OF SUCH WORK.
P-0 el y? (41 P ( C-7-
CONTRACTORS LICENSE NO. E STATE
SIGNATURE OF APPLICANT DATE J
G'—O-3