HomeMy WebLinkAbout209 Brook Street (15)PERMIT NOT.q / U
DEPARTMENT DECISION APPL I CAT I O N FOR
Application is hereby : PLUMBING PERMIT
TOWM OF SOUTH WINDSORAPPROVEDDISAPPROVEDBUILDINGINSPECTIONDEPT.
644-2511 Ext. 230
Dat g Inspector Application must be printed or typed.
1. LOCATION OF JOB:
re57 4?
FEE SCHEDULE
2. OWNER:
0 - $19 000 -10.00 3. ADDRESS:
Over $19 0 0 0 -10.0 0
per $1 ,000 or 4. APPLICANT:fraction thereof
c'a-,*e`
5. ADDRESS:
6. EST. COST:
7. IS THIS A CONTRACT COST? YES 'Nn
8. FEE ENCLOSED:
9. TYPE OF BUILDING:
PRESIDENTIAL COMMERCIAL
10. TYPE OF JOB:
ORIGINAL ALTERATION
INSTALLATION YADDITION
REPAIR
BD 2A 11/88
APPLICATION FOR PLUMBING PERMIT (Cont. from Reverse Side)
11. LOCATION OF JOB:
GENERAL PLUMBING
12. KIND OF INSTALLATION: 13. SIZE OF MAIN DRAIN
14. NO. OF TOILETS lt% Z STYLE 15. NO. OF URINALS STYLE
16. N0. OF BATHTUBS 16A. NO. OF SHOWERS 17. N0. 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? / S
27. SIZE OF WINDOW
28. IF NO WINDOW, WHAT KIND OF VENTILATION IS THERE?
29. SIZE OF DUCTS 30. SEWER OR SEPTIC TANK? e I'
31. SIZE OF WATER MAIN 31A. SIZES OF WATER PIPING & RISERS
32. REMARKS AND FURTHER DETAILS
WATER HEATER
33. TYPE 34. MANUFACTURER e/
TANKS SAFETY DEVICES
TEMPERATURE
35. CAPACITY 39. RELIEF VALVE
36. TEST PRESSURE LBS. 40. MANUFACTURER
37. WORKING PRESSURE LBS. 41. PRESSURE RELIEF VALVE j/PS
38. TYPE 42. MANUFACTURER
z LICENSE NO. DATE SIGNATURE OV APPLICANT
PHONE NO. ,// -/?z,z