HomeMy WebLinkAbout25 Green Lane (6)PERMIT NO.
DEPARTMENT DECISION
A P P L I C A T I O N F 0 R dl 3 c)-7
APPLICATION IS HEREBY:
PLUMBING PERMIT
APPROVED DISAPPROVED TOWM OF SOUTH WINDSOR
BUILDING INSPECTION DEPT.
644-2511 Ext. 230
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DATE PLUMBING INSPECTOR Application must be printed or typed.
1. LOCATION OF JOB:
2. OWNER:C--
3. ADDRESS:
FEE SCHEDULE Srskt-c!S
0 - $1,000 - $10.00 4. APPLICANT: 'L
Over $1,000 - $10.00 5. ADDRESS: (Q Gr-a Q
per $1,000 or
Fraction Thereof S (A-) ACl S 11 IC E
6. EST. COST: $ do- OG
7. IS THIS A CONTRACT COST? YES NO
8. FEE ENCLOSED: $ 3)
9. TYPE OF BUILDING:
RESIDENTIAL COMMERCIAL
10. TYPE OF JOB:
yo ORIGINAL ALTERATION
INSTALLATION ADDITION
REPAIR
BD 2A 11/88
APPLICATION FOR PLUMBING PERMIT (Cont. from Reverse Side)
11. LOCATION OF JOB: CrGe yx L o . Lb t J
GENERAL PLUMBING
12. KIND OF INSTALLATION: Ll'e 13. SIZE OF MAIN DRAIN y
f,
14. NO. OF TOILETS STYLE /,a,. (,c 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
r
20. NO. OF CONDUCTORS SIZE 21. NO. OF STACKS Z SIZE 3
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 X z
28. IF NO WINDOW, WHAT KIND OF VENTILATION IS THERE? yG
29. SIZE OF DUCTS 30. SEWER OR SEPTIC TANK?Se rp ,
31. SIZE OF WATER MAIN 31A. SIZES OF WATER PIPING & RISERS Z_
32. REMARKS AND FURTHER DETAILS It, ' A) V
it t
WATER HEATER
33. TYPE 34. MANUFACTURER
TANKS SAFETY DEVICES
TEMPERATURE
35. CAPACITY 39. RELIEF VALVE 1 A
36. TEST PRESSURE p b LBS. 40. MANUFACTURER lA S
37. WORKING PRESSURE LBS. 41. PRESSURE RELIEF VALVE
38. TYPE 5-,-{ i 42. MANUFACTURER
i3
LICENSE NO. DATE SIGNATURE OF APPLICANT
PHONE NO. y` /9,2