HomeMy WebLinkAbout25 Stone Crossing (4)DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT
TOWN OF SOUTH WINDSOR
PERMIT#
Application is hereby:
BUILDING DEPARTMENT
APPRO 1540 SULLIVAN AVENUE
644-2511 ext. 230 Bldg.Permit#
2?3 3
Date Building Inspector
Application must be printed or typed
FEE SCHEDULE Location of Job:
Lot # #25 RtnnP c--rnggi ng0-$1,000=$15.00 Street No. Street Lot No.
Over$1,000=
15.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT State Line O i 1
APPLICANT ADDRESS 514 Salmon Brook St POB 209
Granhv C'_t 06035
APPLICANT PHONE#6 5 3-7 2 41
SOW N S
4
OWNER Mannarino Builders
4( OWNER ADDRESS 1169 Ellington Road
S. Windsor Ct 06074
t
OWNER PHONE 2 8 9—7 0 5 5
C ESTIMATED COST$
law IS THIS A CONTRACT COST? X Yes No
t FEE ENCLOSED$
TYPE OF JOB:
SOR Cp 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 OCCUPANCY Dwelling
EDUCATIONAL
INSTITUTIONAL
FACTORY ENGINEER'S NAME PHONE
STORAGE
GARAGE ADDRESS
MIXED USE
CITY STATE ZIP
Other please specify)
TYPE OF INSTALLATION SIZE OF MAIN DRAIN Y
NO.OF TOILETS STYLE NO.URINALS-0 STYLE
NO.OF BATHTUBS 2 NO.OF SHOWERS I NO.OF LAVATORIES (D
y
NO.OF CONDUCTORS Z,— SIZE NO.OF STACKS SIZE
AREA OF ROOF NO.OF CATCH BASINS NO.OF FLOOR DRAINS
NO.OF OTHER FIXTURES KIND
ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW YES 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 etr.44 MANUFACTURER a' a
DESCRIPTION OF WORK
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS TO
COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE
PERFORMANCE OF SUCH WORK.
00887 Pi CT
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT DATE l