HomeMy WebLinkAbout26 Castlewood Drive (5)DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT
TOWN OF SOUTH WINDSOR
PERMIT#
Application is hereby: 6c.2BUILDINGDEPARTMENT
APPROVED 1540 SULLIVAN AVENUE Bldg.Permit#
a116 6 L X,644-2511 ext. 230 C12
ate Building Inspector
Application must be printed or typed
FEE SCHEDULE
Location of Job:
0-$1,000=$13.00 Street N Street Lot No.
Over$1,000=
13.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
l 1APPLICANTPe.C'
APPLICANT ADDRESS
S u-,\ CN,
APPLICANT PHONE# k \ —
OW N S OWNER j X
z OWNER ADDRESS
1
k s' OWNER PHONE CU D-,C
C ESTIMATED COST$ d O C
IS THIS A CONTRACT COST? 40"Ves 0 No
f FEE ENCLOSED$
TYPE OF JOB:
SOR.CO stew Installation
0 Alteration/Addition/Repair Revised 8/99
APPLICATION FOR PLUMBING PERMIT (Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
BUILDING PERMIT APPLICATION? YES O
UIE'SIDENTIAL
BUSINESS CURRENT USE AND OCCUPANCY
ASSEMBLY
MERCANTILE FUTURE USE AND OCCUPANCY
EDUCATIONAL
INSTITUTIONAL ENGINEER'S NAME PHONE
FACTORY
STORAGE ADDRESS
GARAGE
MIXED USE CITY STATE ZIP
Other please specify)
TYPE OF INSTALLATION Z ?j 5 '1 SIZE OF MAIN DRAIN A
NO.OF TOILETS STYLE NO.URINALS STYLE
NO.OF BATHTUBS NO.OF SHOWERS NO.OF LAVATORIES 3
NO.OF CONDUCTORS 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 9-- IF NONE C.F.M.OF VENTILATOR
SIZE OF DUCTS SEWER R SEPTIC TANK
SIZE OF WATER MAIN
1
SIZE OF WATER PIPING&RISER
WATER HEATER: TYPE>SQ MANUFACTURER aAn:--
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.
3(lz ZC 7 V- ` C' `
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT 1,r..e fir,DATE Z