HomeMy WebLinkAbout26 Sally Drive6P TO T BUMDING INSPEMR
Of the APPLICATION FOR
PLAN EXAMINATION ANDTOWNOFSOUTHWINDSOR,CONK
PLAN
PERMIT
7-
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX.O
ZONING
AT (LOCATION) DISTRICT
LOCATION NO STREET)
OF BETWEEN
t
AND
BUILDING ROSS STREET CROSS STREET)
LOT _ZSUBDIVISIONV"ZIL LOT--5V BLOCK S ZE 00 + 3.f!n
N
II. TYPE AND,COST OF BUILDING — All opp ;cants complete Parts A — D X
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking'most recent use
M
11NewbuildingResidotialNonresidential
2 Addition(I/ residential, enter number 12 j7One family 18 Amusement, recreational
of new housing units added, if any,
in Part D. 13) 13 Two or more family — Enter 19 Church, other religious
number of units——— 20 Industrial3 Alteration (See 2 above) 14 Transient hotel motel 21 Parking garage4 Repair, replacement or dormitory — Enter number
5 Wrecking (I/multifamily residential, of units ——————— —-- 22 Service station, repair garage
enter number of units to building in 15 Garage 23 Hospital, institutional
I'art D, 13)
16 Carport 24 Office, bank, professional6 Moving (relocation)
17 Other — Specify 25 Public utility7 Foundation only 26 School, library, other educati nal
B. OWNERSHIP 27 Stores, mercantile
8 ePfivate (individual, corporation,28 Tanks, towers
nonprofit institution, etc.) 29 Other -, Specify
9 Public (Federal, State, or
local government)
C. COST Omit cents) Nonresidential — Describe in detail proposed use of buildings,e.g., food
processing plant, machine shop, laundry building of hospital,elementary
10. Cost of improvement,,,,,,,,,,,,,,,, S school, secondary school, college, parochial school, parking garage for,
department store, rental office building, office building at industrial plant.To be installed but not included If use of existing building is being changed,enter proposed use.
in the above cost
a. Electrical....................... tea S'
b. Plumbing ......................
c.Heating, air conditioning.........
d. Other(elevator, etc.)............
11. TOTAL COST OF IMPROVEMENT $
III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — L;
for wrecking, complete only Part J, for all others skip to IV.
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS
30 L J Masonry(wall bearing) 40 U Public or private company
48• Number of stories................
Total square feet of floor area,31 W ad frame 41 Private (septic tank, etc.)
49.
all floors, based on eatefiOf
32 Structural steel dimensions .....................
33 Reinforced concrete H. TYP OF WATER SUPPLY
42 Public or private
Total land area, sq. ft. ........... 334 Other Specify p ' ate company
43 Private(well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
51. Ericlosed .......................
35 1Z Gas Will there be central air 52. Outdoors........................
36 Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 Yes 45 go N 53. Number of bedro ins..............
38 C o1
39 Other— Specify Will th r be on elevator?
54. Number f
Full..........
46 Yes 47 IV,N bathr ams
Partlol........
IV. IDENTIFICATION - To b compl t d by all applicants
Name Mailing oddr ss — Number, street, city, and State ZIP cod Tel. No,
Clark Realty Inc.,, 658 Ellington n Road,Owner or
Lessee South Windsor, Ct. 06074 82-0628
2.Same Same
Contractor
3.
Architect or
Engineer
The owner of this building and the undersigned agree to conform to all applicable laws of this jurisdiction.
Signature of applicant A44iress Application date
a 8
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans B NotesFeeStartedyApprovedy
BUILDING
PLUMBING
MECHANICAL
ELECTRICAL
OTHER is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date
Number By Permit or Approval I Check Date Number ByObtainedObtained
BOILER PLUMBING
CURB OR SIDEWALK CUT ROOFING
ELEVATOR SEWER
ELECTRICAL SIGN OR BILLBOARD
FURNACE STREET GRADES
GRADING USE OF PUBLIC AREAS
OIL BURNER WRECKING
OTHER OTHER
VII. VALIDATION
Building
P rmit number
Bui Iding
Permit issu d -5r 19 _
Building 50 vPermitFe
3, C 0 'r
W31
e'V A rove y: Qo
a.
TiT
TOWN OF SOUTH WINDSOR
BUILDING PERMIT
Date May 6
q 19 8 6
Fee Paid $.4.5 0..0 0 Eat. Value $. 7 5.,0 0 0
Permit N° 15 039
on the side of
I,n,t #5 4 Rally Drive Suet
Street No. 96
Owner l ar]c Rea ltxI ne .
Applicant Muriel Ja:cue s
CERTIFICATE OF OCCUPANCY ISSUED:
Date
No.
Fee Paid $3 .0 0
CLASSIFICATION
Dw lina
BUILDING PERMIT
M 15039
OFFICE OF
THE BUILDING INSPECTOR
of the
Town of South Windsor, Conn.
South Windsor, Conn. my 6 116
94ts is to Certify, That Clark Realty Tnc.
is hereby granted permission to Dwellincr
at estimated value of It r A A A
on the side of loot 2 54 Sa Ve Street on land
owned by Clerk Realty. TnC e
Said .yip to be as described in Application
No. i rvi:iand to conform to spedfications and plans filed with said Application, and Building By.
Laws of THE t(QwN OF SOUTH WINDSOR.
Isfued 1986
f l( fj 1
i-8uil ing as dor.
Streets and sidewalks, obstructed by emavations or building materials, must be guarded by barriers
during the day'ind by both barriers and colored lights by night.
SECTION',1343, GENERAL STATUTES OF CONNECTICUT: `When any person shall place
or keep buildinj,materials, or any obstacle in any highway (or any sidewalk) either with or without a
license therefor 'from the city or borough in which such highway may be situated, be shall pay said city,
town or borough al costs and damages which it shall sustain, or be compelled to reason therefor."
Dwelling - Lot #54 Pl.Val . 2 5/6/86ClarkRealtyInc.
26 Sally Drive Permit # 15039
Electrician Richard Barrett 9222
Heating Contr. So.Windsor P & H # 6501
Plumbing " SO-Wind. P & H 7065
Oil Burner
Certificate of Occupancy 7595
Sewer Permit
Plot plan apprd. per Engr.
1'
M
N
Permit No. l t
TOWN OF SOUTH WINDSORM
SOUTH WINDSOR, CONN.
w
r
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wPermit N U 7595
w
Certificate of Occupancy
THIS IS TO CERTJFY that the
at No. in the,' own of South Windsor, Connecticut, has
w been erected and compl Wed in accordance with the'Buildirg Code and Zoning Regulations of
the Town of South Windsor, and is hereby app owed r occupancy.
M
M
u ecFor
j kF r
Owner, Builder
Fee Paid, '.' Date 19
REINO E. HYYPPA 86 ASSOCIATES
C11HL ENGNEERS Q LAND SURVEYORS
GLASTONWRY, CONN.7k
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9222
ELECTRICAL APPLICATION
Application No. 10 7 3 6
on the side of
Street
Street No. Lot 54 .26 Sally -Dr.
Owner JMJ Construction Co.
Electrician Richard Barrett
FILED IN OFFICE OF
The Building Inspector
June 2 19 86
INSPECTION.
r&No Electrical Work shall be started until a Per-
mit is granted by the Building Inspector.
In New Buildings no wiring shall be started
until the plumbing and heating pipes, and the fire
stops (if of wood) are installed, without a special
permit from the office of the Building Inspector.
Electrical Permit No. . /.4 a'
Master License No. .. w!.i`04307
TOWN OF SOUTH WINDSOR Building Permit No. .. J..q.3.q.................
BUILDING DEPARTMENT Date Filed .......... ..:.. .. ........
Date Final Approval ...................................................
APPLICATION FOR ELECTRICAL WORK
Electrical Inspector
A 2TIN: C .....................................OB LOC O OB VNER: fiJ '-
Side of etwe ..C .. and............
gNameofBuilding Owner C>.......... ...... ........ Address C ......?.. ... . .... .. .....S.
If work is for Lessee—Give name . Address
Building now occupied as (unl ss new) No. of family units now .. ......................l rr
Building to be occupied as ........... Number of family units to be ....... ..t.......................
Is this w in uded i a
tBuilding
Per ? . Permit Fee ..................................................................
If no Building P it)
Permit . . Business Address elephone b....
COSTOF INSTALLATION: .r. ... O'Z) 1...........................................................................................................................................................................................................
TO BE FILLED OUT BY PERMITTEE
TO BE WIRED) aj' EXISTING APPLIANCES
Number of light outlets to be installed . . . 'K..........
Number of convenience outlets to be installed Number of present Appliance Circuits ...................................................
Number of switches to be installed
Number of appliances to be installed Do these include Range Water Heater
as listed below) Dryer Air Conditioner Oil Burner
TYPE RATING NO.
Dish Washer Gas Burner
Range
Well Pump Elec. Heaters
Range Top . . . . . .
Oven . . . . . . . . REMARKS:
Water Heater
Clothes Washer
Clothes Dryer . . . . .
Dish Washer . . . . . .
Air Conditioning Motor .
Oil Burner Motor . . . .
Gas Burner . . . . . .
Circulator Motor . . . .
Attic or Large Fan
Well Pump . . . . . .
Electric Heat . . . . .
Other . . . . . . . .
Number of new Lighting Circuits
Number of new Appliance Circuits . . .
Number of Heating Circuits
Number of Motor Circuits . . . .
Size of present service .........
Size of service to be ................ZLZ: 1...
7065 Aly
PLUMBING APPLICATION
No. 6136
on the ...... rde of
Lat.....#`5.......Sally Drive
Street No. ......___ 26
Owner . __.Clark Realty Inc .
PIumberSo.Windsor Plbg. & Htg.
Filed in Office of
The Building I rpecmr
7 f 9 9 19HG_
No person:hall onsumt, add m a abet ash
portion of the drainage system of say bo&&g
m=pt to repair lairs) until a Prrmit is Brasted
by the Building lnspectm
APPLICATION FOR PLUMBING PERMIT (Continued from Reverse Side)
TOWN OF SOUTH WINDSOR, CONN.
11. LOCATION OF JOB -Lot- 164 Sally Drive
NO. STREET FLOOR APT.NO.
GENERAL PLUMBING
12. KIND OF INSTALLATION Residential 13. SIZE OF MAIN DRAIN
14. NO. OF TOILETS 3 STYLE tank t;,-xe 15. NO. OF URINALS O STYLE
16. NO.OF BATHTUBS 1 17.NO.OF LAVATORIES 3 18. NO.OF SINKS 19. NO. OF WASHTUBS 0
20. NO.OF CONDUCTORS SIZE 21. NO. OF STACKS 1 SIZE 3 11
22. AREA OF ROOF 23.N0. OF CATCH BASINS 24. NO. OF FLOOR DRAINS
25. NO. OF OTHER FIXTURES O::e KIND 3' filberalass shower
26. ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW? -\'es 27. SIZE OF WINDOW
28. IF NO WINDOW, WHAT KIND OF VENTILATION IS THERE? electric vent -IL--an
29. SIZE OF DUCTS 3 30. ARE SEWAGE AND WATER FACILITIES AVAILABLE? Ores
SIGNATURE ADDRESS 521, Burnh ani Street, South Windsor
LICENSE NO. 203068 ESTIMATED COST 5 TELEPHONE 528-41r13
OWNER Clark Realty Inc. ADDRESS 658 Ellington Road South Windsor
WATER HEATER
as i ired
1
31. TYPE gas 32. MANUFACTURER `'• It11 E h
TANK SAFETY DEVICES
33. CAPACITY 40 gallons 37. TEMPERATURE RELIEF VALVE 210
34. TEST PRESSURE_ 150lbs 38. MANUFACTURER_ 1,atts
35. WORKING PRESSURE 80lbs 39. PRESSURE RELIEF VALVE 150
36. TYPE glass lined 40. MANUFACTURER Watts
ALL WORK COVERED BY THIS APPLICATION HAS BEEN AUTHORIZED BY THE OWNER OF THIS PROPERTY
AND WILL BE DONE IN STRICT ACCORDANCE WITH THE BUILDING CODE.
7114186
CD962 DATE SIr1ol APPL NT
PERMIT #
Application For 6299 6501
DEPARTMENT DECISION Heating Permit
APPLICATION IS HEREBY:
0 w DEPARTMENT OF LICENSES AND INSPECTIONS
N APPROVED DISAPPROVED
Cd TOWN OF SOUTH WINDSOR
C p. 7191,/86 Thcrn g P D' A uri00ODATECHIEFINSPECTOR APPLICATIONS MUST BE PRINTED OR TYPED. BEGIN WITH NUMBER ONE BEL MIO
o v 1. LOCATION OF JOB
0L, O
164 26 Sally DriveC
O NO. STREET
4 54
LOT NO.FLOOR APT. NO.
O O4jto
Ili
0
A 2. OWNER Clark Realty Inc.
cc
0 ADDRESS 658 Ellington Road
3
South Windsor 282-0628
4.PHONE
Cc
C/2 S. APPLICANT South Windsor Plunhing
e»
0 .o 6. ADDRESS 524 Burnham Street
w South Windsor PHONE 528-4413
S. LICENSE NO. 307190
a
0 w S. EXPIRATION DATE OF LICENSE 10/1/87
v
p 10. ESTIMATED COST S o2 fdy
W c
b0 11. IS THIS A CONTRACT COST?YES No
12. FEE ENCLOSED : Permit 1503 9
x
13. TYPE OF BUILDING:
C b RESIDENTIAL COMMERCIAL
c
cc14. TYPE OF JOB: INDUSTRIAL3
ORIGINAL ALTERATIONlxJINSTALLATIONADDITION
REPAIR
APPLICATION FOR HEATING PERMIT (Continued from Reverse Side)
11. LOCATION OF JOB Lot #54 Sally Drive
NO. STREET FLOOR AFT. NO.
12. TYPE OF INSTALLATION: OIL BURNER ELECTRIC VENTILATION SPRINKLER
GAS BURNER STACK INCINERATOR MISCELLANEOUS
IDENTIFY
SIZE LOCATION SIZE SIZE
13. OF TANK none OF TANK none OF FILL none OF VENT none
14. B.T.U. EQUIP. AT REGISTER FURNACE MAKE AND NO. AT BONNET FIRING RATE
BOILER OR FURNACE MAKE AND NO. Ilt 1ra-B.T.U. OR SQ. FT. NE175 ff 000 B.T.U. OR SQ. FT. GROSS FIRING RATE
FLOORS TO BE HEATED two NEW OR OLD BUILDING DEW INSULATEDX- YES OR NO vPs
TYPE OF WALLS frame INSULATION f i berctl a-m-, ROOF OR CEILING CPilincr INSULATION fiberQ1ass
AVG. SYSTEM WATER TEMP. 1,80 B.T.U./SQ. FT./HR. EMISSION
INDOOR-OUTDOOR TEMPERATURE DIFFERENCE 0-80 FAHRENHEIT
MAKE OF RADIATION: BASEBOARD. COPPER CONVECTORS, OR C.I. RADIATION. OUTPUT PER SECTION OR LINEAL OF RADIATION. SQ.
FT. OR B.T.U. Suntemp
DESCRIPTION OF WORK stall complete 3 zone heating15. TO BE DONE: 1P g system
16. HEAT LOSS SCHEDULE. (TO BE INCLUDED FOR ALL JOBS):
ROOM slzE wINDOws AREA - SQUARE FEET e.T.U. T.U.o DISTRIBUTION INSTALLED
AND DOORS VOLUME TOTAL TOTAL
J r I'-LL
ROOM No'GROSS GLASS NET WALL CEILING FLOOR CU.FT. AT 70•F CORRECTED j U. REGISTER
L W N AND S TEMP. TO TYPE AND SIZE RAD. OR LEADER
SIZE < WALL
f'LtG INFILT.) DIFF. F m N SO' FT. FREE AREA
TOTALS
A. HEAT LOSS FROM BUILDING B.T.U./HR.
B. DOMESTIC HOT WATER DEMAND 40 gallons B.T.U./HR.
C. PIPING. OTHER THAN NORMAL B.T.U./HR.
ALLOWANCE FOR HEAT VALVE OF FUEL (A B C) FACTOR
17. ELECTRICAL WORK BY: Barrett Electrical
NAME ADDRESS
SUBCONTRACTORS AND
Ia. THEIR TRADES
ALL WORK COVERED BY THIS APPLICATION HAS BEEN AUTHORIZED BY THE (OWNER) OR (AGENT) OF THIS PROPERTY AND WILL
BE DONE IN STRICT ACCORDANCE WITH THE BUILDING CODE.
APPLICATION TO BE COMPLETELY FILLED IN.
7/14/86
DATE IGN [ A LIC
C w
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OF si"- It
AT =0
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Will AhLFA 06
ovum
BALL co"--*'T*ucTtO"
C,
INCRE^Sff BATHROOM
TWWO 9j,Me 3 x H) 07 9,00 Ilea TOrTAL 20%
ti TYPIJ 4)[0 apL-A-M
MMIllam of UM*used-for Lkw 0
O'T!aiLtkG CoNsTRUCIr.oft tFQ"CONCRETE FLOOR ON
GROUND OR FILL ATMable9.L x W) QR^DE LEVEL,USE LINEAR
CONSTRUCTION? FEET OF EXPOSED EDGE
118ble 0,L x Warr Lin.Ft) 4e7 0
9-OOLD PARTITION comigToucroom
9.L
I Wall(With OpenIr4)0
v-3:dta
Itwous(Whh 0 72!!!!"1-x,Ara a
A Waft I*hh Pilo m wo-4w a^t 41t I f
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eye,),
This'xn+Is available tram TA Hydro ies la i6350unaPtec ,Borkel*V2m.oWt%P4.J- 7922 FORM 1503
f FINAL INSPECTIO
Buildin APPLICATION FOR BUILDING PERMIT
Plumbing
HVAC Date:
Sprinkler 26 SALLY DRIVE
Elect Estimated Cost $ y
Zoning 9083
Permit Fee$ Z
1
c,o
Affidavit NO.Occupancy Fee $
Eng. Dept. COMPLETE RED BOXED AREAS.
Fire Dept. TYPE OR PRINT ONLY Total Fee $ 2 C;3
Health Dept. SIGN ON REVERSE SIDE.
Approved for CO:I (Additional Cost) $
TO BUILDING DEPARTMENT, TOWN OF SOUTH WINDSOR, CT
The undersigned, hereby applies to do work according to the following specifi tions:
Job Location co Lot No. S T Side of Street Lone '
Applicant l V ` S%d i J4 A-i -7-,4irf 6 Tel. # 6
Address
STATE
Zip Lic.#
Cyy7-Y
Owner e0llvrBEET oe ddress
Architect D /49-S Address wa
Size New Area: Ft. Front Overall Ft. Deep Overall Total Area -< Garages
Lavatories
No. of Families No. of tories Construction Bathrooms Rooms 1st - 2nd 3rd-
Size of Lot COd x336. Dist. o Streetmtret Line Dist. from Side Street Line
Purpose of this Permit ,Te( UVAO G',4W r 3-fZZ2, c5`C-'fN/ c -f iv/*-
City Water Well Septic Sewer
Approved by Date aI_ BD1A 11/88
I hereby agree to conform to all the requirements of the Laws of the State of Connecticut and the Ordinances of the Town of South Windsor-
and to notify the Building In pector of any alt ration in th plans or specifications of th Building for which this permit is asked,and agree
that this building is to be located the proper distance from all street lin s,side yard lines and required distances from all other zones and is
located in a zone in which this building and its use is allowed.
Signe
I hereby apply for a Certificate of Occupancy for the work described in this application for permit.
Signed
DO NOT WRITE BELOW THIS LINE—
INSPECTION RECORD
Footin s--4 Framiiq'--4 i—
Foundation Fireplace/Chimney Insulation
Plumbing Permit# Inspections:
HVAC Permit# Inspections:
1
Electrical Permit# 7 / Inspections
Sprinkler Permit# Inspections:
BUILDING INSPECTION DEPARTMENT
SOUTH WINDSOR, CONNECTICUT
FEE PAID: $3.00
CERTIFICATE OF OCCUPANCY
ZONE: DATED 6/13 1991
This is to certify that 26 Sally Drive
Erected under permit No. 19033 conforms substantially to the requirements of the building ordinances and the
zoning regulations of the Town of South Windsor and is hereby approved for occupancy as indicated below.
Approved for Occupancy— Ingraund Pool
USE GROUP: U
CONSTR. TYPE: 2C Building Official
Notice:If this certificate is lost or destroyed, a duplicate should be obtained immediately from the Building Department.
Any change or extension of the use herein approved requires a new certificate of occupancy.
PERMITp.#
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT to
Application is hereby :TOWN OF SOUTH WINDSOR
APPROVE DISAPPROVED BUILDING INSPECTION DEPT.
644-2511 Ext . 230
1- Application must be printed or typed .
a e Building Inspector
1. LOCATION OF JOB
6 sp- Z& 0,?-,
FEE SCHEDULE No . Street
0 - $19000 -10. 00 Floor Apt . No .
Over $1,000 -10.00
per $1 ,000 or 2 . OWNER
fraction thereof
3. ADDRESS of—
CC770 6 a7 L-/
4 . APPLICANT b I— a
5 . ADDRESS /2/ S' & ZeO
Saul6 _ Gc n••-{
6 . ESTIMATED COST $
7 . IS THIS A CONTRACT COST
Yes o
8 . FEE ENCLOSED $ /•DO
O9 3
9 . TYPE OF BUILDING:
L/ ESIDENTIAL COMMERCIAL
10 . TYPE OF JOB :
4e6riginal Installation
Alteration/Addition /Repair
BD 3A 11/88
APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side)
11 . LOCATION OF JOB Z 6
NO . STREET APT. NO ,
12 . TYPE OF INSTALLATION c. C)
13 . SIZE OF MAIN FEEDER
14 . NO . OF LIGHT LOOPS 15 . NO. OF HEAT LOOPS
16 . NO. OF POWER LOOPS 17 . NO. OF LIGHT OUTLETS
18 . NO. OF HEAT CIRCUITS 19. NO. OF POWER OUTLETS
20 . NO. OF CONVENIENCE OUTLETS 21. NO. OF HEAT CIRCUITS
22 . NO. OF POWER CIRCUITS 23. NO. OF LIGHT CIRCUITS
24 . SIZE OF HEAT CIRCUITS 25 . NO. OF MOTORS_
26 . NO. OF PANELS 27 . TOTAL WATTAGE
28 . NO. OF POWER FEEDERS 29 . NO. OF SWITCHES
30. A/C LOAD 31. SIZE OF POWER FEEDERS
32 . NO. OF FIXTURES 33. TOTAL HORSEPOWER
34 . NAME OF SUBCONTRACTORS AND THEIR TRADES
35 . REMARKS AND FURTHER DETAILS :
LU r !77 fih /0cv r
zey
LICENSE NO.SIGNATURE OF APPLICANT DATE
PHONE NUMBER: ?.3 _067
PEPMIT NO.
DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT
Application is hereby :TOWN OF SOUTH WINDSOR
APPROVED DISAPPROVED
BUILDING INSPECTION DEPT.
1540 SULLIVAN AVENUE
644-2511 Ext. 230
Date Building Inspector Applications must be printed or typed
1. LOCATION OF JOB:
FEE SCHEDULE 2. OWNER:
3. ADDRESS:
I ^
0 - $15000 - 10.00
Over $1 ,000 - 10.00
j
p e r $1 ,0 0 0 or 4. APPLICANT:
fraction thereof
5. ADDRESS:
6. EST. COST: $
7. IS THIS A CONTRACT COST? 4YES NO
8. FEE ENCLOSED: $
9. TYPE OF BUILDING:
RESIDENTIAL COMMERCIAL
10. TYPE F JOB:
ORIGINAL ALTERATION
INSTALLATION ADDITION
REPAIR
BD 2A 11/88
APPLICATION FOR PLUMBING PERMIT (Cont. from Reverse Side)
11. LOCATION OF JOB:FIL
GENERAL PLUMBING
12. KIND OF INSTALLATION: 13. SIZE OF MAIN DRAIN
14. NO. OF TOILETS STYLE 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
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?
27. SIZE OF WINDOW
28. IF NO WINDOW, WHAT KIND OF VENTILATION IS THERE?
29. SIZE OF DUCTS 30. SEWER OR SEPTIC TANK?
31. SIZE OF WATER MAIN 31A. SIZES OF WATER PIPING & RISERS
32. REMARKS AND FURTHER DETAILS
fte- aomv-
WATER HEATER
33. TYPE /Y Y//=-- r
34. MANUFACTURER
TANKS SAFETY DEVICES
11
TEMPERATURE
35. CAPACITY 39. RELIEF VALVE
36. TEST PRESSURE LBS. 40. MANUFACTURERS ? C
37. WORKING PRESSURE LBS. 41. PRESSURE RELIEF VALVE
38. TYPE 42. MANUFACTURER
Z-A4 "797 P-
LIC NSE NO. DATE SIGNAT E VAPPLICANT
PHONE NO. cry
TEINSPECTOR TIME
LOCATION
INSPECTIONS CODE: RESULT(12/A) :
BUILDING:
ELECTRICAL:
PLUMBING:
7
HVAC:
OTHER: