HomeMy WebLinkAboutBuilding 24 Arthur Drive (8)DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT
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Application is hereby:
TOWN of SOUTH WINDSOR
Bldg p it#
BUILDING DEPARTMENT
APPROVED
1540 SULLIVAN AVENUE
644-2511 est. 230
IS;uilding Inspector Application must be printed or typed
Location ofjob
F-2Street
D
Street Lot No.
FEE SCHEDULE Apt. No.
Floor
0 - $1,000 - $12.00
Over $1,000
12.00 per$1,000 OWNEoranyfraGtionthereof
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ADDRESS Ll A R u
Sc jn/1/.Kl.$n 2
OWNERS PHONE# 1 6
APPLICANT k c All M b 1.-1 12cPA f
0W N S F
ADDRESS- -P o Ba 963
ESTIMATED COST$
IS THIS A CONTRACT COST?C YES NO
S.f
FEE ENCLOSED a "
11 TYPE OF JOB:
OR•Co original Installation
e Alteration/Addition/Repair Revised 10/96
APPLICATION FOR PLUMBING PERMIT(Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
BUILDING PERMIT APPLICATION YES /
V RESIDENTIAL
BUSINESS CURRENT USE AND OCCUPANCYASSEMBLY Est w Q(e1J ni
MERCANTILE
FUTURE USE AND OCCUPANCY 3A M cEDUCATIONAL
INSTITUTIONAL
FACTORY ENGINEER'S NAME PHONE
STORAGE
GARAGE ADDRESS
MIXED USE
CITY STATE ZIP
Other please specify)
TYPE OF INSTALLATION SIZE OF MAIN DRAIN
NO. OF TOILETS STYLE NO. OF URINALS STYLE
NO. OF BATHTUBS NO. OF SHOWERS NO.OF LAVATORIES
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 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 MANUFACTURE Y A a /4,,At"A
TANKS SAFETY DEVICES
TEMPERATURE
CAPACITY a 14 RELIEF VALVE
TEST PRESSURE 3-n WORKING PRESSURE q A PRESSURE RELIEF VALVE
tC,e, Xe—' 3
TYPE " /y MANUFACTURER wS
DESCRWTION OF WORK
J.A ((a,7
L,oR 1 0A 5
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS
TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONN. BUILDING CODES IN THE
PERFORMANCE OF SUCH WORK.
fG 1a c /`'q CO.y 07 P—l
NAME STATE LICENSE NO. TYPE SIGNATURE OF APPLICANT
PHONE NO. r670 632 J DATE 9-1/-71