HomeMy WebLinkAbout10 PINE KNOB CIR DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT
PERMIT#
Application is hereby: TOWN OF SOUTH WINDSOR
i BUILDING DEPARTMENT
APPROVED 1540 SULLIVAN AVENUE Bldg.Permit#
-� 644-2511 ext. 230
Date R lding Inspector
Application must be printed or typed
FEE SCHEDULE p Location of Job:
$0-$1,000=$15.00 Street No. Street Lot No.
Over$1,000=
$15.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
IL
APPLICANT /Vj AAA I,c All Plumbing Repat-hic.
APPLICANT ADDRESS P.O. Box 853
Tolland, -
APPLICANT PHONE# r6-7G• "S-I d 5
S O W N S 4t OWNER "d c-A S o"
OWNER ADDRESS n P !�*�C. k/y e 1.
Q ak
u k At1,-c0S.,4 Cf o -7�(� �
a y OWNER PHONE Y 3 " D?Lj
C ESTIMATED COST$ g a
•�; IS THIS A CONTRACT COST? h Yes _No
q �� FEE ENCLOSED$ 1 5 r
S 0�� TYPE OF JOB:
OR C _New Installation I�
25' Alteration/Addition/Repair
Revised 4/01//2002
�oq 01D ba
APPLICATION FOR PLUMBING PERMIT (Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
;W RESIDENTIAL BUILDING PERMIT APPLICATION? ❑ YES ElNO
❑BUSINESS CURRENT USE AND OCCUPANCY
❑ASSEMBLY
❑MERCANTILE FUTURE USE AND OCCUPANCY
❑ EDUCATIONAL
❑INSTITUTIONAL
❑FACTORY ENGINEER'S NAME PHONE
❑STORAGE
❑GARAGE ADDRESS
❑MIXED USE
CITY STATE ZIP
(Other please specify)
TYPE OF INSTALLATION GvA}tA SIZE OF MAIN DRAIN
NO.OF TOILETS STYLE NO.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 AIAI U,"L Gn5 MANUFACTURER GE PAc.eM
DESCRIPTION OF WORK L
�Gtoo i4cc -w /VAi'V,eAZ (SAS
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE Wz5RK DESCRIBED AND is To
COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE
PERFORMANCE OF SUCH WORK.
.2 .."(13st P - ( Lt
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT �Z•c�,�.Q -m DATE 0 1
r+• cs. yk 's �' � _
... x i i• -1.
'?. ? L _ } •}r_.y � �:_ � lr + -5 ,ta. t *.c ,SL?ci..!dPi!c V.
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Pr I
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1 - x • ' • -Y 1T{. fit�
14
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i Lot Numbers: refer to Map Entitled
j "Subdivision Map, nine Knob 1iill. Sectioji I ,f
f Avery Street, South- Windsor, Connecticat, Seale
l"=60'.Aprii 20, 1959, Revise&April 23, 195.9. " 4
f
Building Located as Shown Proposed Layout .
Hereon. October 31, 1939. .�` '� 1. R.Stich Associates, L,c.
- Pine Knob Hill
Pine Knob Circle
�z:ci:tad ;ubstantiaily correct
'+ a:"?z South Windsor, C onnet.ucut
No zoni. g YlUlati011S• ..�: <r.(:` '
Scale I"-b0' April _'6. 1959