HomeMy WebLinkAbout138 HILLSIDE DR DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT PERMIT#
Application is hereby: TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
APP Ov 1540 SULLIVAN AVENUE
644-2511 EXT.230 Bldg.Permit#
(Date) (Building Inspect
Application must be printed or typed
FEE SCHEDULE ` 1 d Loca ' fJob:
I JD I��IIon S► E 5(;t
$041,000=$15.00 Street No. Street Lot No.
Over$1,000-
$15.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT 111 t(614 le"
APPLICANT ADDRESS a PA(1 fG1,t'_
APPLICANT PHONE 44)cj K a - I
�0 IN St OWNER L. 0( -u L 11
OWNER ADDRESS I
CIO) a. OWNER PHONE
G• = ESTIMATED COST $ In w
IS THIS A CONTRACT COST? YES NO
FEE ENCLOSED$
TYPE OF JOB: U 9
R•Cod New Installation
Alteration/Addition Repair
Revised 12/22/11
APPLICATION FOR PLUMBING PERMIT (Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
O RESIDENTIAL BUILDING PERMIT APPLICATION? ❑ YES ❑ NO
O BUSINESS CURRENT USE AND OCCUPANCY
O ASSEMBLY
O MERCANTILE O EDUCATIONAL FUTURE USE AND OCCUPANCY
O FACTORY
O STORAGE ENGINEER'S NAME PHONE
O GARAGE
O MIXED USE ADDRESS
(Other please specify) CITY STATE ZIP
TYPE OF INSTALLATION A� a A I ���,�;^ 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 O YES O 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 A MANUFACTURER
I DESCRIPTION OF WORK
wo-� r 1�ce — U A�
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.
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT DATE
HILLSIDE DRIVE
MON 102.00' R= 708.21
54'� �= 40
LOT 41
2d LOT 43
19, 19
r
N / F
DANIEL J.
N/F a I
ARMAND M. KATHELEEN E.
a 0J''-HANE
CEC!LE D.
BAP,D
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o �
v �r
d o
v rn
N
LOT 42
'�/�fYYYtrNNrfw�, i u
CON •i O
eP(v°f cA NFL`'•.
0.
LOT
No. 5032 2,` .r
36 LOT 35
D suft,4
•n.•n000
I HEREBY CERTIFY THIS MAP TO MAN FOR
BE SUBSTANTIALLY CORRECT AND
IN ACCORDANCE WITH CLASS C)
CODE OF CONN. TECHNICAL COUNCIL INC. H U B E R T MORROW
HILLSIDE DRIVE SOUTH WINDSOR j
SCALE I = 4-0 AUGUST 197!D
WILLIA , REG. !.S.
1300550 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER PLUMBING PERMIT
DATE: 12/19/2013
GIS ID:43800138 FEE: 15.00
MUNIS APPLICATION# 201301818 BUILDING DESCRIPTION:
APPLICANT LOCATION
NAME: AKT INSTALLATIONS ADDRESS: 138 HILLSIDE DRIVE
ADDRESS: 211 PARK AVENUE OWNER. ROSE F PEREZ&VICTOR J TRUSTEES
EAST HARTFORD, CT 06108 , 138 HILLSIDE DRIVE
SOUTH WINDSOR,CT 06074
DESCRIPTION OF WORK: 40 ALLN GAS WATER HEATER REPLACEMENT.
SPECIAL CONDITIONS:
ALL WORK TO BE DONE IN ACCORDANCE WITH THE APPLICATION AND PLANS APPROVED BY THE BUILDING DEPARTMENT.
CONSTRUCTION TYPE:
OCCUPANCY GROUP: BUILDING OFFICIAL
12/19/2013 3:18 PM THE FEE ABOVE INCLUDES A$0.26 PER THOUSAND CT STATE EDUCATION SURCHARGE