HomeMy WebLinkAbout225 OAKLAND RD UNIT 104 DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT
PERMIT#
Applicat a TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
1540 SULLIVAN AVENUE
_ Bldg.Permit#
644-2511 ext. 230
Date Bfil&y g Inspector
Application must be printed or typed
Location of Job:
FEE SCHEDULE Z Z 5 ONK L^n a QO AQ
$0-$1,000=$15.00 Street No. Street Lot No.
Over$1,000=
$15.00 per$1,000 10,4
or any fraction thereof Tenant Designation Apt. No.
APPLICANT �r R a•T�'� S j t<.�G- .
APPLICANT ADDRESS I [0_ �• �Aal'r, ST
p cV�Q; Q e _ CT Q to a in to _
APPLICANT PHONE# - 971 Z- +77 0 �O
S O W N St OWNER G'b 0 7e hr- Z
OWNER ADDRESS _ 27 Su1rMC CL- 511 C
� Q . A
O r. OWNER PHONE 4 / a
A
C ESTIMATED COST$ �j CDO •b V
.� IS THIS A CONTRACT COST? ✓Yes _No
FEE ENCLOSED$ S • O O C��/�PJ f/
���SO ••co TYPE OF JOB:
R % ew Installation
Alteration/Addition/Repair
Revised 4/01//2002
APPLICATION FOR PLUMBING PERMIT (Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
BUILDING PERMIT APPLICATION? ❑ YES D NO
❑VSIDENTIAL
USINESS CURRENT USE AND OCCUPANCY
❑ ASSEMBLY
D MERCANTILE FUTURE USE AND OCCUPANCY
D EDUCATIONAL
❑ INSTITUTIONAL
D FACTORY ENGINEER'S NAME PHONE
❑ STORAGE
❑GARAGE ADDRESS
❑ MIXED USE
CITY STATE ZIP
(Other please specify)
' t t
TYPE OF INSTALLATION N ��1 r�G SIZE OF MAIN DRAIN
NO. OF TOILETS STYLE NO.URINALS STYLE
NO. OF BATHTUBS NO.OF SHOWERS NO.OF LAVATORIES
r'
NO.OF CONDUCTORS SIZE NO.OF STACKS SIZE
AREA OF ROOF NO.OF CATCH BASINS NO.OF FLOOR DRAINS
NO. OF OTHER FIXTURES KIND SAL tOy% r)V S
I WAstteA.. koac-u.p
ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW DYES ❑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 4 D 6rP6 MANUFACTURER A .Q . S M 1
DESCRIPTION OF WORK
t
1-3 k3
�S,
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS T7—
COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE
PERFORMANCE OF SUCH WORK.
7.03-7 ZCo -P� l Crt"
CONTRACTORS LICENSE NO. TYP STATE
SIGNATURE OF APPLICANT DATE RYb 10
DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT
PERMIT#
Application—is herch
TOWN OF SOUTH WINDSOR Z-1-F 30-Z
BUILDING DEPARTMENT
1540 SULLIVAN AVENUE Bldg.Permit#
644-2511 ext. 230
to u'lding Inspector
Application must be printed or typed
FEE SCHEDULE Location of Job:
FTenant
$0-$1,000=$15.00 Street Lot No.
Over$1,000=
$15.00 per$1,000
or any fraction thereof gnation Apt.No.
APPLICANT L , �l0 Lit' —f
APPLICANT ADDRESS Q C `3 7
art L. l NG-7'Z►4 d 2�
APPLICANT PHONE+# Pee 0 — 88 3 3 8 3
S O W N St OWNER Cf /L)—Z7—L-
OWNER ADDRESS 7-7
Or OWNERPHONE33—/121�-
C a ESTIMATED COST$ S' 70
IS THIS A CONTRACT COST? Yes _No
FEE ENCLOSED$ -76
� •CO�� TYPE OF JOB:
OR-CO Installation
_Alteration/Addition/Repair
APPLICATION FOR HVAC PERMIT (Continued from reverse side)
TYPE Oft SYSTEM: TYPE OF BUILDING:
^HEATING ❑RESIDENTIAL
)a.A/C .rOMMERCIAL
VENTILATION O INDUSTRIAL
HEATING
O STEAM LOW PRESSURE LIMIT LBS. HIGH PRESSURE LIMIT LBS.
❑HYDRONIC 'WARM AIR ❑UNIT RADIANT HEATER
EXISTING RADIATION ADDITIONAL RADIATION TOTAL RADIATION
DESIGN TEMP. OUTSIDE OF INSIDE OF DIFFERENCE OF
TOTAL HEAT LOSS(BTUH) OF(HEAT LOSS SHEET MUST ACCOMPANY
APPLICATION)
� ESCRERE ALL HEATING EQUIPMENT(INCLUDING MAKE&MODEL NO.)
GROSS HEATING CAPACITY(INPUT-BTUH) NET RATING(OUTPUT-BTUH)
TYPE OF FUEL
❑OIL-GPM OIL TANK LOCATION :❑ INSIDEO OUTSIDE CAPACITY
&GAS-INPUT LPG TANK CAPACITY ELECTRIC-KW
AIR CONDITIONING
DESIGN TEMP.OUTSIDE OF INSIDE OF DIFFERENCE OF
TOTAL HEAT GAIN(BTUH) (HEAT GAIN SHEET MUST ACCOMPANY APPLICATION)
l DESCREBE ALL COO ING EQUIPMENT(INCLUDING MAKE&P40DEL NO.
00-1 C¢ /w Cc!mac
TONNAGE COOLING CAPACITY(BTUH) C
VENTILATION
DESCRIBE ALL AIR HANDLING EQUIPMENT(INCLUDING KITCHEN EXHAUST EQUIPMENT)
TOTAL SIZE OF SYSTEM(CFM) FRESH AIR INTAKE(CFM)
(PLANS MUST ACCOMPANY APPLICATION)
FURTHER 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.
3a3S-4-z 5 _� C-7r
CONTRACTORS LICENSE NO. TYPE �7 STATE
SIGNATURE OF APPLICANT DATE