HomeMy WebLinkAbout25 MARILYN RD DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT
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PERMIT Applic ' n is TOWN OF SOUTH WINDSOR FERMI BUILDING DEPARTMENT 6 l
1540 SULLIVAN AVENUE Bldg.Permit#
644-2511 ext. 230
Date ilding Inspector
Application must be printed or typed
FEE SCHEDULE Location o ob:
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$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.
APPLICANT
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APPLICANT PHONE#
OWN g�q OWNER S G l Vti LfZ G
OWNER ADDRESS
OWNERPHONE
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TYPE OF JOB: .�yt{�1,
R. _Ngw Installation
Alteration/Addition/Repair
Revised 4/01//2002
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APPLICATION FOR PLUMBING PERMIT (Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A�
❑RESIDENTIAL BUILDING PERMIT APPLICATION? ❑ YES ®' O
❑BUSINESS CURRENT USE AND OCCUPANCY
❑ASSEMBLY
❑MERCANTILE El EDUCATIONAL FUTURE USE AND OCCUPANCY
❑INSTITUTIONAL
❑FACTORY ENGINEER'S NAME PHONE
❑STORAGE
❑GARAGE ADDRESS
❑MIXED USE
CITY STATE ZIP
(Other please specify)
TYPE OF INSTALLATIONNnI�}.a 1,,�Qv��- 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 G0.5 MANUFACTURER
I ( 1 DESCRIPTION OF WORK
THE D R I ll APPLIES R A PERMITP RF E ll S
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
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1500421 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER PLUMBING PERMIT
DATE: 10/16/2015
GIS ID: 56700025 FEE: 15.00
MUNIS APPLICATION# 201501431 BUILDING DESCRIPTION:
APPLICANT LOCATION
NAME: LAURETTI PLUMBING INSTALLS ADDRESS: 25 MARILYN ROAD
ADDRESS: 785 MIDDLE STREET, OWNER: RIZZA GARY J
SUITE#5 ;. 25 MARILYN ROAD
BRISTOL,CT 06010 SOUTH WINDSOR,CT 06074
DESCRIPTION OF WORK: REPLACE LEAKING 40 GALLON GAS WATER HEATER.
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
10/16/2015 3:58 PM THE FEE ABOVE INCLUDES A$0.26 PER THOUSAND CT STATE EDUCATION SURCHARGE