HomeMy WebLinkAbout2600 TAMARACK AVE COMMUNITY ROOM DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT
TOWN OF SOUTH WINDSOR PERMIT#
Application is hereby: 1966121
BUILDING DEPARTMENT
APPROVED 1540 SULLIVAN AVENUE
Bldg. Permit#
644-2511 ext. 230
Date Building Inspector
Application must be printed or typed
FEE SCHEDULE Location of Job:
AGE ,M�F0 " be,
$0-$1,000=$15.00 Street No. Street Lot No.
Over$1,000=
$15.00 per$1,000 /Py�, /� / ���
or any fraction thereof Tenant Designation Apt.No.
APPLICANT
APPLICANT ADDRESS P0,4;x 24W
��r� fir. �5aaz
APPLICANT PHONE# 96 -
let O W N S Fq OWNER ASrdCS �f
OWNER ADDRESS 2-CO &"Aaw
Avow (T 06001
Op , OWNER PHONE
C ESTIMATED COST$
IS THIS A CONTRACT COST? Yes _No4a
FEE ENCLOSED$ 110
— a'1ov
TYPE OF JOB: ?j i a 3 Pv
SCR'CO New Installation
Alteration/Addition/Repair �20 12-oO7;-�
Revised 4/01 H2002
APPLICATION FOR PLUMBING PERMIT (continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
El RESIDENTIAL BUILDING PERMIT APPLICATION?RYES ElNO
k.BUSINESS CURRENT USE AND OCCUPANCY
❑ASSEMBLY
❑MERCANTILE❑EDUCATIONAL FUTURE USE AND OCCUPANCY
❑INSTITUTIONAL
❑ FACTORY ENGINEER'S NAME PHONE
❑ STORAGE
❑GARAGE ADDRESS
❑MIXED USE
(Other please specify) CITY STATE ZIP
TYPE OF INSTALLATION B/ll69d/AC SIZE OF MAIN DRAIN 2
NO.OF TOILETS & —STYLE NO.URINALS (!) —STYLE
NO.OF BATHTUBS O NO.OF SHOWERS y 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 51Nk
ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW ❑YES WNO
SIZE OF WINDOW IF NONE C.F.M.OF VENTILATOR
SIZE OF DUCTS // SEWER OR SEPTIC TANK
SIZE OF WATER MAIN 1/4 SIZE OF WATER PIPING&RISER / - a
WATER HEATER: TYPE MANUFACTURER EJAX
DESCRIPTION OF WORK
Am 2 u.res� 2 L 4W,4�f _! rnti r 3 -/2o V 1AMAIR1000
Sy�Pw_
THE UNDERSIGNED HEREBY APPLIES FOR
A PERMI F TO PERFORM THE WORK DESCRIBED AND IS TZ7—
COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE
PERFORMANCE OF SUCH WORK.
CONTRACTORS LICENSE NO, PE STATE
SIGNATURE OF APPLICANT DATE 3
APPLICATION FOR ELECTRICAL PERMIT
DEPARTMENT DECISION TOWN OF SOUTH WINDSOR PERMIT#
Application is hereby: BUILDING DEPARTMENT 1;o 00%
APPROVED 1540 SULLIVAN AVENUE Bldg.
644-2511 ext. 230 Btdg.Permit#
Date Building Inspector
Application must be printed or typed
FEE SCHEDULE Location of Job:
$0 $1,000=$15.00
Over$1,000= 19treet No. Street Lot No.
$15.00 per$1,000 t'^0w�w Lz�n
or any fraction thereof Tenant Designation Apt.No.
APPLICANT 6— 94e dr--C
APPLICANT ADDRESS 3/
IB f2rS�ro1
APPLICANT'S PHONE# OG 010
OWNER kK-td,t04 �C
let OW N S f4 OWNER ADDRESS
` ! OWNER PHONE 0 G 0-aV
ESTIMATED COST$ G /
C :
Vol U IS THIS A CONTRACT COST? des No
'S+ FEE ENCLOSED$ o7�d
TYPE OF JOB:
yx
�AN
SOR•C0N V New Installation
Alteration/Addition/Repair
Revised 03/05/10
APPLICATION FOR ELECTRICAL PERMIT(Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
BUILDING PERMIT APPLICATION? ❑ YES ❑ NO
❑ RESIDENTIAL CURRENT USE AND OCCUPANCY
U'BUSINESS
❑ ASSEMBLY FUTURE USE AND OCCUPANCY
❑ EDUCATIONAL
❑ INSTITUTIONAL ENGINEER'S NAME PHONE
❑ FACTORY
❑ STORAGE ADDRESS
❑ GARAGE
❑ MIXED USE CITY STATE ZIP
(Other please specify)
TYPE OF INSTALLATION/WIRING METHODC
SIZE OF SERVICE SIZE OF MAIN CONDUCTORS
NUMBERS OF METERS NUMBERS OF DISCONNECTS AND RATINGS
NUMBERS OF PANELS NUMBERS OF DISCONNECTS REQUIRED? ❑ YES ❑ NO
NUMBERS OF LIGHT CIRCUITS NUMBER OF POWER CIRCUITS
NUMBER OF SWITCHES NUMBER OF OUTLETS
NUMBER OF LIGHT FIXTURES NUMBER OF HEAT CIRCUITS
NUMBER OF A/C CIRCUITS
SEPARATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED.
DESCRIPTION OF WORK
h qxlftc.( 4-S Rtn D n.4,w i one SLv�LU4'
THE UNDERSIGNED HEARBY 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 PERFOR-
MANCE OF SUCH WORK _
1 0 (( �v Z- / Ct
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT DATE