HomeMy WebLinkAbout280 NUTMEG RD N APPLICATION FOR PLUMBING PERMIT
TOWN OF SOUTH WINDSOR BUILDING DEPARTMENT
1540 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 (PHONE) 860-644-2511 EXT.230
DEPARTMENT DECISION PERMIT NUMBER:
APPLICATION IS HEREBY:
APPRO BLDG.PERMIT NUMBER:
DATE IWECTOR
LOCATION OF WORK:
APPLICANT: OWNER: TYPE OF STRUCTURE:
NEW BUILDING
NAME: / Da lltloz1eol-w. NAME: ar/a / '�•�L�i ❑ADDITION
PHONE NUMBER: 7L �3 y% PHONE NUMBER: d ❑EXISTING BUILDING
CJ ADDRESS: y L P Wu 5,, ADDRESS:
TYPE OF USE:
❑RESIDENTIAL pCcOUNERCIAL
PLUMBING INFORMATION: FURTHER DESCRIPTION OF WORK:
TYPE OF INSTALLATION:
NO.OF TOILETS: STYLE: NO.OF BATHTUBS: eoG L° ✓�
NO.OF SHOWERS: NO.OF LAVATORIES: k vU l N S
NO.OF CATCH BASINS: NO.OF FLOOR DRAINS:
ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY WINDOW? ` L�
DYES DNO ESTIMATED COST:
SIZE OF WINDOW: SIZE OF DUCTS: /
SEWER OR SEPTIC TANK: FEE ENCLOSED: !
SIZE OF WATER PIPING AND RISER:
WATER HEATER: TYPE MANUFACTURER
FEE SCHEDULE:$18 PER$1,000 OF THE ESTIMATED COST.
ROUND UP TO THE NEXT THOUSAND ONCE THE PROJECT IS
$1.00 OVER. (.26 CENT EDUCATIONAL FEE INCLUDED AS PART
OF THE PERMIT FEE)
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 PERFOMANCE OF SUCH WORK. f
CONTRACTORS LICENSE NO.: L/'7 O .1 / TYPE: STATE: ZIII4
SIGNATURE OF APPLICANT: — ���� DATE: /y
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