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Home My WebLink About186 Windsorville Road BFINALi g SPEC Ns: APPLICATION FOR BUILDING PERMIT Plumbing HVAC Date:- Sprinkler 18 6 1 R R WTNn-gQRV-ILI+E ROAD Electric Estimated Cost $ �v Zoning 21337 Permit Fee$ q�Q Affidavit NO. Occupancy Fee $ -3 Eng. Dept. COMPLETE RED BOXED AREAS. �(3 Fire Dept. TYPE OR PRINT ONLY Total Fee $ Health Dept. SIGN ON REVERSE SIDE. Approved for CO: 2 (Additional Cost) $ TO BUILDING DEPARTMENT, TOWN OF SOUTH WINDSOR, CT The undersigned, hereby applies to do w r ccordi�g the oll ing specifications: Job Location i Lot No. Side of Street--Zone AppIican - Tel. Address # MET CITY STAT Owner - Address � �✓ Architect Address Size New Area: Ft. Front Overall Ft. Deep Overall Total Area #Garages Lavatories Size of Lot Dist. from Street Line _Bathrooms Rooms 1 st 2nd 3rd ��yy/9 T& 14-C4 uv ?zv ^F Purpose of this Permit � � d /t gY City Water ❑ Well ❑ Septic ❑ Sewer ❑ Use Group Construction Type 5 Approved by Date 2 �� BD1A 11/88 I h r by agree to conform to all the requirements of the Laws of the State of Connecticut and the Ordinances of the Town of South Windsor and to notify the Building Inspector of any alteration in the plans or specificati uilding for which this permit is asked,and agree that this building is to be located the proper distance from all street lines,s' a yard lines a d required distar c s from all other is located in a zone in which this building and its us is allowed. igned I hereby apply for a Certificate of Occupancy for the work descri i is pplicat' n for Signed —DO NOT WRITE BELOW THI INE— INSPECTION RECORD Footing Framing - Foundation Fireplace/C imney Insulation Plumbing Permit# �5 Inspections: HVAC Permit# l Inspections: Electrical Permit# / 2 Inspections: Sprinkler Permit# Inspections: INSPECTOR DATE T LOCATIONA-1,U �C �►r T �.� % ��%ems o INSPECTION: CODE: RESULT(D/A) : S � BUILDING: v ( Pl r ELECTRICAL: PLUMBING: HVAC: OTHER: / 74 PERMIT DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT t Application is hereby : TOWN OF SOUTH WINDSOR BUILDING INSPECTION DEPT. APPROVED DISAPPROVED 1540 SULLIVAN AVENUE 644-2511 Ext . 230 ate 1 n s p e c t o r Application must be printed or typed 1. LOCATION OF JOB A66 - 166 117 7 FEE SCHEDULE No . Street $ 0 - $10000 - $10.00 Floor Apt . No . Over $1,000 - $10.00 per $1 ,000 or 2 . OWNER fraction thereof 3 . ADDRESS So 44- ��c r 4 . APPLICANT 4L41) 5 . ADDRESS 2 6 . ESTIMATED COST $ 2500, 7 . IS THIS A CONTRACT COST C� Yee No 8 . FEE ENCLOSED $ 30• � 7 ZA 9 . TY�PEE N OF BUILD G: RESIDENTIAL COMMERCIAL 10 . TYPE OF JOB : Original Installation `�eration/Addition/Repair Rn 3A 11 i8e APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side) 11 . LOCATION OF JOB NO. STREET APT. NO , 12 . TYPE OF INSTALLATION i�zr-'- �e - 13 . SIZE OF MAIN FEEDER ��G 14 . NO . OF LIGHT LOOPS / 15 . NO. OF HEAT LOOPS 16 . NO . OF POWER LOOPS 17 . NO. OF LIGHT OUTLETS 18 . NO . OF HEAT CIRCUITS 19 . NO. OF POWER OUTLETS 20 . NO. OF CONVENIENCE OUTLETS ��1. NO. OF HEAT CIRCUITS 22 . NO, OF POWER CIRCUITS 23 . NO. OF LIGHT CIRCUITS} 24. SIZE OF HEAT CIRCUITS 25 . NO. OF MOTORS 26 . NO . OF PANELS 1�zl 27 . TOTAL WATTAGE 28 . NO . OF POWER FEEDERS 29 . NO. OF SWITCHES 30. A/C LOAD 31. SIZE OF POWER FEEDERS 32. NO . OF FIXTURES 33. TOTAL HORSEPOWER 34. NAME OF SUBCONTRACTORS AND THEIR TRADES 35 . REMARKS AND FURTHER DETAILS : 41 I'll c) Fz fK,7—S e�!14-) LICENSE NO. SIGNATURE OF APPLICANT DATE PHONE NUMBER: INSPECTOR DATE G TIME /h4A LOCATION �j r t-�f1jolo V ► 111 /?G INSPECTION: CODE: RESULT(D/A) : BUILDING: ELECTRICAL: co I PLUMBING: HVAC: OTHER: -� � C r RMIT NO. OL DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT Application is hereby : TOWN OF SOUTH WINDSOR A OVED DISAPPROVED BUILDING INSPECTION DEPT. (-� / 1540 SULLIVAN AVENUE PP ,,�iloMC7/ 644-2511 Ext . 230 at ui g Inspector Applications must be printed or typed 1. LOCATION OF JOB: FEE SCHEDULE 2. OWNER: �. $ 0 - $1 ,000 - $10.00 3. ADDRESS: Over $1 ,000 - $10.00 p e r $1 ,0 0 0 or 4. APPLICANT:JOHAl L,4ohdy fraction thereof 5. ADDRESS: /,5-& �AIA) 6. EST. COST: $ �a 00 7. IS THIS A CONTRACT COST? YES Y 8. FEE ENCLOSED: $ ,�• �� 9. TYPE OF 7LDING: ESIDENTIAL COMMERCIAL 10. TYPE OF JOB: ORIGINAL ALTERATION INSTALLATION A DITION REPAIR BD 2A 11/88 APPLICATION FOR PLUMBING PERMIT (Cont. from Reverse Side) 11. LOCATION OF JOB: x -18g fifp T GENERAL PLUMBING 12. KIND OF INSTALLATION: 13. SIZE OF MAIN DRAIN 14. NO. OF TOILETS STYLE 15. NO. OF URINALS STYLE 16. NO. OF BATHTUBS 16A. NO. OF SHOWERS 17. NO. OF LAVATORIES 18. NO. OF SINKS / 19. DISPOSAL 19A. DISWASHER 20. NO. OF CONDUCTORS SIZE 21. NO. OF STACKS SIZE 22. AREA OF ROOF 23. NO. OF CATCH BASINS 24. NO. OF FLOOR DRAINS 25. NO. OF OTHER FIXTURES KIND 26. ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW? 27. SIZE OF WINDOW 28. IF NO WINDOW, WHAT KIND OF VENTILATION IS THERE? 29. SIZE OF DUCTS 30. SEWER OR SEPTIC TANK? 31. SIZE OF WATER MAIN 31A. SIZES OF WATER PIPING & RISERS 32. REMARKS AND FURTHER DETAILS WATER HEATER 33. TYPE�` �!G 0A1 0(4- �6�L�iCT 34. MANUFACTURER TANKS SAFETY DEVICES TEMPERATURE 35. CAPACITY 39. RELIEF VALVE 36. TEST PRESSURE LBS. 40. MANUFACTURER 37. WORKING PRESSURE LBS. 41. PRESSURE RELIEF VALVE 38. TYPE 42. MANUFACTURER 03 Lfo /f3 LICENSE NO. IfATE S URE OF APPLICANT PHONE NO._�� PERMIT N0. '77 DEPARTMENT DECISION APPL I CATION FOR Application is hereby : PLUMBING PERMIT TOWM OF SOUTH WIND SOR APPROVE DISAPPROVED BUILDING INSPECTION DEPT. 644-2511 Ext. 230 Date Building Inspector Application must be printed or typed. 1. LOCATION OF JOB: W/wfi�v , llae- fie FEE SCHEDULE 2. OWNER: 0 - $ $19000 - $10.00 yb�wwll- -�54 3. ADDRESS:Over $1 ,000 - $10.00 per $1 ,0 0 0 or 4. APPLICANT: fraction thereof 5. ADDRESS: G7-- 6. I� L� 0 �o EST. COST: $ 000 7. IS THIS A CONTRACT COST? YES Q ,F -It7 8. FEE ENCLOSED: $ jJ a �3�7 9. TYPE OF BUILDING: RESIDENTIAL COMMERCIAL 10. TYPE OF JOB: ORIGINAL ALTERATION INSTALLATION ADDITION REPAID. BD 2A 11/88 APPLICATION FOR PLUMBING PERMIT (Cont. from Reverse Side) 11. LOCATION OF JOB: M �'�'�" �Y Om Ft- GENERAL PLUMBING 12. KIND OF INSTALLATION: 13. SIZE OF MAIN DRAIN 14. NO. OF TOILETS , STYLE 15. NO. OF URINALS STYLE 16. NO. OF BATHTUBS_ 16A. NO. OF SHOWERS 17. NO. OF LAVATORIES 18. NO. OF SINKS 19. DISPOSAL 19A. DISWASHER �{N 20. N0. OF CONDUCTORS SIZE 21. N0. OF STACKS 1 SIZE Gf- 22. AREA OF ROOF 23. NO. OF CATCH BASINS 24. NO. OF FLOOR DRAINS 25. NO. OF OTHER FIXTURES KIND 26. ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW? Y65 27. SIZE OF WINDOW 10 ff� 28. IF NO WINDOW, WHAT KIND OF VENTILATION IS THERE? 29. SIZE OF DUCTS 30. SEWER OR SEPTIC TANK? 31. SIZE OF WATER MAIN ` 31A. SIZES OF WATER PIPING & RISERS J 32. REMARKS AND FURTHER DETAILS y�lg k1p6rL- f--y 0('L tJ6 WATER HEATER 33. TYPE 34. MANUFACTURER I TANKS SAFETY DEVICES TEMPERATURE / 35. CAPACITY .40 aT,C d 39. RELIEF VALVE VVV Qjj11� _ 36. TEST PRESSURE Ju LBS. 40. MANUFACTURER 37. WORKING PRESSURE 56-P LBS. 41. PRESSURE RELIEF VALVE 38. TYPE 42. MANUFACTURER J16 LICENSE NO. DA E SI T RE OF LICANT PH E NO. FOR OFFICE USE ONLY APPLICATION FOR HVAC PERMIT DATE: .7 9% (NO. ) TOWN OF SOUTH WINDSOR EST.COST: BLDC. PERMIT NO. 1540 SULLIVAN AVENUE FEE SOUTH WINDSOR, CT 06074 FEES: 644-2511 - Ext. 230 $ 0 - $19000 - $10.00 )yw/ Igg $1000 or fraction LOCATION OF BUILDIN thereof - $10.00 OWNER ADDRESS TOWN PHONE NO. HVAC CONTRACTOR ADDRESS TOWN PHONE NO. TYPE OF SYSTEM: HEATING TYPE OF BUILDING: RESIDENTIAL A/C COMMERCIAL _ VENTILATION _ BUSINESS INDUSTRIAL IF HEATING: STEAM LOW PRESSURE LIMIT LBS. HIGH PRESSURE LIMIT LBS. HYDRONIC_ WARM AIR UNIT RADIANT HEATER (INCLUDING WOOD COAL BURNING STOVE) TYPE OF FUEL: OIL-GPM,/,;so GAS IN-PUT ELECTRIC KW WOOD COAL OIL TANK - SIZE b LOCATION: INSIDE OUTSIDE CAPACITY -300 � ��v •�3�A/�� LPG TANK - CAPACITY EXISTING RADIATION_ ADDITIONAL RADIATION/ �TOTAL RADIATION /3d ,�f,C 75-, yo0 DESIGN TEMP. OUTSIDE OF INSIDE OF DIFFERENCE OF TOTAL HEAT LOSS (BTUH) Is (HEAT LOSS SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL HEATING EQUIPMENT (INCLUDING MAKE 6 MODEL N0.) 7- GROSS HEATING CAPACITY (INPUT-BTUH) ooa NET RATING (OUTPUT-BTUH) IF AIR CONDITIONING: DESIGN TEMP. OUTSIDE OF INSIDE OF DIFFERENCE F TOTAL HEAT GAIN (BTUH) (HEAT GAIN SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL COOLING EQUIPMENT (INCLUDING MAKE & MODEL NO.): TONNAGE COOLING CAPACITY (BTUH) IF VENTILATION: DESCRIBE ALL AIR-HANDLING EQUIPMENT (INCLUDING KITCHEN EXHAUSE EQUIPMENT): TOTAL SIZE OF SYSTEM (CFM) FRESH AIR INTAKE (CFM) (PLAN MUST ACCOMPANY APPLICATION) The undersigned hereby applies for a permit to perform the following work and is to comply with all local ordinances and State of Conn. Building Codes in the performance of such work. FURTHER DESCRIPTION OF WORK: STATE LICENSE - NAME b TYPE f DATE SI NATURE OF APPLICANT JAI 7/2- , APPROVED DA E 80 as 11/88 I - 8 - R CALCULATION SHEET 1503 (Mod rn Method) Copyright 1977 by The Hydronlcs Institute WHER ADDRESS DESIGN TEMPERATURE DIFFERENCE F. DATE COL. A COL.B COL.C COL.D COL.9 COL.F COL.G 1 ROOM Q O H L W H L W H L W H L W H L W Design Water Temp. 2 ROOM DIMENSIONS, FT. ~ _ U OTUH per Fo t of 3 LENGTH EXPOSED WALLS, FT. < Radiation Selected 4 WINDOW AND OUTSIDE DOOR AREA to STUN BTUH BTUH OTUH •TUN 5 WALL CONSTRUCTION ROOM LIN.FT.OF (Table 9, Line 3 x HI TOTALS RADIATION 6 TYPE OF GLASS FROM LINE 12 SELECTED (Bottom f table used for Line 5) 7 CEILING CONSTRUCTION C (Table 9, L x W) B FLOOR CONSTRUCTION1 (Table 9, L x W or Lin. F t) E 9 COLD PARTITION CONSTRUCTION F (Table 9, L M) G 10 -g 1 Wall I W Ith Oponing&) H c a 2 Wells(With Openings) �X _ .J 1 3 Wells IWsIh Openings)or Ent.Hall p. 11 TOTAL BTUH AT 7OF TEMP DIFFERENCE' 12 TOTAL BTUH AT DESIGN TEMP DIFFERENCE K C L.A COL.O COL.H -- COL.1 COL_J — COL. K COL.L TOTAL BTUH TOTAL OF BUILDING RADIATION 1 ROOM ¢ AT SELECTED O H L W H L W H L W H L W H L W DESIGN TEMP.- 2 ROOM DIMENSIONS. FT f' DIFFERENCE U — — 3 LENGTH EXPOSED WALLS, FT. 41 WINDOW AND OUTSIDE DOOR AREA LL STUN BTUH BTUH BTUH BTUH d WALL CONSTRUCTION *INCREASE BATHROOM (Table 9, LIns 3 x HI TOTAL 20% 6 TYPE OF GLASS — Ieott m f table used for Line 51 7 CEILING CONSTRUCTION IFOR CONCRETE FLOOR ON ( GROUND OR FILL AT Table 9, L x WI GRADE LEVEL,USE LINEAR B FLOOR CONSTRUCTIONt FEET OF EXPOSED EDGE (Table 9,L x W r Lin Ft.) 9 COLD PARTITION CONSTRUCTION ITable 9,L x H) 10 c 1 Wall(With Openingal O - 2 Wells IWHh Openings) pX ----- -- ------ --- — 3 Wells(With Openings) or Ent.Hall J -- - - - 11 TOTAL BTUH AT 70F TEMP DIFFERENCE' 12 TOTAL BTUH AT DESIGN TEMP DIFFERENCE — FORM 1503 This form Is available fr m The Hydronlcs Institute. 36 Russo Place,Berkeley Heights,N J 01922 - INSBECTOR � ' DATE p �y TIME LOCATION INSPECTION: CODE: RESULT(D/A) : BUILDING: ELECTRICAL: PLUMBING: HVAC: OTHER: FINAL INSP�,��M: J APPLICATION FOR BUILDING PERMIT Building Plumbing HVAC Date: Sprinkler 18 6 : 18 8 TA�T1�TI)S()R fi , - Electric Estimated Cost $ fLCIn Zoning Permit Fee $ Affidavit NO. 22325 Occupancy Fee $ Eng. Dept. Fire Dept. COMPLETE RED BOXED AREAS.TYPE OR PRINT ONLY Total Fee $ Health Dept. C Approved for CO: SIGN ON REVERSE SIDE. (Additional Cost) $ TO BUILDING DEPARTMENT, TOWN OF SOUTH WINDSOR, CT The undersigned, hereby applies to do wok according to the following specifications: Job Location Lot No. Side of Street Zone Applica 2 r Tel. i r ' Address Zipcoey �Z Lic.# STREET CITY STATE Owner -� ddress Ax4h+tect Address Size New Area: Ft. Front Overall Ft. Deep Overall Total Area #Garages Lavatories Size of Lot Dist. from Stre� Line 7 Bathrooms Rooms 1st 2nd 3rd Purpose of this Permit " "VC9 YA �-- r City Water Well �� Septic �— Sewer 0 Use Group Construction Type Approved by Date ZqtS BD1A 11/88 I hereby agree to conform to all the requirements of the Laws of th State of Connecticut and the Ordinanc s of the Town of South Windsor and to notify the Building Inspector of any alteration in the plans or specification Building for which this permit is asked,and agree that this building is to be located the proper distance from all street Imes,si yard lines nd required distances from l yen located in a zone in which this building and its use is allowed. - j gnad — I hereby apply for a Certificate of Occupancy for the work describ in t s applicat' r r- igned —DO NOT WRITE BEUOW TT4HI�SNE— INSPECTION RECORD Footing Framing Foundation Fireplace/Chimney Insulation Plumbing Permit# -/ S 7Z Inspections: HVAC Permit# Inspections: Electrical Permit# /3 7 6 Inspections: Sprinkler Permit# Inspections: Inspection / Approval Date By Appl Code Description Due Whom Code Comment ------------------------------------------------------------------------------- 95-22325-B 4,000 B03 FRAMING (ROUGH) 06/07/95 JRC A P03 ROUGH 06/07/95 JRC A E03 ROUGH 06/07/95 JRC A NEEDS SMOKE DETECTORS IN HALL AND BEDROOMS B10 FINAL 09/10/97 JRC A APPROVED FOR CO & CLOSEOUT 95-13476-E 960 _ f ARTICLE IV - Membership Section I The membership and terms of office shall be as specified in Section 502 of the South Windsor Town Charter, as amended and approved November 6, 1979, and Article VII of the South Windsor Town Code in accordance with a resolution adopted, and later revised 2/4/80 as Ordinance No. 99, Section 9-23 and 9-25. Regular members and alternates will attend a minimum of 75% of all scheduled meetings during any six-month period and will notify the chair or staff secretary of any anticipated absence. The chair shall notify regular members or alternates of an attendance problem. The Commission may recommend to the appointing authority consideration be given to replacing individuals when attendance requirements are not met. Section 2 Members will be required to carry a Town issued photo identification. ARTICLE V - Officers and Their Duties Section 1 The officers of the Agency shall consist of a Chair, a Vice-Chair, and a Secretary. Section 2 The Chair shall preside at all meetings and hearings of the Agency and shall have the duties normally conferred by parliamentary usage of such officers. Section 3 The Chair shall be one of the Agency members and shall have the privilege of discussing all matters before the Agency and of voting thereon. Section 4 The Vice-Chair shall act for the Chair in the Chair's absence and have the authority to perform the duties prescribed for that office. The Vice-Chair shall be an Agency member. Section 5 The Secretary shall be a member of the Agency. The Secretary shall take minutes of the executive sessions and, in the absence of the Staff Secretary, shall take minutes of regular and special meetings. PERMIT DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT 1 :3 10 Application is hereby: TOWN OF SOUTH WINDSOR BUILDING INSPECTION DEPT. APPROVE DISAPPROVED 1540 SULLIVAN AVENUE �(2 644-2511 Ext . 230 Date Building Inspector Application must be printed or typed 1 . LOCATION OF JOB 5.Z z; f -- -, - f. -'s ve(.),16 e- FEE SCHEDULE No . - Street $ 0 - $19000 - $10.00 Floor Apt . No. Over $1 ,000 - $10.00 per $1 ,000 or 2 . OWNER �C;%h ell,- � a-� fraction thereof 4 . APPLICANT 5 . ADDRESS /, ;2 � • t,-T6 A)4L), ZZE 6,oe-� 6 . ESTIMATED COST $ , (� 7 . IS THIS A CONTRACT COST L� N X013 8 . FEE ENCLOSED $ 9 . TYPE O BUILDING: SIDENTIAL COMMERCIAL 10. TYPE OF JOB : Origin 1 Installation �C'Llteration/Addition/Repair 80 3A 11/88 APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side) 11. LOCATION OF JOB l �J 4 ,� � C��t-<' -�'P NO. STREET APT. NO , 12 . TYPE OF INSTALLATION 13. SIZE OF MAIN FEEDER 14. NO. OF LIGHT LOOPS r 15 . NO. OF HEAT LOOPS 16. NO. OF POWER LOOPS 17 . NO. OF LIGHT OUTLETS 18. NO. OF MEAT CIRCUITS 19 . NO. OF POWER OUTLETS 20 . NO. OF CONVENIENCE OUTLETS /.9'0'21. NO. OF HEAT CIRCUITS 22 . NO. OF POWER CIRCUITS Zl 23. NO. OF LIGHT CIRCUITS 24. SIZE OF HEAT CIRCUITS 25 . NO. OF MOTORS 26 . NO. OF PANELS 27 . TOTAL WATTAGE 28 . NO. OF POWER FEEDERS 29 . NO. OF SWITCHES 30. A/C LOAD 31. SIZE OF POWER FEEDERS 32. NO. OF FIXTURES 33. TOTAL HORSEPOWER 34 . NAME OF SUBCONTRACTORS AND THEIR TRADES 35 . REMARKS AND FURTHER DETAILS : LICENSE NO. SIGNATURE OF APPLICANT DATE PHONE NUMBER. z- Vq / 6 V - SF- /6 FOR OFFI E USE ONLY APPLICATION FOR HVAC PERMIT DATE: 0- A' 96 (NO. .5 TOWN OF SOUTH WINDSOR EST.COST: Z, oo,oa BLDG. PERMIT NO. �'" 1540 SULLIVAN AVENUE FEE y®, � SOUTH WINDSOR, CT 06074 FEES: 644-2511 - Ext. 230 $ 0 - $19000 - $10.00 $1000 or fraction LOCATION OF BUILDING thereof - $10.00 / �' ,S_ /i�ir��.sorv/�� yl� r-Z:;r" rn. ayr Sau f� 99 -/v5_0 7 OWNER ADDRESS TOWN PHONE NO. x G 5 6 49 HVAC CONTRACTOR ADDRESS y TOWN PHONE NO. TYPE OF SYSTEM: HEATING _� TYPE OF BUILDING: RESIDENTIAL_ A/C COMMERCIAL VENTILATION BUSINESS INDUSTRIAL IF HEATING: STEAM LOW PRESSURE LIMIT LBS. HIGH PRESSURE LIMIT LBS. HYDRONIC WARM AIR y/ UNIT RADIANT HEATER (INCLUDING WOOD/COAL BURNING STOVE) TYPE OF FUEL: OIL-GPM =7.5 GAS IN-PUT ELECTRIC KW WOOD COAL OIL TANK - SIZE b LOCATION: INSIDE_ OUTSIDE/ _ CAPACITY o?7S LPG TANK - CAPACITY EXISTING RADIATION -.aa" ADDITIONAL RADIATION_ TOTAL RADIATION Y/S e; DESIGN TEMP. OUTS DE OF INSIDE OF DIFFERENCE °F TOTAL HEAT LOSS (BTUH) ' (HEAT LOSS SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL HEATING EQUIPMENT (INCLUDING MAKE & MODEL GROSS HEATING CAPACITY (INPUT-BTUH),i o5.a0o NET RATING (OUTPUT-BTUH) ?T IF AIR CO&DITIONING: DESIGN TEMP. OUTSIDE OF INSIDE OF DIFFERENCE OF TOTAL HEAT GAIN (BTUH) (HEAT GAIN SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL COOLING EQUIPMENT (INCLUDING MAKE & MODEL NO.): TONNAGE COOLING CAPACITY (BTUH) IF VENTILATION: DESCRIBE ALL AIR-HANDLING EQUIPMENT (INCLUDING KITCHEN EXHAUSE EQUIPMENT) : TOTAL SIZE OF SYSTEM (CFM) FRESH AIR INTAKE (CFM) (PLAN MUST ACCOMPANY APPLICATION) The undersigned hereby applies for a permit to perform the following work and is to comply with all local ordinances and State of Conn. Building Codes in the performance of such work. FURTHER DESCRIPTION OF WORK: in �' i/ i.rG✓ rQf. S ��r�r f�� r eg� s / S G /2��ia c tol e le c T'^I� CQ 5 s fesr� pG�e�Li y S Coo & Qaev�y- 85$71 1--211"Izz/al E/-//.s - a STATE LICENSE - NAME & TYPE # DATE SIGNATURE OF APP ANT (4f �G APPROVED DATE I - 8 a A CALCULATION SHEET 1503 (Modern Method) Copyright 1971 by The Hydronlcs Institute OWNER ADDRESS DESIGN TEMPERATURE DIFFERENCE F. DATE COL A COL.B COL.C COL.D COL.E COL.F COL.G 1 ROOM lx n Water Temp. O H L W H L W H L W H L W H L W Design 2 ROOM DIMENSIONS, FT. ~ U BTUH oar f of of 3 LENGTH EXPOSED WAILS,FT. t Radiation Selected 1 WINDOW AND OUTSIDE DOOR AREA IL BTUH BTUH BTUH BTUH STUN 5 WALL CONSTRUCTION ROOM LIN. FT.OF (Table 9. Line 3 x H) TOTALS RADIATION 6 TYPE OF GLASS FROM LINE 12 SELECTED (Bottom f table used for Line 5) 7 CEILING CONSTRUCTION C (Table 9,L a W) g FLOOR CONSTRUCTIONt O_ (Table 9, L x W r Lin. F t) E 9 COLD PARTITION CONSTRUCTION or (Table 9, L a HI G 10 _c 1 Wall(With Openings) O c+ 2 Wells lWith Openings) 2x 3 Wells 1 W rih Openings)or Ent.Hall J 1 11 TOTAL BTUH AT 7OF TEMP DIFFERENCE* 12 TOTAL BTUH AT DESIGN TEMP DIFFERENCE K -- COL.A _ i_- -__ COL.B COL.H — COL.1 COL_J — COL.K COL.L TOTAL BTUH TOTAL 1 ROOM OF BUILDING RADIATION Q _ AT SELECTED O H L W H L W H L W H L W H L W DESIGN TEMP.• 2 ROOM DIMENSIONS. FT I- DIFFERENCE U - 3 LENGTH EXPOSED WALLS, FT. 1 WINDOW AND OUTSIDE DOOR AREA LL BTUH BTUH BTUH BTUH BTUH S WALL CONSTRUCTION •INCREASE BATHROOM (Table 9.Line 3 x HI TOTAL 20% 6 TYPE OF GLASS (Bost m of table used for Line 51 CONSTRUCTION - IFOR CONCRETE FLOOR ON 7 CEILING CON ( GROUND OR FILL AT Table 9. L x GRADE LEVEL.USE LINEAR B FLOOR CONSTRUCTION? FEET OF EXPOSED EDGE (Table 9,L x W or Lin Ft) 9 COLD PARTITION CONSTRUCTION (Table 9,L x H) 10 c I Well(With Openings) C -- 2 Wells lWith Openings) p X -- -- - - ---- ----- - 3 Wells!With Openings)or Ent Hall r J — — 11 TOTAL BTUH AT 7OF TEMP DIFFERENCE' 12 TOTAL BTUH AT DESIGN TEMP DIFFERENCE — FORM 1503 This form 1s available from The Hydronlcs Institute 35 Russo Place,Berkeley Heights.N J 07922 i INSPECTOR I, DATE. : TE IL /�/ TIMS 3� LOCATION S INSPECTION: CODE: RESULT(D/A) : BUILDING: ELECTRICAL: i PLUMBING: HVAC: QS47 OTHER: 1