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HomeMy WebLinkAbout11 Carman Road f � j DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT TOWN OF SOUTH WINDSOR PERMIT# Application is hereby: BUILDING DEPARTMENT APPRL���> 1540 SULLIVAN AVENUE Bldg.Permit# C aZ jo- 644-2511 ext. 230 D to' Building Inspector Application must be printed or typed Location of Job: FEE SCHEDULE H ca & $0- $1,000=$13.00 Street No. Street Lot No. Over$1,000= $13.00 per$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANT i le r- APPLICANT ADDRESS as k1ari4Z 42, APPLICANT PHONE# :Fly O�� ,— l 200 W N S OWNER Z H`�U Pro!� 0 _q� OWNER ADDRESS ?,A OWNER PHONE 0yf ESTIMATED COST$ f 300 IS THIS A CONTRACT COST? 0Yes 0 No FEE ENCLOSED$ TYPE OF JOB: s(0)R C 0 New Installation 0 Alteration/Addition/Repair Revised 8/99 APPLICATION FOR HVAC PERMIT (Continued from reverse side TYPE OF SYSTEM: TYPE OF BUILDING: ❑HEATING ❑RESIDENTIAL ❑A/C ❑COMMERCIAL ❑VENTILATION ❑INDUSTRIAL HEATING ❑ 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) DESCRIBE ALL HEATING EQUIPMENT(INCLUDING MAKE&MODEL NO.) GROSS HEATING CAPACITY(INPUT-BTUH) NET RATING(OUTPUT-BTUH) TYPE OF FUEL ❑ OIL-GPM OIL TANK LOCATION :❑INSIDE❑ 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) DESCRIBE ALL COOLING EQUIPMENT(INCLUDING MAKE&MODEL NO.) TONNAGE COOLING CAPACITY(BTUH) 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. CONTRACTORS LICENSE NO. TYPE STATE SIGNATURE OF APPLICAN DATE_! 0 Z - DECISIO ' APPLICATION FOR tip-7 '\ �. HEATING PERMIT 1 � hereby _. bISAPP.RO�'ED .PERMITS No. BUILDING DEPARTMENT } TOWN OF'NIANCHESTER MUST-BE PRINTED OR TYPED �PECTOR ' ^ = JOB LOCATIONDd - le I;000-=-----=$14:00 = NO. _STREET Gere0f---- ----=$14:00 OWNER b✓✓ ..tion---7--------.$20.00 Y✓� ----�-----------=-=�25•.00 ADDRESS ✓�® $5.00* �� `----------= ---=45.-00* e. a permits---excepts for new ' Q j1, =APPLICANT-' rC 1/Y► �r in.residentia l.permits. t f � �f 6 ADDRESSv���'���� //-yto STIMATED COST,, _ -,FEE . 'COST=S 6 + - -FEES E,L'ECTRICA L lVORI(,DO`NE'.:By,.:_ -NAME,r -ADDRESS = ILLL-AWOR-K,COVERE1D-BY THIS-AP-PLICATIN HAS BEEN JOBS CRIPTIONT�HORIZED-IBY`_THE OWNER(OR=AGENT)OF THIS ------- i OPERTY=AND�WILL`DONE ACCORDING'TO LOCAL : DE-AND-REGULATIONS. - - SINGLE_F'AMIL--—Oli'NE;``01— ICUPIED � ------------------- Expar-at ion Date r SATE LI SENO. TYPE OF BUILDING OLD ❑ NEW .�.�-°/�a� *�_ —RESIDENTIAL COMMERCIAL TEL.iVO. SIGNATURE r OF APP ICAN PERt<1I�'=# - �dh'v ❑ INDUSTRIAL TYPE OF JOBQWrREPLACEMENT low PERMIT EXPIRES ❑ -ORIGINAL ❑ ADDITION i INSTALLATION (❑ REPAIRS REC.# CASH( ` e dd rt:t ° I c, a� . - ALELit02�M5 PTO 70''iNItFJ"=_BEL©W ER° - - _ -- , a40) (CIfiC:f80)WARM4AItt.(GRAV.;250)=(FORCED 200) ELEC-(3, 1'BT.U=1"avA'r�-; CUBIC BOOM LOSSr _ INS T AC-ED=RADIA AON s XFP CEIL1N6s GI:ASS�•FL'OOR, "CON= � ROOMS� L - -SQ/LIN.�FT - STYLE' 'TENTS= Al - - - - 4ii, TYPE - - 'ST'(Rf I_ = - - - �INSUL�ATION� �WINDAW.S.`YES „NO_ T�-I 1 C KN ESS