HomeMy WebLinkAbout104 Ident Road (5) DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT
TOWN OF SOUTH WIlVDSOR PERMIT#
Application is hereby: I Cp j
BUILDING DEPARTMENT
(�--;A��;QLVVED 1540 SULLIVAN AVENUE Bldg.Permit#
661o"; 644-2511 ext. 230 1_1
ate Building Inspector
Application must be printed or typed
FEE SCHEDULE Location of Job:
F:Tenant
�tN j �oo�
$0-$1,000=$15.00 o. Street Lot No.
Over$1,000=
$15.00 per$1,000 !
or any fraction thereof esignation Apt.No.
APPLICANT L O S to N L,8-r�l
APPLICANT ADDRESS ') g ( cop ,W�„�
APPLICANT PHONE#
N S OWNER
O W . Fq
` OWNER ADDRESS /o 4'
0 Y OWNER PHONE 51-g,- (��lr�f
C ESTIMATED COST$
IS THIS A CONTRACT COST? Yes No
FEE ENCLOSED$
f11r �� TYPE OF JOB:
dSOR S COS New Installation
Alteration/Addition/Repair
Revised 4/01//2002
APPLICATION FOR HVAC PERMIT (Continued from reverse side)
TYPE OF SYSTEM: TYPE OF UILDING:
❑HEATING A 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 CIO _OF INSIDE OF DIFFERENCE l�� OF
TOTAL HEAT GAIN(BTUH) s L (HEAT GAIN SHEET MUST ACCOMPANY APPLICATION)
DESCRIBE ALL COOLING culp"ff� ENT(INCLUDING MAKE&MODEL NO.)
TONNAGE I L COOLING CAPACITY(BTUH) ov o
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 S-'-� W��q � w
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.
S- ( 3°t )-? $'o S-�
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT �jBvL b��s sa �^t/ DATE /I l2'Le L
r)687-L1 1 S-16-12-R9
Job No. Date
RESIDE,,:T IAL %vOLING DA„, SHEET outside Design TelTip Ds V'JB._
svrar s:
de✓es1yi,Tc,Tip. 'Dail':Dan C
"'IS� 0 '� � t,✓_,� S���� Design Temp.Diff. Latitude
HEATING CONTRACTOR
ADDRESS ���JJJ Floor Area By
NAME OF JOB a� t-L f IJ/t`'c 1,,/t. 1 W`— t '� re 4- fi1
ADDRESS
1 Room Use and Floor Level f•'���1" , ;.r 1• i�-
1 2(,`,� 3 I� a CrV��i 6. 7. 8.
2. Room Length and Width
Type and Direction oT TABLE Area Area Area 1 Area Area Area Area Area
HTM or Btuh Btuh 6 ' I Btuh Btuh FBtuh Btuh Btuh
E Yposure NU�NIBE R or or or I or or , Or or
No. Gain No. 1 Gain No Gain NO. ( Gain No. Gain No Gain No. Gain No Gain
NORTH Exposed .'all Length r-=a •'. 1 ;t fi.C� ?
(OR SHADED) Ceiling Height �� .. r• ,
3. Wall and Glass Gr *, ,s .r tr{. :r y.•.'� L'e • • �?:';,
Oss Exposed Wall_ .!t'+'- .i: •.-iw i,�ri'!. .►.,••: ^1. ;ate'•'••t, . .. r :�!!• + ,k y :.
(Solar& Sq Ft Glass Area
Conduction) Net Exposed
EAST Cxposed'!Vall Leng'•l (�• a t K"a'• Z ``(•. �. i
Ceiling Height -- -� i � � � �. - ��'; • '"x '}•' •. ::- ~. -�;�t :t•,•�"* ;
a. Wall and Glass G:css E x used i":ai:" '.��, T�.' + 61.
- 5 '"''"' '�'� " , '+�:=s•
(Solar& Sq Ft Glass Area
Conduction) Net Exoesed Wale
SOUTH Exposed'.Nal! Le^rrh �;' rt�,Se 1• "'> y +�. L _Y: •y' �.
---- �tr. _�'• �• •:�:�• .• •4--..: �.:. ..: .•�• •� r;••��.�� rr"':�:+'-•'� --,`• :�� .. x:,.ter' �
Ceiling Heigh c�:ti.:a: t1• .:1 r .�..�� �'•: . • 1 1, Li �, A
5. Wall and Glass Gross ExoosedyJal �., s 1 r.• .r •['1 fi' — .. ..- `-,.. :�•h •y'� ~=� .•1
;: 3 ,,:�a• 1 f•a; .-.� .► s.
:�'��'P!' f Gp � ,'r#'a' ?' ..�.�a•,�, (� r , '� -!�i,�e > ,�y.l'.�:�• -r.�'' •: t;�'r:""•\' .•�:
(Solar& Sq F t Glass F•:ea__-- 1 p i 4 S 1 I r
Conduction) Net Exposed
WEST Exposed b"1a1, Li^y;yt y'�f•_1.I"./��..\.`FY'���' ! 41: -�1:�•. .fi, t�'l�,'vi 4�t.{J_„i t:4`%tr=:;�� �)_ j _`i t 'y,.
Ceiling Heso'ht --- -�;r :�T, i��/�! NL:� J• tijj', ,a . aw..s 'F7{`o ' ,•
6. Wall and Glass Goss E xDoserj v�r' "�fi �t�• r Y► +•�.� �1 ?• 3-rtiJ, c••� ��j• ''a �rC'n
(Solar& Sq Ft Glass t=r d
Conduction) Net Excosea Wai! _ = f --j---�----- � � I
7.Wood Doors _�� —�-- -
8 Warm Partition
9_Warm Ceiling — - - i _ i :�a ��CQP ��' �'� ���G �"�'4;�'•x -�---- --+--�
_10 Warm Floor - `_` � 1- � t --�1-� _--�I• 1
f
11. Appliances-Kitchen (Sen I )
.. r is .'4 1�,•„��•7•� ��O ����.. s�' ,� Ai'1�:.
12.People(Sensible) __ �� p+ ,C, .� p- -,•�o
13.Outside Air or Infiltration(Sensible) /• S m
14.Sub-Total-Sensible _�- ���„��`•.:. - •F��: ti�� 1 �•.S i;;r�y.'�r.;,: �r~• �.'`'= �`' •''�.,.
15. Duct Allowance %
16.Total Sensible G► �?�•_ •� f �y y f
17.Total Latent .3 x Tot.Sensible �-c:: • :x f�. S -
18.Total Sensible& Latent :t,• ,•+.. �� � ��Y •`�• .M ���~��
19.Theoretical drn
20. Delivered cfmRES r �� f jj. `
•• 1; ".� O N M+• I•
CAP.MULTIPLIER (For �F Swing) LENNOX Equip. Btuh Cap. @ of
MIN-EQUIP.CAP, C Ar"tl sating Cfm Rpm Air Changes S/T Ratio S.P.
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