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DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT
PERMIT#
TOWN OF SOUTH WINDSOR
Application is hereby: N
BUILDING DEPARTMENT 5 C0
APPROVE 1540 SULLIVAN AVENUE
Bldg.Permit#
644-2511 ext. 230
ate Building Inspector
Application must be printed or typed
FEE SCHEDULE Locati n of Job:
z CA 0
$0-$1,000=$15.00 Street No. Street Lot No.
Over$1,000=
$15.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT
APPLICANT ADDRESS P 0
APPLICANT PHONE#
SFq
OWNER
,0 N T2�'SGt ,�JD��s
OWNER ADDRESS :17 C
3
a
OWNER PHONE S, S' .3 F 6 �
C ESTIMATED COST$
V
IS THIS A CONTRACT COST? es No
FEE ENCLOSED$ �3C>
TYPE OF JOB:
�SOR O CO w N 1 e Installation
-;�/ A
Alteration/Addition/Repair
Revised 4/01//2002
APPLICATION FOR HVAC PERMIT (Continued from reverse side)
TYPE OF 'STEM: TYPE OF BUILDING:
HEATING ❑RESIDENTIAL
❑A/C ❑COMMERCIAL
❑VENTILATION ❑INDUSTRIAL
HEATING
❑ FEAM LOW PRESSURE LIMIT LBS. HIGH PRESSURE LIMIT LBS.
C7 HYDRONIC ❑WARM AIR ❑UNIT RADIANT HEATER
EXISTING RADIATION 9 Y`ADDITIONAL RADIATION Z 3 ' TOTAL RADIATION 117
DESIGN TEMP. OUTSIDE OF INSIDE OF DIFFERENCE OF
TOTAL HEAT LOSS(BTUH) OF(HEAT LOSS SHEET MUST ACCOMPANY
APPLICATION)
DESCRIBE TALL HEATING EQUIPMENT(INCLUDING MAKE&MODEL NO.)
C/,,*l..Z/ c �-/Q' - P/U'V A, _$`�. �0C /1/1-41, rU4
,4"Le/ -;>3, ye
GROSS HEATING CAPACITY(INPUT BTUH) �5 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 �/'�i2� �1.U1' �f c AIZ4
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.
---oo " 7 D :� 5 / L—
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT , -SATE
I , I
ALLIED PLUMBING SUPPLY, INC.
AVENUE
FRANCIS 14 A NUE
f . B= R CALCULATION SHEET 1503 (Modern Method) HARTFORD, CT 06106-2101'
II1 All
!+ ADDRESS `S /hAR��7 LQ,VC—S6 W//✓p +20�0
DESIGN TEMPERATURE DIFFERENCE F. DATE
i� COL.A COL.B COL.C COL.D COL.E COL.F COL.G ;
:1 •ROOM �•G�0/f/o/✓
li O H L W W H L W H L W H L W Design Water Temp.
ROOM DIMENSIONS FT. 1'- 6 !
i U S BTUH per Foot of
f fp il
LENGTH EXPOSED WALLS, FT. Q Radiatl n Selected
WINDOW AND OUTSIDE DOOR AREA U. ! ,
BTUH BTUH BTUH BTUH BTUH
WALL CONSTRUCTION ROOM LIN.FT. E,
(Table 9,Llne 3 x H) U s / 706 TOTALS RADIATIt''
TYPE OF GLASS FROM LINE 12 SELECTED
(Bo&m of table used for Line 5) �'�� 6 Soo r�
CEILING CONSTRUCTION C
(Table 9,L x W) 00
FLOORVONSTRUCTIONI D G 7
Pv
(Table 9,L x W or Lln. Ft.) 'r Oj 06 �( E -p* i
• COLD PARTITION CONSTRUCTION F
QfY9L it
(TsbIs 9,L x H)
jii0
�C 1 Wall(With Openings) O OG 1
2 Wells(With Openings) e X H I •i
w
b 3 Wells( Ith Openings) or Ent. Hall Iw J �Oj O 0 I '
• 1 TOTAL BTUH AT 70F TEMP, DIFFERENCE*
2 TOTAL BTUH AT DESIGN TEMP, DIFFERENCE X,vG Q K
L
I4
COL.A COL.B COL.H COL. 1 COL.J COL. K COL.L TOTAL BTUH TOTAL;
1 ROOM OF BUILDING RADIATIO
a AT SELECTEI
p H L W H L W H L W H L W H L W DESIGN TEMP.°
H DIFFERENCE
2 ROOM DIMENSIONS,.FT. U
13 LENGTH EXPOSED WALLS,FT. Q
4 WINDOW AND OUTSIDE DOOR AREA U.
BTUH BTUH BTUH BTUH BTUH '
WALL CONSTRUCTION INCREASE BATHROOM
! '
'
(Table 9,Line 3 x H) TOTAL 20% �!
I
r67
TYPE OF GLASS(Gott m of table used for Line 5)
iFOR CONCRETE FLOOR ON
CEILING CONSTRUCTION(Table 9, L x W) GROUND OR FILL AT
GRADE LEVEL,USE LINEAR
B FLOOR CONSTRUCTIONI FEET OF EXPOSED EDGE,
(Table 9,L x W or Lin. Ft.) ,
9 COLD PARTITION CONSTRUCTION
(Table 9,L x H)
10 _C 1 Wall(With Openings) o 94
t .
2 Walls(With Openings) 2 Xjo
�•1
I " 3 Wells(With Openings) or Ent.Hell FJ
tl TOTAL BTUH AT 70F TEMP, DIFFERENCE'
1I TO-r' ' Tlllr PT -�I nIFFFnENr1-