HomeMy WebLinkAbout1535 John Fitch Boulevard (18) DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT PERMIT#
Application is hereby TOWN of SOUTH WINDSOR 4
BUILDING DEPARTMENT Bldg Permit#
APPRO 15.10 SULLIVAN AVENUE -
` �6 J - 644-2511 ext. 230
Date Building Inspector
Application must be printed or typed
Location of job
Rnrat Alm
Street No. Street Lot No.
FEE SCHEDULE
$0 - $1,000 - $12.00 Floor Apt. No.
Over $1,000
$12.00 per$1,000 OWNER
or any fraction thereof it
ADDRESS
OWNERS PHONE# 0
APPLICANT_4V �14CIr°
0�1 ADDRESS 1<0
4(
(0) ; ESTIMATED COST $
0 E•,, •
C = IS THIS A CONTRACT COST?
S NO
.r FEE ENCLOSED $
�SOR-CO� TYPE OF JOB:
Original Installation
Alteration/Addition/Repair
� 1
`mil
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 F INSIDE F DIFFERENCE,O F
TOTAL HEAT LOSS(BTUH)
(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 GAS-INPU10% 7 ELECTRIC-KW
OIL TANK SIZE&LOCATION
INSIDE OUTSIDE CAPACITY LPG TANK CAPACITY
AIR CONDITIONING
DESIGN TEMP. OUTSID)r�F INSIDE '/_SF DIFFERENCE O_F
TOTAL HEAT GAIN(BTUH) 00099'
(HEAT GAIN SHEET MUST ACCOMPANY PLCATION)
DESCRIBE ALL COOLING VQUIPMENT (INCLUDING MAKE&MODEL NO.) -call)
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TONNAGE COOLING CAPACITY(BTUH(�7Z O
VENTILATION
DESCRIBE ALL AIR HANDLING EQUIPMENT(INCLUDING KITCHEN EXHAUST EQUIPMENT)
All
TOTAL SIZE OF SYSTEM(CFM) FRESH AIR INTAKE(CFM) d00
(PLANS MUST ACCOMPANY APPLICATION)
FURTHER DESCRIPTION OF WORK Aidf4 'fo
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THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS TO
COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONN.BUILDING CODES IN THE
PERFORMANCE OF SUCH WORK.
STATE LICENSE-NO. NAME&TYPE SIGNATURE bF OPLIC NT
PHONE NO&M /�� DATE 1,111,4�7 1:�'