HomeMy WebLinkAbout136 Robert Drive Application No. 3110 Permit No. ... 2$..0
TO THE BUILDING INSPECTOR
of the
TOWN OF SOUTH WINDSOR, CONN.
hereby make application for a permit to (erect (make alteration to) a building according
to the following detailed statement of the specifications and plans herewith submitted. (Draw a line through
word "erect" or words "make alteration to" as the case may require.)
All provisions of the Building By-Laws (Sections 2 to 32 inclusive) shall be complied with in the execu-
tion of this work whether specified herein or not.
South Windsor, Conn., . ........... .................................... 19............
Signhere .................................................................................................................
Address ................./............................L.................................................. .................
Location? .....I�..o.. .°�..1 ...........�.Q'.t..........✓... .......................side of? ........ ,.�� .1.....................................................................
Nearest cross street? 0....!Y...oT.. ......................Street No. .. ...../......, ..... ................ Lot No. .............. ............
Owner of land is? �� TIA. ....�. ?L'...!c!G e !QAddress ..Ch 5 d ..>S r.......... ....... ..... ...... ...........
Owner of building is? .... Address ... ............................................................................................................
......... . ...........................................................
Architectis? d..,O�L:............................................ .......................Address ............................................................................... ..................................
rBuilder is? . ........................... .........................................................................Address .1n.L. .. ....7.............I R..`...J.. +..................................
Doe A'
Dimensions of 46ilding. ...........Feet front? ........[.3 .... ... Feet rear. .....1....... ........... Feet deep. ... . ..
Extreme height to highest point of roof? ....:........................ No. of stories in height? . ............. .
Purposeof building is? ....... .. ...................................................................No. of stores? ..................................................................:..................................
Howmany families? .....................................................................No. of rooms? .... �. .................................................................................
Distance from street line is? .... ...... .......................................from building line is? ...........4o................
............................. ..
ADDITIONS AND ALTERATIONS
(Give Brief Description)
Q.O.." .�.... /.8� .._5 ...'.....'r.........f.Z....X.......................................... . �.N.G..s.......... E..c�Fo�PS47_Z'........................
0!.!�
MapNo. .. . ......... ........
If of steel frame, what is exterior construction? ... . ... ... ........I.......... .........................
What kind of columns used? .................... ..... ..... . ... ...........Size of columns used? .... .. .. .
What length of columns used? ...How protected? ....... ... . ... .............. ........... ...
What kind of beams or girders? Size of beams or girders? ..... . ..............................
Longest span of beams or girders? These rest on? . - .. . . . . ........ ... ........................ .........
Roof construction is? ... ..... . ... .... ... .....................................Roof covering is? .. ................... ............................ .
The floors are of .... ........ .... ...... . construction and are calculated to carry a safe load of
lbs. per square foot.
(See Section 14, Building By-Laws.)
BRICK CONSTRUCTION.
Of what material will walls be constructed? ..... . ..... ................... ...................... . ...............................
Compositionof mortar? . ........ ............................................. .......... .............................. .......... ..............................
Height and Thickness of Walls
Height Stories Front Walls, Side Walls Rear Walls Partition Walls
Basement,
......................... ........................I................................................... ............................................................................................................................................................................................
1st Story
....................... ........................................................... ................................................................ ............................................................................................... ......................... . ...............
2nd "
.. ............. .... ...................................................... ... ......... ...................................................................... ........ .......... .................... .... ................. ... ............ ............ ........... .
3rd "
...................................................................................................................I............................................................................................................. ............................................................. ......
4th "
...................... ... ......................................................... .................................................I..................................................... .. .................... .... ................ ............ .. .... ... ........ .......
5th dd
..................... ...... . ................................................ ...................................I........................................ .......................................................................... ...........................................
6th cc
.. .. ....... ... ...............................................................................................................................................................................................................................................................
7th d'
................................................. .................................................. ......................................................................... .............. I .............................................. .......................................................
8th 'd
....................................................................................... ...............I................. .......... .. ......... ............ ......... . ..................................... .............................................................................
9th "
.. ...............................................I...........10th........................ . .... .. ............ . .......... ...... .I.. . .... ................... ....................... ..................................................
Material.of Front? ....If stone, what kind? .. ...... ...... ...
Thickness of Ashlar? Thickness of Backing? . ..........
Backed up with what? Arches or lintels over openings?
WOOD CONSTRUCTION.
Give Size, Longest Span and Distance Between Centres, of Joists, Girders and Columns
JOISTS GIBDANS cmmws
Floors Size Longest Span Centres Bridging Size Longest Span Centres Size Leng i Centres
1st Floor
2nd ....I...... .... .............. ...................................... _................. ........................ ....................
3rd.....�...... .............. .................................. ..................... ................ ................................... .................... ................ ..........._._.. ....................
.4 .....f;..... ............. ................................. ...................... ............... ................................ .....
-........ _.................
Size of outside studs? ................ ... ... ...... Distance on centres? .. ......... . ... ..... Size of sill? .......... ......................
Size of rafters? ...... . .. ......... . . Distance on centres?.... . .. . ....... ......... . . Size of plate? ............. .....................................
Size of ledgers or girts? ... ..... ......... . . .................................. .....Size of deck rafters? .. ....... . . ...................................... ...............
Distance on centres. ............. ......................... ..........................................Size of studs in bearing partitions? ....... ............ ......................
MISCELLANEOUS
Style of roof, flat, pitch, Mansard, or hipped? Fireplaces? ................ ..............................
Material of roof'covering? ................ ......Material of Cornice? .... .. .......................................... .. ............
Howis building heated? ....... ........................................................Lining of flues? . .. ...................................................... ......... . ..............
Thickness of shell of flues? ...... . ..... ..........................................Any elevators or lifts? ...... . ... ...... . ........... ....................
What kind? . . ..... How many? ... Any hoistways? ..
a o �..How protected? ............. .... ........ ................ . ....... .....Total Value of Building . f ..... ........ . .................. ................
When will work be commenced? . . . .............................. ... ................... .. .......................... I................
The applicant warrants that the lot for residential purposes, shown on a plot plan accompanying this appli-
cation, has 20,000 square feet, or more, and at least 100 foot frontage on a Town road shown on a map of
South Windsor showing Town Roads dated December 1949, or on any other roads officially accepted by the
Town of South Windsor since 1949.
Applicant
?,-,0 )U
BUILDING APPLICATION
ApplicationNo. .3.1.1.0........................................................
on the ......N.qr.t.h........... ..................................... side of
...... ......
Robert Drive
.... ................ ..... .............. . . ... . ... ......... ............ Street.
Street No, . 13 6...... . ......... ............ .............
JOwner Ru..th....J.. ..Sp enq er.. ................................
Applicant ..J... Rober.t ..S.Pe.nc.er............
CLASSIFICATION
Swimming Pool 18 1.x3_61
.Swimming. . .Pool.... ................ . .... .....................
. ............. ......... ... . ... .. ......... .. .. ..................
. ...................... .... ......... .......................................
Permit issued on above Application.
Date, .......June 10.
............. ....I........ .. 19...59.
TOWN OF SOUTH WINDSOR
BUILDING PERMIT
Date June 10 a 19 59
Fee Paid $ 8•.00 Est. Value $ 1800.0.4.
Permit N° 2850
on the North side of
Robert Drive Street
Street No. 136 Lot #3 8
Owner Ruth J. Spencer-
Applicant
E
' We Robert Spencer
CERTIFICATE OF OCCUPANCY ISSUED:
Date
No.
Fee Paid
CLASSIFICATION
Swimming Pool 18 1 x36'
k
k
i
i
f
BUILDING PERMIT
N° 2850
OFFICE OF
THE BUILDING INSPECTOR
of the
Town of South Windsor, Conn.
South Windsor, Conn. JLii=® 10: 19 59
T4io to to Tertify, That We Robert -3'pencaer
is hereby granted permission to Sw, irr_irr— Pool 18 r X3 s
-- at estimated value of $ 1800&QQ
on the North side of P Gi.-,c r* T r iv t� Street on land
owned by — Ruth J. ` p H n C n,r Said Work — _ to be as described in Application
No. 3110 and to conform to specifications and plans filed with said Application, and Building By-
Laws of THE TOWN OF SOUTH WINDSOR.
Issued _ j UMe 10, 19 59
Building Inspector.
Streets and sidewalks, obstructed by excavations or building materials, must be guarded by barriers
during the day and by both barriers and colored lights by night.
SECTION 1343, GENERAL STATUTES OF CONNECT IC UT: "When any person shall place
or keep building materials, or any obstacle in any highway (or any sidewalk) either with or without a
license therefor from the city or borough in which such highway may be situated, he shall pay said city,
town or borough all costs and damages which it shall sustain, or be compelled to reason therefor."
Application No. 7041 Permit No. 6701
TO THE BUILDING INSPECTOR
of the
TOWN OF SOUTH WINDSOR, CONN.
herebymake application for permit to (awL- (make alteration to) a building according
PP
to the following detailed statement of the specifications and plans herewith submitted. (Draw a line through
word "erect" or words "make alteration to" as the case may require.)
All provisions of the Building By-Laws (Sections 2 to 32 inclusive) shall be complied with in the execu-
tion of this work whether specified herein or not.
South Windsor, Conn., .........1 ................... 19.1� ...
Sign ....... ......, ......
Address ..................................... ...... .............. .......... ... . . .......
Location? . .. ........... ............... ... ...............................................................side of? . ...................................................................................................................
nNearest cross street? ....... .......... ................... ...... .......................#...........Street No. . . ........... ............................. Lot No. ...... ......... ......i
Owner of land�s? . .�.�' ....._.... �-4.0.-Y ..Address / ....�d gpk...�..1...�............ !¢
lot
Owner of build' g is?t. '� -4 .............. .................� ... �T
.... ................................................... ..Address .. ...... . 't .. ....� �•a/. . .. .........
Architect is? ��.. . ... ;74 Address �,..1o..ar. ....../�'� . ./J fi�.�. ... ....... LrjI�ICI�.......... T.'G...FiE.... .. ['�h. ........
3 C V Builder is? J,,4-AV-C-,..,.r..l.. .......�... .r. .. ..Addre ('P.. o.e.. .�... .a..X7
Dimensions of building? .?.c/a �-f�.... Feet front? ............ . ....... Feet rear? ....... ...... .......... Feet deep? ... . .. ..... ..
J
Extreme height to highest point of roof? ............. No. of stories in height? . .
Purposeof building is? :fe.11:�. ...................................No. of stores? ... .................. .......................................................................
Howmany families? .... ................a..�67 ..........................No. of rooirs? .... ...................... .........................................................
Distance from street line is? ... ... ..... ......................................from building line is? .................... ........ ...............................................
ADDITIONS AND ALTERATIONS
(Give Brief Description)
AI a
... l. ... ..... .. .................... ........... .......
. ... �. ./.�..W......... .......... -- •G14�.1r ................. ...... ........... .............. ............��s.
Map No. .
If of steel frame, what is exterior construction? .
What kind of columns used? ....... ...... ..... ....... .. . ..........Size of columns used?
What length of columns used? ... ... ..How protected?
What kind of beams or girders? .. ... Size of beams or girders? . .. .... .... ..
Longest span of beams or girders? . ... ...... ... These rest on? .
Roof construction is? .................................... ..............................................Roof covering is?
The floors are of ....... ............... ...... construction and are calculated to carry a safe load of
lbs. per square foot.
(Sze Section 14, Building By-Laws.)
BRICK CONSTRUCTION.
Of what material will walls be constructed? . ......... . .. .. .. . ......... .... ....................... ............... .... ............ ... ... . ..... ....
Compositionof mortar? . .......................................................................... .................................................... ............................ .... .... .... ... .. ...........
Height and Thickness of Walls
RAW Stortes Front Walla Side Walls Rear Walls Partition Walls
Basement,
................................. ........._............................................................. .........._........._...._.........._.............._............................................................................................................................ .......
1st Story
.......................... ................_......................................... ................................................................................................................................................................ ............................
2nd "
..........................................._......._........._....................................................................._............................................... ........... _........................................... .... ................ ......... ..........
3rd "
...................... _......................_... ................................................. ........................_....................... ......................................... ,.............................. ... .......... ......................... ..... ...... .....
4th "
... .................... ... ............__............................................................................................. ..............................................._....................................................... ....... . ......... .................
5th "
.................................. ............... ................................ .................. .......................................... ,.........................._.................................................................... .................................................
6th "
.... ............. ............... ....._.................._............................I.........._............................ ......................................................................................................._.........................................................
7th "
............I.. ......_....... .... . .......................................................... ............. ........................... ,................ .. ... .. ........... ........................................... .............. ..............................
8th `.
.............................................._....................................... ............... .............................. .........., . ......... .. ... . ........... ........... ..... .... ................. . ................. ........................
9th "
............................................_.. .....10th......................I........ ........ .......... ... ............... ................ .............. ........ ....................... . ....................... ...................................................
Material.of Front? ....If stone, what kind?
Thickness of Ashlar? . ...... ....... .....Thickness of Backing?
Backed up with what? Arches or lintels over openings?
WOOD CONSTRUCTION.
Giv Size, Longest Span and Distance Between Centres, of Joists, Girders and Columns
JOISTS 11 GIBDBBS QOLVMNS
Floors Size Longest Span Centres Bridging Size Longest Span Centres She," Length Centres
Ist Floor Z
/...1...... ..........�..7............... .../ ...... w v.. P-
. J ' _........... Y .. .... _.................
2nd
....... ......................................................_..................... ......................... ................._..................
..............................._........ .............................._.__. ................_....
_
3rd ••
4 .... ..... .................................................... .................. _....._... ...............................w _..._.... ..... _........_.. ......................
Zx
.. Distance on centres.
a
Size of outside studs? ? �Q ...... Size of sill?............ ... 7...................
Size of .. ........n .rafters. y` �... . Distance on centres ..........
� � � ./rp........ .............. Size of plate? ........... x.. ........................
Sizeof 1 dgers or girts? ... ..... . ..... . . ......................................Size of deck rafters? .. ........ ...................................................... ...............
Distance on centres? .. ..Size of studs in bearingpartitions? Z—p y .................
MISCELLANEOUS
Style of roof,.flat, itch Mansard, or hipped? P, .Tc. ... Fireplaces? .... ...............
..................................
.... .. ..... ? ............ .c,c?na
Material of roof covering. �.���-..� . ........Material of Cornice. ... . �...................... .............
How is building heated? ...............Lining of flues? ...........
Thickness of shell of flues? . . .. .. .............................. ......Any elevators or lifts? . .. ........ ... ......
. .............. ...... .....................
What kind? .. ....... How many? ... Any ho'lways? .. ......... .. ......... ..............
How protected? ... ..... .. .... .. ....... ................. ... ............Total Value of Fuilding ................................
o
When will work be commenced? ... .., .. ...•. e- --- - : ..• .................
The applicant warrants that the lot for residential purposes, shown on a plot plan accompanying this
application, conforms to the zoning regulations of the Town of South Windsor.
Town of South Windsor since 1949.
Applicant
6701
BUILDING APPLICATION
ApplicationNo. ........7001...................................................................
onthe ................................................................................ Side of
... ......Br. -ook.....S-t-im......... .... ................. .... Street.
Street No,
. .. ........ .......... ...... .........
OwnerAlbert Pe.1 l.e tr.........
.... .. ... . ............. .... . ..
Applicant .. Vincent. T..Joh.ns.qn....
... ........... .
CLASSIFICATION
Construction of rooms over existing
... ........ ........... ....................
two car garage. This application Just
cover.s......the.....shall and.. ele.Orloal work.
Permits required for heating & plumbing
work..,... ........ ... . .. .. . ... . ........... ........
Permit issued on above Application.
Date, . .5-a&-!-69....
TOWN OF SOUTH WINDSOR
BUILDING PERMIT
Date may 16 t , 109
Fee Paid $. 18.00 Est. Value $. -� 000
Permit 6701
i on the r side of
"Cf
o- 9NMWC=XR0bert Drivestreet
i
3
i Street No. 1 6
Owner Albert Pelletier
Applicant Vincent T. Johnson
CERTIFICATE OF OCCUPANCY ISSUED:
i
Date
No. 3 823
j Fee Paid $ 3•00
E CLASSIFICATION
Construction of rooms over existing
two car garage. Thts apptia on just
covers the shell and electrical work*
permits required for heating & plumbing
work,
a
BUILDING PERMIT
No 6701
OFFICE OF
THE BUILDING INSPECTOR
of the
Town of South Windsor, Conn.
South Windsor, Conn. Hwy 16 0 19619
4 is is ter Trrtif1 j, ThatV!w ent T. Jorias�n
is hereby granted permission to C 3 r1 8 t1'u C-t i o G of rooms over existing two Car
garage . This application-just covers the shell and electrical work
Pgrmf tt.s are reauirod for head g At 0umbing wwlkeimated value of
on the side of 7-M2Mrx9= ;f 110 Robert Drive Street on land
owned bybcrt Pelletier
Said -W pr 1z to be as described in Application
No. 7001 and to conform to specifications and plans filed with said Application, and Building By-
Laws of THE TOWN OF SOUTH WINDSOR.
Issued May 1969
Building Inspector.
Streets and sidewalks, obstructed by excavations or building materials, must be guarded by barriers
during the day and by both barriers and colored lights by night.
SECTION 1343, GENERAL STATUTES OF CONNECTICUT: "When any person shall place
or keep building materials, or any obstacle in any highway (or any sidewalk) either with or without a
license therefor from the city or borough in which such highway may be situated, he shall pay said city,
town or borough all costs and damages which it shall sustain, or be compelled to reason therefor."
Permit No. TOWN OF SOUTH WINDSOR
SOUTH WINDSOR, CONN.
Permit N? 3823
Certificate of Occupancy
THIS IS TO CEI
qIFY.4hat the '
at No. in the Town of South Windsor, Connecticut, has
been erected and completed in accordance with the Building Code and Zoning Regulations of
the Town of South Windsor,(7d here pro r acc
Building Inspector
O r, Builder
�O
Fee Pai —"—~ Date 19
Permit No. TOWN OF SOUTH WINDSOR
ISOUTH WINDSOR, CONN.
I
Permit N° 3823
Certificate of Occupancy
� f .
THIS IS TO CE IFY hat they / L
f A
at No. /''• in the Town of South Windsor, Connecticut, has
been erected and completed in accordance with the Building Code and Zoning Regulations of
the Town of South Windsor, d hereby pro r occcy.
�/ Building Inspector
O r, Builder
Z,�_
Fee Pai Date 19
M
4489
ELECTRICAL APPLICATION
ApplicationNo. ............4.8.0.0............................................................. ......
onthe ........ ....... ............. .. ............... ..... ........ side of
... ....... ..,R.ob.e.r.t...Drive.. ..... Street
Street No. 13.6 .. ... ....... . ............. . .. .............
Owner A•F_elletier
Electrician lleTWY. C Williams
FILED IN OFFICE OF
The Building Inspector
.671.1.76-9. . .............. . ..........
INSPRCTION.
................................................................................................................... ...............
.......................................................................................................... .................................
..................................................................................................................................... ....
ZwNo Electrical Work shall be started until a Per-
mit Is granted by the Building Inspector.
In New Buildings no wiring shall be started
until the plumbing and heating pipes, and the fire
stops (if of wood) are installed, without a special
permit from the office of the Building Inspector.
I APPLICATION FOR PERMIT TO DO ELECTRICAI. WORK.
�J / 800
vNo. .. .... ..�.... . ... ..
Permit No. .. .. ..44 S 9..... .
TO THE BUILDING INSPECTOR
of the
TOWN OF SOUTH WINDSOR, CONN.
................ hereby make application tq perform Electr cal Work according to detailed description below. All
provisions of the Rules for Electrical Installation, Section 48, Building -Laws, shall be complied with
whether specified her;ort.
South Windsor, Conn -tL.. 19 Sign here ............. .. .................. ....... ................ ........
Address ��'. .. .. .... .............. .... .................................... '.......Location l.... ..... ... ............ .%.... ....... Side of ..................................................................I..................
Natureof Building .................-`.".. .. ........................ ..... How many stories ................................................................................ .................
oldBuilding ..... ...... .. ... r.. .......... .. .. How many families ...............................................................................................
� S-12-u�aL��-`,ru�,
Kind of Installation ��. ... . .. ... �Z,z -.¢..f?............... .. . How many Stores .....................................................................................................
Owner ............................. ... . ...... . ... ........................................ Address ....
Architect ............ .......... .. ........ Address ............ ........... .................................................._.............................
IM,Builder . . .. 1/.�.....!. . ... �.. � �.... Address .... .... . ..... .. ..... ........... .
Electrician .... ... ... .. ........ ....... .. .. v ...... ........... . ..`.. Address `� /. .............. ....................'' �-
Size of Main Wires ... G
No. of Light Loops ...... .. ...... /. No. of Heat Loops . ........ .. No. of Power Loops .........................................
No. of Light Outlets .f No. of Heat Outlets .... No. of Power Outlets ............ ........ ......
No. of Light Circuits .... .. .. ........... .... No. of Heat Circuits No. of Power Circuits .. ... . . .......
No. of Sockets ...... .. ... . No. of Heat Receptacles ... No. of Motors ............... . . .. ..................
No. of Panels ................ . .. ...... ...... Size of Heat Circuit No. of Power Receptacles
No. of Switches ...... r .. . Total Wattage Size of Power Circuit ..
Total Horsepower
No. of Straight Electric Fixtures ..... ...... .J.. .. . ... No. of Combination Fixtures .
No. of Receptacles ........................ ......... . . ..... ..... . No. of Cord Drops ... ........... . ...................... ...............
Remarks: For other kind of Installation .. . ....... .... .................... . .. :.: ....
........................................ ..................... .... .. .. ...... . ........... ... .. .. . ............................. .. . .. ..
s
........................ .......... ..... .. _...... ....................... ...... ............... ........... ...........
. ...
................................................................................. ......... .. .. .... . ...................................................... . ...... ....... ........ . ... .. .. . .....
R
Estimated Cost ....I P.......... .......
PERMIT #
Application For 3648
DEPARTMENT DECISIONCd Heating Permit
387
3 APPLICATION IS HEREBY: DEPARTMENT OF LICENSES AND INSPECTIONS
4-3
N IN APPROVED ❑ DISAPPROVED
TOWN OF SOUTH WINDSOR
Cd 0
7---749
00 O DATE CHIEF VWECTOR APPLICATIONS MUST BE PRINTED OR TYPED. BEGIN WITH NUMBER ONE BEL W
O
c � 1. LOCATION OF JOB
O
C ~
O
4-11
0 NO. STREET
W
LOT NO. FLOOR APT. NO.
{ 40, O
N
O
0 r
OWNER i'' . , L' 7-f L-
2 n
ce
t 0 0 9. ADDRESS l 3 L`r,7— 0 0,j
b0
4.PHONE
D
cd
S. APPLICANT 'T 19'&1 c--S
° e. ADDRESS l 0 Co�� '` �' ti 4 ve
' •^' '�
$., 4 /V L�w An%'�'Cd
�-;�- .PHONE
0 19
I -4-1 S. LICENSE NO. 3 O 4=/ o
,4? ,o
s�.
c w 9. EXPIRATION DATE OF LICENSE
.Q c 10. ESTIMATED COST
� o
11. IS THIS A CONTRACT COST? LJ'YES ❑ NO
bq
12. FEE ENCLOSED S �- O
a� 0
v 19. TYPE 0 BUILDING:
CA bc
RESIDENTIAL ❑ COMMERCIAL
_O 9
14. TYPE OF JOB: ❑ INDUSTRIAL
GINAL
� 3
~ "IMSTALLATION ❑ A DITIONON
L_3
REPAIR
J,_ ry 4, 3 6 p ) U
APPLICATION FOR HEATING PERMIT (Continued fr m Reverse Side)
11. LOCATION OF JOB C �� � C`
NO. STREET FLOOR APT.N .
12. TYPE OF INSTALLATION: ❑ OIL BURNER ❑ ELECTRIC ❑ VENTILATION ❑ SPRINKLER
❑ GAS BURNER ❑ STACK ❑ INCINERATOR ❑ MISCELLANEOUS
IDENTIFY
SIZE LOCATION SIZE SIZE
13. OF TANK OF TANK OF FILL OF VENT
14. B.T.U. EQUIP. AT REGISTER//--L•Q�FURNACE MAKE AND NO.AJ JfO AT BONNET I-1-00 r, FIRING RATE
BOILER OR FURNACE MAKE AND NO.f Z -5,V 0 J B.T.U. OR SQ. FT. NET B.T.U. OR SQ. FT. GROSS FIRING RATE
FLOORS TO BE HEATED 0n'L: NEW OR OLD BUILDING 0 L_Lb INSULATED — YES OR NO y L` 4
TYPE OF WALL INSULATION ROOF OR CEILING INSULATION
AVG. SYSTEM WATER TEMP. B.T.U./SQ. FT./HR. EMISSION
INDOOR-OUTDOOR TEMPERATURE DIFFERENCE °FAHRENHEIT
MAKE OF RADIATION: BASEBOARD, COPPER CONVECTORS. OR C.I. RADIATION. OUTPUT PER SECTION OR LINEAL OF RADIATION. SQ.
FT. OR B.T.U.
DESCRIPTION OF WORK
15. TO BE DONE: I?L�("A &I: r vt.
16. HEAT LOSS SCHEDULE. (TO BE INCLUDED FOR ALL JOBS):
R OM SIZE WIN oows AREA - SQUARE FEET B.T.U. B.T.U. o DISTRIBUTION INSTALLED
AND DOORS VOLUME
TOTAL TOTAL y LL
ROOM NO' GROSS GLASS NET WALL CEILING FLOOR CU.FT. AT 70'F CORRECTED J j LL REGISTER
L W H AND K TEMP. TO f F TYPE AND SIZE RAD. OR LEADER
SIZE < WALL F'LtC (INFILT.) DIFF. .F O N SQ. FT. FREE AREA
/a.
TOTALS
A. HEAT LOSS FROM BUILDING B.T.U./HR.
B. DOMESTIC HOT WATER DEMAND B.T.U./HR.
C. PIPING, OTHER THAN NORMAL B.T.U./HR.
ALLOWANCE FOR HEAT VALVE OF FUEL (A B C) FACTOR
17. ELECTRICAL WORK BY: �� L'V/L S U-/L c L c---
NAME ADDRESS
SUBCONTRACTORS AND
18. THEIR TRADES
ALL WORK COVERED BY THIS APPLICATION HAS BEEN AUTHORIZED BY THE (OWNER) OR (AGENT) OF THIS PROPERTY AND WILL
BE DONE IN STRICT ACCORDANCE WITH THE BUILDING CODE.
APPLICATION TO BE COMPLETELY FILLED IN.
D TE SIGNATUR F APPLI ANT