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Home My WebLink About110 Highland Drive Application No. .346 ............ ... ....... Permit N.. ...3205... TO THE BUILDING INSPECTOR of the TOWN OF SOUTH WINDSOR, CONN. ........14 hereby make application for a permit to (erect 'ma-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. /w . South Windsor, Conn., . .. u.`, .�............... 19...E RK, Sign here :....:::c5 ....�!l1,R�?hE...IP..iCE................................. STER, CONK. Address ................................................................................................ ................. Location? .. ................ ..l.0 . .L ........ ) .....side of? .................. .......................................................... .. . ... .. . . .......... Nearest cross street? ..................Q. ..............................................Street No. .. ........................................... Lot No. ......`0/......... . Ownerof land is? . ............W. 00DLAND PARK, I VAddress .............................................................................................. ....................... ........................... ............. ..... ,"W WEST MIDDLE TPKE. Ownerof building is? .... ..M-ANGHESTE.R,....CONN.,.Address ... .............................................................................................................. Architectis? . ..........................................................................................Address .................................................................................................................. Builderis? . .............................................. .............................................................Address ..................................................................................................................... 7�j �4— �� imensions of building. ........... . ..........Feet front. ........... ............. Feet rear. ................. ........... Feet deep. ........ .............. Extreme height to highest point of roof? ................ ..' '..... ........ . ... No. of stories in height? ..............Z. .... . ... iv Purpose of building is? ............ I.. ......No. of stores? ..................................................................................................... • How many families? .....................I...............................................................No. of rooms? .... ..... ......6............................................................................. Distance from street line is? ..............4.(c:5...................................from building line is? ...... ....................................................................... ADDITIONS AND ALTERATIONS (Give Brief Description) .... ......... . ............................................................................................................................................................................................................................................. ................................................................................................................_....... ..................................................................................................................................................................... .......................................................................................................................................................................................................................................................................................... MapNo. .. ......................... 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. (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, .................. .. . .......................................................................... .......................................................................................................................... .......... ......................................_........ 1st Story . ................... . ... ........................................................... .... ........................................................................................................................ ............. ... ... .................... .. .... .. .. . 2nd " ................. ................_.................................................. ....................................................................................... ........... ................ ....... ............... .... ............. .. .. . 3rd " ..................... .... . ................. •.............................................. .......................................... ........................................... I............................................... ....................................... ..... 4th " .. ............. . _...._.................................. .. .. ... .....................:................. ... ............................................................... ...... .... ......... . .. ...... ..... . ....... .. ..... . ...... 5th " 6th do .. ........... ..... ............................................................................................................................................ . .. ................................................................................................................. 7th ................................. ...... ..•.. ................................................. ............. .. ,. ................ ........ ..... ............................................ ................................................... 8th " ....... .......... ............................ .......................... ............... 9th " ......10th......«.. ... .. ................ . . . . .... . ...... .. . .. 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 JOINTS GIRDMS COLUMNS Floors Sim Longest Span Centres Bridging size Longest Span Centres Size Length centres 1st Floor A2 1 /9 R k �/ — — - 7 .... ............ /...... .W ...................... .." �). ... 7o ...Y.......2nd .......... . . .. .... .* ....... . ........... .......................................... ............... ................................... I ****"******"'1"*'**'***** ...................... *....*.....11 1*****--11....................I.....................I........................ Size of outside studs?,...6Z.4................ Distance on centres? ............. Size of sill? ..................... Size of rafters? .. ... .......... Distance on centres?......... ... .......-(nize of plate.? .................... ........7..... .... Size of ledgers or guts? ....................... ... .......... ...............................Size of deck rafters? ... .............. ......................................... ............... '�'2 'N� 4- Distance on centres? ..................................................................................Size •of studs in bearing partitions? ..................... ............ ........... MISCELLANEOU Style of roof, flat, pitch, Mansard hipped? Fireplaces? ................... .. ............................. . ..... .... Material of roof'covering? .........A I.... . ...Material of Cornice? .... . .A-e ............................... How is building heated? .... ...... ..............................Lining of flues? Thickness of shell of flues? ....................................................................Any elevators or lifts? ........ .......... .... .. ..................... What kind? .... ....................... . How many? . Any hoistways? .. ... .. . ......... ........ ... . How protected? .................. .................................................... Total Value of Building ........f t.... ................ When will work be commenced? ... ..... ... ... .. . ....... ...................... . ............................... ................. The applicant warrants that the lot for residential purposes, s�ho 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. P I - Poqn5T MIDDLE TPKE. /Applicant 6OWCHESTER, CONN. -32o5 BUILDING APPLICATION Application No. .....346.5.................................................... West onthe ................................... ...................................... side of Highland Drive ... .. ......... ....I................ .. . .............. ....... .. Street. Street No, .. . LQ t #1 Q I... .. ....... ............. Woodland Park., Inc. Owner ...... . .. ... . ... ...... ... ............... ............ Applicant . .. .Same . .... ...... .. . . .......... ..... CLASSIFICATION Dwelling 24'x321 .... ...... .... ... .. ..................... . ............ ..... .. . ... ......... .. .. ................. . ................... ..... ..... ... .. .... ........ ........................................ Permit issued on above Application. Date. . July . ....... 19......60 ............ TOWN OF SOUTH WINDSOR BUILDING PERMIT Date July 8. , 19 6G° Fee Paid $76.0G Est. Value $19 3r 000 k Permit N? 3205 on the We at side of Highland Drive Street Street No. Lot #101 //0 Owner Woodland Park, Inc. Applicant Same w CERTIFICATE OF OCCUPANCY ISSUED: 0 Date No.1987 Fee Paid $ 3.00' CLASSIFICATION Dwelling 2)1 1 x37t BUILDING PERMIT N� 3205 OFFICE OF THE BUILDING INSPECTOR of the Town of South Windsor, Conn. South Windsor, Conn. Jul4 8, 19 60 Cj4io 'to to Terttf 1j, That Woodland Park_ Inc is hereby granted permission to Dwelling 24 V X321 at estimated value of on the West side of 11 ighl and Drive Lot #101 Street on land owned by Woodland Park, Inc;. Said Work to be as described in Application No. 3465 and to conform to specifications and plans filed with said Application, and Building By- Laws of THE TOWN OF SOUTH WINDSOR. Islu/cl 9;tl S k 1960 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. -Z TOWN OF SOUTH WINDSOR SOUTH WINDSOR, CONN. Permit N? 1982 Certificate of Occupancy THIS IS TO CERTIFY that the u �� at No. Ane in the 4own of South Windsor, Connecticut, has been erect and completed in accordance with the Building Code and Zoning Regulations of the Town of South Windsor, and is hereby approved for occupancy. BUILDING INSP19CTOR !/ OWNER, BUILDER Fee Paid/6- Date , 19 i ! I r itt •'/C fIL t i i • ' � •j I PROPERTY of HIGHLAIND STRMT SOUTH WINDSOR# CDNI's Being; Lot No. 101 on reap entitled *K'a.p of OODLAND ACRI-."'S Avery Street South Win,,sor Conn. Property of Amelia 1. Blozie, Developer William Peck, Scale I " = 50' Apr. 18, 1�i5�, :.ayden L. Griswold C.E. " Sheet 1 of 2 Seale 1" as 5G' June 15, 1961 Hayden L. Griswold C.E. 4110 Application No. 4 3? Permit No. 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., ... ............ . .......Y................ Signhere ...........�. ...... ..... ......:._........... of Adams .yr...................... .... . .... :.. .. G� .� w �°Location? ... .. ...............................................................side of? l11 /�..! d............ �................................................ 4 Nearest cross street? ........ ......... ................................................................Street No. . ............ . ........... .. .............. Lot No. ............................ . a . n - Owner of land is? ' !l1�C......... ........&.1/65AAAdcliress /0..... /.�� '. Q.rl.................��....... .............. ..... Owner of building is? ..................................Address 5. ... ........................................ . ........... ............... ' Architect is? ��/` ..�.,1� ... ...6.iqv�g...... ..Je ..........Address ...... P f.!..%�...........ryl.14..*........oeel2ll :,JW wilder is? . ref.../../ .Y'...................................Address ............. .................�S ��.`e....................................... ........... /6X 2, Feet front? ........ .. �.:.... Feet rear? b r ? 1 d Dimensions of building. .. ............ � ..�..... ...... Feet deep. ... . . . Extreme height to highest point of roof? ....... . ..... ....t.....' ... ........... .. No. of stories in height? . . ....... . Purpose of building is? ... ......a IZ �J.. ..........................................No. of stores? ....................... ................................................... Howmany families? .. ......................................._...._...................................No. of rooms? .... .......................... .......................................................... Distance from street line is? .... ......1 .....................from building line is? ...... ADDITIONS AND ALTERATIONS (Give Brief Description) d r ....................... Co � aO 6-a2 � t ,r .1' . .. .... ........... ...T ..............r ..oerSP.H ......... e�.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. (See Section 14, Building By-Laws.) BRICK CONSTRUCTION. Of what material will walls be constructed? Compositionof mortar? . ......... .... .. ......... ..... .......... ........ ....... . ......... ..... ..................... Height and Thickness of Walls Helaht Stories Front Walls Side Walls Rear Walls Partition Walls Basement, ..................................................................................................................._..................................................................... .................................. ......... .......................................... .. 1st Story ......................... ... ............................................................................................................................................ .................................... . ........ .. 2nd " ..................... . .. ..........._..................................... ... ................................................................................ ... .. .......... .................... .... ............. .. 3rd " ..................... ... .... ................................................... ................ .......................................... .......................................... ,..................... ...... ... ........ . ..... .. ...... ..... ... . ... 4th " .. .................. .. ............_.......................................... ....... .................................... I.... ....................................................... ..... ....... ... ... .. .... ....... 5th ....................... ....... . ........-. .................................. ................ I.................. ......... ........... .............-...... ....................... . ............ ... . ....................... 6th '1 ................... . .............................................................................. .................................................................................................................................................................................................. 7th " .................................. ... ......................_.................... ................ ................ ..................... ,. ................ . ... .. . ........ .......................... ........ ...... .............................................. 8th is ...................................................................................... .............. .................. ....................., . ..... ... ... .......... .......... ... . ... ........... .............. ........................ 9th it ............................ 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 GUMA S 0OLUMNS Floors 81" Longest Span Centres BrNging Size Longest Span Centres Sbe Length Centres lst Floor a.....,�.... _..........._..._.............. _._.........._. _.... _..........__. _._........_�..... a.....N..... ... .................. ............. ........................ _... .............. ......... ...................... ... ............ _........... _......... ...._......_._.... ........_....... _...w..... M.._...._... ._........._.._.. 4th Size of outside studs? ........ .'r.`�.... ........ Distance on centres? ........ .G....a.'e.............. Size of sill? ........ ................'................... Size of rafters? ........ .z.k..�... Distance on centres?........../.G...°...- .�........... Size of plate? f,�.x.�........ Y'..k-Y.......................... 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. ..... - .. e.4................... . ................................................. Fireplaces ..... � fir.. . . � Material of roof covering? . ��¢./................ . .....Material of Cornice? .............. .............................................. ................... A�PHow is building heated? . ...... ...Lining of flues? . .......... .............. Thickness of shell of flues? .......................................................... .......Any elevators or lifts?. ...................... ........................... ...................... What kind? .. . .... .. .. ........... How many? ....... .... ....... Any hoistways? .. ... . . Cc��iQcr� How protected? ... . ..............Total Value of Building �. '......................................... C Whenwill work be commenced? .. . ..... . .. .. . .. ........... ............................. ..................................... ................................ ................. 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 illio BUILDING APPLICATION 370 ApplicationNo. .... ..4.................................................................. -''16 St onthe ..................... .......... .... ......... .............. side of -r-T Drive e .. .......... ...ighip.►nd 7-..r. ....... Street. 110 Street No, .. . ....... . .. ..... ,T '' .D-1 ,TiS0v,1 Owner Applicant Phi lliPs Constr. (-1'0 - CLASSIFICATION rarage 1611720' ...... ...... . . ............ ........ Permit issued on above Application. IT 62 Date, Sept.6, - 19 . . a TOWN OF SOUTH WINDSOR BUILDING PERMIT Date Sept.6, 19 62 Fee Paid �$. .. 0 0 � Est. Value 14 . 4.. 0 0 g Permit 1r? 4110 on the We s t side of Highland Drive Street Street No. 110 Owner W.R.Davison Applicant Phillips C m s tr.C,0. CERTIFICATE OF OCCUPANCY ISSUED: Date No. Fee Paid $ CLASSIFICATION Garage 16tx201 0 BUILDING PERMIT N° 4110 OFFICE OF THE BUILDING INSPECTOR of the Town of South Windsor, Conn. South Windsor, Conn. Sept.6, 1962 M#io tic to Terfif1j, That Phillips Constr.Co. is hereby granted permission to Gar ag a 161 x2 0 at estimated value of $ 144 2.00 �lle_st Highland Drive on the side of Street on land 'uJ.R.Davison owned by Said Work to be as described in Application 4370 No. and to conform to specifications and plans filed with said Application, and Building By- Laws of THE TOWN OF SOUTH WINDSOR. Issued Sent.6 s 1962 T 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." FINAL INSPECTIONS: ` wilding APPLICATION FOR BUILDING PERMIT Plumbing HVAC Date-T//�__/70 Sprinkler 110 HIGHLAND DRIVE El ctric Estimated Cost s OD,O d6 Zoni Permit Fee$ 23Q ` Aff'davit NO. 1 87 9 9 Occupancy Fee $ -2 Eng. Dept. COMPLETE RED BOXED AREAS. o Fire Dept. TYPE OR PRINT ONLY Total Fee $ H alth D Pt. SIGN ON REVERSE SIDE. Approved for CO: /g qd V�-L (Additional Cost) $ TO BUILDING DEPARTMENT, TOWN OF SOUTH WINDSOR, CT The undersigned, hereby applies to do work according to the following specifications: Job Location Lot No,M a Side of Street Zone "2 Applicant V V02 U 7" Tel. # `1.,IlI-J 3 S7,1 Address L L ip Q9,0 _Lic.#.�'D T E � CITY STATE Owner ddress-Address 144MD 09. Architect Address Size New Area: Ft. Front Overall L Ft. Deep Overall Va Total Area U 3 0 #Garages Lavatories No. of Families No. of Stories Construction Bathrooms Rooms 1st 2nd 3rd Size of Lot 1OD Y .2 0 Q Dist. from Street Line Z Dist. from Side Street Line 14 Purpose of this Permit U�r - �F 9-0 p111 City Water 1K Well 0 Septi Sewer r Approved by Date`��6��y BD1A 11/88 I hereby agree to conform to all the requirements of the Laws of the State of Connecticut and the Ordinances of the Town of South Windsor and to notify the Building Inspector of any alteration in the plans or specifications of the Building for which this permit is asked,and agree that this building is to be located th proper distanc from all street lin s,side yard lines and required distanc s from all oth r zon s and is located in a zone in which this building and its use is allowed. Signed4ft - - I hereby apply for a Certificate of Occupancy for the work described in this applicati o rmit. Signed —DO NOT WRITE BELOW TH INE— 1 INSPECTION RECORD Footing'V Ll—`� Framinb l g�7" `� Foundations E Fireplace/Chimney '7- Insulati�q' `Z Plumbing Permit# Inspections: HVAC Permit# Inspections: Electrical Permit# z�`T� Inspections: Sprinkler Permit# Inspections: BUILDING INSPECTION DEPARTMENT SOUTH WINDSOR, CONNECTICUT FEE PAID: $3.00 CERTIFICATE OF OCCUPANCY i ZONE: DATED 10/05 ig 90 This is to certify that 110 Highland Drive Alter d under permit No. 18729 conforms substantially to the requirements of the building ordinances and the zoning regulations of the Town of South Windsor and is hereby approved for occupancy as indicated below. Approved for Occupancy— Residential addition -- Den Use Group: R4 Constr. Type: 5B -� . Building Official Notice:If this certificate is lost or destroyed, a duplicate should be obtained immediately from the Building Department. ` Any change or extension of the use heron approved requires a new cefiftate of occupancy. ,.,:s.,,.l..� ,+T,Y.�.,.T,.�...",ir ,.-._.,��_e..>.l .,?,. ..� ,..�....,n "-!F r,�..,. .a..,�...w�.,•,-o:�.;J`.n. ,. «,�� r. ".z.,�..,,.�,!.�+.�, ... ��V.'..,..._. .. ,..,M... ..,. ..,.> �w.. .w s..w.".M..%,,',n.� ,.. � .a,�M1," ..+......»,.,r....:;r^' f- t N/F AMELIA BLOZIE 5tDRAINAGE EASEMENT V 79,P 173 100.00 V. 331 P 313 LOT NO. 101 ! a t�~ �'A A N/F, A LV I N G. A N D N/F �1�M 'A - MCC f.1 ISABE LLE CULVER LOT NO.�I�O�L `j _ - - .LbT NO. 100 :O �- PATIO PATIO O 9 0 0 '. i ' O i b cld N t 48 0 I, N N 16 23't 32 ct • It OVERHANG 40� L. SUBJECT TO CLEW EASEMENT V.77,P.147 100.00, HIGHLAND DRIVE THIS MAP IS COMPILED FROM OTHER MAPS, DEED DIMEW SIONS AND OTHER SOURCES OF INFORMATION , NOT TO BE CONSTRUED AS AN ACCURATE SURVEY AND SUBJECT TO FINAL CHANGES AS A MORE ACCURATE SURVEY MAY DISCLOSE. Pc� .-,cposed building(s), use(s) andjor struct_� 16,E r. shown on this plan appear(s) to be ..onform3nce with current South Winds AUG 161990 -rwU1:0 ions. Variances and special exceptloc." y apply. South Windsor BUILDING DEPARTMENT 1 3 9.`r+//I • i ' cl ng Enforcement Officer _,,j at .z iscud,�.� C,* if a col Oil 1:... 1 ttull;ing tnspeciF> T Clerk No G C�- PERMIT�j # DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT l/ a Application is hereby: TOWN OF SOUTH WINDSOR APPROVED DISAPPROVED BUILDING INSPECTION DEPT. 644-2511 Ext. 230 9-4 9y Application must be printed or typed . Date Bifilding Inspector 1. LOCATION OF JOB FEE SCHEDULE No . Street $ 0 - $19000 - $10. 00 Floor Apt . No. Over $1 ,000 - $10.00 per $1,000 or 2 . OWNER aF�C S'C'f-�/Cc-tJIitJG fraction thereof 3. ADDRESS 4. APPLICANT 5 . ADDRESS _,4'70 6. ESTIMATED COST $ Z'gQ 7 . IS THIS A CONTRACT COST Wool Yes _No 8 . FEE ENCLOSED $ n _ 70 9. TYPE OF BUILDING: RESIDENTIAL COMMERCIAL 10. TYPE OF JOB: Original Installation _jj!!fAlteratio Addition Repair BD 3A 11/88 APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side) 11 . LOCATION OF JOB 6/d�, . 0 . STREET APT. NO 12 . TYPE OF INSTALLATION �♦� 13. SIZE OF MAIN FEEDER �- 14 . NO. OF LIGHT LOOPS 15 . NO. OF HEAT LOOPS 16. NO. OF POWER LOOPS 17 . NO . OF LIGHT OUTLETS 18 . NO . OF HEAT CIRCUITS_ 19 . NO. OF POWER OUTLETS 20. NO. OF CONVENIENCE OUTLETS _21 . NO. OF HEAT CIRCUITS 22 . NO. OF POWER CIRCUITS 23 . NO. OF LIGHT CIRCUITS 24. SIZE OF HEAT CIRCUITS 25 . NO. OF MOTORS 26. NO. OF PANELS_Z 27 . TOTAL WATTAGE 28 . NO. OF POWER FEEDERS 29 . NO. OF SWITCHES 30. A/C LOAD 31. SIZE OF POWER FEEDERS 32 . NO. OF FIXTURES 33. TOTAL HORSEPOWER 34 . NAME OF SUBCONTRACTORS AND THEIR TRADES 35 . REMARKS AND FURTHER DETAILS : /o-3 212 LICENSE NO. SIGNATURE OF APPLICANT DATE PHONE NUMBER: Or9y- lorI-l6 FOR OFFICE USE ONLY APPLICATION FOR HVAC PERMIT DATE: 5?•/s .90 (NO. D ) TOWN OF SOUTH WINDSOR EST.COST: BLDG. PERMIT NO. 1540 LIVAN AVENUE FEE d SOUTH WYNDSOR, CT 06074 FEES: 644-2511 ='Exi.6,230 " $. 0 - $19000 - $10.00 . 4 : � $1000 or fraction LOCATION OF BUILDING thereof - $10.00 OWNER ADDRESS TOWN PHONE NO. PCw /� i (*J�, • / HVAC CONTRACTOR I ADDRESS TOWN PHONE NO. TYPE OF SYSTEM: HEATING x TYPE OF BUILDING: RESIDENTIAL_ A/C COMMERCIAL VENTILATION BUSINESS INDUSTRIAL IF HEATING: STEAM LOW PRESSURE LIMIT LBS. HIGH PRESSURE LIMIT LBS. HYDRONIC_.)S._ WARM AIR UNIT RADIANT HEATER (INCLUDING WOOD COAL BURNING STOVE) TYPE OF FUEL: OIL-GPM GAS IN-PUT ELECTRIC KW WOOD COAL OIL TANK - SIZE & LOCATION: INSIDE OUTSIDE CAPACITY LPG TANK - CAPACITY EXISTING RADIATION ADDITIONAL RADIATION TOTAL TOTAL RADIATION � , DESIGN TEMP. OUTSIDE OF INSIDE OF &FFERENCE OF TOTAL HEAT LOSS _(BTUH) ,S(jsr" D (HEAT LOSS SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL HEATING EQUIPMENT (INCLUDING MAKE & MODEL NO.): 5$426t 1c�.., '�s u GROSS HEATING CAPACITY (INPUT-BTUH) NET RATING (OUTPUT-BTUH) IF AIR CONDITIONING: DESIGN TEMP. OUTSIDE °F INSIDE °F DIFFERENCE F TOTAL HEAT GAIN (BTUH) (HEAT GAIN SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL COOLING EQUIPMENT (INCLUDING MAKE & MODEL NO.): TONNAGE COOLING CAPACITY (BTUH) IF VENTILATION: DESCRIBE ALL AIR-HANDLING EQUIPMENT (INCLUDING KITCHEN EXHAUSE EQUIPMENT): TOTAL SIZE OF SYSTEM (CFM) FRESH AIR INTAKE (CFM) (PLAN MUST ACCOMPANY APPLICATION) The undersigned hereby applies for a permit to perform the following work and is to comply with all local ordinances and State of Conn. Building Codes in the performance of such work. FURTHER DESCRIPTION OF WORK: LS c STATE LICENSE - NAME & TYPE # tATIE SIGNATURE OF APPLICANT -d ROVED DA E BD 4A 11/88 46 1 - B - R CALCULATION SHEET 1503 (Modern Method) Copyright 1977 by Th Hydronics institute ADDRESS) L OWNER eU In l Q DESIGN TEMPERATURE DIFFERENCE F. DATE �2 C L.A COL.S COL.C COL.D COL.E COL.F COL.O 1 ROOM O H L W i L W H L W H L W H L W Design Water Temp. 2 ROOM DIMENSIONS, FT. ~ _ U I BTUH por F 11 3 LENGTH EXPOSED WALLS,FT. < "L5-46 Radiation Selected Sn 4 WINDOW AND OUTSIDE DOOR AREA LL BTUH BTUH STUN BTUH STUN 5 WALL CONSTRUCTION ROOM LIN.FT.OF (T able 9,Linea x HI t0� �� g� Q�rU ✓ TOTALS RADIATION 6 TYPE OF GLASS c�.�t� `�' FROM LINE 12 SELECTED (Bottom f table used for Line 5) 3ati Jv�' Q��W �j(j U �W //�� 7 CEILING CONSTRUCTION C Ab w (Table 9,L x W) 0A�r�v g FLOOR CONSTRUCTIONt D (Table 9. LxWor Lin. Ft) 9 COLD PARTITION CONSTRUCTION fr r{d'O j Z (Table 9,L x H) °; .f�/Z �Oa'0 1�f0� O� G l y lei. 10 c 1 Well(With Openings) H G3Urj O t� 0V c 2 Wails(With Openings) DX Y 'CJ J —~ 3 Walls(with Openings) or Ent.Hall 11 TOTAL BTUH AT 70F TEMP DIFFERENCE' �,3� ! 00 � 12 TOTAL BTUH AT DESIGN TEMP. DIFFERENCE G Oa go K r �= L COL.A COL.B COL.H COL.1 COL.Jam-- COL.K COL.L TOTAL BTUH TOTAL 1 ROOM 4 d �3 OF BUILDING RADIATION IxAT SELECTED O H L W H L W H L W H L W H L W DESIGN TEMP.• 2 ROOM DIMENSIONS,FT �j �� ,Z jO DIFFERENCE U 3 LENGTH EXPOSED WALLS, FT. 4 3,r 41 WINDOW AND OUTSIDE DOOR AREA LL f lZ BTUH BTUH BTUH BTUH BTUH $ WALL CONSTRUCTION ��n� -INCREASE BATHROOM (Table 9,Llne 3 x H) ,i6 YOU vv v Q'(� TOTAL 20% 6 TYPE OF GLASS (Bottom of table used for Line 5) 's'� S� pZ oz.:) 7 —'— f FOR CONCRETE FLOOR ON CEILING CONSTRUCTION (Table 9, L x W) ► 9� 6a� �� GROUND FILL AT GRADE LEVEL.USE LINEAR B FLOOR CONSTRUCTION, FEET OF EXPOSED EDGE (Table 9,L x W ►Lin Ft.) 9 COLD PARTITION CONSTRUCTION (Table 9, L x H) 10 -0 1 Well(With Openings) O; � 2 Walls(With Openings) o J 7� tau 3 Wells(With Openings), r Ent.Hall ie 1141 TOTAL BTUH AT 70F TEMP. DIFFERENCE' 12 TOTAL BTUH AT DESIGN TEMP. DIFFERENCE s This form Is available fr m The Hydronics Institute,35 Russo Place,Berkeley Heights,N.J. 07922 FORM 1503