HomeMy WebLinkAbout100 Bidwell Road (41) i
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DEPARTMENT DECISION AppLICATION FOR HVAC PERMIT PERMIT#
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Application is hereby: TOWN of SOUTH WINDSOR
BUILDING DEPARTMENT Bldg Permit#
APPROVE 1540 SULLIVAN AVENUE
644-2511 ext.230
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Date Building Inspector Application must be printed or typed
Location of job
Street No. Street Lot No.-
FEE SCHEDULE
$0 - $1,000 - $12.00 Floor Apt.No.
Over $1,000
$12.00 per$1,000 OWNER_ -:;D7 r-no d Fu
or any fraction thereof
ADDRESS /Q Sr Go v-
OWNERS PHONE#
APPLICANT MW ic.-n i c��-vr( S �C.
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W N S ADDRESS /fib I n n Qt Raj
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CIO ESTIMATED COST $
C h ' IS THIS A CONTRACT COST?
YES NO
FEE ENCLOSED
l)SOR C0 TYPE OF JOB:
Original Installation
Alteration/Addition/Repair
Revised 11/95
APPLICATION FOR HVAC PERMIT (Continued from reverse side)
TYPE OF SYSTEM TYPE OF BUILDING
HEATING RESIDENTIAL
A/C COMMERCIAL
VENTILATION _�L 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 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-INPUT ELECTRIC-KW
OIL TANK SIZE&LOCATION
INSIDE OUTSIDE CAPACITY LPG TANK CAPACITY
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)
VENTILATION
DESCRIBE ALL AIR HANDLING EQUIPMENT(INCLUDING KITCHEN EXHAUST EQUIPMENT)
S ��a.� ►:, s as r-o v,
TOTAL SIZE OF SYSTEM(CFM) FRESH AIR INTAKE(CFM)
(PLANS MUST ACCOMPANY APPLICATION)
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FURTHER DESCRIPTION OF WORK —f- 1'� S .f t Cli-,, 6 6 RTU r�
Eoc k a,.J's 4 /�B"s 'D V �wa,-)� d, G
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 SIGN OF APPLICANT
PHONE NO. o 71-&ZI DATE 7 20 Zvoo