HomeMy WebLinkAbout100 Bidwell Road (49) DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT
TOWN OF SOUTH WINDSOR PERMIT#
Application is hereby: G
BUILDING DEPARTMENT
APPROVED 1540 SULLIVAN AVENUE Bldg.Pernut#
/ fiA 644-2511 ext. 230 f��M ?()-
Date Buil g Vector
Application must be printed or typed
FEE SCHEDULE 1N /�_ULocation of Job:
$0-$1,000=$13.00 Street No. Street Lot No.
Over$1,000=
$13.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT
APPLICANT ADDRESS % �r /i� %� 6)L4 X
0 lv J 3 7.
APPLICANT PHONE# g7 �•
At O W N S F-4 OWNER
OWNER ADDRESS
OWNER PHONE
C ESTIMATED COST$ � uvv —
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* IS THIS A CONTRACT COST? OeYes 0 No
ICJ FEE ENCLOSED$ -
TYPE OF JOB: �IF,l �
sOR�CO 0 New Installation
*.klteration/Addition/Repair Revised 8/99
APPLICATION FOR HVAC PERMIT (Continued from reverse side
TYPE OF SYSTEM: �-� TYPE OF BUILDING: avz �C
❑HEATING ❑RESIDENTIAL
r`A/C /a ❑COMMERCIAL
4 VENTILATION °C 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 OF INSIDE OF DIFFERENCE OF
TOTAL HEAT LOSS(BTUH) OF(HEAT LOSS SHEET MUST ACCOMPANY
APPLICATION)
DESCRIBE ALLL��HEATING EQUIPMENT(INCLUDING MAKE&MODEL NO.)
e 6�Izlz/ 7- ;��jZ -Z,
GROSS HEATING CAPACITY(INPUT—BTUH) 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.)
7
' AGE 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) r-< L 3
FURTHER DESCRIPTION OF WORK
C�21 ,,,a
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. 41e� .c
CONTRACTORS LICENSE NO. E STATE
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SIGNATURE OF APPLICANT i1�-'� DATE