HomeMy WebLinkAbout12 Ahern Drive (5) DEPARTMENT DECISION APPLICATION FOR HVAC PERMITS
Application is hereby: TOWN of SOUTH WINDSOR
BUILDING DEPARTMENT Bldg Permit#
APPRO 1540 SULLIVAN AVENUE
644-2511 ext. 230
Date Building Inspector Application must be printed or typed
Location of job
c�7'J ba.l
Street No. Street Lot No.
FEE SCHEDULE
Floor Apt. No.
$0 - $1,000 - $12.00
Over $1,000 j 1
$12.00 per$1,000 OWNER -�S I' D N2 �� i n(
or any fraction thereof AA
ADDRESS �2 N k C evj D2
��,.r►� W N o 5CIP 2 C�
OWNERS PHONE# 4 y y - Z-to 9 -1 �—�--'
APPLICANT Q S-e A r-,
Ow N SF
ADDRESS �aa �- ST' QG
q<
r EI1 ,Ng-ro ti q
ESTIMATED COST $ ^l�13 , IG
O
IS THIS A CONTRACT COST?
a V YES NO
ICJ FEE ENCLOSED $
OR-Co TYPE OF JOB:
Original Installation
Alteration/Addition epair
Revised 11/95
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 HIGH PRESSURE LIMIT LBS.
HYDRONIC WARM AI �Bs*
, 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.)
,u [ /�7rv0�!!� 4ZTve,>/ 1�25 A-F 4 F_Ue- AlAG�
GROSS HEATING CAPACITY (INPUT-BTUH) NET RATING (OUTPUT-BTUH) fnjool,
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)
TOTAL SIZE OF SYSTEM(CFM) FRESH AIR INTAKE(CFM)
(PLANS MUST ACCOMPANY APPLICATION)
FURTHERI/DESCRIPTION
IOIIF WORKn
VIa S trtioT KI �venAZQ Augt
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 7E
PERFORMANCE OF SUCH WORK.
STATE LICENSE-NO. NAME&TYPE _,,8f6Nl(T(JREA APPLICANT
PHONE NO. `F3"70 ' 8-7 z::,o DATE