HomeMy WebLinkAbout19 Andries Trail (5) PERMIT #
Application For 6326 5935
DEPARTMENT DECISION Head Permit
C
3 APPLICATION IS HEREBY: DEPARTMENT OF LICENSFS AND INSPECTIO.'
t4 �'' APPROVED DISAPPROVED
TOWN OF SOUTH WINDSOR
Cd 6/26/84 Thanas P. D' Auria
00 d DATE CHIEF INSPECTOR APPLICATIONS MUST BE PRINTED OR TYPED. BEGIN WITH NUMBER ONE BELOW
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C -� 1. LOCATION OF JOB
.� 19 Andreis Trail
NO. STREET
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+' W 22
y LOT NO. FLOOR APT. NO.
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+� N
41
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2. OWNERj'�
0
0 S. ADDRESS J
y 4.PHONE
a�i d
0
w S. APPLICANT
a. ADDRESS
7.PHONE
a B. LICENSE NO.
C B. EXPIRATION DATE OF LICENSE Ia
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p C 10. ESTIMATED COST s-
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0 ^ 11. IS THIS A CONTRACT COST? ❑ YES L'3'NO
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Ia. FEE ENCLOSED s 32A ma i t 13 6 Q 3
Q
53 ai Is. rYP�E7jo/E BUILDING
m L.7 R[fID[NT1AL ❑ COMMERCIAL
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}' •d cc 14. TYPE OF JO INDUSTRIAL
1,4
IGINAL ❑ ALTERATION
INSTALLATION ADDITION
REPAIR
APPLICATION FOR EATING PERMIT (Continued it m Reverse Side)
11. LOCATION OF JOB I (:�?' �CQGe /Y
NO. STREET FLOOR AFT.NO.
12. TYPE OF INSTALLATION: [2f-M BURNER Cl ELECTRIC ❑ VENTILATION ❑ SPRINKLER
❑ GAS BURNER ❑ STACK ❑ INCINERATOR ❑ MISCELLANEOUS
/f// IDENTIF
13. SIZE OF TANK (/ v OF SIZE SIZE
OF FILL OF VENT
14. B.T.U. EQUIP. AT REGISTER e NA SiE MAKE D NO. ���,/AT BONNET FIRING RATE /
BOILER OR FURNACE MAKE AND N B.T.U. OR SQ. FT. NET,�Q961 B.T.U. OR SQ. FT. GROSS FIRING RATE h
FLOORS TO BE HEATED NEW OR OLD BUILDING /Xi� L INSULATED - YES OR NO
TYPE OF WALL ff INSULATION ROOF OR CEILING INSULATIO
AVG. SYSTEM WATER TEMP. B.T.U./SQ. FT./HR. EMISSION
INDOOR-OUTDOOR TEMPERATURE DIFFERENCE te)- '?O °FAHRENHEIT
MAKE OF RADIATION: BASE99ARD. COPP R CONVECTORS, OR C.I. RADIATION. OUTPUT PER SECTION OR LINEAL OF RADIATION. SO.
FT. OR B.T.U. T 7-
DESCRIPTION OF WORK
15. TO BE DONE:
16. HEAT LOSS SCHEDULE. (TO BE INCLUDED FOR ALL JOBS):
d
�TGi�.S � r••-_ - - — -
I � I
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:
NAME ADDRESS
SUBCONTRACTORS AND
is. 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 f
DAT! / SIGNATURE OF APPLICANT