HomeMy WebLinkAbout104 Andries Trail (6) PERMIT #
Application For 6303 5 910
DEPARTMENT DECISION Head Permit
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3 APPLICATION Is HEREBY: DEPARTMENT OF LICENSES AND INSPECTIONS
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TOWN OF SOUTH WINDSOR
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00 w DA E CHIEF INSPECTOR APPLICATIONS MUST BE PRINTED OR TYPED. IBEGIN WITH NUMBER ONE BELOW
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p 1. LOCATION OF JOB
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cd A NO. STREET
y LOT NO. FLOOR APT. NO.
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2. OWNER
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S. APPLICANT
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B. LICENSE NO.
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°5 10. ESTIMATED COST i
1 t. IS THIS A CONTRACT COS" ❑ TES
,al Permit #13665
is. FEE ENCLOSED s
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aXi 1B. TYPE OF BUILDING:
dl [i10[NTIAL ❑ COMMERCIAL
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14. TYPE f JOB: ❑ INDUSTRIAL
xGINAL ALTERATION
INSTALLATION ❑ ADDITION
REPAIR
APPLICATION FOR HEATING P�ERMIT (Continued from Reverse Side)
11. LOCATION OF JOB- //J C ''��7LL�q y/" --
NO. STREET FLOOR AFT.NO.
12. TYPE OF INSTALLATION: LLd-OIL BURNER ❑ ELECTRIC Cl VENTILATION ❑ SPRINKLER
❑ GAS BURNER ❑ STACK ❑ INCINERATOR ❑ MISCELLANEOUS
IDENTIF
SIZE 2 LOCATION SIZE SIZE
13. OF TANK /l 7f OF TANK �L-P OF FILL clz OF VENT �Y
14. H.T.U. EQUIP. AT REGISTER__NFU NA4C M)*AND NO. AT BONNET FIRING RATE
BOILER OR FURNACE MAKE AND N B.T.U. OR SQ. FT. NET/ O� B.T.U. OR SQ. FT. GROSS FIRING RATELa0
FLOORS TO BE HEATED NEW OR OLD BUILDING INSULATED - YES OR NO
TYPE OF WALL INSULATION ROOF OR CEILING INSULATION
AVG. SYSTEM WATER TEMP. /& -ate G B.T.U./SQ. FT./HR. EMISSION
INDOOR-OUTDOOR TEMPERATURE DIFFERENCE 0 FU `FAHRENHEIT
MAKE OF RADIATION: BASE ARD, COP R CONVECTORS. OR C.I. RADIATION^ OUTPU PER SECTION OR LINEAL OF RADIATION. SQ.
FT. OR B.T.U.
DESCRIPTION OF WORK 2
15. TO BE DONE:
1s. HEAT LOSS SCHEDULE. (TO BE INCLUDED FOR ALL JOBS):
ROOM 9IIE Ie 0 wa R - U. S.T.U. ``�'
AREA - SVUARE FEET O i OI$TRISUTION INSTALLED
AND OOORf 1 TOTAL TtlfwL III
NO. GLAU NET MAL, CEILING FLOOR Cu.FT AT A•F comaCT[O •�j r A
ROOM 3 OROIt Tw TD TY►t ANO lIZE RAG. OR LEADER
L A N AND E RALL t—i.� ONFILT.1 D J,•I I .� �F I):s •O. FT. FREE ARIA
size 7 4A
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70T.ALs
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W. ut� �h? OTWATER Dlg1R►U- - l 1_- B.T.U./HR.
C. PIPING. OTHER THAN NORMAL B.T.U./HR.
ALLOWANCE FOR HEAT VALVE OF FUEL (A B C) FACTORS
17. ELECTRICAL WORK BY-
NAME ADDRESS
SUBCONTRACTORS AND
18. 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.
DATE SIGNATURE OF APPLICANT