HomeMy WebLinkAbout105 Andries Trail (4) PERMIT
Application For 6366 5975
y DEPARTMENT DECISION Heating Permit
0
3 APPLICATION IS HEREBY:
DEPARTMENT OF LICENSES AND INSPECTIONS
N APPROVED C1 DISAPPROVED
TOWN OF SOUTH WINDSOR
>~
O p $/1,$L� Thmas P.�Tl1 iiria
G) DATE CHIEF b�R APPLICATIONS MUST BE PRINTED OR TYPED. BEGIN WITH NUMBER ONE BELOW
O �
C v 1. LOCATION OF JOB
1. 10 5 ����7��
0 NO.� STRICT
co
co U
d w
yLOT NO. FLOOR APT. NO.
O G
� O
lV
4) O
2. OWNER �2' ye `J
0
O
o !. ADDRESS
3
d y _ 4.PHONE
.� >
Cc
>b X
Go _ B. APPLICANT
vi a0
a. ADDRESS
7.PNON
d B. LICENSE NO.
a:
E B. EXPIRATION DATE OF LICENSE lU/dj/
0
2,000
c 1o. ESTIMATED COST s
mCq
^ 11. IS THIS A CONTRACT COSTT ❑ YES d NO
b0
y �
12. FEE ENCLOSED s- P P rm i t 1 3761
o d
x
ai 13. TYPE OF BUILDING:
rA
b IV-RLSIDEMTIAL ❑ COMMERCIAL
O �
" d 14. TYPE OF JOB: ❑ INDUSTRIAL
a`�i 3
L!7 IMSTALLATION ❑ ADDITIIONON
REPAIR
APPLICATION FOR H ATING PERMIT (C ntinued it m Reverse side)
If. LOCATION OF JOB
NO. �� STREET FLOOR APT. NO.
L�12. TYPE OF INSTALLATION: 'OIL BURNER ❑ ELECTRIC ❑ VENTILATIO ❑ SPRINKLER
❑ GAS BURNER ❑ STACK ❑ INCINERATOR ❑ MISCELLANEOU
///�j} n ID TIFT
SIZE `� LOCATION SIZE
`�c —OF FILL OF VENT /!7 13. OF TANK 1OF TANK
14. B.T.U. EQUIP. AT REGISTER U AC MAK�E-pAND NO. AT BONNET FIRING RATE
BOILER OR FURNACE MAKE AND NO / T.U. OR SQ. FT. NET U � A.T.U. OR SO. FT. GROSS FIRING RATE
FLOORS TO BE HEATED NEW OR 045 BUILDING INSULATED — YES OR NO
TYPE OF WALL L� INSULATION 6 ROOF OR CEILING INSULATION
AVG. SYSTEM WATER TEMP. /& � J B.T.U./SQ. FT./HR. EMISSION
INDOOR-OUTDOOR TEMPERATURE DIFFERENCE IQ' :2 O 'FAHRENHEIT
MAKE OF RADIATION: BASEBOARD. COPPER CONVECTORS. OR G.I. RADIATION. OUTPUT PER SECTION OR LINEAL OF RADIATION. SQ.
FT. OR B.T.U.
i
DESCRIPTION OF WORK
13. TO BE DONE:
—
is. HEAT LOSS SCHEDULE. (TO BE INCLUDED FOR ALL JOBS):
- y' .�-.•.fie,�-- ` .m_ ' D13T iilUV TtON tHST ALL[6 t
I a r, _ l.• t vF. 4WD ill[ NAO i
w. OR Ll4U[,1 t
r7. fRQC •AtA
.k:
y
1 t
!'OTAiS
A. HEAT LOSS FROM BUILDING C>s d D 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:
NANL 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
DATE SIGNATURE OF APPLICANT