HomeMy WebLinkAbout15 Apple Tree Lane (13) DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT Ja(i 1 b
Application is hereby: TOWN of SOUTH WINDSOR
BUILDING DEPARTMENT Bldg Permit#
APPRO 1540 SULLIVAN AVENUE
2��
644-2511 ext. 230
I
Date Building Inspector
Application must be printed or typed
Location of job
Street No. Street Lot No. i
I
FEE SCHEDULE
Floor Apt.No.
$0 - $1,000 - $12.00
Over $1,000
$12.00 per$1,000 OWNER X f'ke 1�Tov e Clark
or any fraction thereof
ADDRESS
CT I
OWNERS PHONE# S(Q p- !o qq ,—// S 9,Sy
APPLICANT CpZ���rlq �teaf%rig Co'Yb
SOW N SFq ADDRESS Loom!/5
s-tp.+- CT
C*0 ESTIMATED COST $ .1,9 3 I. 0 O
lot-
IS THIS A CONTRACT COST?
YES NO
FEE ENCLOSED $ �J�o� 0 O
i
OR-C0 TYPE OF JOB:
Original Installation
✓ Alteration/Addition/Repair
Revised 11/95
9
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APPLICATION FOR HVAC PERMIT(Continued from reverse side)
TYPE OF SYSTEM TYPE OF BUILDING
HEATING y RESIDENTIAL
V-YAIC ti/ COMMERCIAL
VENTILATION 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_: 10°F INSIDEJFDIFFERENCE ReF
TOTAL HEAT LOSS(BTUH)
(HEAT LOSS SHEET MUST ACCOMPANY APPLICATION)
DESCRIBE ALL HEATING EQUIPMENT (INCLUDING MAKE&MODEL NO.)
Cfs ,no ea s fi ~ a rearm arr qq _S �urv�2L� and add► ►�►G
-ls7 i% e_H ( I oo,Om Bf Lc -F" acePjec.tric, Zone, c4gmp rs spt" _- ng .e�-i-
�% y1,92� 13-F vutburt)
GROSS HEATING CAPACITY (INPUT-BTUH) NET RATING (OUTPUT-BTUH)
N ecLt f o 5 s
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)
FURTHER DESCRIPTION OF WORK Add zo"a da► p@e r s yr-�srewt, a.ne(- S N e e'f m e-ta l
�GGc-1 ww� TTpm � 2 xc SrC a a• Warm air -P"rn4 e% -1 d �e_a_t 4e, ba 5emetf+-
0-rea. DCc (,�av+c
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFO THE WORK DESCRIBED AND IS TO
COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONN. BUILDING CODES IN THE
PERFORMANCE OF SUCH W7S!
30 3 (o70 5-- I JL
STATE LICENSE-NO. NAME&TYPE NATURE OF AP ICANT
PHONE NO.F&c) -CoL&—oft,2 DATE S- 9 9