HomeMy WebLinkAbout100 Bidwell Road (49)DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT
TOWN OF SOUTH WINDSOR
PERMIT#
Application is hereby: GBUILDINGDEPARTMENT
APPROVED 1540 SULLIVAN AVENUE Bldg.Pernut#
fiA 644-2511 ext. 230 f M ?()-
Date Buil g Vector
Application must be printed or typed
FEE SCHEDULE
1N ULocation of Job:
0-$1,000=$13.00 Street No. Street Lot No.
Over$1,000=
13.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT
APPLICANT ADDRESS % r /i % 6)L4 X
0 lv J 3 7.
APPLICANT PHONE# g7 •
At OW N S F-4
OWNER
OWNER ADDRESS
OWNER PHONE
C ESTIMATED COST$ uvv —
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IS THIS A CONTRACT COST? OeYes 0 No
ICJ FEE ENCLOSED$
TYPE OF JOB:IF,l
sOR CO 0 New Installation
klteration/Addition/Repair Revised 8/99
APPLICATION FOR HVAC PERMIT (Continued from reverse side
TYPE OF SYSTEM: TYPE OF BUILDING: avz C
HEATING RESIDENTIAL
r`A/C a COMMERCIAL
4 VENTILATION C 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 OF INSIDE OF DIFFERENCE OF
TOTAL HEAT LOSS(BTUH) OF(HEAT LOSS SHEET MUST ACCOMPANY
APPLICATION)
DESCRIBE ALLL HEATING EQUIPMENT(INCLUDING MAKE&MODEL NO.)
e 6 Izlz/ 7-jZ Z,
GROSS HEATING CAPACITY(INPUT—BTUH) NET RATING(OUTPUT—BTUH)
TYPE OF FUEL
OIL—GPM OIL TANK LOCATION:INSIDE OUTSIDE CAPACITY
GAS—INPUT LPG TANK CAPACITY ELECTRIC—KW
AIR CONDITIONING
DESIGN TEMP.OUTSIDE OF INSIDE OF DIFFERENCE OF
TOTAL HEAT GAIN(BTUH) HEAT GAIN SHEET MUST ACCOMPANY APPLICATION)
DESCRIBE ALL COOLING EQUIPMENT(INCLUDING MAKE&MODEL NO.)
7AGECOOLING 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)
r-< L 3
FURTHER DESCRIPTION OF WORK
C 21 ,,,a
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS TO
COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE
PERFORMANCE OF SUCH WORK. 41e c
CONTRACTORS LICENSE NO. E STATE
U
SIGNATURE OF APPLICANT i1-' DATE