HomeMy WebLinkAbout104 Ident Road (5)DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT
TOWN OF SOUTH WIlVDSOR
PERMIT#
Application is hereby: I Cp jBUILDINGDEPARTMENT
A;QLVVED 1540 SULLIVAN AVENUE Bldg.Permit#
661o"; 644-2511 ext. 230 1_1
ate Building Inspector
Application must be printed or typed
FEE SCHEDULE Location of Job:
F:Tenant
tNj oo
0-$1,000=$15.00 o. Street Lot No.
Over$1,000=
15.00 per$1,000
or any fraction thereof esignation Apt.No.
APPLICANT L O S to N L,8-rl
APPLICANT ADDRESS ') g ( cop ,W„
APPLICANT PHONE#
N S OWNER
OW . Fq OWNER ADDRESS o 4'
0 Y OWNER PHONE 51-g,- (lr f
C ESTIMATED COST$
IS THIS A CONTRACT COST? Yes No
FEE ENCLOSED$
f11r TYPE OF JOB:
dSOR S COS New Installation
Alteration/Addition/Repair
Revised 4/01//2002
APPLICATION FOR HVAC PERMIT (Continued from reverse side)
TYPE OF SYSTEM: TYPE OF UILDING:
HEATING A RESIDENTIAL
A/C 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 OF INSIDE OF DIFFERENCE OF
TOTAL HEAT LOSS(BTUH) OF(HEAT LOSS SHEET MUST ACCOMPANY
APPLICATION)
DESCRIBE ALL HEATING EQUIPMENT(INCLUDING MAKE&MODEL NO.)
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 CIO _OF INSIDE OF DIFFERENCE l OF
TOTAL HEAT GAIN(BTUH) s L (HEAT GAIN SHEET MUST ACCOMPANY APPLICATION)
DESCRIBE ALL COOLING culp"ff ENT(INCLUDING MAKE&MODEL NO.)
TONNAGE I L COOLING CAPACITY(BTUH) ov o
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 S-'- W q w
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.
S- ( 3°t )-? $'o S-
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT jBvL b s sa ^t/ DATE /I l2'Le L
r)687-L1 1 S-16-12-R9
Job No. Date
RESIDE,,:T IAL %vOLING DA„, SHEET outside Design TelTip Ds V'JB._svrar s:
de es1yi,Tc,Tip. 'Dail':DanC
IS 0 t,_, S Design Temp.Diff.Latitude
HEATING CONTRACTOR ADDRESS JJJ Floor Area ByNAMEOFJOBa t-L f IJ/t`'c 1,,/t. 1 W`— t ' re 4- fi1ADDRESS
1 Room Use and Floor Level f•'1" , ;.r 1• i-1 2(,`, 3 I a CrV i 6. 7. 8.
2. Room Length and Width
Type and Direction oT TABLE Area Area Area 1 Area Area Area Area Area
HTM or
Btuh Btuh 6 ' I Btuh Btuh FBtuh Btuh Btuh
E Yposure NU NIBE R or or or I or or , Or or
No. Gain No. 1
Gain No Gain NO. ( Gain No. Gain No Gain No. Gain No Gain
NORTH Exposed .'all Length r-=a •'. 1 t fi.C
OR SHADED) Ceiling Height r•
3. Wall and Glass Gr
s .r tr{. r y.•.' L'e
Oss Exposed Wall_ .!t'+'- .i: •.-iw i,ri'!. ..,••: 1. ate'•'••t, .
r
k
y :.
Solar& Sq Ft Glass Area
Conduction) Net Exposed
EAST Cxposed'!Vall Leng'•l (•a t K"a'• Z i
Ceiling Height --
i x '}•' t t•,•"*
a. Wall and Glass G:css E x used i":ai:" '., T.'61.5 s•
Solar& Sq Ft Glass Area
Conduction) Net Exoesed Wale
SOUTH Exposed'.Nal! Le^rrh ;' rt,Se 1• "'>y L _Y: •y' tr. _'• • 4--..: .:. ..: .•• • r;••. rr"'::+'-•'x:,.ter'
Ceiling Heigh c:ti.:a: t1• 1 r 1 1, Li
A
5. Wall and Glass Gross ExoosedyJal
s 1 r.• r •['1 fi' h y' ~= .•1
3 ,,:a• 1 f•a;s.P!' f Gp ,'r#'
a' ?'
a•,, ( r , ' -!i,e > ,y.l'.:•r.'' •:t;'r:""•\' Solar& Sq F t Glass F•:ea__-- 1 p i 4 S 1 I
r
Conduction) Net Exposed
WEST Exposed b"1a1, Li^y;yt y'f•_1.I"./..\.`FY'' ! 41: 1:•. fi, t'l,'vi 4 t.{J_„i t:4`%tr=:; j i t 'y,.Ceiling Heso'ht --- -;r :T, i/! NL: J• tijj',a . aw..s F7{`o
6. Wall and Glass Goss E xDoserj v r' fi t•
r Y +•. 1 ?• 3-rtiJ, c•• j• a rC'n
Solar& Sq Ft Glass t=r d
Conduction) Net Excosea Wai! _ f j--------I
7.Wood Doors
8 Warm Partition
9_Warm Ceiling i _ i :a CQP ' ' G "'4;'•x
10 Warm Floor 1- t --
1- _--
I•1
f
11. Appliances-Kitchen (Sen I )r is 4 1,•„•7• O .. s' Ai'1:.12.People(Sensible) p+ C, .p- o
13.Outside Air or Infiltration(Sensible) S m
14.Sub-Total-Sensible F: ti 1 •.S i;;r y.'r.;,: r~•
15. Duct Allowance %
16.Total Sensible G ?•_
f y y f
17.Total Latent .3 x Tot.Sensible c:: • :x f.
S
18.Total Sensible& Latent t,•
Y M
19.Theoretical drn
20. Delivered cfmRES r
fjj.
1; O N M+• I•
CAP.MULTIPLIER For F Swing) LENNOX Equip. Btuh Cap. @ of
MIN-EQUIP.CAP,C Ar"tl sating Cfm Rpm Air Changes S/T Ratio S.P.
Litho U.S.A.