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HomeMy WebLinkAbout11 Carman Roadf j DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT TOWN OF SOUTH WINDSOR PERMIT# Application is hereby: BUILDING DEPARTMENT APPRL> 1540 SULLIVAN AVENUE Bldg.Permit# C aZ jo- 644-2511 ext. 230 D to' Building Inspector Application must be printed or typed Location of Job: FEE SCHEDULE H ca 0- $1,000=$13.00 Street No. Street Lot No. Over$1,000= 13.00 per$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANT i le r- APPLICANT ADDRESS as k1ari4Z 42, APPLICANT PHONE# :Fly O ,— l 200 W N S OWNER Z H`U Pro!0 q OWNER ADDRESS A OWNER PHONE 0yf ESTIMATED COST$ f 300 IS THIS A CONTRACT COST? 0Yes 0 No FEE ENCLOSED$ TYPE OF JOB: s(0)R C 0 New Installation 0 Alteration/Addition/Repair Revised 8/99 APPLICATION FOR HVAC PERMIT (Continued from reverse side TYPE OF SYSTEM: TYPE OF BUILDING: HEATING 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 OF INSIDE OF DIFFERENCE OF 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 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. CONTRACTORS LICENSE NO. TYPE STATE SIGNATURE OF APPLICAN DATE_! 0 Z DECISIO ' APPLICATION FOR tip-7 HEATING PERMIT 1 hereby bISAPP.RO'ED PERMITS No. BUILDING DEPARTMENT TOWN OF'NIANCHESTER MUST-BE PRINTED OR TYPED PECTOR ' ^ JOB LOCATIONDdle I;000-=-----=$14:00 NO. STREET Gere0f---- ----=$14:00 OWNER b tion---7--------.$20.00 Y 25•.00 ADDRESS 5.00* 45.-00* e. a permits---excepts for new Q j1,APPLICANT-' rC1/Y r in.residentia l.permits. t ff6ADDRESSv' //-yto STIMATED COST,, FEE COST=S 6 FEESE,L'ECTRICA L lVORI(,DO`NE'.:By,.:_ NAME,r ADDRESSILLL-AWOR-K,COVERE1D-BY THIS-AP-PLICATIN HAS BEEN JOBS CRIPTIONTHORIZED-IBY`_THE OWNER(OR=AGENT)OF THIS i OPERTY=AND WILL`DONE ACCORDING'TO LOCAL DE-AND-REGULATIONS. SINGLE_F'AMIL--—Oli'NE;``01— ICUPIED Expar-at ion Date rSATE LI SENO. TYPE OF BUILDING OLD NEW a RESIDENTIAL COMMERCIALTEL.iVO. SIGNATUREr OF APP ICAN PERt<1I'=#dh'v INDUSTRIAL TYPE OF JOBQWrREPLACEMENTlow PERMIT EXPIRES ORIGINAL ADDITION i INSTALLATION REPAIRS REC.# CASH( e dd rt:t I c, a ALELit02 M5PTO 70''iNItFJ"=_BEL©W ER° a40) (CIfiC:f80)WARM4AItt.(GRAV.;250)=(FORCED 200) ELEC-(3, 1'BT.U=1"avA'r-; CUBIC BOOM LOSSr _ INS TAC-ED=RADIA AON s XFP CEIL1N6s GI:ASS•FL'OOR, "CON=ROOMS L SQ/LIN.FT - STYLE'TENTS= Al 4ii, TYPE - ST'(Rf I_ INSULATION WINDAW.S.`YES NO_ T-I 1CKN ESS