HomeMy WebLinkAbout118 Berle Road (6)Application For
PERMIT
DEPARTMENT DECISION Heatmg Permit
3 APPLICATION IS HEREBY:
DEPARTMENT OF LICENSES AND INSPECTIONS
N El APPROVED DISAPPROVED
TOWN OF SOUTH WIN DSOR
O DATE CHIEF IN APPLICATIONS MUST BE PRINTED OR TYPED. BEGIN WITH NUMBER ONE BELOWO
p W 1. LOCATION OF JOB
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LOT NO. FLOOR APT. NO.O
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2. OWNER S e 42Cd
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S. LICENSE NO.
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c s. EXPIRATION DATE OF LICENSE
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0 10. ESTIMATED COST s
1 t. IS THIS A CONTRACT COST? YES NObA
12. FEE ENCLOSED s
13. TYPE OF BUILDING:
C RESIDENTIAL COMMERCIAL
cis 3 14. TYPE OF JOB: INDUSTRIAL
i --i ORIGINAL ALTERATIONINSTALLATIONADDITION
REPAIR
pI APPLICATION FOR HEATING PERMIT (Continued from Reverse Side)
11. LOCATION OF JOB L y
N0. 5TREET FLOOR APT.N0.
12. TYPE OF INSTALLATION: OIL BURNER ELECTRIC VENTILATION SPRINKLER
GAS BURNER D STACK INCINERATOR MISCELLANEOUS
IDENTIFY
SIZE LOCATION SIZE SIZE
13. OF TANK OF TANK OF FILL OF VENT
14. B.T.U. EQUIP. AT REGISTER FURNACE MAKE AND NO. AT BONNET FIRING RATE
BOILER OR FURNACE MAKE AND NO. B.T.U. OR SQ. FT. NET B.T.U. OR SQ. FT. GROSS FIRING RATE
FLOORS TO BE HEATED NEW OR OLD BUILDING INSULATED — YES OR NO
TYPE OF WALL INSULATION ROOF OR CEILING INSULATION
AVG. SYSTEM WATER TEMP. B.T.U./SQ. FT./HR. EMISSION
INDOOR-OUTDOOR TEMPERATURE DIFFERENCE FAHRENHEIT
MAKE OF RADIATION: BASEBOARD, COPPER CONVECTORS, OR C.I. RADIATION. OUTPUT PER SECTION OR LINEAL OF RADIATION. SO.
FT. OR B.T.U.
DESCRIPTION OF WORK
15. TO BE DONE:
is. HEAT LOSS SCHEDULE. (TO BE INCLUDED FOR ALL JOBS):
ROOM SIZE WINDOWS AREA - SQUARE FEET B.T.U. B.T.U. F O
AND DOORS VOLUME DISTRIBUTION INSTALLED
TOTAL TOTAL ul LL
ROOM NO'GROSS GLASS NET WALL CEILING FLOOR CU.FT. AT 70•F CORRECTED J j REGISTER
L W H AND K WALL t0 lt INFILT.)
TEMP. TO F F a TYPE AND SIZE SQ AF OR LEADER
SIZE F'L DIFF. F I-<D a FREE AREA
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TOTALS T-FL><
A. HEAT LOSS FROM BUILDING 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:
NAME ADDRESS
SUBCONTRACTORS AND
18. 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 IN.
DATE SIGNATURE OF APPLICANT
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