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HomeMy WebLinkAbout135 Debbie Drive3 TO THE BUELDING INSPECTOR of the APPLICATION FOR PLAN EXAMINATION AND OF SOUM WI1rDSOR, BUILDING PERMIT z IMPORTANT — Applicant to complete all items in sections: 1, 11, III, IV, and IX.O aa ZONING AT (LOCATION) /y DISTRICT A— LOCATION NO.) STREET) OF BETWEENAzlz 64 d_d AND BUILDING CROSS STREET) CROSS sT/,E5 LOT SUBDIVISION e% LOT_BLOCK SII ZE 9S•6 E n /,/O to 11. TYPE AND COST OF BUILDING — All applicants complete Parts A — D A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use 1 New building Residential Nonresidential 2 Addition(If residential, enter number 12[2'6ne family 18 Amusement, recreational of new housing units added, if any,13 Two or more family - Enter 19 Church, other religi us in Part D, 13) number o units- - - - -J 20 Industrial 3 Alteration (See 2 above) 14 Transient hotel, motel,21 Parking garage 4 Repair, replacement or dormitory - Enter number 5 Wrecking (If multifamily residential, of units ------- - i Service station, repair garage enter number of units in building in 15 Garage 23 Hospital, institutional Part D, 13) 16 Carport 24 Office, bank, professional 6 Moving (relocation) 25 Public utility17 Other - Specify 7 Foundation only 26 0 School, library, other educational B. OWNERSHIP 27 Stores, mercantile e EPrivote(individual, corporation, 28 Tanks, towers nonprofit institution,etc.)29 Other - Specify 9 Public(Federal, State, or local government) C. COST Omit cents) Nonresidential - Describe in detail proposed use of buildings,e.g.,food processing plant, machine shop, laundry building at hospital, elementary 10. Cost f improvement................ I school, secondary school, college, parochial school, parking garage for, department store, rental office building, office building at industrial plant. To be installed but not included If use of existing building is being changed, enter proposed use. in the above cost a. Electrical...................... b. Plumbing ...................... c.Heating, air conditioning......... d. Other(elevator, etc.)............ 11. TOTAL COST OF IMPROVEMENT III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — L; for wrecking, complete only Part J, for all others skip to IV. E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS 30 Masonry(wall bearing) 40&Public or private company 48. Number of stories................ 31 L Wood frame 41 Private (septic tank, etc.) 49• Total square feet of floor area, all floors, based on exterior ag32 Structural steel dimensions .................... 33 Reinf rced concrete H. TYPE OF WATER SUPPLY Other - Specify 42 Public or private company Total land area, sq. ft. ........... 34 43 Private(well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES 51. Enclosed ...................... F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 351_f!f Gas Will there be central air 52. Outdoors....................... 36 Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY z37 Electricity 44 Yes 45 2No 53. Numb r f b dro ms.............. 38 C of 39 Other- Specify Will th re be an levator? 54. Number of Full.......... 46 Yes 47 PNo batter ms Partial....... IV. IDENTIFICATION — To b comp/ t d by all applicants Name Mailing addr ss — Number, street, city, and State ZIP code Tel. No. Owner or Lessee 0-7/ 2. Contractor 3. Architect or Engineer The owner of this building and the undersigned agree to conform to all applicable laws of this jurisdiction. Signature of applicant Address Application date 00 NOT WRITE BELOW THIS LINE V. PLAN REVIEW RECORD — For office use Plans Review Required Check Plan Review Date Plans By Date Plans By NotesFeeStartedApproved BUILDING PLUMBING MECHANICAL ELECTRICAL OTHER VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Permit or Approva I Check ObDa ted Number By Permit or Approval I Check ObtDained Number By BOILER PLUMBING CURB OR SIDEWALK CUT ROOFING ELEVATOR SEWER ELECTRICAL SIGN OR BILLBOARD FURNACE STREET GRADES GRADING USE OF PUBLIC AREAS OIL BURNER WRECKING OTHER OTHER VII. VALIDATION Building Permit number Building Permit issued T/ 19 Building Permit Fee $ 1/1/17` 2 CZ prov d y: TITLE TOWN OF SOUTH WINDSOR BUILDING PERIVHT Date Dec . 10 198 5 Fee Paid $. .41.7. .0 0 Est. Value $.6 9.,,5 0 0 Permit N° 14836 on the side of Lot #13 Debbie Drive Street Street No. 135 Owner Dart Hill Realty Applicant Muriel Jacques CERTIFICATE OF OCCUPANCY ISSUED: Date No. 7417 Fee paid $ 3 .0 0 CLASSIFICATION Dwelling i i BUILDjNG PERMIT N ' 1483E OFFICE OF THE BUILDING INSPECTOR of the Town of South Windsor, Conn. South Windsor, Conn. Dec 10 1985 i 94is is to Qrrrtif#, That Dart Hill Realty is hereby granted permission to Dwelling at estimated value of on the side of Tint #13 Dabbia Drive Street on land owned by Dart 14 Raba I t__ Said Work to be as described in Application No. 15,136 and to conform to specifications and plans filed with said Application, and Building By- Laws of THE TOWN OF SOUTH WINDSOR. Issued /f- Dec. 10 105 Building Inspector. Streets and sidewalks, obstructed by excavations or building materials, must be guarded by barriers during the day and by both barriers and colored lights by night. SECTION 1343, GENERAL STATUTES OF CONNECTICUT: "When any person shall place or keep building materials, or any obstacle in any highway (or any sidewalk) either with or without a license therefor from the city or borough in which such highway may be situated, he shall pay said city, town or borough all costs and damages which it shall sustain, or be compelled to reason therefor." Dwelling - Lot #13 Mtn.Vw.l 12/10/85 Dart Hill Realty 135 Debbie Drive Permit # 14836 Electrician Richard Barrett 9087 Heating Contr. So.Windsor. P & H # 6394 Plumbing it So.Windsor P & H #6940 Oil Burner Certificate of Occupancy 7417 Sewer Permit Plot plan apprd. per Engr. i Permit No. TOWN OF SOUTH WINDSOR SOUTH WINDSOR, CONN. Permit y Certificat of Occupancy rHI CER t th at No. in th own of South Windsor, Connecticut, has N kl been erected and completed in accordance w h the ilding Code and Zoning Regulations of I the Town of South Windsor, and is hereby ap ove f occupa l Building Inspector f Owner, Builder v Fee Paid-Date 19 6i REINO E. NYYPPA a ASSOCIATES VIAL EN"EERS a LAND SURYEYMS GLASTONBURY, CONK OTHER LAND OF JEAN MARC JACQUES 300 N 4' 30' 30" E r z9g i 3 AREA= 26,860 S,F if ^ z r00 _ n Co o it N. N Q 0t f t .. u,s o' gLDc, 300 t ! d t 1=90 00 o0 0 c s --39 Z7' c-H=ZZ.G3' I ._94 S 4 30' P.- W 550.Op' —"-- DEBBIE DRIVE Ak LOT U14E.S.,FROW MAP a FILE TITLED, ft*s°%.E SJW 4+ 5+Oy A-S0 ZoKjr- R.m PL^w 5evrK).1 1 µoowAANvtEv4 Esm-res $ovfN Y1 1wD50R,col'*j•'By Rcwo E. 14YIPM#AssmiAlE s IK=40 0, AcX.3•-14-K MAP No.M0-6-5•tG T 3 of`4+ Rev. -3a-PREPARED FOR pol.s. %.cc*-tcn ^*lw S4-wwN 4-l4-Si. LofNOZ.c i'VCn.AT*N46 F)A RT HILL REALTY INC. CE.KTff1EO SMS1ANTlAU.y CORRECT SOUTH WINDSOR, CONN. SCALE : V"40' pATE: i 1-Z7-$ 50- s3-# 4 4-«.- vein 9087 ELECTRICAL APPLICATION Application No.10601 1 on side of Lot #13 Debbie Drive Street Street No. 135 Debbie Drive Owner Dart Hill Realty Electrician Richard Barrett FILED IN OFFICE OF The Building Inspector 0AL. 3 -2 19_ L6- IN$PRC'TION. r&No Electrical Work shall be started until a Per- mit is granted by the Building Inspector. In New Buildings no wiring shall be started until the plumbing and heating pipes, and the fire stops (if of wood) are installed, without a special permit from the office of the Building Inspector. Electrical Permit No. f 7 Master License No. ....:J.... ._ TOWN OF SOUTH WINDSOR Building PerT.T.- BUILDING No. DEPARTMENT Date Filed ... ................. Date Final Approval ................................... .... .. APPLICATION FOR ELECTRICAL WORK Electrical Inspectai JOB LO TION. J B R ...... .....'.6...... .-r....................................... Side of . etween a d ... Name of Building Owner . .... . Address I..l J......._ If work is for Lessee--,Give name ... .... Address .............................................................................................. Building now occupied as (unle new) No. of family units now ........................... Building to be occupied as tling Number of family units to be ............................. Is this wo 'nc uded in B Permit Permit Fee ................ .................................................................................... If no Building P it) Permittee . Business Address c ... 1f,. ...... I.......3delephone ....... .........3) , COSTOF INSTALLATION. . ............. ........ ............................................ ....................................................................................................................................................M...... TO BE FILLED OUT BY PERMITTEE TO BE WIRED EXISTING APPLIANCES Number of light outlets to be installed . . ...... .. .. ......... Number of convenience outlets to be installed Number of present Appliance Circuits .................................................. Number of switches to be installed . . . .......Do these include Range Water Heater Number of appliances to be installed as listed below) Dryer Air Conditioner Oil Burner TYPE RATING NO. y Dish Washer Gas Burner Range Well Pump Elec. Heaters E) Range Top Oven . . . . . . . . REMARKS: Water Heater Clothes Washer rG A e- perYClothesDryer . . . . . J C` Dish Washer . . . . . . Air Conditioning Motor . Oil Burner Motor . . . . Gas Burner . . . . . Circulator Motor Attic or Large Fan , , , Well Pump . . . . . . Electric Heat . . . . . Other . . . . . . . Number of new Lighting Circuits Number of new Appliance Circuits . . . ....... _........... Number of Heating Circuits Number of Motor Circuits . . . . . . . Size of present service ................: . . .::_.yarn: ...._............Size of service to be ..................... 711111 _..... 6940 PLUMBING Application Na 6.711 on the of Lot #13 Debbie ari ver s- P- Street Igo. ----—— 13 Dart Hill RealtyOwner plumber So.Windsor Plbg. & Htg- Filed in Office of The Bing Ma r 9 IgAaL— No person&A ooestruct, add to or aher my portion of the drainage system of any bwl&og except to repair lealm) uma a Peomit in gcmftd by the Building Impactor. APPLICATION FOR PLUMBING PERMIT (Continued from Reverse Side) TOWN OF SOUTH WINDSOR, CONN. 11. LOCATION OF JOB STREET FLOOR APTAO. N GENERAL PLUMBING 12. KIND OF INSTALLATION 4 13. SIZE OF MAIN DRAIN 14. NO. OF TOILETS - STYLE Q 15. NO. OF URINALS_STYLE f 16. NO.OF BATHTUBS 17.NO.OF LAVATORIES-,3-18. NO.OF SINKS / 19. NO. OF WASHTUBS 20. NO.OF CONDUCTORS SIZE 21. NO. OF STACKS _SIZE 22. AREA OF ROOF 23.NO. OF CATCH BASINS 24. NO. OF FLOOR DRAINS 25. NO. OF OTHER FIXTURES KINDKIND 26. ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW? ` O 27. SIZE OF WINDOW 28. IF NO WINDOW,WHAT KIND OF VENTILATION IS THERE? Z,t 41-1 L r 29. SIZE OF DUCTS 30. ARE SEWAGE AND WATER FACILITIES AVAILABLE? NEW ADDRESS: SOUTH WIND-SIR PLUMBING & REATINI, INC. SIGNATURE 0ADDRESS S2A r'ZURNHAM ST SOUTH WINDSOR, CT 06074 LICENSE No. 203i)6 ESTIMATED COST L> > 0 TELEPHONE," l-3 OWNER Za--Ll " '1- ADDRESS WATER HEATER 31.TYPE 32. MANUFACTURER ,rC -' TANK SAFETY DEVICES 33. CAPACITY-X 37. TEMPERATURE RELIEF VALVE 34. TEST PRESSURE_ 38. MANUFACTURER 35. WORKING PRESSURE Igoo 39. PRESSURE RELIEF VALVE 36. TYPE 40. MANUFACTURER ALL WORK COVERED BY THIS APPLICATION HAS BEEN AUTHORIZED BY THE OWNER OF THIS PROPERTY AND WILL BE DONE IN STRICT ACCORDANCE WITH THE BUILDING CODE. CD962 AT SIGN F APPLIC i PERMIT # Application For 6193 6394DEPARTMENTDECISION o Heating Permit 3 APPLICATION IS HEREBY: w DEPARTMENT OF LICENSES AND INSPECTIONS N tk APPROVED DISAPPROVEDa C1 TOWN OF SOUTH WIN DSOR c a 3/19/86 Thanas P. D' Auria 00 O DATE O CHIEF INSPECTOR APPLICATIONS MUST BE PRINTED OR TYPED. BEGIN WITH NUMBER NE BELOW oa) 1. LOCATION OF JOB 135c v NO. STREET Cd O OT NO. FLOOR AFT. NO.O Or [V O 2. OWNER C r O s. ADDRESS A3 J 4.PHONWX 9``'ro-lp PC S. APPLICANT o Go Ali/ i WA1IM,or.p s. ADDRESS C SW CT 00074 w ,C 7.PHONE y S. LICENSE NO. - 7l r) a o %-4 s. EXPIRATION DATE OF LICENSE- 7u O 10. ESTIMATED COST >< 7(1[ •L) 7 E I I- IS THIS A CONTRACT COST? YES NOE 12. FEE ENCLOSED s Permit 14836 x IS. TYP OF BUILDING: RESIDENTIALO >~ COMMERCIAL CdCd O 3 14. TYPE OF JOB: INDUSTRIAL ORIGINAL ALTERATIONINSTALLATIONADDITION REPAIR APPLICATION FOR HEATING PERMIT (Continued it m Reverse Side) 11. LOCATION OF JOB NO. STREET FLOOR AFT.NO. 12. TYPE OF INSTALLATION: OIL BURNER ELECTRIC VENTILATION SPRINKLER GAS BURNER STACK INCINERATOR I MISCELLANEOUS U4. met /` 'o 10 NTIFT 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. (!?"ie& B.T.U. OR SQ. FT. NET z7 73I.T.U. OR SQ. FT. GROSS FIRING RATE FLOORS TO BE HEATED &!a NEW OR OLD BUILDING A iEle/ INSULATED - YES OR NO Xe j r TYPE OF WALL l.lrc` '"+ INSULATION 15 fc-gAU" ROOF OR CEILING INSULATION AVG. SYSTEM WATER TEMP. f'©° B.T.U./SQ. FT./HR. EMISSION INDOOR-OUTDOOR TEMPERATURE DIFFERENCE 0 - 0a u FAHRENHEIT MAKE OF RADIATION: ASEBOAR COPPER CONVECTORS. OR C.I. RADIATION. OUTPUT PER SECTION OR LINEAL OF RADIATION. SQ. FT. OR B.T.U. DESCRIPTION OF WORK 15. TO BE DONE 1, /.JCL y G d" TG•: G. /• G L^ f' 16. HEAT LOSS SCHEDULE. (TO BE INCLUDED FOR ALL JOBS): ROOM SIZE WINDOWS AREA - SQUARE FEET e.T.U. IS.T.U.o DIT.TOTALSTRIBUTION INSTALLEDANDDOORSVOLUMETulLL ROOM NO'GROSS GLASS NET WALL CEILING FLOOR CU.FT. AT 70•F CORRECTED t j LL RAD. REGISTER L W N AND TEMP. TO F TYPE AND SIZE OR LEADER 10SIZEWALL INFILT.)afDIFF. F F m Sp. FT. FREE AREA TOTALS A. HEAT LOSS FROM BUILDING B.T.U./HR. B. DOMESTIC HOT WATER DEMAND_ 2'5 '4C 0,4 B.T.U./HR. C. PIPING, OTHER THAN NORMAL B.T.U./HR. ALLOWANCE FOR HEAT VALVE OF FUEL (A B C) FACTOR A 17. ELECTRICAL WORK BY;A'G Ut . Gdi i 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 S NAT F AP"NT 2.fi'=; z°" - r - AM-f._ - .-s - - - yY _ - i' _way'• f J.•r r- CRY- _„--»::`_ :: _•.- >E;_ - `- -_ -f . f K CtYYr r7^0k ow`GR-A 1 1At Ri YE' PF #2Ai E 1PfS4Gft *rgMP. JIFF 1° 2 4 5 16 7r 8 9 1 a 11 2 1 14 i A .tDews AREA-SCE. FT. VOLUMIR 11ASE0 BARDS A SEE MDTE) FT. TgTAi, TOTAL ACCESS0411ESAT70' tgieRELiftD WATER LENGTHGLAD$ WALL _. E anc; 1 lA9fR G Q'B$ TEMP. j TFIAP FINLwHAft9xWALLatccr. I E lewaosugelF.D F r t R 5 i.t MrSC. tsizetwrr. o rf. Tulle 00 j l00 3 In do Q /000 200 f Lj r 0a3 cat ( fIJc 3 Q O JVH D po ?$00 0 F - 6'an 7 0C) oo Yu o C 0E4.4y A s,.- mod: 'yua°.-' .:'-" iL''_ - .'':k-, r-t•^ 1,.'•_ - f. J,A 1 aham: Y344b1.-. _ a ate u.Nam` •tc'b Y-- - .' s -L'!.` F' - fi4'$ deg a' _'!`t-:>-tt•,-lS Y. 4 ,:- - - L. ~•-.S' X sit"= i' Y•R1'b. "t Y`Y-'-• Sf.tµ4!'. _ a-,_ -`e '•4 E li—,. ^ Y": _ 3SY" _i..1vsF", - _ '' iy y`' Ci-T f., •-fin T 3_ ks- .'« r.M;>,a.•{ .._- - - i'.c f-.:i-.::z-.,.F-- r..=3'F Q- t 8ectric# ba APPLICATION FOR BUILDING PERMIT Plumbing# 135 DEBBIE DRIVE HVAC # a{S Date: No. 25 873Sprinkler# FINAL Estimated Cost 0 Buildi COMPLETE RED BOXED AREAS Permit Fee TYPE OR PRINT ONLY Occupancy Fee $ 5 Affidavit SIGN ON REVERSE SIDE Apr.for CO. iPC Total Fee TO BULDM DEPARTMEW,TOWN OF SOUTH Wt4l)SOR,CT Additional Cost) The undersigned hereby applies to do work according to the following specifications: Job Location f 3-5 I)e_6 6;a Lot No. Side of Street Zone Applicant 3'LcGt h n IAA k 1 Tel SG Addr ss 1'65- -W 61,p mac;v — Zip 07 Lic.# Owner emu' nr 21/dI r Co /Na lZ% Address t 3 S h i Architect Address Sq. Ft.New Area: 1st Fl db 2nd Fl 3rd Fl Total New Area Rooms ? Lavatories Bathrooms Garages Purpos of this permit: Ait 6serrwrt+ ' - dyT -Q 4 City Water NJ Well Septic System 0 Sewer Ins. H.O. Cert. Area I I Basement Garage Approved by l Date 141 Use Group Construction Type Rovied 1/97 I hereby agree to conform to all the requirements of the Laws of the State of Connecticut and the Ordinances of the Town of South Windsor and to notify the Building Inspector of any alteration in the plans or specifications of the Building for which this permit is asked,and agree that this building is to be located the proper distance from all street lines,side yard lines,and required distances from all other zones and is located in which this building and its use is allowed Signed x I hereby apply for a Certificate of Occup ncy for the work described in this application for the permit. Signed PW DO NOT WRITE BELOW THIS LINE INSPECTION COMMENTS Inspection / Approval Date By Appl Code Description Due Whom Code Comment 99-25873-B 8,500 B03 FRAMING (ROUGH) 04/20/99 DCJ A E03 ROUGH 04/20/99 DCJ A B04 INSULATION 04/21/99 DCJ A B10 FINAL 05/26/99 JFF D STAIRWAY GUARD AN RAIL BEDROOM SMOKES B10 FINAL 06/02/99 JFF A WITH OWNER SMOKES INSTALLED PLYWOOD GOARD APPROVED FOR CO & CLOSEOUT 99-16200-E 400 99-10454-H 1,000 DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT PEF1vff# Application is hereby:TOWN of SOUTH WINDSOR BUILDING DEPARTMENT Bld Permit# DEPARTMENT A 2!!PRONV;EiD 1540 SULLIVAN AVENUE 4 644-2511 ext.230 DateF Building Inspector Application must be printed or typed Location of job Street No. Street Lot No. FEE SCHEDULE Floor Apt.No. 0 - $1,000 - $12.00 Over $1,900 12.00 per$1,000 OWNER_,JUZanj6.02 MCI V C /Y10- or any fraction thereof ADDRESS Jain b9 iY -ed--S x C4 , C6 0 7 q OWNERS PHONE# 6Yq—)gEb APPLICANT MOJ Z W N S ADDRESS 50 PYL.-e--- ESTUVIATED COST$ IS THIS A CONTRACT COST? YES NO FEE ENCLOSED $ W.0 OR-CON.— TYPE OF JOB: Original Installation Alteration/Addition Repair Revised 11/95 APPLICATION FOR ELECTRICAL PERMIT(Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED TH A RESIDENTIAL BUILDING PERMIT APPLICATION YE / NO BUSINESS ASSEMBLY CURRENT USE AND OCCUPANCY r,Se,r i-P,t MERCANTILE EDUCATIONAL FUTURE USE AND OCCUPANCY Cam, o d v-,n INSTITUTIONAL FACTORY STORAGE ENGINEER'S NAME PHONE GARAGE MIXED USE ADDRESS CITY STATE ZIP Other please specify) TYPE OF INSTALLATION/WIRING METHOD SIZE OF MAIN FEEDERS AND RATING OF WIRE USED NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS NUMBER OF PANELS REMOTE DISCONNECT REQUIRED?YES/NO NUMBER OF LIGHT CIRCUITS NUMBER OF POWER CIRCUITS NUMBER OF SWITCHES NUMBER OF OUTLETS NUMBER OF LIGHT FIXTURES NUMBER OF HEAT CIRCUITS NUMBER OF A/C CIRCUITS SEPERATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED. 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 CONN.BUILDING CODES IN THE PERFORMANCE OF SUCH WORK. NAME STATE LICENSE NO. TYPE SfGNATURE OF APPLICANT PHONE NO. G y`7 DATE / i DEPARTMENT DECISION pAPPLICATIONFORHVACPERMIT Application is hereby:TOWN of SOUTH WMSOR BUILDING DEPARTMENT Bldg Permit#APPROVED 1540 SULLIVAN AVENUE 7 Z 4 Q X4__ 644-2511 ext.230 Date Building Inspector e Application must be printed or typed Location ofjob Street No. Street Lot No. FEE SCHEDULE 0 - $1,000 - $12.00 Floor Apt No. Over $1,000 12.00 per$1,000 OWNER .(' .,or any fraction thereof ADDRESS S o x-N OWNERS PHONE# APPLICANT o a pW N S Fq ADDRESS ESTIMATED COST $ IS THIS A CONTRACT COST? YES NO FEE ENCLOSED $Z OR.CO TYPE OF JOB: Original Installation Alteration/Addition/Repair Reviod 1IN5 APPLICATION FOR HVAC PERMIT(Continued from reverse side) TYPE OF SYSTEM l TYPE OF BUILDING HEATING r/ RESII)ENTIAL 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 F INSIDE F DIFFERENCE F TOTAL HEAT LOSS(BTUH) HEAT LOSS SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL HEATING EQUIPMENT (INCLUDING MAKE&MODEL NO.) ate GROSS HEATING CAPACITY (INPUT-BTUH) NET RATING (OUTPUT-BTUH) TYPE OF FUEL OIL-GPM GAS-INPUT t 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 C .1>Sre THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONN.BUILDING CODES IN THE PERFORMANCE OF SUCH WORK. STATE LICENSE-NO.NAME&TYPE SIGNA F APPLICANT PHONE NO. 64 Cl 1 DATE ' 04/06/99 2 : 14 PM ** HEAT LOSS CALCULATION ** PAGE 2 ' DESIGN TEMP DIFFERENCE : 80 BASEBOARD RATING : 580 R & R P & H SUPPLY INC 135 DEBBIE RD . SUMMARY wwww R & R P & H SUPPLY INC 135 DEBBIE RD . 600 CENTER ST SOUTH WINDSOR MANCHESTER CT 06040 ROOM TOTALS *** ROOM # AND NAME------------ BTUH @ 70 BTUH @ DTD BASEBOARD 01 REC *ROOM 9703 . 12 11061 . 56 19 02 - OFFICE 2303 . 00 2625 . 42 5 TOTALS FOR BUILDING . ***** 12006 . 12 13686 . 98 24 TOTAL FUTURE BASEBOARD---- 0 DENOTES BTUH INCREASED 20 PERCENT MINIMUM BTUH BOILER REQUIREMENT WITH TANKLESS COIL ----- 170108 . 73 CALCULATIONS AND PROCEDURES UTILIZED CONFORM TO THOSE SPECIFIED AS DETAILED METHOD IN IBR PUBLICATION NUMBER H-21