HomeMy WebLinkAbout1486 Main StreetDEPARTMENT DECISION APPLICATION FOR HVAC PERMIT PERM#DEPARTMENT
is hereby: TOWN of SOUTH WINDSOR
BUILDING DEPARTMENT Bldg Permit#
APPROVED 1540 SULLIVAN AVENUE
6 644-2511 ext.230
Dke Building Inspector
Application must be printed or typed
Location ofjob
AC),11 \--\
Street No. Street Lot No.
FEE SCHEDULE
FloorF$0 Apt.No.1,000 - $12.00
Over $1,000
12.00 per$1,000
OWNER Po,11-N o,or any fraction thereof
ADDRESS
OWNERS PHONE# 22
APPLICANT
NUNN
ow N St ADDRESS_
4(
ESTRviATED COST $C0
IS THIS A CONTRACT COST?
YES NO
FEE ENCLOSED $ c,
40 000S TYPE OF JOB:
Original Installation
Alteration/Addition Repair
Revised 11/95
APPLICATION FOR HVAC PERMIT (Continued from reverse side)
TYPE OF SYSTEM TYPE OF BUILDING
HEATING c RESIDENTIAL
A/C COMMERCIAL
VENTILATION INDUSTRIAL
HEATING
STEAM LOW PRESSURE LIMIT LBS.HIGH PRESSURE LIMIT LBS.
HYDRONIC U,--' 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.)
a Cl\,r \<-, 3 \
GROSS HEATING CAPACITY (INPUT-BTUH) NET RATING (OUTPUT-BTUH)—Ik?)
TYPE OF FUEL
OIL-GPM GAS-INPUT 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 p e C -(s
c)Lj o l4,c I (-A 1:±
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.N &TYPE SIGNATURE OF APPLICANT
PHONE NO. LWk- 2 DATE G\ 0 ---