Loading...
HomeMy WebLinkAbout17 Sally Drive60 1 TO THE BUILDING INSPECTOR Of the APPLICATION FOR TOWN OF SOUTH WIMSM CORN. PLAN EXAMINATION AND BUILDING PERMIT IMPORTANT — Applicant to complete all items in sections: 1, 11, Ill, IV, and IX.O ZONINGI• AT (LOCATION) DISTRICT_ LOCATION O.) l EET) 1 OF BETWEEN AND BUILDING GROSS STR T) CROSS STREET) , 7ouLOT7 X-75 7*,? SUBDIVISION LOT BLOCK SIZE do 7 A.-lad N II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D v A. TYPE F IMPROVEMENT D. PROPOSED USE - For"Wrecking' most recent use M M 1 New building Resioeqioal Nonresidential 2 Addition(If residential, enter number 12 One family 18 Amusement, recreational o/new housing units added, if any,13 Two or more family - Enter 19 Church, other religiousinPartD. 13) number of units- - - - -i• 3 Alteration (See 2 above) 200 Industrial 14 Transient hotel, motel, 21 Parking garage4 Repair, replacement or dormitory - Enter number 5 Wrecking (1/multifamily residential, of units ------- - --l. 22 Service station, repair garage enter number of units in building in 15 Garage 23 Hospital, institutional Part D, 13) 16 Carport 24 Office, bank, professional6 Moving (relocation)17 Other — Specify 25 Public utility7 Foundation only 26 School, library, other educational B. OWNER HIP 27 Stores, mercantile 8 rivate (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 d processing plant, machine shop, laundry building at hospital, elementary 10. C st of improvement,,,,,,,,,,,,,,,, J 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 $ o d 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 'Flood from@ 41 Private (septic tank, etc.) 49• Total square feet of floor area, all floors, based on exterior 32 Structural steel dimensions .................... 33 R@inf rc d concrete H. TYPE 0 WATER SUPPLY J/ 50. Total land area, sq. ft. . Q c o34 Other - Specify 42 Public or private company 43 Private(well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES F. PRINC AL TYPE OF HEATING FUEL 1. TYPE OF MECHANICAL 51. Enclosed ....................... 35 Gas Will there be central air 52. Outdoors....................... Oil conditioning?L. RESIDENTIAL BUILDINGS ONLY 37 El ctricity 44 Yes 45 No 53. Number of bedr ms.............. 3B C al 39 Oth r- Specify Will there be an elevat r? 54. Number f Full.......... 46 Yes 47 ON bathrooms Partial........ IV. IDENTIFICATION — To b complet d by all applicants Name Mailing addr ss — Number, street, city, and State ZIP code Tel. No. Clark Realty Inc., 658 Ellington,zRoad, Owner or Lessee South Windsor, Ct. 06074 82-0628 2.Same Same Contractor 3. Architect or Engineer The owner of this building and t-he undersigned agree to conform to all applicable laws of this jurisdiction. Sig; 5;:= Address Application date 00 NOT WRITE BELOW THIS LINE V. PLAN REVIEW RECORD — For office use Plans Review Required Check Plan Review Date Plans B Date Plans B Notes9FeeStartedyYApproved BUILDING PLUMBING MECHANICAL ELECTRICAL OTHER VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Permit or A rova I Check Date Number B Permit or Approval I Check Date Number ByppObtainedyppObtained 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 Bui Iding Permit issued 19 Building Permit Fee $ 3r fz Ct 0 A 7tY: LE TOWN OF SOUTH WINDSOR BUILDING PERMIT Date Feb. 18 9 19B 6 Fee Paid $.4.5 0..0 0 Est. Value $. .7.5.F 0 0 0 Permit N° 14887 on the side of T,nt 851 sal 1 y nri ve Street Street No.17 Owner Clark Realty Inc. Applicant Mur ie 1 jac clue s CERTIFICATE OF OCCUPANCY ISSUED: Date No. 7447 Fee Paid $ 3 _ 0 0 CLASSIFICATION Dwelling I i BUIM NG PERMiT I I NY 1488'7 OFFICE OF I THE BUILDING INSPECTOR of the Town of South Windsor, Conn. South Windsor, Conn. gj.r_I— 1986 I ig4io to to Certif-9, That Clark Realty Inc. is hereby granted permission to Dwelling at estimated value of $ jon the side of La#_A.51 6a 11.vIv -Dr-4 me Street on land I Owned by _mil Arlr RSA!ty Tnc- I Said Mork to be as described in Application I No. 15 1 R7 and to conform to specifications and plans filed with said Application, and Building By- Laws of THE TOWN OF SOUTH WINDSOR. Las ed 1986 i Z e—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." I - I I I I I I I I I I I I I I I Dwelling - Lot #51 Pl.Val. II 2/18/86 Clark Realty Inc. 17 S.ally Drive Permit # 14 8 8 7 Electrician Richard Barrett # 9161 Heating Contr. Gaeton Grondin # 6475 Plumbing it Gaeton Grondin 6970 Oil Burner Certificate of Occupancy 74 4 7 Sewer Permit Plot plan Apprd. per Engr. I t Permit No. TOWN OF SOUTH WINDSOR I SOUTH WINDSOR, CONN. I 1 1 Permit Certificate of Occupancy jTHIS CERTI Pt at No. in the wn of South Windsor, Connecticut, has been erected and completqV in accordance with the Building Code and Zoning Regulations of the Town of South Windsor, and is hereby app ve r occupan qL Building Inspector Owner, der F. Fee Paid Date 5 19 REWO E. NYYPPA 8 ASSOCIATES CIVIL ENGINEERS a NANO SURWYORS GLAS TON&AY, CONN. tiq 3 ILI 7c S` r O e / 1 . J84O Nv nj e TEMFIORARZY CASE OQ 1 FOR UJL-pE-5 SF 11 r tiw 'q00q 0AJ r`8p MS S UN FCT1 copA LOT UMF-S FPoW, w1AP OW F\\AE T«LED, O`r lvy,jOPEw SQAce 5uecivtstow A-W ZowF- PI.oT PLAtj JELTtoN Z FLr=AsAtvT VALLF--1 HotAes R Sou--H Coww."ev Rv-ml+.to E.Nvrvm}Assoc-OM5 C,Autt- Lwv SUp--vE`'oRS r cA,LE t"=40'PREPARED FOP OWE 4,-4-85 MAP too.43-50-II ot= Q 5Hv-ETs-REu 10-10-tg PEASANT VALLEY HOMES II per,, \.=#Mo pss*„N„ 40_14-&o c=DUTH W 1 N D5OR.t GONN. EK1IF4 ED SUe IA-LLY Co zF-c-T I"=40' DATE: %-'to.tfo o-as-5t e-A) 6 v ov. SIG 6970 PLUMBING APPLICATION Application Nee 6 7-A '- on ......_..._ mi&of street Street No. _ 1 l nr i vP r,n t S t Owner ..C,I, . k Realty Plumber . ;;a.etnn C;rnn d i n Filed in Office of The Building Inspecoor 8"ri1 23 ig 86 im C'1 01. No pmm shall eomsomct, add m or ahw ay portion of the drainage system of my bm1d6g compt to repair 66) umil a Plermit is owned by the Building Impemw. APPLICATION FOR PLUMBING PERMIT (Continued from Reverse Side) TOWN OF SOUTH WINDSOR, CONN. 11. LOCATION OF JOB 'z c X a NO. STREET FFLOOR APT.NO. GENERAL PLUMBING 12. KIND OF INSTALLATION /[!- 13. SIZE OF MAIN DRAIN yam/ 14. NO. OF TOILETS STYLE 15. NO. OF URINALS STYLE 16. NO.OF BATHTUBS 17.NO.OF LAVATORIES 18. NO.OF SINKS 19. NO. OF WASHTUBS 20. NO.OF CONDUCTORS SIZE 21. NO. OF STACKS _SIZE r 22. AREA OF ROOF 23.NO. OF CATCH BASINS 24. NO. OF FLOOR DRAINS 25. NO. OF OTHER FIXTURES ^ KIND 26. ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW? 27. SIZE OF WINDOW 28. IF NO WINDOW,WHAT KIND OF VENTILATION IS THERE? 29. SIZE OF DUCTS 30. ARE SEWAGE AND WATER FACILITIES AVAILABLE? SIGNATURE ADDRESS 62 8 3T/y.161L4 V jb 12 S6a7"41 LICENSE NO. ©., ESTIMATED COST TELEPHONE OWNER L / ADDRESS .L LZZ WATER HEATER 31. TYPE < b 32. MANUFACTURER ' ) 79 -4,1 a TANK SAFETY DEVICES 33. CAPACITY 37. TEMPERATURE RELIEF VALVE 34. TEST PRESSURE_ 38. MANUFACTURER_ 35. WORKING PRESSURE 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 CO E. CD962 DATE SIGNATURE OF APPLICANT r 9161 ELECTRICAL APPLICATION Application No.10675 on South side of StMt Street No. 17 Sally Drive Lot 51 Owner JMJ Construction Co. _ Electrician Richard Barrett FILED IN OFFICE OF The Building Inspector Agri 1 23 19Lis_ INSIFIR 'TION. a&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 th!Are stops (if of wood) are Installed, without a special permit from the office of the Building Inspector. 4;0 Wi 1 . G.._.....TOWN OF SOUTH WINDSOR Master License No. Building Permit No. ......_._....... BUILDING DEPARTMENT Date Fled APPLICATION FOR ELECTRICAL WORK Date Final Approval ..._...... Electrical Insp ctor e B LO TION: o. ..,` ........................_.......... ...... OB OWNER: ............1..l. ._ S._:.._C'Z) Side of ....................._....................................................... Between ..................................................._............................ and ..... Name of Building Owner ..... .. N,. .!........ Address ..... ?., ...... If work is for Lessee—Give name ......................................._............_........_.................._.................. Address .. ...._._....._.............___..._-_.._...._._._..._ Building now occupied as (unless new) ........,r No. of family units now .........._i2 Building to be occupied as ....._........_......... ,i„d.....l..f.,n....._..........................._._............. ... Number of fawily units to be .... Is this work included in a Building Permit? Y-Ae ........... Permit Fee ....__...........__..........._.............. w...._....._........_..._........ W If no Bail P t) .. ...... ..... Permittee .. i. .A:,l _..A.. ... Business Address n, .. , S' t .. Telephone 6 ' 7Odepew...... COST OF INSTALLATION f..I..............._...._... w..._.......__.._.._.._...._......_..._..._... TO BE FILLED OUT BY PERMI'I'I'EE TO BE WIRED EXISTING APPLIANCESNumberoflightoutletstobeinstalled Number of convenience outlets to be installed •.......... .. .. Number of present Appliance Circuits ._._...._._... ._....._...._..... Number of switches to be installed . . •••-- •- •••••- Do these include Ran a Water HeaterNumberofappliancestobeinstalled . . ...... ....._......, g as listed below) Dryer Air Conditioner Oil Burner _TYPE RATING NO. Dish Washer Gas Bum Range Range Top Well Pump Mec. Heaters Q Oven . . . . . . . . REMARKS rWaterHeater Clothes Washer Clothes Dryer 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 M t r Circuits . . . . . . . Size of present service Size of service to be .__ 6 7/y3 PERMIT Application ForIDEPARTMENTDECISION Cd EnHeating Permit y O 3 APPLICATION IS HERESY: o DEPARTMENT OF LICENSES AND INSPECTIONSa N KI APPROVED DISAPPROVED 0 TOWN OF SOUTH WINDSOR o p, 6/27/86 Thmas P. D/Auria00ODATECHIEFINSPECTOR APPLICATIONS MUST BE PRINTED OR TYPED. BEGIN WITH NUMBER ONE BEL MO p 1. LOCATION OF JOB 0o 1.4 7s y 00ApCd j O NO STREET Co v W C 51 LOT NO. FLOOR APT. NO. O O N O O E 2. OWNER LlZ.lcc I, O 3 3. ADDRESSbo 4j ai ; C)0 T.L/ `li _) S'd 4.PHONE S. APPLICANT a d o 6. ADDRESS S o 7.PH ON E S. LICENSE NO._,j D A!aZa p w 19. EXPIRATION DATE OF LICENSE c a 10. ESTIMATED COST fO b4 11. IS THIS A CONTRACT COST? YES no 12. FEE ENCLOSED 3_ g-=i t 14227 x 13. TYPE OF BUILDING: b RESIDENTIAL COMMERCIALOA C13 O 14. TYPE OF JOB: INDUSTRIAL3 ORIGINAL ALTERATIONINSTALLATINADDITION REPAIR APPLICATION FOR HEATING PERMIT (Cuntlnu a it m R verse side) 11. LOCATION OF JOB L 6 7-A-1 AZZ e /J/C NO. STREET FL OR AFT.N . 12. TYPE OF INSTALLATION: OIL BURNER ELECTRIC VENTILATION SPRINKLER IN GAS BURNER STACK INCINERATOR MISCELLANEOUS IDENTIFY SIZE LOCATION SIZE SIZE 13. OF TANK OF TANK OF FILL OF VENT 1a. B.T.U. EQUIP. AT REGISTER FURNACE MAKE AND NO. AT BONNET FIRING RATE BOILER OR FURNACE MAKE AND NO.V Cf} B.T.U. OR SQ. FT. NET VB.T.U. OR SQ. FT. GROSS[U3TFIRING RATE FLOORS TO BE HEATED NEW OR OLD BUILDING INSULATED - YES OR NO //'`' TYPE OF WALL_T INSULATION 5 A ROOF OR CEILING -1 x I INSULATION IC. AVG. SYSTEM WATER TEMP. J/ D B.T.U./SQ. FT./HR. EMISSION !2 6:L O INDOOR-OUTDOOR TEMPERATURE DIFFERENCE FAHRENHEIT MAKE OF RADIATION: BASEBOARD. 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: 16. HEAT LOSS SCHEDULE. (TO BE INCLUDED FOR ALL JOBS): WINDOWS B.T.U. B.T.U. F DROOMSIZEANDDOORSAREA - SQUARE FEET voLUME DISTRIBUTION INSTALLED TOTAL TOTAL q ROOM NO' GROSS GLASS NET WALL CEILING FLOOR CU.FT. AT 70•F CORRECTED <J j LL LL REGISTER L W N AND E TEMP. TO TYPE AND SIZE RAD. OR LEADER SIZE < WALL f'Lt0 INFILT.) DIFF. F m N SQ. FT. FREE AREA TOTALS 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: NAM[ ADDRESS SUBCONTRACTORS AND IS. THEIR TRADES ALL WORK COVERED BY THIS APPLICATION HAS BEEN AUTHORIZED BY THE (OWNER) OR (AGENT) OF THIS PROPERTY AND BE DONE IN STRICT ACCORDANCE WITH THE BUILDING CODE. APPLICATION TO BE COMPLETELY FILLED IN.Lx 6'M Fc9 f DATE SIGNATURE OF APPLICANT r BURNHAM CORPORATION W.:Q4;:0MIfl-1— LCOIX... Heating & Cooling Division - Irvin.on, N.Y.o 1=B=R CALCULATION SHEET 1503 CePYrIghI 9bS y •IesIIW+. t Bail«and Redlote Monuleclun:, 3q9 S•v.ntll /w.., N...Y• ,N.Y. r DI rME ' ADDRESS DESIGN TEMPERATURE DIFFERENCE F. DATE COI..A COL.B COL.C. COL.D COI..E COL. P COL.G ROOM 1 ROOM 1K 6 viNC- 1= 14 R A/ (' A TOTALS RADIATION p W W N N N 'L • N L • N L it H• L M FROM LINE 12 SELECTED 2 IROOM DIMENSIONS, FT. I-, O m 1a.t = caL.EMOTN EXPOSED MALLS. FT. t 4 = 3 V6- C NINDO!AND OUTSIDE DOOR AREA 6 G TUN STUN aTtm STU" BTU"D MALL CONSTRUCTION I 07 1 3Cc) V ckj-E TYPE F GLAff G 1ga t od f dQ 7caD F7MusicCnNfTRucrM( „ /hi 9 FLOOR C014TRUCT"1 B CXILO PARTITION CONSTRV CTIOM 10 TWO WA LS ON[wALLIWITN GLASS OR CITERIOR DOOR) O J L 635 Q Q6 1 - 0 0 Z TMR[[MALLS OR E]ITRANCE HALL ` •Qa o-owe y J 11 TOTAL BTUHAT70FT[MP.DIFFERENCE* t 0 6 16 2 ITOTAL BTUH AT DESIGN TEMP.01 F FERENCIt ar K COL. A COL. B COL. H COL.1 COL.J COL. K COL. L L 1 FWOM 1K A/J AA--Roo JJ O W W H L M H L M H L M M L 11 M I L M MD TOTAL BTU" TOTAL2ROOMDIMENSIONS. FT. L) < 1 :- a OF BUILDING RADIATION LENGTH ExPos[O MALLS, FT. a Z AT SELECTED A M1MD01•ANO OUTBID[ DOOR DESIGN TEMP.AREA DIFFERENCE BTUH BTUH BTUH STUN BTUH 5 WALL CONSTRUCTION. 6 Ttr K OF OLAss 7 CXILIMO.00MfTRUCTIOU INCREASE BATHROOM p r o• TOTAL 20% 11 FLOOR CONSTRUCTION 1 f i R COLD PARTITION OQNSTRUCTION 1 FOR CONCRETE FLOOR OH GROUNOOR FILL AT GRADE LEVEL. USE LINEAR FEET 10 ONIEWALLIwITH GLASS OR tXTERIOR DOOR)a.• OF EXPOSED EDGE 1: TWO%A L z THREE WALLS OR ENTRANCE HALL• .09- 00 r E12 TOTAL STUN AT7OFTEMP.DIFIERENCE• 6 TOTAL BTUH AT DESIGN TEMP.OIFFERENCE I( BURNH AM CORPORATION Heating & Cooling Division Irvington, N.Y.(; 1=d=R CALCULATION SHEET 1503 cop-trios ms by the Institute et deal«and Redlet r Manufacturers, 393 Seventh Ave..Now York.N.Y. 19001 O>r av •— ADDRESS DESIGN TEMPERATURE DIFFERENCE F. DATE COL.A COL.a COL.C COL.D COL.I COL. F COL. G ROOM I RDOM 7r TOTALS RADIATION O W W H L W M I r H L • M L I 1/ H• L V FROM LINE 12 SELECTED 2 ROOM DIMENSIONS. FT. r- Z j FSt 4ELEM6TNEXPOSEDMALLS. F c 7AoT. R WINDOW AND OUTSIDE DOOR AREA IL Bum STUN TUN BTUM STUN D a WALL CCM3T1f ICT10N TYPE F GLASS lots A Or 000D lao o qo0 00 1 00 I 7 Ci1LIN0(pNSTIWCTION F I a q a o 006 Sao Goo a, 18009FLOOR0DOIlTRUCTIONtcl6 9 COLD PARTITION CONSTRUCTION M 5,500 ` 10 ONEWALLIWITM ftk"OR CXTLEIOA 0004) tt+t•.t:ayco TVOWALLS D1 It saD I THREE MALLS OR ENTRANCE HALL • J 11 TOTAL HTUHAT7DFT CUP.DIFFERENCE 30 ,}.D 00 ' i3!TOTAL 1:TTUH AT DESIGN TEMP.DIFFERENCE R COL. A COL. 11 COL. H COL.1 COL.J COL. K COL.L L 1 ROOM cc O W w H L W H L W H L W H L If L 2 ROOM DIMENSIONS. FT. TOTAL dTUH TOTALV V < OF BUILDING RADIATION 3 LENGTH EXPOSED WALLS. FT. z AT SELECTED S WINDOW AND OUTSIDE DOOR AREA DESIGH TEMP. DIFFERENCE STUN TUH dTUH MITUM STUH S WALL OONSTRUCTION d TV PC Or GLASS O 7 MLING.CONSTRUCTION INCREASE BATHROOM TOTAL 20% FLOOR CONSTRUCTION I S COLD PARTITION CaQINfTRUCTIOM 1 FOR CONCRETE FLOOR ON GROUND OR FILL AT GRADE LEVEL. USE LINEAR FEET t0 ONE WALL IwITM SlAts OA t><TtM10R 000111 (j OF EXPOSED EDGE TW O WA LL.S s THREEWALL.S OR EIiTRANCE HALL• 11 ITOTAL STUN AT70F TEMP.DIFFERENCE 12 1 TOTAL BTUH AT DESIGN TEMP.DIFFERENCE 4. ctlau cn• P7hY,':,'a S} hL4 a?r`«.___ - ....'r< ::r i`a,"'i.=':•_"•:•m'i^._. •`S`--" ' ' e'i r_ ::;.i r; .`."i; ..fi'iiii---- - - "y' — - '- ------T=— twt:sne NOR OFFICE USE ONLY APPLICATION FOR HVAC PERMIT DATE:r NO. TOWN OF SOUTH WINDSOR EST.COST.-"' BLDG. PERMIT NO.1540 SULLIVAN AVENUE FEE D SOUTH WINDSOR, CT 06074 FEES: it 644-2511 - Ext. 230 0 - $19000 - $10.00 1000 or fraction LOCATION OF BUILDING012 thereof - $10.00 OWNE ADDRESS TOWN PHONE NO. HfVAUCONTRACTOR ADDRESS TOWN PHONE 0. TYPE OF SYSTEM: HEATING TYPE OF BUILDING: RESIDENTIAL A/C COMMERCIAL VENTILATION BUSINESS INDUSTRIAL IF HEATING: STEAM LOW PRESSURE LIMIT LBS. HIGH PRESSURE LIMIT LBS. HYDRONIC WARM AIR UNIT RADIANT HEATER (INCLUDING WOOD/COAL BURNING STOVE) TYPE OF FUEL: OIL-GPM GAS IN-PUT ELECTRIC KW WOOD COAL OIL TANK - SIZE & LOCATION: INSIDE OUTSIDE CAPACITY LPG TANK - CAPACITY EXISTING RADIATION ADDITIONAL RADIATION TOTAL RADIATION DESIGN TEMP. OUTSIDE OF INSIDE OF DIFFERENCE OF TOTAL HEAT LOSS (BTUH) HEAT LOSS SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL HEATING EQUIPMENT (INCLUDING MAKE & MODEL NO.): GROSS HEATING CAPACITY (INPUT-BTUH) NET RATING (OUTPUT-BTUH) IF AIR CONDITIONING: DESIGN TEMP. OUTSIDE OF INSIDE OF DIFFERENCE F TOTAL HEAT GAIN (BTUH) HEAT GAIN SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL COOLING EQUIPMENT (INCLUDING MAKE & MODEL NO.): TONNAGE COOLING CAPACITY (BTUH) IF VENTILATION: DESCRIBE ALL AIR-HANDLING EQUIPMENT (INCLUDING KITCHEN EXHAUSE EQUIPMENT) : TOTAL SIZE OF SYSTEM (CFM) FRESH AIR INTAKE (CFM) PLAN MUST ACCOMPANY APPLICATION) The undersigned hereby applies for a permit to perform the following work and is to comply with all local ordinances and State of Conn. Building Codes in the performance of such work. FURTHER DESCRIPTION OF WORK: ®p/, ,c./B. 00,0C D 3 0p'!'If 0M STATE LICENSE - N & TYPE #D TE SIMATMPLICANT PROVED DATE I - 8 - R CALCULATION SHEET 1503 (Modern Method)Copyright 1971 by The Hydr nics Institute OWNER ADDRESS DESIGN TEMPERATURE DIFFERENCE F. DATE COL A COL.B COL.C COL.D COL.E COL.F COL.G 1 ROOM ti Design Warr Temp. O H L W H L W H L W H L W H L W g 2 ROOM DIMENSIONS, FT.U BTUH par F of of 3 LENGTH EXPOSED WALLS.FT. 4( Radiation Selected 4 WINDOW AND OUTSIDE DOOR AREA to STUN STUN STUN STUN STUN 5 WALL CONSTRUCTION ROOM LIN.FT.OF Table 9,Line 3 x H) TOTALS RADIATION 6 TYPE OF GLASS FROM LINE 12 SELECTED bottom f tobla used for Line 5) 7 CEILING CONSTRUCTION C Table 9,L x W) g FLOOR CONSTRUCTIONI Table 9, L x W r Lin. F t) E 9 COLD PARTITION CONSTRUCTION F Table 9,L x H)G 10 c 1 Wall 1With Openings)D H0 2 Wells(With Openings) o j53WallsIWrthOpenings)or Ent.Hall 1 J 11 TOTAL BTUH AT 7OF TEMP DIFFERENCE' 12 TOTAL BTUH AT DESIGN TEMP DIFFERENCE K C L.A COLS COL.H COL.1 COL. J COL.K COL.L TOTAL BTUH TOTAL OF SUILDING RADIATION 1 ROOM Ic AT SELECTED O H L W H L W H L W H L W H L W DESIGN TEMP.* DIFFERENCE 2 ROOM DIMENSIONS. FT I.- U 3 LENGTH EXPOSED WALLS. FT. 4 WINDOW AND OUTSIDE DOOR AREA IL STUH STUN STUN BTUH STUN 5 WALL CONSTRUCTION INCREASE BATHROOM Table 9,Line 3 x H) TOTAL 20% f) TYPE OF GLASS Bottom I table used for Line 51 1fOR CONCRETE FLOOR ON 7 CEILING CONSTRUCTION GROUND OR FILL AT Table 9, L x WI GRADE LEVEL,USE LINEAR 9 FLOOR CONSTRUCTIONT FEET OF EXPOSED EDGE IT able 9.L x W r Lin F t) 9 COLD PARTITION CONSTRUCTION Table 9,L x H) 10 c 1 Well(With Openings)o 2 Walls(With Openings) x 3 Wells(With Openings) or Ent. Hall 11 TOTAL BTUH AT 7 F TEMP DIFFERENCE' 12 TOTAL BTUH AT DESIGN TEMP DIFFERENCE FORM 1503 This form Is available from The Hydr nlcs Institute 35 Russo Place,Berkeley Heights,N J 07922